Monsoons come with relief from the summer heat but also bring with them a risk of infections. Apart from the regular viral colds and coughs the risk of getting lung problems, wheezing, water, and mosquito-borne diseases increases. Through this update, we will identify symptoms of diseases that increase during monsoons and also will suggest measures to keep your child protected.

Viral Infections: Children have a higher risk of getting colds and coughs and in those with a history of asthma can have an attack of asthma. Contact your doctor if you have the following symptoms

• • Fever
  • Cold and cough
  • Breathlessness

Prevention:

• • Hand washing
  • Avoid contact with sick persons
  • Avoid crowded places
  • Good nutrition

Mosquito-borne diseases: Monsoon is the time when the breeding of mosquitoes increases due to the collection of water. Diseases like Malaria and Dengue are the most common mosquito borne diseases which become rampant during this season. These diseases if not treated timely can lead to serious consequences. Contact you, doctor, if you have the following symptoms

• • High-grade fever with or without chills
  • Red eyes
  • Severe body ache and weakness
  • Rashes
  • Bleeding from any site
  • Swelling on the body
  • Excessive drowsiness

Prevention:

• • Use of mosquito repellents both in the day and night
  • Prevention of breeding of mosquitoes by reducing stagnation of water
  • Informing your local Municipality in case of patients with Malaria/ Dengue
  • Fumigation

Water borne diseases: Infections like Diarrhea, Dysentery, Jaundice, and Typhoid increase during monsoons because of vectors like flies and contaminated food and water. It is best to avoid food and water from outside during monsoons. Vaccination against diseases like Typhoid and Jaundice is a definitive way to prevent these diseases. Contact your doctor if you have the following symptoms

• • High grade Fever
  • Frequent loose stools
  • Blood in stools
  • Very dark urine
  • Nausea and weakness

Prevention:

• • Food Hygiene
  • Hand Washing
  • Vaccination

Rat Borne Diseases: Diseases like Leptospirosis also increase during monsoons. It spreads due to presence of rat urine from an infected rat in stagnant rain water. Wading through water without protective clothing/ shoes especially if there are cuts and wounds on the skin predisposes a person to get Leptospirosis. Contact your doctor if you have the following symptoms

• • Fever
  • Red eyes
  • Vomiting and loss of appetite
  • Jaundice
  • Lethargy and swelling in the body
  • Headache and drowsiness

Prevention:

• • Avoiding walking through stagnant rain water
  • Rat control
  • Informing Mumbai Municipality if there is a case of Leptospirosis

A healthy newborn baby might look strange at first. Before being born, a baby is surrounded by liquid in the uterus but when the baby comes out it is covered in a thick white substance and bloody fluid. The baby is also in a curled-up position, because there’s not much space to move around. Your newborn might prefer to keep his or her arms and legs bent and close to the body, like they were when he or she was in the womb. The arms and legs should move equally on both sides of the body.

A healthy newborn’s skin is usually pink. But sometimes the skin can look slightly blue, especially in the hands, feet, and around the lips. That is normal. Your baby might have some bruises, red spots, or scratches on his or her skin after being born. This is nothing to worry about.

Head – A newborn’s head usually looks big compared to the rest of the body. Newborns have several “soft spots” on their heads where the bones have not yet grown together. Some babies are born bald, while others have hair. Often, the hair that a baby is born with will fall out within a month or so and be replaced by new hair.

Chest and belly – You might notice that your newborn has some swelling in the breast area. Sometimes the breasts might even leak a milky fluid. This is because of hormones from the mother’s body. This swelling or leaking usually goes away within a few days or weeks. Your newborn’s belly will probably be round and stick out a bit. After the umbilical cord is cut, a small stump will stay attached to your baby’s belly button……The stump will fall off on its own within a week or two.

Genitals – In both boys and girls, the genitals often look puffy or swollen after birth. If your baby is a girl, you might notice some discharge from the vagina. It is usually white in color but can sometimes be bloody. This is normal. It is caused by hormones in the mother’s body, and will go away on its own. In newborn boys, the foreskin (the skin covering the tip of the penis) is usually tight and should not be pulled back. This skin will be removed surgically if you choose to have your baby circumcised.

Cord care: aseptic care is routine in the clamping and cutting of the umbilical cord, additional topical care beyond dry-cord care is not needed. It requires medication if there is foul odor/ redness or swelling near the umbilicus.

• Other normal phenomena
• Stool frequency
• Hiccups
• Noisy breathing
• Sneezing/ occasional cough
• Crying
• Stretching
• No awareness of day/ night rhythm
• Frequent feeding in both day and night up to 5 months of age

Newborn screening

Hearing loss  — Universal screening for hearing loss is recommended to detect infants with hearing loss.

Metabolic and genetic disorders  — In addition, screening for disorders that are threatening to life or long-term health in asymptomatic newborns is recommended so that interventions can be initiated to prevent or reduce morbidity and mortality. Universal screening of newborns for congenitally acquired infections, metabolic disorders, and genetic disorders, including phenylketonuria, congenital hypothyroidism, galactosemia, toxoplasmosis, and hemoglobinopathies is recommended.

Feeding — Infants should be fed early and frequently to avoid low blood sugar. Breastfeeding is recommended because of its increased benefits for both the infant and mother compared to formula feeding, except when medically contraindicated, such as in infants with mothers with human immunodeficiency viral (HIV) infection or in some cases of maternal drug abuse or certain medications that the mother may be on.

