Ask The Expert: Holistic Child Care
We look at various questions you have regarding your child's health. From vaccinations to sleep cycle, from food habits to skin allergies, our expert answers your queries.
By Dr Rajath Athreya
Q. My baby started eating solids from the age of 5.5 months. I don't give him any kind of sugar; just a bit of salt. Is this okay or should I avoid salt completely?
A. It is perfectly okay if you gradually move him to the family diet. So, salt, sugar, spice and hard textures are all fine to incorporate into your baby’s diet. However, keep in mind that the intake of salt should be at a minimum. Avoid using too much sugar. Apart from honey, considering your baby’s age, you need not ‘completely’ avoid any food.
Q. My daughter is ready to start consuming baby formula food a week from now. The doctor has recommended wheat-based baby formula food. However, for my friend's daughter, the same doctor advised a rice-based one. Please let me know if this has something to do with her weight?
A. Is your daughter okay with wheat-based baby food? If so, you may continue. A small proportion of babies are intolerant to wheat. Personally, I advise starting with either rice or ragi-based baby food for the first time. This is because if the initial experience is something that may not agree with a baby, making the transition to solids can become a bit troublesome.
Q. My daughter is four years old. Sometimes, she expresses her feelings in words like, "I am very angry," or "You hurt me." When angry, she does not cry but runs away and makes grunting/snorting noises. How do I know when she is really hurt or angry?
A. Looks like your four-year-old is very articulate and has found ways of telling you when she is upset either in words or by making some noises. Younger children often cry a lot as they cannot express their frustration in any other way. Anger, sadness, joy and disappointment, and many other emotions and feelings are all natural for kids. Encourage her to discuss with you why she is upset. When we are angry we all need some way to let our steam off. If it is not disruptive, let her do what she is doing.
Q. My son was in good health till the age of six months. However, after his vaccination, he suffered from high fever resulting in deteriorating mental health. We never had a family history of autism/mental issues. What could be the reason?
A. Initially, there were concerns about vaccination being related to autism. A lot of research has gone into this and now, we are certain it is not related to vaccinations. Most communication and language issues do not come to the fore before 6–9 months of age.
The good thing is that there are a lot of specialists and therapists in India who can assess and help children. Early intervention is important.
Was there an incident of high fever with very prolonged crying after vaccines in the first 2–3 months? Although this is also not related to autism directly, it is always advisable to get your son checked by a paediatric neurologist.
Q. My son is eight years old and consumes a lot of sugar in various foods. What could be the reason behind this?
A. Your son should enjoy all varieties of foods including the ones that are sweet and contain sugar, but in moderation. Do not force him but gradually try to make him change this habit of eating too much sugar.
Q. I feel my four-year-old niece is underweight. The problem is she eats every one hour but does not gain weight. Is this a bad sign?
A. Many parents feel their child is underweight. There is a range of weight and height for each age group, which is considered normal. Your paediatrician will plot your niece's growth on graphs and explain it to you. For a child of her age, there should be set meal timings. I would strongly advise not to offer anything in between, apart from water.
As grown-ups, we need to lead by example and make sure that as a family we eat healthy.
Q. Why does my six-year-old still wet the bed?
A. This is not an uncommon problem in children. About five per cent of children are still not able to control their urge to urinate at this age. However, there is no need to see a paediatrician for this problem. Only after a thorough examination will your doctor be able to reassure you and provide a solution.
Please look up this excellent resource. I used to refer it to parents when I was working in the UK. Most of this is relevant to us here in India too.
Q. I have a question regarding the pneumococcal conjugate vaccine, which is given after consulting the parent. We were told that it is not mandatory but is helpful. We are not sure how important this vaccine is and if my child will be missing something useful if she does not take it. Please advise.
A. I would advise that your daughter take the vaccination. It provides protection against dangerous forms of lung and brain infections, and even nasty throat and ear infections. It is being rolled out in a phased manner across the country in the Government's schedule. If still in doubt, discuss your concerns again with your doctor.
Q. My baby catches a cold almost every month. As a result, he suffers from a blocked nose and is unable to sleep properly. It goes away on its own and comes back every month. What could be the reason?
A. Cold in babies is common and nothing to be concerned about. Every year, we deal with about 8–10 cases, wherein babies catch a cold and suffer from mild fever, when they go to a daycare centre or a nursery.
A blocked nose and disturbed sleep may mean your baby will need assessing for adenoids or allergic rhinitis. It is best to consult your doctor regarding this.
Q. My seven-year-old niece suffers from skin allergies, especially on the elbows and near the lips. It usually starts with itching and the skin often turns black in colour. Please suggest what we should do.
A. This could be a case of eczema, which is a condition when the skin becomes dry and itchy in patches. Keep her skin moisturised and let her use soaps that are gentle on the skin. Remember, all this should be done in consultation with a paediatrician or a dermatologist.
Q. Is there any way to find out whether my son is normal or autistic during the first three months of birth? If we find out earlier, is there any step to help him?
A. As a new parent, it is natural to be concerned about your baby. Coming back to your question, the likelihood of autism running in the family is not very high. Take your son for regular vaccines and periodic checks with the paediatrician. Around the age of 16–18 months, we can use a screening questionnaire called M-CHAT, which is available online. If that throws up any concerns, we then do a full evaluation, so that we can start treatment early.
Dr Rajath Athreya is a Lead Neonatologist and Paediatrician at Rainbow Children’s Hospital, Bengaluru.
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Dr Rajath Athreya