Treatment of Child and Adolescent Problems
Thyroid Problems Treatment
Thyroid Disorder Treatment
Paediatric Critical Care
Treatment of Childhood Infections
Child Nutrition Management
Growth And Development Including General Paediatri
Management of New Born Care
Preimplantation Genetic Diagnosis (Pgd)
Congenital Ear Problem Treatment
Treatment of Polycystic Ovary Syndrome In Adolesce
Treatment of Thyroid Disease in Children
Cleft Lip Treatment
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Excessive hair fall, thinning of hair and bald spots are not only concerns of adults, children too suffer from hair woes. Look for signs and identify causes that are leading to your child's hair loss. With proper treatment hair loss can be reversed and your child's hair can be restored.
Look for these signs to determine whether your child is suffering from hair loss.
1. Bald patches on the head.
2. loss of hair from the entire body
3. Excessive hair loss but not complete fallout
4. Spots of broken hair and scattered hair loss
1. Alopecia areata.- This condition results in oval patches of hair fallout from certain portions of the head. It is a noncontiguous condition that appears when the body's immunization attacks the hair follicles. About 25% of affected kids also suffer from ridging nails.
2. Tinea capitis- Also known as ringworms of the scalp, this is a type of fungal infections that are often seen in children. It causes oval shaped scaly spots on the head due to breakage of hair and the remaining roots seem like black spots.
3. Telogen effluvium- If your child has undergone some kind of trauma, be it physical or psychological, it can cause the hair follicles to enter into the resting phase and within 6 to 16 weeks excessive hair loss occurs leaving your child partially bald.
4. Trichotillomania- Stress and anxiety can cause your child to pullout his/her own hair. This results in scattered hair loss and broken hair which is prominent on the sides of the head.
5. Lack of nutrients- Nutritional deficiency can cause hair loss, if your child lacks vitamin A, B complex and biotin it can trigger hair fall.
Hair fall in children is common and treatable if they are of medical causes. Sometimes rubbing and playing with hair can also cause hair loss so parents are advised to look into all the probable causes that might lead to shedding. If you wish to discuss about any specific problem, you can consult a Pediatrician.
Your baby's skin requires constant care and protection because it is exposed to the ravages of pollution, dust and harmful UV rays. A healthy skin also has aesthetic benefits apart from being disease resistant.
It takes about a year for the epidermis of a baby to develop and function effectively. Once the baby turns one, the skin gets thicker and more immune to skin problems.
Here are four common skin problems found in almost every infant:
- Prickly heat rashes: Prickly heat rashes are the rashes, which develop on the face, neck, back or the bottom of the baby because of heat. To deal with this situation you should try to keep the infant cool and dry (not let him/her sweat) and ensure that they wear loose and comfortable clothes made of cotton.
- Seborrhea: Rashes that develop on the scalp, eyebrows, cheeks, chest, and/or neck of a newborn baby (up to 6 months), are known as seborrhea. It appears to be gruesome, but does not bother the baby. It is recommended to use mild baby shampoo and creams to get rid of the problem. If there is no improvement, consult a dermatologist.
- Eczema: About 20% of the babies suffer from a very itchy skin rash known as 'eczema'. The affected area of the skin may turn red, ooze pus or crust over. It can be a result of an irritation caused due to sweating in a hot weather or due to the drying up of skin in a cold weather. Some clothing, specifically wool can even trigger this skin condition in a baby. A dermatologist or a paediatrician should be consulted in order to know what should be done.
- Diaper rash: Diaper rash is the development of red and inflamed skin in the area under the diaper. It is recommended to check the diaper for any wetness at regular intervals, and to change it when required. The diaper should not be too tight or left on too long. Applying a diaper rash ointment and keeping the area dry and open whenever possible can help in relieving your baby from the problem.
