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Dr. Nirmala

Pediatrician, Mumbai

Dr. Nirmala Pediatrician, Mumbai
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Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; a......more
Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; as a health provider being ethical is not just a remembered value, but a strongly observed one.
More about Dr. Nirmala
Dr. Nirmala is a trusted Pediatrician in Mumbai, Mumbai. She is currently associated with Savant Clinic in Mumbai, Mumbai. You can book an instant appointment online with Dr. Nirmala on Lybrate.com.

Lybrate.com has a number of highly qualified Pediatricians in India. You will find Pediatricians with more than 39 years of experience on Lybrate.com. You can find Pediatricians online in Mumbai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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My son is 7 months old and he is diagnosed for retinoblastoma it is in advanced stage doctor said he has to undergo for chemotherapy one cycle of chemo is already done can you pls suggest me the best doctor to cure this. I am from bangalore.

FELLOWSHIP IN PCCM, FELLOW-PEDIATRIC FLEXIBLE BRONCHOSCOPY, FELLOWSHIP IN PEDIATRIC CARDIAC CRITICAL CARE, D.C.H., M.B.B.S
Pediatrician, Ahmedabad
My son is 7 months old and he is diagnosed for retinoblastoma it is in advanced stage doctor said he has to undergo f...
Meet Dr. Chetan in people tree hospital he would guide you better. Yes chemo shall be started. As far as I know. Retinoblastoma has good results.
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My baby boy is just 10 months old. We had medically examined him and found that his hemoglobin is just 5.4. He is very much dependent on mother feed but we always try our best to feed him with other than mother feed. We use Cerelac, also nanpro as supplements. Please advice.

MBBS, Diploma in Child Health (DCH), DNB (Pediatrics), FACEE PEDIATRICS
Pediatrician, Allahabad
My baby boy is just 10 months old. We had medically examined him and found that his hemoglobin is just 5.4. He is ver...
Since ypur baby is more than 6 month of age. He should be given complemenatery feed (like dal, rice massed potato, chapati massed in dal, egg, suji ka halwa, sabudana, kheer, massed fruits, boil fruits, chiken puree, etc) you have to start one food at one time and continue for three or four day ask aboserve that baby like or reject the food. If he like continue this food nd start other one. Sine mother milk has lees iron. And baby is anemic also (hemoglobin is 5.4) I would also advice to test for cause of anemia .and treatment of low hemoglobin.
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My son 2 years old he have prob in worm in motion area. He said always biting that worm. 2 months back I gave bandy suspension. Now what I do? He is crying fully night for that. Kindly answer and help soon urgent! Pls.

MBBS, MD - Paediatrics
Pediatrician, Pune
My son 2 years old he have prob in worm in motion area. He said always biting that worm. 2 months back I gave bandy s...
Worms is generally a family problem though all will not show symptoms. So all family members should be treated at the same time with bandy. Also look for any other source for repeated infection. Keep nails cut properly. Eat only home food as it's more hygienic that any outside food. Wash hands properly before eating. See area around motion area for redness. Treat constipation if any.
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We have a 7 days old daughter but my wife unable to produce her breast milk and my daughter is not able to feed her breast milk please suggest with remedy.

DGO, MD, MRCOG, CCST, Accredation in Colposcopy
Gynaecologist, Kolkata
You can try lactare tablets - 2 tablet once daily and see if it helps. Best is to keep trying by putting the baby to the breast and expressing the milk that comes out. It should gradually increase.
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Pneumonia - 5 Ways You Can Prevent Yourself Against it

C.S.C, D.C.H, M.B.B.S
General Physician,
Pneumonia - 5 Ways You Can Prevent Yourself Against it

Are you aware of the number of people who suffer because of pneumonia? As the weather becomes cold and damp, chances of getting affected by pneumonia increases. Pneumonia can originate from virus, bacteria and a host of other factors. It is one of the most common ailment which affects the adults, all over the world. Hence, it is important for all of us to prevent  ourselves from pneumonia and for that we can follow the below mentioned steps:

