I am Dr. Lata Bhut, I am a pediatrician specially trained to handle a developmental problem in children and running Palak Child Development Centre in Mayur Vihar, Phase- 2, Delhi.
Today I am going to talk about Autistic spectrum disorder, earlier I spoke about how to suspect a child for high-risk Autism based on signs and symptoms, today I am going to talk about the evaluation and management of such children. Autism is a social communication skills disorder where this impairment nonverbal and verbal communication both and there repetitive behavior patterns which impaired child day to day functioning. Speech delay is the commonest presentation although they can be some intellectual disability in some children. So early intervention is very important because in earlier years especially below the age of 3 years brain has compass fantastic capacity to rewire in response to environmental stimulation and 1 to 3 years is the best age to teach speech and language to a child. So American Academy of Pediatrics recommends starting early intervention starting specially below 2 years of age and do not wait till the diagnosis made because diagnosis may take some time, so all children should be scream for Autism between 18 to 24 months of age using a screening tool by a pediatrician and once a pediatrician suspects a child to be high risk for Autism, child should be referred to a development pediatrician or even if the parents suspect the child to be at risk for Autism they can come directly to the child development centre or to developmental pediatrician and the child is handled by multidisciplinary team of developmental paediatrician, paedia technologies, clinical psychologist, occupational therapies, special educators, speech and language therapist and parents are a part of the Core Team. In the diagnosis hearing assessment is very important because there is speech delay and other tests are done based on the clinical features and decide by the doctor, a detailed evaluation is done by the team using Autism diagnosis tools and once a diagnosis made or even before that early intervention is started once we suspect Autism. Early intervention involves intensive behavior modification therapy to teach nonverbal communication, speech, improve cognition, improve the independent self-help skills of the child and to enumerate the problematic behavior of the child. Occupation therapy, especially by the therapist trained in sensory integration, aims to develop self-help skills and fine motor skills and to enumerate the problematic sensory behaviors because if the child problem is sensory issues then the child can have difficult behavior, difficulty in learning and also in feeding. A special educator aims to give remedial education to help in academics and speech therapist in to develop speech of the child. It has to be individualized, goal-oriented, the intensive systematic model where we review it time to time because a development of change time to time, parents are a part of a Core Team. At least 25 hours per week of therapy should be given which means some hours at the center and followed by at least one and a half and two hours at home therapy should be done. And coming to the medications there is no medication to cure or Autism, although we can give medicines to enumerate the problematic behaviors and prognosis the earlier we start the better it is.
For any further queries, you can contact me on Lybrate.read more
Good afternoon, I am Dr Lata Bhat, a developmental Pediatrician in Delhi. We take care of developmental disorders in children like Autism, Hyperactivity, ADHD, learning and physical disability. Today I will talk about Autism.
Autism is a spectrum disorder that means there is a wide range of presentations.
Why did I choose to speak on this topic? The incidents are alarmingly high. It is a sort of epidemic and if not addressed, it can lead to a disaster.
The cause is Genetic. If one child has got Autism then the siblings also have the maximum chance to suffer from the same disease.
How does it affect the children?
Autism affects the communication of the child. It affects the speech, language as well as the non- verbal communications. Communication is the exchange of thoughts, ideas between the two or more people. Speech is delayed.
How do the parents or a care taker suspect the child?
Initially, the norms of the communication come first and then the speech.
Preterm Labor and Birth
Good Evening. I'm Dr. Lata Bhat. I'm a Neonatology and I take care of the developmental problems of children. So today I want to talk a bit about pre-term babies who're born before 36 weeks. Normal babies are born from 37-40 weeks of gestation after the mother becomes pregnant and babies who're born before 36 weeks have some problems. Babies who're born from 34-36 weeks donot have that much problem but those who're born before 34 weeks, especially those born below 28 weeks have lot of problems and especially babies who're less than 1.5kg or less than 1kg. But in good centers in India, like my center also, we do save babies, about 600 or 700 or 800gm babies and also thos born in about 25-26 weeks of gestation and there is a success rate of about 90%.
