Dr. Amit Jain

Making appropriate food choices for your baby during the first year of life is very important. More growth occurs during the first year than at any other time in your child's life. It's important to feed your baby a variety of healthy foods at the proper time. Starting good eating habits at this early stage will help set healthy eating patterns for life.

Recommended feeding guide for the first year

Don't give solid foods unless your child's health care provider advises you to do so. Solid foods should not be started before age 4 months because:

• Breast milk or formula provides your baby all the nutrients that are needed for growth.
• Your baby isn't physically developed enough to eat solid food from a spoon.
• Feeding your baby solid food too early may lead to overfeeding and being overweight.

The American Academy of Pediatrics (AAP) recommends that all infants, children, and adolescents take in enough vitamin D through supplements, formula, or cow's milk to prevent complications from deficiency of this vitamin. In November 2008, the AAP updated its recommendations for daily intake of vitamin D for healthy infants, children, and adolescents. It is now recommended that the minimum intake of vitamin D for these groups should be 400 IU per day, beginning soon after birth. Your baby's health care provider can recommend the proper type and amount of vitamin D supplement for your baby.

Guide for formula feeding (0 to 5 months)

Feeding tips for your child

These are some things to consider when feeding your baby:

• When starting solid foods, give your baby one new food at a time — not mixtures (like cereal and fruit or meat dinners). Give the new food for 3 to 5 days before adding another new food. This way you can tell what foods your baby may be allergic to or can't tolerate.
• Begin with small amounts of new solid foods — a teaspoon at first and slowly increase to a tablespoon.
• Begin with dry infant rice cereal first, mixed as directed, followed by vegetables, fruits, and then meats.
• Don't use salt or sugar when making homemade infant foods. Canned foods may contain large amounts of salt and sugar and shouldn't be used for baby food. Always wash and peel fruits and vegetables and remove seeds or pits. Take special care with fruits and vegetables that come into contact with the ground. They may contain botulism spores that cause food poisoning.
• Infant cereals with iron should be given to your infant until your infant is age 18 months.
• Cow's milk shouldn't be added to the diet until your infant is age 1. Cow's milk doesn't provide the proper nutrients for your baby.
• The AAP recommends not giving fruit juices to infants younger than age 6 months. Only pasteurized, 100% fruit juices (without added sugar) may be given to older infants and children, and should be limited to 4 ounces a day. Dilute the juice with water and offer it in a cup with a meal.
• Feed all food with a spoon. Your baby needs to learn to eat from a spoon. Don't use an infant feeder. Only formula and water should go into the bottle.
• Avoid honey in any form for your child's first year, as it can cause infant botulism.
• Don't put your baby in bed with a bottle propped in his or her mouth. Propping a bottle has been linked to an increased risk of ear infections. Once your baby's teeth are present, propping the bottle can also cause tooth decay. There is also a risk of choking.
• Help your baby to give up the bottle by his or her first birthday.
• Avoid the "clean plate syndrome." Forcing your child to eat all the food on his or her plate even when he or she isn't hungry isn't a good habit. It teaches your child to eat just because the food is there, not because he or she is hungry. Expect a smaller and pickier appetite as the baby's growth rate slows around age 1.
• Infants and young children shouldn't eat hot dogs, nuts, seeds, round candies, popcorn, hard, raw fruits and vegetables, grapes, or peanut butter. These foods aren't safe and may cause your child to choke. Many health care providers suggest these foods be saved until after your child is age 3 or 4. Always watch a young child while he or she is eating. Insist that the child sit down to eat or drink.
• Healthy infants usually require little or no extra water, except in very hot weather. When solid food is first fed to your baby, extra water is often needed.
• Don't limit your baby's food choices to the ones you like. Offering a wide variety of foods early will pave the way for good eating habits later.
• Fat and cholesterol shouldn't be restricted in the diets of very young children, unless advised by your child's health care provider. Children need calories, fat, and cholesterol for the development of their brains and nervous systems, and for general growth.

Feeding guide for the first year (4 to 8 months)

Feeding guide for the first year (9 to 12 months)

Children are much more susceptible to tooth decay and gum disorders than grown-ups. This is because the gum and teeth in toddlers are very delicate. Moreover, children are more attracted to sweets and other food items, which cause damage to the teeth.

Here are several ways to protect the teeth of your little one:

1. Have a dental checkup: You should take your child to a dentist on his first birthday. Early prevention is important as any kind of problem in the teeth will be detected and this will save you from a lot of trouble in the future.
2. Teaching healthy habits: Brushing is very important and you should teach your child to brush regularly, more than once a day. Before the development of teeth in your baby, you should brush his gums gently by using water on a soft baby toothbrush or with a clean and soft cloth. After developing teeth, brushing must be practiced with delicate toothbrushes and fluoridated toothpaste. If several teeth touch against each other, you should use flossing. Brushing is essential before going to bed, and no food should be taken after brushing.
3. Prevent "baby bottle decay": You should not let your child go to sleep with a bottle of juice or milk. The sugar contained in these liquids sticks to the child's teeth, which activates bacteria and may lead to tooth decay.
4. Avoid giving juice to your child: Juice may be healthy for the body, but it leads to tooth decay in little kids. The amount of regular juice intake should never be above four ounces.
5. Avoid excess use of a sippy cup: Sippy cups enable children to shift from bottles to a glass. However, all day long usage of sippy cups should be restricted as it may cause decay on the front and back portions of teeth, when the drinks are rich in sugar.
6. Be careful about sweet medicines: Many medicines meant for children are sugary and stick to the teeth, increasing the chance of cavities. Several antibiotics cause overgrowth of Candida or yeast and cause an oral disease known as oral thrush. This disease causes creamy patches on the tongue. In case your child needs sweet medicines, brushing should be increased.
7. Stop using a pacifier by the age of 2 or 3: Pacifiers are good for children, but using pacifiers for a long period of time affects the lining of teeth. The shape of the mouth may also change. Hence, do not let your child use pacifiers after 2 or 3 years of age.