Has your child been coughing frequently? Is the cough chronic in nature, making your child breathe rapidly and does he/she complain about a tightened chest? These symptoms signify that your child is having asthma. Asthma is a medical condition characterized by paroxysmal wheezing respiration dyspnoea. It is common in children and an affected child experiences difficulty in breathing, and a whizzing sound is produced, especially during expiration. Asthma may lead to severe health complications and needs immediate diagnosis and treatment.
Diagnosis: The diagnosis of asthma is based on the symptoms, medical history and a physical examination of the child.
The different modes of asthma diagnosis are as follows:
- Medical history and symptoms: You must tell the doctor about any history of breathing trouble with your child or whether there are chances of other inherited health conditions. You must explain your child's symptoms properly, which may include coughing, wheezing, chest pain or tightness and others if observed.
- Physical examination: A physical exam will be carried out in your child where the doctor will listen to his heart and lungs, and look for eye or nose allergies.
- Medical tests: A chest X-ray of the child has to be carried out, along with a simple lung function test known as spirometry. This test measures the amount of air present in the lungs and determines how fast it can be exhaled. Spirometry enables a doctor to determine the severity of the asthma. Some other tests are also carried out for the identification of asthma triggers. They include allergy skin testing, blood tests and X-rays to know if sinus infections are affecting the asthma. An asthma test determines the amount of nitric oxide in your child's breath.
Treatment: Based on your child's severity of asthma symptoms and his medical history, the doctor will provide you with an action plan to treat the same. This action plan explains all the medications your child requires, the dosage and schedule of the medicines. The plan also includes points on what to do when the asthma worsens and when an emergency treatment is required. Anti-inflammatory drugs are prescribed to children who require bronchodilator medication. All asthma medicines used by adults can be used in case of children but in lower dosages.
You should give the asthma medications to your child using a home nebulizer or a breathing machine. A nebulizer delivers asthma drugs by transforming them from liquid to a mist. The child gets the drug by breathing it via a face mask.
In order to control and manage asthma in children, they must avoid the triggers and should keep away from any source of smoke. A doctor must be consulted to know about the best diagnosis and treatment methods.
Which baby doesn't spit up their food! This is usually not a reason to worry, but if this spitting up is chronic and is accompanied by other symptoms it is known as Gastroesophageal reflux disease or GERD. Severe GERD can cause weight loss and breathing problems and thus, should not be ignored.
Reflux occurs when food is pushed out of the stomach and back up the esophagus. This is usually because the digestive system in babies is not yet fully developed. Vomiting often during the day is one of the most common symptoms of GERD. Other symptoms include:
- A persistent cough
- Choking or gagging while eating
- Refusing to eat
- Crying while feeding
- Pain in the stomach
Most cases of GERD can be diagnosed by its symptoms and a look at the baby's medical history. In some cases, additional tests may be required, such as:
- Barium swallow: The child is given a chalky substance to drink. This highlights the esophagus, stomach and upper part of the small intestines in a special X-ray. It is used to check if there are any blockages in the digestive system.
- pH probe: A long, thin tube with a probe at one end is put down the child's throat. This is kept in the esophagus for 24 hours. The probe measures the levels of acidity in the stomach. This test is usually done when the child complains of breathing problems along with reflux.
- Upper GI endoscopy: Here the doctor puts a thin, flexible tube down the child's throat. At one end of the tube is a camera that allows the doctor to look into the esophagus, stomach and small intestine.
- Gastric emptying study: One of the causes of reflux is the slow emptying of the stomach. To check this, the doctor will mix a radioactive chemical with the baby's milk that allows a special camera to follow its path down the digestive system.
In most cases, GERD can be treated by making a few lifestyle changes. Some of these are:
- Raise the head of the baby's crib
- After feeding the baby, do not let him lie down, but hold him upright for half an hour or so.
- Change his feeding schedule
- Ask your doctor if you can try giving him solid food. Else, check if you can thicken his feed with cereal.
- Make the baby burp after feeding
Most infants outgrow this condition within a year, so do not stress yourself and enjoy life with your baby.