Now, globally about 15 million babies are born pre-term and out of this 25% are born in India. So imagine the burden of pre-term babies in India and the facilities that exist in India are abysmal as compared to the number of babies who're born pre-term, and we've to remember out of all the number of deliveries about 12.5% are born pre-term which is a huge number. About 27 million babies are born annually and out of this about 3.6 million babies are born pre-term.
So now considering the problem all the prospective parents and everybody should know what causes prematurity. Because however much educated a gynecologist maybe or a pediatrician maybe there is no full proof method to predict or prevent it but there are certain factors which contributes more to prematurity. So early recognition and timely transfer to higher center with better facilities is very important. Now in India it happens due to complex factors, it happens in poor people as well as rich people. Pregnancy in adoloscent people, whose womb is no yet ready to take babies or if the mother is underweight, there are recurrent infections in the mother, under-nutrition or impropoer nutrition, then substance abuse by the mother, in vitro fertilisation, if the mother has diabetes during pregnancy, mother has uncontrolled blood pressure during pregnancy, infections during pregnancy, especially urinary tract infection or genital infection, Sexually Transmitted Diseases.
These are the conditions where we can definitely predict that baby can be born pre-term, and also in case of multiple pregnancies, especially if the mother has twins or triplets then risk of pre-term birth is more. Now stress also leads to pre-term birth. In the current lifestyle there is stress, everybody is career oriented so we're facing a lot of infertility, people are taking treatment for infertility, having in vitro fertilisation that is also leading to pre-term birth. Now, once we know there are a lot of factors how do we prevent it. First is prevention then comes treatment. For prevention, as I told you before conception we've to think that mother's nutrition should be good, she should be well nourished, mother's age should be appropiate, she should not be a teenager or an adolescent, that is more than 22-23yrs of age. Then pregnancy planning, birth spacing, then we've to think about preventing sexually transmitted diseases, we've to give vaccines which are recommended for adoloscents, then genetic counselling, screening for diabetes, if there is substance abuse you've to stop it, stop smoking, prevent stress and all these things. And also proper ante-natal care by a proper gynecologist where they screen for everything and do regular ultrasound examination of the mother and they train the mother to handle the pregnancy well
Now, despite doing everything if we're not able to avoid pre-term labour then one has to plan to deliver at a center where there are facilities, there is trained new born consultant who'll be attending the delivery and they have all the facilities to take care of the baby after birth. And supposing if sill the baby is born in a center where there are no facilities then a proper transport should be arranged. We should not just pick up the baby and shift to a center because temperature mainatainance is very important, we've to take care the baby is getting continuous glucose, baby is receiving oxygen and is properly transported. Even during transport if these things are not taken care of the baby's brain development can be affected. If transient dip of oxygen, even for a few seconds or for few minutes if the baby is not receiving any glucose or if there is very rigorous transport the baby can suffer haemorrahage in the brain.
So new born babies, especially a pre-term babies can be very very delicate and so transport should be done in a proper manner and then once you've gone to a center where they're saving babies, you've to first maintain the temperature, take care of the breathimg, if require breathing support, if require oxygen then maintanance of blood sugar, prevention of infections, hen regular screening to lok for the eye problems, brain problems and once the baby survives at the time of discharge these babies may stay in a hospital for a long time and after discharge you should listen carefully to what the doctor is telling because a proper follow up is what will give a quality outcome in the long run. Because we just don't want to save lives and give them long term problems like hearing, speech, vision or physical disability.
All these are preventable and to a certain extent correctable. If you follow properly the pediatrician and if possible the developmental pediatrician. So that's very important. So the take home message is try to prevent pre-term birth by knowing the factors which cause it and if its inevitable get your delivery done in a center that has facilities to take care of the pre-term babies and after the baby survives follow up all the instructions given by your doctor and pediatrician.
So, if you've any further doubts related to a pre-term baby or any baby you can consult me through librate.com where we can chat or telephonic conversation or you can contact me at Child Developmental Clinic which is at Poorvanchal Plaza, Shop No-106, Mayur Vihar, Phase-2.read more
Here are Symptoms of ADHD and how to handle the Children suffering with ADHD.
