Ask The Expert: Holistic Child Care

In this edition, 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

Ask The Expert: Holistic Child Care

Q. I started solids for my baby since he turned 5.5 months since he showed signs of readiness. I don't give him any kind of sugar. I add a little salt to his food. Is it ok to add a little salt to his food or should I avoid it 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 and avoid using too much of sugar. Apart from honey, considering your baby’s age, you need not ‘completely’ avoid any food.

Q. My daughter is ready to start consuming Cerelac a week from now. The doctor has recommended Cerelac wheat. However, for my friend's daughter, the same doctor advised Cerelac rice. 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 turning 4 years this month end. Sometimes, she expresses her feelings in words like "I am very angry' ‘you hurt me’ etc. However, she cries very less and doesn't express herself by crying. Sometimes, when she is angry, instead of expressing herself she runs away and makes grunting/snorting noises. How do I decide 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 more why she is upset. What would make it better?

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 6 months. However, after his vaccination, he suffered from an instance of 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 opinion 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 8-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 ones that are sweet and contain sugar but in moderation. Do not try to 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 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 normal. Your paediatrician will plot her growth on graphs and explain it to you. Children of her age should have set meal timings. Usually three + one snack time. 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 as a family we eat healthily and sensibly.

Q. Why does my six-year-old still wet the bed?

A. This is not an uncommon problem in children. About 5 per cent of children is 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 parents to this 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 vaccine 'Pneumoccal Conjugate' which is given after consulting the parent. We were told that it is not mandatory but very helpful. We are not sure how important this vaccine is and if we skip using this, will my child be missing something very useful?

A. I would advise you to have it done. It provides protection against dangerous forms of lung and brain infections and even nasty throat and ear infections too. 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 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 when babies catch cold and suffer from mild fever as well if they attend a daycare or a nursery.

A blocked nose and a 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 on the skin and often turns black in colour. Please suggest what needs to be done?

A. This could be a case of eczema, which is a condition when the skin becomes dry and itchy in patches. It could have a specific basis for allergy or it could just be a general sensitivity. Your niece requires a good and regular moisturising of the skin and sparing use of soaps that are gentle on the skin. Remember, all this should be done in consultation with a paediatrician or a dermatologist.

Q. My little one is almost 10 months old. He still does not have a set sleep pattern and is unable to sleep properly at night. What could be the reason? When will he be able to have a proper sleep cycle?

A. First, please remember that each baby is different from the other. A few useful tips on sleep hygiene at this age is:

  1. Avoid daytime naps.
  2. Avoid too much activity prior to sleep. A quiet hour before the baby sleeps is ideal.
  3. Avoid offering food to the baby if she wakes up during the night. Try to give some water.
  4. Avoid engaging with the baby if she wakes up, keep the lights down.

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 in 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. It that throws up any concerns, we then do a full evaluation with the aim to start early treatment.

Dr Rajath Athreya is Lead Neonatologist and Paediatrician at Rainbow Children’s Hospital, Bangalore.

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