4 Major Causes of Constipation in Children (+ 2 Ways To Handle It)
Constipation is a very common problem among toddlers and children. It takes place when the child's stool is dry, hard and unusually large, and the frequency of bowel movement is low and inconsistent. Although it is not a serious cause for concern, constipation in children should be recognised and treated early so that it does not develop into a chronic long-term ailment.
Constipation in children is seldom directly caused by any disease or medical disorder, which is known as idiopathic constipation and may be cause by a number of factors:
1. Diet: This is the primary cause of constipation in children. If the child's diet has low water and fibre content and heavily features sugar and processed foods, stool becomes hard and bowel movement gets restricted.
2. Deliberate Withholding: Often children may consciously avoid visiting the toilet, which may make them feel constipated. This may be due to embarrassment, especially in public spaces or they might be too engaged in playing to not go to the toilet, altogether. Some children do it out of fear when a previous toilet experience has been particularly painful.
3. Lack of Physical Activity: The digestive system is boosted through regular exercise. Lack of physical activity, thus, inhibits regular bowel movement.
4. Illness and Medication: Infections and illnesses, especially ones pertaining to the stomach cause the child to become constipated. Many medicines and supplements also affect the digestive system and can lead to constipation.
What are the ways to manage constipation in children?
Constipation in children is treated differently than in adults as their diets and patterns of bowel movement are dissimilar.
The primary treatments for constipation in children are:
1. Stool Softeners and Laxatives
The administration of bowel movement enhancing medication is the simplest way of treating constipation in children. There are various kinds of stool softeners and laxatives that are safe for children and must always be used under the supervision of a paediatrician.
2. Dietary Adjustment
Making changes to the child's diet by including high fibre foods (such as fresh fruits and vegetables, whole grain breads, cereals, etc.) can help cure constipation. Compelling the child to intake ample fluids in the form of water or milk is also necessary. Sugary drinks must be avoided.
Research shows that overweight children have a higher chances of developing chronic health problems such as hypertension, asthma, high cholesterol, and even cancer as they grow up. Apart from these health conditions, being obese can cause severe self-esteem problems as well. In short, obesity in children, more specifically childhood obesity, can affect the overall physical, mental and emotional health of your child.
Here are 5 easy ways to prevent your child from falling into the perils of obesity.
1. Develop healthy eating habits in your child
Encouraging your little ones to develop healthy eating habits is vital for maintaining optimum body weight. Instead of high sugar and high fat foods, a child’s diet should consist of fruits, vegetables and whole-grain foods (such as oats, quinoa and wheat). Proteins such as lean meats, lentils, beans and fish should be included in his/her eating plan as well. Most importantly, serving food in the right portion sizes will ensure your child is getting the right amount of nutrients, while preventing him/her from consuming empty calories. Inculcate these eating habits in them right from the time they are toddlers so that it stays with them as they get older.
2. Make your child avoid calorie-rich foods
Getting your child to avoid fatty, sugary and salty foods can also prevent him from tipping over the weighing scale. Present before your child low sugar and low fat alternatives that he/she would enjoy eating such as apples, bananas, carrots, etc.
3. Encourage your child to pursue physical activity
Try to encourage your child to engage in some form of physical activity for about 60 minutes every day. From brisk walking, swimming, dancing to skipping - your child could opt for any of these physical activities. Having your child lead an active life can see him/her enjoying a number of health benefits like respite from stress, strengthening of his/her bones and muscles and decrease in blood pressure, to name a few.
4. Put a limit on your child’s TV time
When it comes to the time that your child may spend before the TV, computer or other gizmos, it should be not more than 2 hours a day. Instead, devise fun activities wherein your child as well other members of the family can take part in or ones in which your child does not need a company.
5. Ensure your child gets enough sleep
Lastly, a good night’s rest that lasts about 9-12 hours is vital for optimal weight maintenance. Studies reveal that children who slept for fewer hours were more at risk of being obese. This is because less sleep causes fatigue, leading to a decrease in physical activity and therefore, use of energy.