Good afternoon, I am Dr. Lata Bhat. I am a pediatrician who is specially trained for newborn care and developmental problems of children. Today, I am going to talk about one of the conditions which is very common. It is known as ADHD- attention deficit hyperactivity disorder.
Many of you may have read about it in the newspapers or online. About 8-10% of schoolchildren have this problem. Now this is not a disease, so you need not be scared of this problem. All you need to know is to understand the kids and provide support and this is essential both by the parents and teachers. These kids have generally poor concentration, very easily distractible that means even if a door bell rings or a horn or if somebody is playing music or television or if somebody in the surroundings is talking and laughing their concentration gets distracted. They may or may not be hyperactive because the core component is lack of concentration which affects their studies. But they may be impulsive which means they may act without thinking. They may land up into frequent fights because of that. They may have certain behavioral issues which teachers and parents may find difficult to handle. They may have learning disability which can be because of lack of concentration or it can be specific learning disability.
Now, there is no need to get worried about it. All you need to do is to contact a developmental pediatrician, get the right assessment done. Then come to the management of these children. First and foremost, is how the parents and teachers handle the children are very important. They need a lot of attention, so kindly give it but it should be positive attention. Always praise and encourage for whatever good they do, never criticize. If there is a bad behavior, you first explain to them and then if it’s a very small kid you can sometimes just track them so that they get distracted from the bad behavior and calm down. There is something called household roles.
You can fix certain household roles, routines so that children can understand the do’s and dont’s which itself takes care of 50% of the problems. Still if they behave badly, you can count up to 10 and then there is something called time-out. Time-out means 1 minute per year of each, if it’s a 5 year old child then 5 minutes; it means that lights off, TV off, nobody is talking to them, physical, visual and verbal attention- all three are not given by anybody in the house and the child is made to sit in a corner. At the end of it, you hug the child and tell them that the child is very good but the behavior was bad so that the child does not lower his self-esteem because self-esteem of a child is supreme. Your behavior should always uplift the self-esteem of your child.
Secondly, what you have to remember is never criticize or compare him with any other child and all the adults should follow the household rules consistently. Coming to studies, they have a very short attention span. So set short targets for studies and give breaks in between. They need 1:1 attention for studies which means somebody has to sit with them while they are studying at home either the tutor or the parent. In school, the teacher should make sure that they are sitting in the front row, close to teacher, away from doors and windows and give them a little extra attention. Apart from this, you also need to remember that you have to decrease the TV, video, mobile and computer watching. These lead to hyperactivity. You also need to limit the amount of chocolates and fast food intake. Remember, by understanding the condition, you and the teacher can really make a difference to the child’s future.
For any other further information, you can contact me on lybrate.com.read more
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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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Patient Review Highlights
Saving a life is a noble cause and the one who is chosen by God to save lives is always special to him as god bestow some of his powers to the chosen one, this is what a Doctor is, the chosen one to save life of the suffering ones and that is what I found after meeting Dr. Lata Bhat. Dr. Lata is highly experienced, skillful in the field of neonatology. She has been incredible is dealing with our New borns. One thing I like most about her is that she is a very understanding, supportive and a down to earth human being can’t find easily in today world. She is an Idol doctor who takes full responsibility and know her duties very well. I wish her Good Luck and may god help her with his utmost powers in saving the little one. I recommend her for New born all time.
My child was suffering from excess fever 1 month ago. Earlier I thought that the issue is not that critical. But when I met Dr Lata Bhat, I got to know that my child is suffering from Pneumonia. I became really worried after knowing therbut the doctor helped me calm down and provided a critical care to my child. Now She is absolutely fine . I owe her a big thank. The critical care She provided really helped my child's quick recovery.
Dr Lata has been very helpful, nice,courteous and has shown a lot of empathy in listening to my problem and providing medical treatment which helped me in overcoming all the problems. Thank you Dr Lata Bhat from bottom of my heart.
I found the answers provided by the Dr. Lata Bhat to be very helpful and well-reasoned. Got a call and dr was quite helpful Thanks a lot
Our experience with doctor was satisfactory...
