Dr. Anil Vaishnavi

Tonsillitis, in the easiest terms, is the swelling of tonsils in our throat that is accompanied by symptoms like throat pain, difficulty in swallowing/ drinking, altered voice and fever etc.

As in the case of most infections, the occurrence of tonsillitis is more common in children due to relatively lower immunity and habits that invite infections. Let's take a look at the first line of defence when you have a cranky child with swollen tonsils.

1. Make your child gargle with salty warm water: This treatment is most helpful in any infection in the mouth. Add half teaspoonful of salt to a glass of warm water and make the child gargle with the mixture as many times in the day as possible (to a maximum of 5 times). Continue till the condition prevails. Gargles difficult in children below 10yrs, but one can try gargles in older children. Make sure the child spits out the water and not drinks it.

2. Antibiotics: Consult a child specialist or pediatrician in case throat pain and fever doesn't settle, inspite of home remedies and let your doctor decide if antibiotics are required, rather than going for self medication as it have side effects. 

3. Painkiller/numbing lozenges: Painkillers that are prescribed by the doctor can be given to ease the pain. Same is the case with lozenges but care should be taken that he/she should not have too many of these.

4. Allow him/her to take rest: It does help in a betterment of the condition!

5. Give warm (not hot) soothing food: Soup, ginger honey mixture, ginger tea can help soothe the inflamed tonsils in most cases. The condition, more often than not, gets better within 7-10 days. If you wish to discuss about any specific problem, you can consult a Pediatrician.

Constipation in children may be caused by a variety of factors. What is misleading about children with constipation is that it initially might seem like diarrhea as the more liquid stool passes around the hardened stool. The leading cause for constipation in children are:

1. Lack of roughage in diet: Low water intake coupled with improper eating habits may lead to constipation as well.

2. Medications: Side effects of few medications, such as certain antidepressants.

3. Deliberately not letting the stool pass: Traumatic toilet training or unpleasantness while letting stool pass once might create an unpleasant memory, thus making the child not want to poop.

Treatment of constipation in children can be achieved by multiple techniques best used together:

1. Regularising the toilet time: Using the toilet first thing in the morning makes it habitual for the child to automatically make it a part of their system to flush out their innards. This sets the body’s pattern to want to expel its contents after a few weeks at the same time as it gets habituated in doing so.

2. Consuming a diet rich in roughage: Plenty of fibre is of utmost importance in preventing constipation. Whole wheat and multigrain breads, ragi, legumes, beans and raw vegetables incorporated into the daily diet help clearing the bowels. Fruits should be made habitual and those, which can be consumed with their peels should be eaten that way to provide for maximum roughage. In addition to changing food habits, consuming plenty of water throughout the day is important as roughage without water will worsen the symptoms of constipation. Yoghurt and other probiotic drinks help with constipation too.

3. Stool Softeners: Ask the paediatrician on the kind of stool softener recommended for your child and follow the prescribed duration of the course of the medication as they should not be discontinued even if the child starts to pass clear stools. Discontinuing the prescribe drugs will only make matters worse.

The above three methods, when combined together, best help in the treatment of constipation in children. If you wish to discuss about any specific problem, you can consult a Pediatrician.

As a new mother, you will be always in a constant state of worry whether you are doing things right. And of those many, many things you worry about, your baby’s bowel movements are one of them.

A baby’s poop is a sign of his/her health. Thus, you do need to know what is normal and what needs medical attention. Read on to know more about your baby’s poop.

What’s Normal?

The kind of poop depends on how you are feeding your child. If you breastfeed the baby, his/her poop will be:

1. Small in size—no bigger than a coin

2. Light in colour, usually a greenish-brown or bright yellow

3. Sloppy in texture

The first few weeks of breastfeeding will produce waste daily, after each feed. The frequency will diminish later, but that is not a concern, as long as the waste is easily passed and is soft.

