From the time a baby is born, a mother is also born. It is only natural for you to be worried and concerned about every little thing about your little one. Whether you baby is eating well or not could be your biggest worry in the initial few months. The information given by friends, relatives and what all you read could be rather confusing. Once your little once is 6 months old, weaning him or introducing food to 6 month old will be an area that you will need advice. This article will help to clear all baby food myths you have as we will discuss in detail the myths that are associated with infant feeding and their actual facts.

Baby Food Myths And Facts

(1) Formula Feeding: One of the most common baby food myths surrounding bottle feeding is that if the baby is constipated due to it, then you ought to switch to a low iron formula.

FACTS: The fact is that the iron content of formula does not affect the bowel habits of the baby. Low iron formulas or introduction of cows milk before the age of one, can lead to iron deficiency anaemia in babies. Breast milk is the best thing for babies and the iron content in it is quite low. Newborn formula feeding may constipate the child at times as it is comparatively difficult to digest. Follow a baby formula feeding chart which will tell you exactly how much formula the baby needs per feed at each month. Older babies can be given prune juice to help relieve the constipation.

(2) Introducing Solids to the Baby: Many believe that when the baby is weaned off and solids are introduced; only jar foods must be fed to the child. Starting baby on solids should be a gradual and systematic process and one should never rush if the child is not ready. You can wait a week or two and try again.

FACTS: Jar foods are a convenient way of feeding and baby food companies make sure the foods served are hygienic, but it is not the only method. You can give healthy homemade baby food by trying out different fruit and vegetable combinations freshly pureed at home on a daily basis. Cooking for baby recipes are easily available online these days.

The best first food that should be introduced is rice cereal. Initially you could prepare it a bit runny and give cereal in baby bottle. After a few weeks, you can thicken up the consistency and feed it with the help of a bowl and spoon.

You can begin by introducing boiled and pureed apples, peaches, pears, carrots, potatoes, sweet potatoes, bananas, avocados and peas. Yogurt and fruit purees mixed with yogurt are also other best foods to introduce to baby. The thumb rule is that whenever you introduce a new food, it should be done one at a time for at least three days so that if it does not suit the child or causes an allergy, you are able to identify it.

Gradually as the child gets older, you may not continue feeding a baby. Try baby led weaning and let your baby explore different textures and tastes. Give him the food on his high chair and let him feed on his own. You can also stop making purees and begin to give small chunky foods that are soft and well boiled. This can be followed by larger chunks and finally by the age of one the child should be able to eat what is made for the entire family with less salt, sugar, chilly or oil as per what your baby likes.

(3) Eating Meat and Eggs: Another common baby food myths that a lot of parents follow is that eating eggs and meat regularly is unhealthy for babies.

FACT: The fact is that in the growing years, all the protein that the child takes only helps him grow better. Meat and eggs are a wonderful source of iron, zinc and protein. After 9 months you can introduce meat, chicken, fish and beef that is well cleaned, boiled and cooked. It should be chopped up very finely in the chopper to make small pieces that are soft so that the baby can chew them.

These foods can be served upto few times a week. Some caution that you need to maintain is look out for allergies and try giving only cooked eggs rather than runny ones. Avoid giving canned meats or hamburgers. Prefer only home cooked delicious food for the baby.

(4) Food Rejection: It is a myth that if your child rejects a food at one point, she will never eat it.

FACT: The fact is that children like to eat what they find comfortable over and over again. Trying something new is more a matter of surprise and the unknown rather than actual rejection. If your toddler rejects your home made tortillas, don’t fret as he or she may need to have a new food at least 15 times before actually liking it. So just keep offering them new items and club them with their old favourites. Make a list of homemade toddler food and ask your child to choose from the list, this way they will generate an interest in the new item.

(5) Allergic Foods: It is a myth that the baby should not be fed any kind of allergic food till they are one year old and preferably even after that. This helps to prevent food allergies in them.

It is not advisable to give cow’s milk to babies under the age of one as it is deficient in nutrients and can cause iron deficiency anaemia and allergies in the child. Yogurt and cheese being milk products can be safely given to children as one of the first foods without any problem.