Frequently asked questions?
Q1. Did I do something wrong in my pregnancy which resulted in my baby having congenital hypothyroidism?
A The answer is most certainly NO. In the vast majority of cases, no cause can be identified and no link has been found with drugs, smoking or any particular foods
Q2. I am worried that I might miss giving my baby a dose of thyroxine. Would this matter?
A. Fortunately, thyroxine lasts in the body for quite some time and so even if a day?s dose is missed, your child will still benefit from the previous day?s dose. Clearly it is important to maintain a regular daily treatment and it will certainly matter if several days are missed.
Q3. Are there any side effects of thyroxine treatment?
A. No. Thyroxine is identical to the natural hormone produced by the thyroid gland and is a relatively simple chemical substance. It is really a replacement hormone treatment rather than a drug, so any side effects only occur if the dose is wrong. If too much thyroxine is given, symptoms of hyperthyroidism will occur. If not enough is given, the hypothyroid symptoms will return. Thyroxine tablets can be stored at room temperature, last a long time, and are widely available throughout the world.
Q4. What is the risk of having other children with hypothyroidism?
A. In the commonest form of hypothyroidism, i.E. When the gland has not developed properly, the risk of having another affected child is small, perhaps about 1 in 100. When the cause of hypothyroidism is due to a block in the production of the hormone, rather that normal development of the gland, the risk of having an affected child is much higher and is usually 1 in 4 in each pregnancy, with boys and girls equally affected. The late onset form of hypothyroidism also has an increase risk of brothers, sisters and other relatives having thyroid problems.
Q5. If my child is at risk of developing hypothyroidism, for instance they have Turner or Down?s syndrome, how often should they have a blood test?
A. Probably every one to two years, but your specialist will advise you on this.
Q6. How long will treatment last for?
A. We must assume that the treatment is for life as the thyroid gland will not grow again or recover, but the treatment is easy and well tolerated. White temporary or transient hypothyroidism does exist, it is uncommon, and most children will need to continue on thyroxine through adulthood. The dose will need to be increased to match their growth, but by the time adult life is reached the dose usually remains stable with the need for only an occasional blood test.
What is a growth disorder?
A growth disorder is any type of problem in infants, children, or teenagers that prevents normal growth. Normal growth depends upon several factors, such as nutrition, genetics, and hormones (chemical messengers of the body). Hormones are necessary for normal growth and development; they regulate the body's growth, metabolism (the physical and chemical processes of the body), and sexual development and function.
Endocrine (hormonal) causes of growth disorders include thyroid hormone deficiency (hypothyroidism), growth hormone deficiency, hypopituitarism, or other hormone disorders. However, some growth problems are not necessarily growth disorders; normal variants of growth patterns include genetic short height (familial short stature) and slow growth/delayed puberty (constitutional growth delay).
Although growth hormone was originally used to treat growth hormone deficiency (this group of patients respond the best to growth hormone therapy), there have been other conditions for which growth hormone therapy has been approved for use. These include Turner syndrome, chronic renal insufficiency, Prader-Willi syndrome, and children who were small for gestational age and have not caught up in their growth by the age of two years. In 2003 the FDA approved the use of growth hormone for children who have
A child's growth pattern is an important part of determining normal growth. No child has a perfectly steady growth rate; children go through growth spurts and periods of slower growth. The best way to evaluate a child's growth pattern is to plot the child's height and weight on a growth chart. This can be completed by a doctor or a health care practitioner, at school, or even at home. The growth chart will show the child's growth over a period of time.
Any departure from a prior growth pattern appropriate for the child's genetic background may signal the appearance of a disease. Contact a doctor or healthcare practitioner if the child's growth or height is a concern. The doctor may suggest seeing a specialist paediatric Endocrinologist who can perform tests to determine if the child has a hormone deficiency.