  1. Know about the symptoms of pneumonia first: It is difficult to detect or diagnose pneumonia, especially in people over the age of 65. In older patients, the common symptoms such as fever, chills, cough may not be experienced. You should watch out for non-respiratory symptoms like weakness, dizziness, delirium and confusion. It is even more difficult to diagnose pneumonia in people who are suffering from preexisting conditions.
  2. Practice good hygiene: Common respiratory infections, influenza and cold may cause pneumonia. You should follow hygienic habits. Wash your hands regularly before meals and use hand sanitizers in order to prevent the illness from spreading. You should also maintain proper oral hygiene as several oral infections may also lead to pneumonia. You should also keep away from people who are affected by pneumonia or any other illness like flu, cold and serious diseases such as measles or chicken pox. All these factors may cause pneumonia.
  3. Get vaccinated: It is recommended for people of all ages who may be at a risk of getting pneumonia to get vaccinated and immunised against pneumonia causing virus called pneumococcal pneumonia. This is a one-time vaccine, which prevents and reduces the severity of pneumonia. A booster vaccine after every five years may also be prescribed. Elderly people should be vaccinated against all diseases which cause pneumonia.
  4. Quit smoking: Smoking accounts for being a major cause or risk factor for pneumonia. It increases a person’s chance of getting pneumonia as the lungs’ ability to defend themselves from the infection is reduced. By quitting smoking, you will be able to prevent pneumonia.
  5. Maintain a good general health: Maintaining an overall good health and following healthy habits will help you in preventing pneumonia. This is because your immune system stays strong and is able to fight efficiently against pneumonia-causing infections. A proper diet with all essential nutrients is also recommended along with regular physical exercise and proper rest.

Severe cases of pneumonia are capable of making you suffer and you may be admitted to a hospital. According to studies, it has been estimated that more than 60% of people over the age of 65 need to be hospitalised because of pneumonia.

3559 people found this helpful

Benefits of Endoscopic Surgery

MBBS, DGO, DNB
Gynaecologist, Delhi
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Benefits of Endoscopic Surgery
I’m Dr. Aparna Jain, Senior Consultant Obstetrics and Gynaecologist.
We are going to discuss about Endoscopic surgery or Laparoscopic surgery in gynaecology. It is basically a pinhole surgery in which doctors don’t open the abdomen. We just put two or three small scar at the abdomen, pet par do ya teen chote scar lagate hain jiske through we can do surgeries.

Various surgeries can be performed laparoscopically or endoscopically like removal of uterus, removal of fibroids from the uterus, removal of ovarian cyst, or ovary me jo gaanth hai uske removal ke lie kar sakte hain, or removal of cyst, any type of cyst like familial cyst or atopic pregnancy i.e, pregnancy inside the fallopian tube. It is outside the uterus and it a is very life threatening condition in which we can do laparoscopic surgery and take out the embryo.

Another issue which can be solved through laparoscopy is the case of infertility. Suppose Somebody, Who is not able to conceive. If there is some problem in the fallopian tube which can be opened by Laparoscope. Endometriosis is another very important problem which leads to infertility which can be corrected laparoscopically.

These are the various conditions which can be dealt with laparoscopy without opening the abdomen. What is the advantage? Why is laparoscopic surgery better rather than opening abdomen?
It is very very important to know about it because logo ke dimag me yeh myth hota hai ki abdomen open karenge toh complete surgery hogi aur laparoscopically agar surgery karenge to wo complete nahi hoga but it is not like that. If we are doing laparoscopic surgery we are having ten times magnification in comparison to a normal eye so it will give better vision, better insight to the disease which we will be able to handle better and the scope of recovery in laparoscopic surgery is much faster than open surgery.

There is not a single large scar on the abdomen. There are multiple, two, three or sometime four scar which is 1 cm or 0.5 cm scar at the abdomen which heal so well that post of pain is very very little after laparoscopic surgery. One is very early, one can ambulate very fast after laparoscopic surgery in comparison to open surgeries and post of addition formation. Sometime, after doing a surgery one landed up in another surgery then, after open surgery there is lot of addition formation inside so second surgery become very difficult but in laparoscopic surgery addition formation is very little so the second surgery becomes easier if somebody has laparoscopic surgery initially. Cosmetically, it is also very good because scars are very less, very little. It is almost an invisible scar in comparison to open surgery.