Autism spectrum disorder is a condition related to brain development that impacts how a person perceives and socializes with others, causing problems in social interaction and communication.
If your child comes out of bathroom and cries that while he or she poops it hurts, it's time that you start doing something for his or her constipation. This is a problem that is found among many children and most of the times, if left unnoticed, it can prove to be dangerous. There are many signs that will let you know that your child is suffering from constipation. For instance, if you find your child complaining about stomach pain, or bloating, there are chances that he or she is suffering from constipation.
In such a situation, your child needs your help, and you can do so by:
- Take a peek: It is something your child may not love you to do, but you must see his poop. The consistency of the poop must be of peanut butter. If it seems hard or is sticking to the walls, then your child is suffering. Take action soon.
- Give him more fiber: This is something that most children hate in their diet. Give him or her whole grains or food that is rich in fiber like carrots, brown rice, nuts, beans, lentils, banana, pasta and bread. Foods rich in fiber helpsin preventing constipation, and thus it may be of great help to your child too.
- Increase water in take: Children seldom drink water! They drink only when they are very thirsty. Do not promote this habit; instead ask them to drink more water. With the help of water your child can push through the food that they have eaten.
- A little juice may also help: Fruit juice is good for constipation, especially prune juice that acts as a laxative. Too much fruit juice is not good for them, but depending on their age, four to five ounces of fruit juice can be given as that helps in relieving constipation.
- Stimulate the rectum of your baby: Although it may seem a bit odd, yet it can be tried to help your baby get rid of constipation. Sometimes rectal stimulation helps the movement of bowel.
- Switch formula: If you are breastfeeding you baby, then there are very less chances that your baby will suffer from constipation. But if they are on instant food, the formula you are using may be a reason. Thus, you can switch formula and see if it helps.
A baby should be breastfed for at least the first few months after birth. Breastfeeding has a number of benefits for both the mother and child. Apart from being the best source of nutrition for the baby, it also helps the mother and child bond.
Here are a few benefits of breastfeeding your baby.
- Nutrition: No formula can be compared to the nutrition provided by a mother’s milk. The first milk produced by a mother’s breasts is known as colostrum which is rich in antibodies and proteins. Breast milk is made up of the perfect mix of proteins, vitamins and essential fats. It is also easier to digest as compared to formula feeds.
- Immunity boost: A mother’s milk is rich in antibodies and helps strengthen the newborn child’s immunity. These antibodies also help lower the baby’s risk of developing asthma or allergies later in life. Babies that are breastfed are also said to have a lower risk of suffering from ear infections, respiratory problems and diarrhoea. It also plays an important role in lowering chances of sudden infant death syndrome. Breastfeeding is also said to protect babies from certain types of cancer in infancy and later stages,
- Bonding: While being breastfed, a baby is held close to the mother and has skin to skin contact. This makes the baby feel secure and helps him or her to bond with the mother. For the mother, this process can also help fight postpartum depression and help reconnect with the baby.
- Healthy weight: Babies who are breastfed are said to be less likely to develop obesity. Babies fed on breast milk have been found to have lower levels of insulin than babies who are fed with formula milk or any other milk. As they grow, these babies put on a healthy amount of weight, but refrain from overeating and have healthier eating patterns. This helps maintain a healthy BMI and prevents diseases like diabetes etc.
- Boosts intelligence: Studies show that babies who were breastfed for the first six months have a higher IQ than those who were not. Thus, breastfeeding is said to play a significant role in cognitive development. There are two main reasons for this. Firstly, breast milk is said to fatty acids that are not available in formulas, Secondly, the emotional bonding between mother and child is also said to contribute towards boosting IQ levels.
For the growth and development of children, they need an essential nutrient; Iron. It helps in the transfer of oxygen from lungs to the body's tissues. Red blood cells contain iron in the hemoglobin. The hemoglobin carries oxygen in the blood to the different parts of the body. Iron has an important role to play in the development of brain and generating energy in a child's body. The lack of sufficient iron in the child's body can lead to anemia, which is a nutritional deficient illness and will require medical attention. When a child suffers from anemia, the lack of oxygen makes a child weak and sick.
