Dr. Mahesh Balsekar, Senior Consultant in Paediatric Medicine at Narayana Health SRCC Children's Hospital, Mumbai, ...

dr-mahesh-balsekar-answers-questions-about-your-child39s-health

Dr  Mahesh Balsekar answers questions about your child&#39;s health

I'm Dr Mahesh balar I'm a consultant pediatrician at srcc Children's Hospital managed by narana Health I'll be happy to take your questions today the questions will appear on the screen and I'll be happy to answer them sugar is responsible for most of the lifestyle diseases and obesity and it's very important that we restrict the intake of sugar in children young infants don't need sugar if you need to introduce sweet substances it's best to use natural sugars like figs or grunes or dates children sometimes develop a preference for sweet substances if you introduce sugars in early life so it's best to delay as much as possible and in older children it is 3 g of sugar this does not mean that we should give this much sugar this is the maximum permissible amount the L less are the better and no sugar is the best if you need to sweeten Foods it's best to use natural substances like figs and prunes and dates sugar substitutes are not recommended Jager is healthier than sugar but not recommended honey is not recommended till one year of age a date Sugar and palm sugar may be slightly better than normal sugar but they also cause the same consequences and must be limited in their intake screens as you know if used correctly in moderation has positive consequences if you use it for communication for education for problem solving for entertainment it's not a bad thing but excess screen time and inappropriate content has extremely harmful consequences at all ages particularly in children there are Official Guidelines from the Indian Academy of Pediatrics which says that under 18 months of age screen time may be permitted only for Facetime with family members between 18 to 24 months of age screen time may be used but only for high quality educational programs what this means in practice is that the parent should sit with the child and use the screen as a tool to converse and educate using the screen as a babysitter is harmful if the mother is busy elsewhere and the child is osed with the screen it does no good for the child it's important to note that children seem quite mesmerized with the screen but they are not able to absorb the content from screen it's equally important that parents should educate their children to sleep adequately be active socialize and most important read books preventive checkups for children are extremely important and there is something called Health supervision of children that means we have a existing protocol by which children are monitored most infants are monitored for their health during their vaccination visit so they normally come every 6 weeks between birth and 6 months then at 6 months 9 months 1 year 15 months 18 months and two years and annual thereafter Health supervision also includes guidance on nutrition on development on lifestyle accident prevention it also includes references for a dental check and uh Vision check so health screening in children is extremely important to prevent and promote good health our body has healthy bacteria what is called the microbiome so the probiotics try to restore the healthy bacteria and improve health so while probiotics are extremely important for health there is no evidence that routine administration of prob biotics to otherwise healthy children is beneficial in any way many of the drinks which are available with probiotics have more sugar and low Pro probiotics and they're not recommended in children worms are very important and common in tropical countries so we routinely start deworming children after the age of 2 years and we administer it once a year once they are older and hand washing and hygiene is Tau after the age of 6 or seven then the need goes down any child with abdominal symptoms whatever they are are routinely deformed a pink eye basically means there is a inflammation of the conent diver and there are many reasons for this it may be simple allergies like exposure to dust or smoking or pollution it can also be because of infection so conjuntivitis can lead to pink eye and exudation less commonly a pink eye can be because of major illnesses like corneal diseases or other problems to boost a child's immunity naturally we need to have a healthy lifestyle and this includes a proper balanced diet it means the child should be physically active the child should get adequate sleep and sometimes if the child is vulnerable a routine multivitamin with all the micronutrients may be offered to the child flu is an extremely common infection more common during the monsoon to prevent it the most important thing is that parents should not send their child to school when the child is unwell this is our infection splits children should also be taught respiratory hygiene which means that when a child is coughing or sneezing the child should cough in the elbow and not in the hands which can contaminate surfaces and other children under under the age of 5 years all children are offered the flu vaccine which prevents influenza older children who have underlying asthma heart diseases or chronic illnesses are also offered the influenza vaccine annually a healthy diet in a child is extremely crucial and for a balanced diet we follow what is called the plate method of eating it means that imagine your 24-hour intake and divide it into a plate with four quad 25% should be fruit 25% should be vegetables 25% should be protein and 25% should be grain in the Indian diet for example we have at least 50% of grain intake so in Practical terms we should reduce our intake of carbohydrates and Grain and increase our intake of fruit vegetables and protein it's very healthy to include two cups of milk in a child for growing children it's also important to include nuts because they have essential fatty acids and Omega acids so including dry fruit is important it's very important also to encourage sufficient intake of water and at least six glasses of water is important for older children the entire world is sleep deprived and it's extremely important that children get adequate sleep a sleep is important for their growth important for their immunity and important for their academic success in life and important for their mental health newborns till the age of 3 months normally sleep about 14 to 17 hours between 3 months and 1 year they sleep roughly 12 to 15 hours in a day between 1 to 2 12 to 14 hours in children between 6 years and 12 years they need at least 10 hours of sleep in a day the pattern of sleep changes with age most children need about three laps in the day in yearly infancy by 9 months they drop it to approximately two naps in a day and usually by 15 months they make it one nap a day most children drop their afternoon nap somewhere around the age of 3 years it's very important to encourage sleep hygiene in a child so that they get a good night sleep and this means that the child should be physically active there should be a gap between dinner and bedtime there should be no overstimulating activity in the late even evenings which may impair sleep which means that television and Screen should be minimized for at least 1 1 and a half hours before bedtime and some calming effects or cooling down behaviors are important which may include music or sleep or dim lights or conversation with parents so sleeping early is extremely important for the well-being of a child constipation means the stool has to be either hard large or or infrequent If the child passes the stool every 2 days but it is soft painless comfortable and the child is otherwise well we might leave it alone but in general we should encourage regular bar movements and for this we have to reduce our intake of biscuits breads cheese you'll be surprised to know that milk is one of the most constipating foods so the child is drinking a lot of milk that is more than two cups at one year of age that needs to be reduced and fiber needs to be increased which mean that infant should be offered more fruit and more vegetables and dry fruit like figs prunes and Tes with this most children settle down if the child is uncomfortable or passes painful stool then medication may be required a child who is having a balanced diet does not need any medication or special effort to improve digestion digestive enzymes are not required any child who has sufficient amount of fruit and vegetables in the diet and adequate water will usually have no digestive problems most of these rubs which are used have Menthol and CER in general they are very marginally beneficial and there are many safer options many of them also have side effects mainly when you take it orally but also when you apply to the skin particularly in infants because there are safer effective options generally these kind of medications are not encouraged in children processed foods comes under the category of fast foods which means all of them have excess salt it has excess sugar and they're generally considered not a part of the daily routine but they are a part of life and most children enjoy them so processed food should be kept as minimum as possible and usually we encourage such consumption mainly on occasions and on weekends so that most of the diet during the week is a healthier more balanced diet attention deficit hyperactivity disorder is a common condition more common in boys and girls it has three characteristics they have motor hyperactivity they're very fidgety the mind is restless and they unable to focus and sometime they have impulsive behavior most of these children do well with behavior therapy in severe cases you might need occupational therapy medication is rarely required teachers are normally advised that these children should be kept in the front row so that there is some eye contact with the child and the distraction for the children is less parent education and behavior modification Works in most of the cases young children are normally encouraged free play and there is is no strict routine which is advised in older children and adolescents the guideline is that they should have at least one hour of vigorous moderate to vigorous physical activity some of it may be aerobic like running and some of it may be muscle building like exercises but physical activity for 1 hour a day is extremely important I hope you have found this session useful if you have any further questions or clarifications please reach out to your pediatrician or family doctor thank you and take care

Dr.

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