If you want to consult further, want to know more about laparoscopic surgery or you have any problem, for that you want to consult, you can consult us on Lybrate website.

 

3206 people found this helpful

My daughter 3.5 years old by mistake had diabetic (glyco mat) tablet, within a seconds we take out from her mouth, what is the short run side-effect, what is long run-effect?

Diploma in Child Health (DCH), F.I.A.M.S. (Pediatrics)
Pediatrician, Muzaffarnagar
As you have taken out within seconds, it was not absorbed so no need to worry. Precautionary you may give sugar for 2 to 3 times. There should not be any long or short side effects.
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Doctor, my son have 6 months, since 1 week I started to give wheat at 9 am, now he started to cry in the eve also for food, Bt I have enough milk he refused to drink just before his sleep, he only drink after 1 nap, what should I do now? Shall I give food two times a day? I'm confused. Pls. Reply me.

MD - Paediatrics, MBBS
Pediatrician, Jaipur
Doctor, my son have 6 months, since 1 week I started to give wheat at 9 am, now he started to cry in the eve also for...
You should encourage weaning with liquids-semisolid-solids with increasing age. In the meantime continue breast feeding as long as possible.
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My baby girl is 4 months old. From past 4 days she is having fever of 100 degree. Though she was urinating in every 1-2 hours but she was urinating very less. So we consulted a doctor and he prescribed medicines such as Pro wel, apex-p and ofloaxin since she was passing out green stools from past few days. We also undergo a urine test and it is found to be normal. What my concern is from past few days she is drinking very less breast milk. She sucks for only 30 secs to one minute and then she refuses to take it even after burping. She screams when she looks at my breast I tried feeding her through spoon and she is ok with it but not with sucking Can you please help since manual extraction of milk is a time consuming and difficult process.

MD - Paediatrics
Pediatrician, Kolkata
Breast milk production and secretion is mostly depend on overall wellbeing and mental status of mother. First of all you need to relax and try to take adequate rest. Do any relaxation technology which is suitable for you. Drink plenty of water and take half to one glass of water 15 minutes before feeding. As your baby is sick and passing loose stool she might be thirsty but easily fatigued. So she needs frequent feeding.
1 person found this helpful
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My son is 3 yrs and 3 months old and he is having bronchopneumonia from last year nov. And doctor treatment is going on doctor is giving antibiotics from last 3 months but it is not getting complete cure every month aft. Stopping medicines please ans antibiotics same problem is coming like fever cold and cough what to do I am very scared about My son health. Please suggest me

MD - Paediatrics, MBBS
Pediatrician, Bangalore
If your child is getting pneumonia very regularly he may be having reduced immunity. He may be having a heart problem, which predisposes to recurrent pneumonia. Please get suitable blood test, x ray and echo test done with consultation with your local pediatrician.
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Dear Doctor, My daughter does not like to eat anything. I have tried baby foods, I have tried home made foods like rice with dal and vegetables etc. But she hates em all. What should I do? We are little worried, though she is enough spontaneous to play and make fun. Should we try Gripe Water or Gripe Mixture? Sometimes her mother forces her to eat and she cries by the time of eating. What should we do? Please Help.

M.D.( Pediatrics), DCH
Pediatrician,
Dear Doctor,
My daughter does not like to eat anything. I have tried baby foods, I have tried home made foods like ri...
Parents must understand that, every child has mind of it's own. Forcing to eat against their wish is not going to work. It will create some rebellious behavior. Instead eat family meals together and share happy moments. During meals offer her all you want, but let her decide what to eat. And after some days you will see the results. Check your expectations, if they are hyper..
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My 3 year old son is sick with a temperature of about 100 degree, he can not keep anything down including liquid s. What should I do? Please help!