There are certain symptoms of Iron deficiency in a child's body. These are:
- Infections and weak immune system can make a child suffer from frequent infections.
- Lethargy and fatigue is another common symptom of an iron deficient body. Due to deficiency of Iron it is difficult for the body to transport oxygen to cells in the body and hence it unable to generate enough energy levels.
- Breathlessness and increased sweating can be a sign that your child may be suffering from iron deficiency.
- Pica Children suffering from iron deficiency may find a special taste for non-food substances like chalk, dirt and clay.
- Lack of iron in the body hampers the physical growth of a child.
The deficiency of iron in children can be diagnosed through blood tests. Your doctor may recommend supplementing iron content orally or through multivitamin medicines. But the deficiency of Iron in a child's body should be taken care of with absolute urgency.
Proper steps should be taken to prevent the deficiency of Iron in children. Those notable precautions are mentioned below:
- Balanced diet: A well balanced diet is always recommended. For older children (within 9-12 years of age), red meat, chicken and fish would suffice as good sources of iron.
- Oral iron supplements: Oral iron supplements would be required for children with low weight at birth and who have a deficiency of iron in their daily diet.
- Vitamin C: Foods such as strawberries, tomatoes and potatoes help in providing the sufficient iron content when included in daily diets, thus reducing the chances of anemia.
- In vegetarian diet green vegetables, jaggery, dates etc. are rich sources of iron.
Lactose intolerance is a condition wherein you are not able to digest lactose, which is a sugar found in milk. Other foods that contain lactose include cheese and ice-cream. Inadequate production of the lactase enzyme in children causes lactose intolerance. This enzyme is produced in the intestine that helps in the digestion of lactose.
Lactose intolerance is often confused with milk intolerance. The symptoms are similar but they do not share the same cause. Milk allergy is an adverse reaction towards milk and it is a problem of the immune system, whereas lactose intolerance involves the digestive system.
The symptoms of lactose intolerance are:
Bloating; on consumption of milk over a period of time
Diarrhea is also very common
It is self -diagnosable; just strike out foods containing lactose from your child’s diet and see if the symptoms get better with time. If the symptoms happen to fade away gradually, then it certainly must’ve been lactose intolerance.
However, it can be tricky as many non-dairy products also contain lactose.
If the child is lactose intolerant, then he/she might have to undergo a lactose breath test. This is used to test the levels of hydrogen in the child’s breath after the child consumes a lactose solution. Usually, hydrogen levels are low in one’s breath. However, if the lactose solution is not digested properly, then it will lead to a temporary increase in the levels of hydrogen in the breath, thus indicating lactose intolerance.
This disorder does not have a cure; so in case your child has lactose intolerance, you need to adjust his/her diet accordingly. Over-the-counter lactase is also available that helps in digesting lactose based foods. You can also go for the ‘lactose- free’ milk variety for your child. In case you have a concern or query you can always consult an expert & get answers to your questions!
If the children do not get sufficient amount of sleep at night, then their health will start getting deteriorated slowly. According to the medical surveys, it has been discovered that kids need much more sleep than adults.
It is pretty impossible to maintain kids' health without proper sleep at night. The kids will get tired soon and will lack in energy because of poor sleep.
Why sleep is important for kids' health?
- Growth promotion: Growth process might get retarded as a result of less hours of sleep. If the kids
stop growing, then their health cannot be maintained.
- Proper weight maintenance: If the kids lack in proper sleep, then their weight might get decreased slowly. A good sleep of at least 10 hours a day is necessary for maintaining weight of children so that great health can be acquired.
- Boosting internal energy: More energy will be generated so that daily activities can be performed with ease. The stamina level of kids can also be boosted as well.
- Growing improved bed-time habits: Bed-time habits can be properly scheduled with good sleep. If the sleep routine is not properly maintained, then the health condition of the kids will be adversely affected. Sleep can be audited properly, and your kids can grow fast.
- Promotes learning process: The kids can get an improved learning process by means of having good amount of sleep. If you want to make your kids learn new things or habits, then for that sufficient sleep during the night is needed.