FACT: The fact is that exposing the child to allergic foods does not cause or initiate allergies, but it does help you to identify at an early age what does not suit your child. If there is a history of allergies in the sibling or a previous allergic attack in the form of eczema, then you should talk to your doctor before introducing solids to the baby.

(6) Liking for Sweet: Lastly, the last of all baby food myths that keeps the parents worried is that feeding your baby fruits purees can cause a sweet tooth in the baby.

The fact is that all babies are born with a liking for sweet and that is the reason their first food-breast milk and formula are slightly sweet. Giving babies sweet purees cannot cause a sweet tooth as they already have one.

What you can do is introduce them to a wide variety of food tastes and textures. Give them cereals, pulses, vegetables and meats so that they derive nutrients from each of them. Follow a balanced diet that comprise of all of the above in balanced proportions each day with different food combinations.

Encourage your baby to try out new things and offer them lots of finger foods. It is common for babies to show initial rejection but after a few times, they begin eating everything.

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Once the baby is born and the umbilical cord is cut, the first parameter to be assessed is the cry of the baby followed by the weight. These are considered as important check points by doctors and a matter of great concern for every new mother. If the baby has a very low birth weight which is seen in premature births, then it will be at a risk of failure to survive and will need intensive pediatric care. If the baby is a full term mature baby, then the weight will be checked at the time of birth and again at the time of discharge. A slight drop is expected in the weight check that happens after 24 hours because the baby looses water weight in the first few days after birth. Doctor’s will keep a close watch on the newborn weight gain of the baby as it is an indicator of adequate nutrition and a sign of proper physical and mental development. At every visit to the doctor, the height, weight and the head circumference will be checked. Newborn weight chart by week will be tabulated by the pediatrician in each of these visits. The graph that is formed will give a fair idea of the growth percentile the baby falls in.

Weight Loss After Birth

This is a very normal phenomenon and all full term babies loose 5 to 10 percent of their birth weight in the first one week. This is because babies are born with extra fluids that are eliminated. The weight loss will be more predominant in babies who are overweight as they will lose baby weight. If the weight loss is more than 10% then it is a matter of concern and it could be due to an underlying illness or pathology. Neonatal weight gain is approximately 20 to 30 grams per day depending on their birth weight.

Weight Gain After Birth

After first five to seven days, newborn weight gain is a steady rate. By the time they are two weeks old, the baby gain weight lost in the first week and a little more. This is the normal trend but there are a small percentage of babies who do not gain back the weight so fast. They do so at a slower rate. There is nothing to worry as long as your baby is feeding well and is active.

Factors Affecting the Baby’s Weight After Birth

• Full term baby (born between 38 to 40 weeks) or premature baby
• Gender
• Mothers health during pregnancy and after delivery
• Medical problems in the baby immediately after birth
• Onset of breast feeding
• Feeding effectively or not
• Latching onto the breast
• Formula feeding

Newborn Weight Gain in The First Year

(a) Newborn: Your newborn weight gain begins around the 10th day and do so steadily at the rate of 20 grams per day. This is the average weight gain for breastfed babies. At this stage the baby can eat breastmilk or formula. Baby formula is slightly more difficult to digest and babies who are exclusively formula fed tend to be comparatively heavier. At this stage babies will feed every 2 to 3 hours and this pattern continues till they are 2 months of age.

(b) 6 month old: Gradually as your baby grows, so does the size of his stomach. He is able to retain more milk and so the interval between two feeds begins increasing. By month 6, he is rolling about and also holding his neck straight. The amount of milk per feed will increase by almost one ounce (30 ml) per month. After 6 months, you can add water and wean the baby off by introducing semisolid foods. Baby food and formula should be the main diet at this age. At six months the growth rate is 3 to 5 ounces per week.

(c) 12 month old: By 12 months of age, your baby’s weight should be between 9 to 11 kgs on an average. This will depend on the normal birth weight which is between 2.5 to 3 kgs. By this age the baby should be eating all that is prepared at home. You can make the food less spicy so that the baby can eat it. You can try giving him new food textures and tastes. Searches online for 7 month old baby food ideas are going to be common now.