BHMS
Homeopath, Thane
My 3 year old son is sick with a temperature of about 100 degree, he can not keep anything down including liquid s. W...
HI, For fever 100degree and above first do sponging with lukewarm water 2-3times. Give him semisolid food very much smashed and free flowing. it should not be too spicy and oily. Give him Tab Biochemic 11(SBL) 4tabs to be chewed thrice a day or mix 4tabs in 2tablespoon water and give for 15 days
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On 22nd July my son (4 years old) had 101 fevers at night. I consulted homeopathic doctor (with whom I have consulted earlier and found effective in my son’s treatment of cold & cough). While the temperature reduced, my son started coughing. Homeopathic doctor gave him medicines for cough that I continued administering my son for next 2 days. However, I noticed that the cough increased, even though I also kept doing some home made things (like ginger honey paste, tulsi extract) to help reduce the cough fast. Since the cough increased in next 2 days, I assumed the homeopathic medicine is not effective in curing cough though it cured the fever .I therefore, started giving S-mucolite 3 times 3.5 ml (this was prescribed by our allopathic doctor 5 months back when he had chest cold). As expected, I could see significant improvement in frequency and sound of his cough with each passing day. In next 4 days my son’s coughing reduced to bare minimum though he is still coughing with a heavy cough sound and still has minor cold. I wanted to know whether I should continue only with S –mucolite for 3 more days (full course is of 7 days as last prescribed by the doctor during same type of cough). Should I also add a decongestant like Alex junior as prescribed earlier for regular cough? Or with passage of time the cough will subside and there is no need to start any other medicine. Please provide your suggestions?

FELLOWSHIP IN PCCM, FELLOW-PEDIATRIC FLEXIBLE BRONCHOSCOPY, FELLOWSHIP IN PEDIATRIC CARDIAC CRITICAL CARE, D.C.H., M.B.B.S
Pediatrician, Ahmedabad
Pls continue s. Mucolyte. And beware it is not safe to change or alter or add medication by you. It's registered medical practising doctor shall do so that too after seeing the child. Follow up is must after 3-5 days for such issues.
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My son is 9 year old, he has habit of bed wetting. I am worried. What should i do?

MD - Alternate Medicine, DNHE, BHMS
Homeopath, Ahmedabad
Avoid giving him water 2 hours before bed time. Instruct him to hold urination process for 2 to 3 seconds, even if he has to pass it. This exercise during day time will increase sphincter control in him. If things are not working homeopathic treatment will work marvelously.
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my nephew is suffering from himophilea-b and he is very weak he can't eat proper food. So give me advise abut us. How can cure this problem. Give me some home tips. And give dite chart or name the food which is help full for him.

Pediatrician, Pune
Hemophilia b, cause fie to deficiency of clotting factor 9, causes problems with spontaneous internal bleeding, mainly in the joints, required to be given regular factor 9 transfusions so as to maintain their levels in the body, avoid traumatic activities to prevent internal bleeding, be under supervision and treatment of a hematologist, problem cannot be cured bit its effects can be prevented.
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Attention-Deficit / Hyperactivity Disorder (ADHD) in Children

MBBS, Diploma in Child Health
Pediatrician, Hyderabad
Attention-Deficit / Hyperactivity Disorder (ADHD) in Children

What is ADHD?

ADHD, also called attention-deficit disorder, is a behavior disorder, usually first diagnosed in childhood, that is characterized by inattention, impulsivity, and, in some cases, hyperactivity. These symptoms usually occur together; however, one may occur without the other(s).

The symptoms of hyperactivity, when present, are almost always apparent by the age of 7 and may be present in very young preschoolers. Inattention or attention-deficit may not be evident until a child faces the expectations of elementary school.

What are the different types of ADHD?

Three major types of ADHD include the following:

  • ADHD, combined type. This, the most common type of ADHD, is characterized by impulsive and hyperactive behaviors as well as inattention and distractibility.

  • ADHD, impulsive/hyperactive type. This, the least common type of ADHD, is characterized by impulsive and hyperactive behaviors without inattention and distractibility.

  • ADHD, inattentive and distractible type. This type of ADHD is characterized predominately by inattention and distractibility without hyperactivity.