• Breastfed infants should be fed as soon as possible after delivery, preferably in the delivery room. They should receive 8 to 12 feeds per day. Rooming-in, skin-to-skin contact, frequent demand feedings in the early postpartum period, and lactation support increase the rate of successful breastfeeding.
• Healthy infants who are fed formula should be offered standard 20 cal/oz iron containing formula. They are fed on demand, but the duration between feedings should not exceed four hours. The volume of feedings should be at least 0.5 to 1 oz per feed during the first few days of life.

Weight loss  — Weight loss is normal after delivery, particularly in the breastfed infant. However, weight loss beyond 7 percent requires medical attention and should be evaluated with a complete feeding assessment. Normal infants stop losing weight by five days of age and typically regain their birth weight by 10 to 14 days.

Infection control:

Minimal handling

• Hand washing
• Only gentle oil massage with coconut/olive oil
• No application of kajal/ other substances for massage/ oil instillation in nose/ ears etc.
• No other oral feeds (including water) except breastfeeds

Maternal Diet :

• Healthy nutritional food
• No restrictions
• Adequate calories
• Vitamin supplementation
• When to Consult Doctor
• Refusal of feed
• Fever (Recorded)
• Lethargy
• Excessive crying
• Cough/ breathlessness
• When in doubt

Children and Screen time

Children and TV often go hand in hand. Understand the effects of too much screen time — and how to enforce reasonable limits.

Are you concerned about how much time your child spends watching TV or movies, playing with a Smartphone or computer, or enjoying video games?

Although some screen time can be educational, it’s easy to go overboard. Consider this guide to children and TV, including what you can do to keep your child’s screen time in check.

The effects of too much screen time

The American Academy of Pediatrics discourages media use by children younger than age 2 and recommends limiting older children’s screen time to no more than one hour a day. Too much screen time has been linked to:

• Obesity. The more TV your child watches, the greater his or her risk is of becoming overweight. Having a TV in a child’s bedroom also increases this risk. Children can also develop an appetite for junk food promoted in TV ads, as well as overeat while watching TV.
• Irregular sleep. The more TV children watch, the more likely they are to have trouble falling asleep or to have an irregular sleep schedule. Sleep loss, in turn, can lead to fatigue and increased snacking.
• Behavioral problems. School students who spend more than two hours a day watching TV or using a computer are more likely to have emotional, social and attention problems. Exposure to video games is also linked with an increased risk of attention problems in children. Watching excessive amounts of TV at age 4 is linked with bullying at ages 6 through 11.
• Impaired academic performance. Elementary students who have TVs in their bedrooms tend to perform worse on tests than do those who don’t have TVs in their bedrooms.
• Violence. Too much exposure to violence through media — especially on TV — can desensitize children to violence. As a result, children might learn to accept violent behavior as a normal way to solve problems.
• Less time for play. Excessive screen time leaves less time for active, creative play.

How to limit screen time

Your child’s total screen time might be greater than you realized. Start monitoring it and talk to your child about the importance of sitting less and moving more. Also, explain screen time rules — and the consequences of breaking them. In the meantime, take simple steps to reduce screen time. For example:

• Eliminate background TV. If the TV is turned on — even if it’s just in the background — it’s likely to draw your child’s attention. If you’re not actively watching a show, turn off the TV.
• Keep TVs and computers out of the bedroom. Children who have TVs in their bedrooms watch more TV than children who don’t have TVs in their bedrooms. Monitor your child’s screen time and the websites he or she is visiting by keeping TVs and computers in a common area in your house.
• Don’t eat in front of the TV. Allowing your child to eat or snack in front of the TV increases screen time. The habit also encourages mindless munching, which can lead to weight gain.
• Set school day rules. During school week- Don’t let your child spend all of it in front of a screen. Also, avoid using screen time as a reward or punishment which makes screen time seem even more important to children.
• Talk to your child’s caregivers. Encourage other adults in your child’s life to limit your child’s screen time, too.
• Suggest other activities. Help your child find other things to do, such as reading, playing a sport, helping with cooking or trying a board game.
• Set an example. Be a role model reduce your own screen time.
• Unplug it. If screen time is becoming a source of tension in your family, unplug the TV, turn off the computer or put away the smart phones or video games for a while. You might designate one day a week or month as a screen-free day for the whole family. To prevent unauthorized TV viewing, put a lock on your TV’s electrical plug.

 

Become an active participant

When your child has screen time, make it as engaging as possible:

• Plan what your child views. Instead of flipping through channels, seek quality videos or programming. Consider using parental control settings on your TV and computers. Preview video games and smartphone applications before allowing your child to play with them.
• Watch with your child. Whenever possible, watch programs together — and talk about what you see, such as family values, violence or drug abuse. If you see a junk food ad, explain that just because it’s on TV doesn’t mean it’s good for you.
• Record programs and watch them later. This will allow you to fast-forward through commercials selling toys, junk food and other products. When watching live programs, use the mute button during commercials.
• Encourage active screen time. Have your child stretch or do yoga while watching a show. Challenge your family to see who can do the most jumping jacks during a commercial break. Choose video games that encourage physical activity.

It can be difficult to start limiting your child’s screen time. It’s worth the effort, however. By creating new household rules and steadily making small changes in your child’s routine, you can curb screen time and its effects.