Is Your Baby Gaining Enough Weight

After the baby is discharged from the hospital, the newborn weight gain cannot be checked each day at home. At each doctor’s visit, the weight is assessed. Between this time, parents get anxious and worried whether their child is growing normally or not. Here are some indications that the child is getting adequate feed and is growing normally.

• Diapers: In the first few weeks, the baby may have few wet diapers. But as the breast milk sets in and the baby begins feeding well, the number of wet diapers will go up. If your baby dirties 5-6 wet diapers a day, it is an indication that he is doing fine. In the early months, babies can poop after each feed. So 3 to 4 poopy diapers are a good enough indication for you.
• Skin tone: If the baby is feeding well, then the skin will be fresh and elastic. If the feeding is poor then the baby’s skin will be dry and shriveled up. Depressed anterior fontanelle is a sign of dehydration in babies and it indicates that you need to give more fluids and milk to the baby.
• Activity: If after a feed, the baby is active and happy it indicates that the feed was sufficient and the resultant will be a normal weight gain and happy child.

The above guidelines are to give you an idea about the normal newborn weight gain pattern. If your baby is losing too much weight or not able to gain weight properly, it could be an indication of an underlying illness or mal assimilation problem. It is advisable to get the child checked up. The doctor may suggest you some foods or nutritional supplements that will help the child to gain weight. Always remember that if your child is happy and active, then a few numbers here and there on the weighing scale should not bother you.

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After a nine month long wait, your little bundle of joy is born and he has gifted you the most precious feeling in the world-the feeling of being a mother. It is only natural that you want and wish for only the best for your little bundle. The care that a mother put in begins from the time she conceives. The first thought that comes to any mothers mind when her baby is born, is whether the baby is fine, is everything normal? And this is where newborn baby screening test helps you resolve all your concerns.

A newborn that is just a few minutes old will be apparently healthy and he may not show any visible signs of an underlying problem. This is where postnatal screening tests come in. Each baby is subjected to a set of tests that detect rare but serious health conditions. This is now a vital part of basic baby care. Screening tests include hearing tests, blood tests for genetic diseases and screening tests for heart diseases. The results of these tests are negative in most of the cases and only one third of the cases test positive. Health screening for infants helps in early detection and better management of the positive cases. They serve as the first step and if required further investigations can be done. Majority of the children who are identified to have some newborn abnormalities and treated very early on in life, recover with healthy growth and development.

Each state has a set of health and genetic screening that it decides as a standard protocol which also includes the basic newborn baby screening test. This is because there are many concerns like the cost of the tests, the payment method, medical insurance coverage etc. As a result each state does not cover all types of newborn screening tests.

How Are Newborn Baby Screening Test Carried Out?

After the child is born, the nurses will take the baby to carry out the hearing and cardiac screening tests. A blood sample will be taken and sent to the laboratory for analysis. If there is a family history of certain genetic disorders, then those tests will also be added to the blood testing schedule. The results of newborn screening laboratory will be sent to the baby’s treating doctor. After 2 to 3 days you will be discharged from the hospital and your paediatrician will contact you in case any report is found positive. In normal cases, the baby will have a follow up after 2 weeks for vaccination, weight check etc. During this visit the results of the screening test will be conveyed to the parents and the need for further investigation will be explained where ever necessary. In most of the medical setups, screening tests of babies are a part of standard medical protocol and it is carried our for each and every child. The parents have to sign a consent form at the time of admission, and these tests are included there. The baby receives health screening even if the parents do not have medical insurance.