Symptoms of GH deficiency in children include the following:
Low growth velocity (speed) for age and pubertal stage
Increased amount of fat around the waist
The child may look younger than other children his or her age
Delayed tooth development
Delayed onset of puberty
Symptoms of GH deficiency in adults include the following:
Decreased strength and exercise tolerance
Decreased muscle mass
Weight gain, especially around the waist
Feelings of anxiety, depression, or sadness causing a change in social behavior
Thin and dry skin
If there is a question of growth hormone deficiency in either a child or an adult, consultation with a pediatric or adult endocrinologist, as appropriate, is recommended. The endocrinologist may order an insulin hypoglycemia test wihich is the gold standard for determining HGH deficiency.
insulin (hormone that regulates blood sugar levels) is given through an IV to produce a low plasma glucose (a sugar) level. The peak growth hormone level is measured 20-30 minutes later.
If the peak growth hormone level is less than 10 mcg/mL in children or less than 3 mcg/mL in adults, growth hormone deficiency is diagnosed.
Persons with growth hormone deficiency may have increased total cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein B, and triglyceride levels.
Other tests that may be performed include a CT scan and/or MRI of the brain and/or bones. Images from these tests may reveal tumors. Reduced bone density can be evaluated by a DEXA or bone density scan.
Myth 1: I am overweight. I will eventually develop type 2 diabetes
There are many different causes of diabetes and being overweight doesn?t mean you will get the condition but it does tip the scale. The reason obesity is linked to diabetes is because it increases insulin resistance (which means greater amount of insulin is required to regulate blood glucose levels). This makes the pancreas work overtime to produce insulin. This is what causes diabetes. However, there are cases where thin people have uncontrolled diabetes and obese people have no diabetes whatsoever.
Myth 3: I can?t eat sweets or chocolate because I have diabetes
No food is absolutely forbidden as long as attention to portion control and advance meal planning is done. A piece of sweet or chocolate won?t cause any problem but it?s necessary to keep a check on how much of it you consume.
Myth 4: Fruits contain carbohydrates, so I should avoid including them in my diet
Any food that contains carbohydrate will raise blood sugar levels but the only proper way to see how high your blood sugar levels will rise is the glycaemic index (GI). The lower the GI value, the lower will be the rise in blood sugar level and the better it will be for your health. Most fruits have a low GI value. They are also excellent sources of vitamins, minerals and dietary fibre, and are relatively low in calories. Also beware of fruit juices, especially the packaged ones because they?re very high in calories and sugar.
Myth 5: I should eat special diabetic foods if I have diabetes
There is no such thing as a diabetic diet. A healthy diet is one where you get 40-60% calories from carbs, 20% from proteins and 30% or less from fat. And the same is applicable if you have diabetes. Diet for diabetics should include a good amount complex carbs, vegetables and fruits. It should be low in processed foods, fat, salt and added sugar. It?s better to have five small meals a day instead of three large ones and make sure they?re well-spaced out.
Myth 6: I shouldn?t exercise if I have diabetes
On the contrary, exercise is an important part of diabetes treatment. Regular exercise, especially aerobic (walking, jogging, etc.) helps control your weight, gives you more energy and is good for your overall health. It also helps to control blood sugar elevation by increasing the body?s sensitivity to insulin.
Growth hormone deficiency is a disorder that involves the pituitary gland (a small gland located at the base of the brain). This gland produces growth hormone and other hormones (chemical messengers of the body). When it does not produce enough growth hormone, growth will be slower than normal. If other pituitary hormones are absent or present in inadequate amounts, the condition is called hypopituitarism.
Growth hormone deficiency can occur at any age. Growth hormone is necessary for normal growth and development in children. In adults, growth hormone is needed to maintain the proper amounts of body fat, muscle, and bone. In adults, low or absent growth hormone can also cause emotional symptoms, such as tiredness and lack of motivation.
Keep your teeth clean.
Don't brush too hard.
Replace tooth brush every 3-4 months
Go to dentist every 6 months for cleaning and examination.
Report any sigh of redness,pus,patches or pain.