Children are quite prone to teeth disorders and decay in the teeth. Hence, measures must be taken to protect the teeth of children from any kind of disorder.

The primary or milk teeth begins to erupt at about 6 months of life with the complete set in place by 2.5 years of age, and the entire set is replaced by the age of 14. The benefits of some of the preventive dental measures are outlined below.

• Maternal care during pregnancy: The teeth begin to form during the second trimester of pregnancy. It is very important that the maternal diet includes sufficient amounts of calcium, potassium, and fluoride for optimal tooth mineralization. Good tooth structure has greater resistance to decay than hypomineralized teeth.
• Routine oral hygiene: For the first 6 months, though there are no teeth, after each nursing, end it with a spoonful or two of water to wash down the milk. Gradually, the gums can be just wiped with a gauze pad or soft cotton to remove any residual bacteria. The baby also gets used to this habit, and once the teeth are in, there are lesser bacteria for the decay process to begin. Once the teeth begin to erupt, the nursing habits also need to be modified to ensure the baby is not allowed to go to sleep with a bottle. This is a common practice to put the baby to sleep and should be avoided to reduce the occurrence of nursing bottle caries.
• Fluoride application: Fluoride has been shown to have significant benefits in preventing caries. Once routine dental visits begin, then the dentist will be able to tell if fluoride needs to be applied. This can happen either in the form of a gel or varnish that is applied in the dental office or as a paste that is used at home. This helps in building resistance to decay.
• Pit and fissure sealants: The tooth has a number of pits and fissures which are 8 times more vulnerable to decay than other surfaces. Deep pits are shown to harbor more bacteria and thereby greater incidence of caries. There are sealants which are thin resins that can be applied on the tooth, which can reduce bacteria accumulation and further decay.
• Space maintainers: In the event that a child has lost a tooth, either due to trauma or decay and subsequent infection, then a space maintainer should be placed within the next 3 months. This helps in maintaining the space and establishing a good bite during the transition phase and later, once the permanent teeth are in place.
• Orthodontic treatment: If there is malocclusion, then early intervention helps by reducing treatment time and getting better results as the teeth and periodontium are still very elastic and are more malleable to movement.

By doing these preventive measures early in life, the result is a child who has healthier teeth, less decay, less pain, and a happy smile all the time! If you wish to discuss about any specific problem, you can consult a dentist and ask a free question.

Causes, Symptoms, and Treatment for Bronchial Asthma

Women tend to develop high levels of blood sugar during their pregnancy (especially within the 24th and 28th weeks), irrespective of whether they already had suffered from diabetes prior to their pregnancy. However, gestational diabetes, if not taken proper care of, might escalate the risks of developing diabetes in the near future for both the mother and the child, accompanied by complications in pregnancy or labor. Gestational diabetes is usually characterized by mild symptoms such as excessive urge to urinate, excessive thirst, blurred vision and fatigue.

Causes:
Insulin, a hormone produced by the pancreas, allows for the utilization of the glucose for energy. The food consumed is broken down by the digestive tract of the body, converting carbohydrates into glucose before releasing it into the bloodstream. The glucose is then absorbed by the cells to be used as an energy source. Now, at the time of pregnancy, the placenta (organ nourishing the fetus) connecting the baby to the blood supply also produces various other hormones in high levels, for instance, estrogen and human placental lactogen. Most of these hinder the normal functioning of insulin in the cells, hence raising the blood sugar count. With subsequent growth of the baby, the placenta keeps on producing more amounts of such insulin resistant hormones to an extent that they are capable of meddling with the development of the baby.

Treatment:
1. Monitoring the blood sugar count at least four to five times a day and keeping it under control might help to ease the complication.
2. A healthy diet consisting of whole grains, vegetables and fruits in the right proportion and limiting sugar or other highly refined carbs meets the nutrition and fiber requirement of the body. Guard against additional weight gain during pregnancy as that hampers the entire process.
3. Exercise or regular physical activities help to normalize blood sugar level by boosting glucose absorption in the cells. Furthermore, exercises also enhance the sensitivity of the cells towards insulin. This means that only a little amount of insulin production by your body would be enough for the transportation of sugar.
4. Medication, If exercise and diet fall inadequate, insulin injections are often administered to control blood sugar count.
5. Keeping the baby under close observation with the help of repeated ultrasound and other tests to record its growth and development is an essential part of the treatment plan. If you wish to discuss about any specific problem, you can consult a gynaecologist.