Types of Screening Tests

1. 1. Blood tests: Blood test for newborn is carried out by making a small and quick prick on the heel of the baby and a blood sample is collected for testing. It is also called as the heel prick test. In order to make the procedure less painful for the baby, always feed the baby before the procedure and hold the baby close to you so that he is warm and comfortable. The prick will hurt just a little. Apply pressure on the pricked area and the baby will be fine. The blood test is usually performed 24 to 48 hours after the birth of the child because in the first 24 hours, certain conditions may remain undetected if the testing is carried out.
   2. Hearing tests: For testing newborn hearing, there are two types of tests:
      • Otoacoustic emissions test is carried out using a small earphone and a microphone. They are inserted into the ear of the baby and sounds of different types are played. If the baby reacts to the sound, it proves normal hearing, else hearing loss. In the test, echo gets reflected back which is picked up by the microphone. However, if no echo gets detected, then it indicates a hearing loss in the baby.
      • Auditory Brain Stem Response is the second newborn hearing screening test that is used for assessing the auditory brain stem and the response of the brain to the sound waves. Small earphones are then placed within the baby’s ear and music is played. Electrodes are attached to the baby’s small head that detect the response of the brain. If the brain of the baby does not respond to the different sounds is a proper and consistent manner, then it indicates a probable hearing problem.
      • If the newborn baby screening test for hearing is not carried out, there is no way to check if your baby can hear till he is a few months old and begins responding to sounds.
   3. Cardiac Testing: For cardiac testing, a pulseoximeter is attached to the finger and electrodes are placed on the chest to record the heart beat and pulse. The pulseoximeter can detect the oxygen levels in the blood. If the levels are less than normal, then it raises the suspicion of a congenital cardiac disorder. This testing is non invasive and takes only a few minutes. It is performed only after the newborn baby is a day old or before the mother and baby are discharged from the hospital.
   4. Other Tests: There are a few other conditions for which the baby needs to be screened and they are:
      • Phenylketonuria
      • Congenital Hypothyroidism
      • Cystic fibrosis
      • Galactosaemia

      If the couple plans to have a home birth, then the doula should be well versed with newborn baby screening test or else they must take the newborn to the nearby hospital or clinic for the screening tests.

      If the baby is preterm or born with medical complications, then they need to be subjected to a number of procedures and treatments. These can have an effect on the screening tests and so the pediatrician must explain the parents about it in detail.

Thus, newborn baby screening test are a very important part of newborn care and they help in early and timely detection of rare medical conditions and hearing disabilities.

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Cradle Cap is a skin condition that is seen in babies less than three months of age. The exact appearance of the rash is a crusty, scaly and yellowish flaky lesion seen on the babies scalp. The rash may extend to the corners of the hairline and behind the ears. If a similar flaky lesion is seen in other parts like the eyebrows then it could be seborrhic dermatitis. The appearance may be a cause of worry for many parents and they might feel it is a result of bad hygiene. However it is important to understand that cradle cap is not part of any disease and does not occur as a result of bad hygiene.

Causes of Cradle Cap

Cradle cap is an inflammatory condition that is not a resultant of any kind of bacterial infection or bad hygiene. The two common causes of cradle cap are overactive sebaceous glands and fungal infection of the skin.

In newborn babies, the maternal hormones are still in circulation and so they have an effect on the overactive sebaceous glands in the skin of the baby. This leads to an increased secretion of sebum which is very sticky and it causes the old skin cells to stick to the scalp rather than falling off. This accumulation of sticky sebum dries up with time and forms a crusty yellow layer on the scalp which is called as cradle cap.

Signs and Symptoms of Cradle Cap

• The scalp is most prominently affected. There are yellow, greasy and crusty scales on the head which may shed off. If the condition is very severe, it may look as yellowish patches all over the scalp. If the infant has baby scalp eczema, then the scalp will be affected and there will be a lesion but no crusts or scales.
• There is hair loss as the hair tends to stick to the scabs.
• The child does not feel any itching or discomfort.
• The other sites that may be affected are the eyebrows, eyelids, areas around the nose and groin. Here it needs to be differentiated from similar looking skin conditions like seborrheic psoriasis face and seborrheic dermatitis chest.

If the cradle cap rash is untreated then it may lead to worsening of the symptoms. The crusty lesions may spread to other parts of the body. The baby may develop fungal infection of the mouth (thrush) or ear fungal infection along with cradle cap. Diaper rash is seen in many cases along with fungal infections and cradle cap.

If the crusty lesions become very severe, there can be bleeding at the site where the scales fall off. These raw areas may become a site of more infection and thus the lesion may spread over a large area of the skin. Cradle cap infection may need to be treated using antibiotics.