What causes attention-deficit/hyperactivity disorder?

ADHD is one of the most researched areas in child and adolescent mental health. However, the precise cause of the disorder is still unknown. Available evidence suggests that ADHD is genetic. It is a brain-based biological disorder. Low levels of dopamine (a brain chemical), which is a neurotransmitter (a type of brain chemical), are found in children with ADHD. Brain imaging studies using PET scanners (positron emission tomography; a form of brain imaging that makes it possible to observe the human brain at work) show that brain metabolism in children with ADHD is lower in the areas of the brain that control attention, social judgment, and movement.

Who is affected by attention-deficit/hyperactivity disorder?

Estimates suggest that about 4% to 12% of children have ADHD. Boys are 2 to 3 times more likely to have ADHD of the hyperactive or combined type than girls.

Many parents of children with ADHD experienced symptoms of ADHD when they were younger. ADHD is commonly found in brothers and sisters within the same family. Most families seek help when their child's symptoms begin to interfere with learning and adjustment to the expectations of school and age-appropriate activities.

What are the symptoms of attention-deficit/hyperactivity disorder?

The following are the most common symptoms of ADHD. However, each child may experience symptoms differently. The 3 categories of symptoms of ADHD include the following:

  • Inattention:

    • Short attention span for age (difficulty sustaining attention)

    • Difficulty listening to others

    • Difficulty attending to details

    • Easily distracted

    • Forgetfulness

    • Poor organizational skills for age

    • Poor study skills for age

  • Impulsivity:

    • Often interrupts others

    • Has difficulty waiting for his or her turn in school and/or social games

    • Tends to blurt out answers instead of waiting to be called upon

    • Takes frequent risks, and often without thinking before acting

  • Hyperactivity:

    • Seems to be in constant motion; runs or climbs, at times with no apparent goal except motion

    • Has difficulty remaining in his/her seat even when it is expected

    • Fidgets with hands or squirms when in his or her seat; fidgeting excessively

    • Talks excessively

    • Has difficulty engaging in quiet activities

    • Loses or forgets things repeatedly and often

    • Inability to stay on task; shifts from one task to another without bringing any to completion

The symptoms of ADHD may resemble other medical conditions or behavior problems. Keep in mind that many of these symptoms may occur in children and teens who do not have ADHD. A key element in diagnosis is that the symptoms must significantly impair adaptive functioning in both home and school environments. Always consult your child's doctor for a diagnosis.

How is attention-deficit/hyperactivity disorder diagnosed?

ADHD is the most commonly diagnosed behavior disorder of childhood. A pediatrician, child psychiatrist, or a qualified mental health professional usually identifies ADHD in children. A detailed history of the child's behavior from parents and teachers, observations of the child's behavior, and psychoeducational testing contribute to making the diagnosis of ADHD. Because ADHD is a group of symptoms, diagnosis depends on evaluating results from several different sources, including physical, neurological, and psychological testing. Certain tests may be used to rule out other conditions, and some may be used to test intelligence and certain skill sets. Consult your child's doctor for more information.

Treatment for attention-deficit/hyperactivity disorder

Specific treatment for attention-deficit/hyperactivity disorder will be determined by your child's doctor based on:

  • Your child's age, overall health, and medical history

  • Extent of your child's symptoms

  • Your child's tolerance for specific medications or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

Major components of treatment for children with ADHD include parental support and education in behavioral training, appropriate school placement, and medication. Treatment with a psychostimulant is highly effective in most children with ADHD.

Treatment may include:

  • Psychostimulant medications. These medications are used for their ability to balance chemicals in the brain that prohibit the child from maintaining attention and controlling impulses. They help "stimulate" or help the brain to focus and may be used to reduce the major characteristics of ADHD.
    Medications that are commonly used to treat ADHD include the following:

    • Methylphenidate (Ritalin, Metadate, Concerta, Methylin)

    • Dextroamphetamine (Dexedrine, Dextrostat)

    • A mixture of amphetamine salts (Adderall)

    • Atomoxetine (Strattera). A nonstimulant SNRI (selective serotonin norepinephrine reuptake inhibitor) medication with benefits for related mood symptoms. 