If you are feeding your child formula, the poop will be different. You will notice that the poop is:

1. Bulkier

2. Yellow-ish brown or pale yellow in colour

3. Smells stronger

The next worry you have is when you change your baby’s feeding routine. When you switch from breastmilk to formula, you will notice:

1. The poop is darker in colour.

2. The texture becomes thicker.

3. The smell also becomes stronger.

The other dramatic change you will see is when your baby starts eating solids.

What isn't Normal?

There are mostly two things you need to be concerned about: diarrhoea and constipation. Both of these conditions mostly affect babies who are formula-fed.

If your baby has diarrhoea, you will notice:

1. The poop is runny

2. Frequency and amount of poop is increased

And if you suspect constipation, be aware of the following signs:

1. Your baby finds it difficult to poop

2. The poop is dry and small

3. The tummy is hard when you touch it

4. There might be blood in the poop

Green poo:

If you're breastfeeding, green poo can be a sign that your baby is taking in too much lactose (the natural sugar found in milk). This can happen if she feeds often, but doesn't get the rich milk at the end of the feed to fill her up. Make sure your baby finishes feeding from one breast before you offer her your other one.

If you are feeding your baby formula milk, the brand you are using could be turning your baby's poo dark green. It may be worth switching to a different formula to see if that has any effect.

If the symptoms last longer than 24 hours, visit your health visitor or GP. The cause may be:

• a food sensitivity

• side-effects of medication

• your baby's feeding routine

• a stomach bug

Very pale poo:

Very pale poo can be a sign of jaundice, which is common in newborns. Jaundice causes your newborn's skin and the whites of her eyes to look yellow, and usually clears up within a couple of weeks of birth. Tell your midwife or doctor if your baby has jaundice, even if it looks like it's going away.

Also tell your midwife or doctor if your baby is passing very pale, chalky white, poos. This can be a sign of liver problems, especially where jaundice lasts beyond two weeks.

Cyclic vomiting syndrome (CVS) is characterized by periodic bouts of nausea and vomiting that happens at cyclical intervals. It affects all ages, but is more common in children. The condition is quite stereotypical in that there are paroxysms or bouts of vomiting that is recurrent and follows days of normal health.

Causes:

There is no definite reason identified, but it is said to have a strong hereditary correlation. Studies have shown mitochondrial heteroplasmies (abnormal growth of mitochondria, which is a cellular component) to be one of the factors that can lead to CVS. The genetic correlation, however, is very difficult to establish, specifically because vomiting and nausea are common symptoms that occur with most conditions in children. And CVS is most commonly noted with conditions like infections and emotional excitement. Infection could be either tooth decay or sinusitis or anything else. Lack of sleep, anxiety, holidays, allergies, overeating, certain foods, menstruation – a host of factors have been shown to induce CVS. There is also a strong association with migraine and conditions that lead to excessive production of stress hormones.

Symptoms:

The syndrome (a group of symptoms) usually has 4 phases:

1. Symptom-free interval phase: The child is completely normal in this phase, which happens in between bouts.

2. Prodromal phase: Prodrome is an indication that a disease or a condition is about to happen. In CVS, this is usually nausea and abdominal pain that can last from a few minutes to a few hours. Treatment in this phase can curb the disease. However, there could be some children in whom this may not manifest and the child may directly start with vomiting.

3. Vomiting phase: Repeated bouts of paroxysmal vomiting happen associated with nausea, exertion, fatigue, and drowsiness.

4. Recovery phase: As the nausea and vomiting begin to subside, which may take a couple of days, the child returns back to normal slowly. However, the lethargy and energy levels will take a couple of days to return to normal.

Treatment:

Treatment again depends on the severity and the phase at which it is being recognized. If a child has repetitive bouts, then the parent and the doctor would have identified a pattern to it.

1. If the causative agent has been identified, for instance, infection or migraines, then managing that takes care of the CVS also.

2. If identified during the prodromal phase, again it can be managed with suitable anti-emetic medications.

3. If identified after full onset, rest and sleep and medications to control nausea and vomiting are required.

Adequate hydration with electrolyte replenishment and sedatives can provide additional support. However, in most cases of childhood CSV, the pattern will be identified and that helps in better management, both the child/parent and the podiatrist.