- Increase in attention and concentration: Mental strength of kids can be increased along with the increase in concentration and attention level. This is very much essential for maintaining studies and daily activities.
- Reduction of injury risk: Immunity system of kids can be boosted to a great extent with proper sleep as a result of which the risks of physical and mental injuries can be reduced. In fact, severe kinds of heart diseases can also be prevented by means of having a good sleep at night.
Sleeping schedules for kids
- Pre-schoolers need almost 10-13 hours of sleep.
- For newborns, 14-17 hours sleep is appropriate.
- Infants need a sleep for almost 12-15 hours.
- Young adults are in need of at least 7-9 hours of sleep.
- Teenagers need 8-10 hours night-time sleep.
- For school-going kids, 9-11 hours sleep is needed.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Please prescribe me vaccine against cervical cancer & at what intervals the vaccine should be taken & how many times? Currently I am not facing any issue regarding cervix.
Bedwetting or nocturnal enuresis, refers to the unintentional passage of urine during sleep. Enuresis is the medical term for wetting, whether in the clothing during the day or in bed at night. Another name for enuresis is urinary incontinence. For infants and young children, urination is involuntary. Wetting is normal for them. Most children achieve some degree of bladder control by 4 years of age. Daytime control is usually achieved first, while nighttime control comes later.
The age at which bladder control is expected varies considerably. Some parents expect dryness at a very early age, while others not until much later. Such a time line may reflect the culture and attitudes of the parents and caregivers.
Factors that affect the age at which wetting is considered a problem include the following:
- The child's gender: Bedwetting is more common in boys.
- The child's development and maturity
- The child's overall physical and emotional health. Chronic illness and/or emotional and physical abuse may predispose to bedwetting.
No one knows for sure what causes bed-wetting, but various factors may play a role:
- A small bladder: Your child's bladder may not be developed enough to hold urine produced during the night.
- Inability to recognize a full bladder: If the nerves that control the bladder are slow to mature, a full bladder may not wake your child, especially if your child is a deep sleeper.
- A hormone imbalance: During childhood, some kids don't produce enough anti-diuretic hormone (ADH) to slow nighttime urine production.
- Stress: Stressful events, such as becoming a big brother or sister, starting a new school, or sleeping away from home, may trigger bed-wetting.
- Urinary tract infection: This infection can make it difficult for your child to control urination.
- Sleep apnea: Sometimes bed-wetting is a sign of obstructive sleep apnea, a condition in which the child's breathing is interrupted during sleep.
- Diabetes: For a child who's usually dry at night, bed-wetting may be the first sign of diabetes.
A structural problem in the urinary tract or nervous system. Rarely, bed-wetting is related to a defect in the child's neurological system or urinary system.
- Wetting during the day
- Frequency, urgency, or burning on urination
- Straining, dribbling, or other unusual symptoms with urination
- Cloudy or pinkish urine, or blood stains on underpants or pajamas
- Soiling, being unable to control bowel movements
Most kids are fully toilet trained by age 5, but there's really no target date for developing complete bladder control. Between the ages of 5 and 7, bed-wetting remains a problem for some children. After 7 years of age, a small number of children still wet the bed.
When to see a doctor: Most children outgrow bed-wetting on their own, but some need a little help. In other cases, bed-wetting may be a sign of an underlying condition that needs medical attention.
Consult your child's doctor if:
- Your child still wets the bed after age 7
- Your child starts to wet the bed after a few months or more of being dry at night
- Bed-wetting is accompanied by painful urination, unusual thirst, pink or red urine, hard stools, or snoring
Here are some tips for helping your child stop wetting the bed. These are techniques that are most often successful
- Reduce evening fluid intake.
- The child should urinate in the toilet before bedtime.
- A system of sticker charts and rewards works for some children.
- Make sure the child has safe and easy access to the toilet.
Some believe that you should avoid using diapers or pull-ups at home because they can interfere with the motivation to wake up and use the toilet.
In case you have a concern or query you can always consult an expert & get answers to your questions!