    • Lisdexamfetamine (Vyvanse)

    Psychostimulants have been used to treat childhood behavior disorders since the 1930s and have been widely studied. Traditional immediate release stimulants take effect in the body quickly, work for 1 to 4 hours, and then are eliminated from the body. Many long-acting stimulant medications are also available, lasting 8 to 9 hours, and requiring 1 daily dosing. Doses of stimulant medications need to be timed to match the child's school schedule to help the child pay attention for a longer period of time and improve classroom performance. The common side effects of stimulants may include, but are not limited to, the following:

    • Insomnia

    • Decreased appetite

    • Stomach aches

    • Headaches

    • Jitteriness

    • Rebound activation (when the effect of the stimulant wears off, hyperactive and impulsive behaviors may increase for a short period of time)

    Most side effects of stimulant use are mild, decrease with regular use, and respond to dose changes. Always discuss potential side effects with your child's doctor.

    Antidepressant medications may also be administered for children and adolescents with ADHD to help improve attention while decreasing aggression, anxiety, and/or depression.

  • Psychosocial treatments. Parenting children with ADHD may be difficult and can present challenges that create stress within the family. Classes in behavior management skills for parents can help reduce stress for all family members. Training in behavior management skills for parents usually occurs in a group setting which encourages parent-to-parent support. Behavior management skills may include the following:

    • Point systems

    • Contingent attention (responding to the child with positive attention when desired behaviors occur; withholding attention when undesired behaviors occur)

    Teachers may also be taught behavior management skills to use in the classroom setting. Training for teachers usually includes use of daily behavior reports that communicate in-school behaviors to parents.

    Behavior management techniques tend to improve targeted behaviors (such as completing school work or keeping the child's hands to himself or herself), but are not usually helpful in reducing overall inattention, hyperactivity, or impulsivity.

Prevention of attention-deficit/hyperactivity disorder

Preventive measures to reduce the incidence of ADHD in children are not known at this time. However, early detection and intervention can reduce the severity of symptoms, decrease the interference of behavioral symptoms on school functioning, enhance the child's normal growth and development, and improve the quality of life experienced by children or adolescents with ADHD.

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My son is14 years old and still he has problem of bed wetting what should I do for him.

MD - Homeopathy
Pediatrician, Mumbai
You can start with first restriction of any liquid intake 2hrs before bed time. He has to be trained daily by telling him to get up at night as the alarm rings. This will train his brain as alarm techniques really work very well to control bed wetting and can also start with bladder exercises to tone the bladder muscles.
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My son is 1 and 1/2 months old. He is suffering from cold and cough. Doctor has told there is no cough in chest and provided with nasoclear one drop in each nostril. He is very irritated and coughing as if vomiting. Also whatever I breastfeed he vomit out. Later doctor given ambrodil drips 3 drops twice a day along with moxclav drops 3 drops twice a day. Is this safe . Can I give it to 6 week baby. Please suggest.

Diploma in Child Health (DCH), F.I.A.M.S. (Pediatrics)
Pediatrician, Muzaffarnagar
My son is 1 and 1/2 months old. He is suffering from cold and cough. Doctor has told there is no cough in chest and p...
I suppose baby is not having fever and taking feed well and if weight is about 3.75 to 4.0 kg, you need not to worry. There is no need of either ambrodil or antibiotic which are of no use. Vomiting after feed is usually regurgitaion. Burping and right posture is solution. Saline nasal drop is safe and may be effective.
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Please guide me regarding vaccination for my daughter she is 15 month old every doctor has there own chart I am. Confused which chart to follow. Last vaccination I have done chickenpox, hepatitis A, MMR 1 dose.

Diploma in Child Health (DCH), MBBS
Pediatrician, Hyderabad
Please guide me regarding vaccination for my daughter she is 15 month old every doctor has there own chart I am. Conf...
Ask and follow the latest iap (indian academy if paediatrics) immunization chart schedule. So far you are following the schedule accordingly only.
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