In few cases, where the immunity is affected, the child may have other symptoms like diarrhoea and frequent infections with dermatitis and cradle cap. These cases need immediate medical attention.

Treatment of Cradle Cap

• In small babies, the cradle cap crusts can be treated by taking good care of the hair and the skin. Shampoo the head more frequently and then in the wet hair use a fine comb and a cotton towel to gently remove the scales. Do not apply too much pressure as it can lead to bleeding and raw areas.
• You may also apply oil to the scalp. Use coconut oil or olive oil and gently massage it on the baby’s scalp. Leave it on for 15 minutes and then gently comb the hair. The oil will help to loosen the scales and make them easy to remove. You can use a fine toothed comb or a clean toothbrush which is soft to remove the crusts. After the oil application, make sure you wash of the oil nicely. If there is too much baby oil on cradle cap, it can add to the secretions by the overactive sebaceous glands and worsen the condition further. Rinse the hair or shampoo them.
• For mild cradle cap, scaling of the crusts is sufficient to take care of the condition. Both these methods should be continued for a week or so for the scales to reduce visibly. If proper care is not taken, it can lead to hair loss as the hair roots stick to crusts and get pulled off.
• For cradle cap ears and cradle cap forehead, you can use the above treatment methods but make sure to remove the crusts using a very soft towel so that the skin is not injured.
• In very severe cases of cradle cap, doctors may suggest the use of anti dandruff shampoos. However they are known to contain substances that cause skin irritation and so should be used only as a last resort.
• If the cradle cap has superadded fungal infection, then an antifungal cream or lotion like clotrimazole may be required. Skin manifestations like yeast dermatitis also respond to anti fungal medications.
• At times the condition persists beyond a few years. The cradle cap in older kids is called as dandruff. In toddlers, the dandruff may be treated with anti dandruff shampoos that are marked safe for children.

Home Remedies: There are a few home based cradle cap remedies for baby. However these treatments are not tested and so they should be tried with caution. Making a paste using baking soda and applying it over the affected area can help to remove the scales. Another home treatment is applying petroleum jelly over the scalp and leaving it overnight. The next morning the crusts soften up and peel off easily.

Differential Diagnosis: The skin condition those are similar to cradle cap like seborrheic dermatitis, dandruff, atopic eczema, dermatitis and psoriasis need to be differentiated well so that the treatment can be effective. The nature of the lesion and its distribution is the most effective way to diagnosing skin pathology.

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If you are a new parent, this is one thing you are going to be worried about at some point of time during the first year of your baby’s life. Baby poop is of various colors and consistencies. It is useful to know what is normal poop first so that you are able to identify abnormal baby poop.

What is Normal Baby Poop?

In newborn babies, normal poop of a breast fed infant will be yellowish, thin in consistency and seedy. In case of formula fed babies, the stool will be denser, darker in color and not seedy. This is because formula is more difficult to digest as compared to breast milk. Another thing that may worry parents is the frequency of the stool. Some babies may pass stool after every meal and others just once in a week. Both of these are normal unless the baby shows no signs of discomfort. In breast fed babies, a frequency (baby bowel movement) of once in 7 days and 7 times in a single day is totally normal. The frequency is much less in formula fed babies.

Types of Baby Poop and What They Indicate

The color of poop or the presence of blood in it may worry parents. Here is a guide to baby poop with the different types of poop you may see.

1. Newborn Poop: Newborn poop guide may be a topic that interests you. The first stool that your baby passes is called meconium. Meconium looks like a sticky, greenish, tarry stool resembling motor oil. It is made up of the wastes that were present in the intestines of the baby when it was inside the uterus. It contains amniotic fluid, mucus, skin cells and hairs that were shed of by the baby in the womb. There is no peculiar smell to it.After 1-2 days, once the meconium has been removed from the body, and the child has begun taking breast milk or formula, the stool will change to a light green and gradually yellow. This is called as transition stool and it indicates that the baby’s intestines have started functioning normally.
2. Breastfed Baby Poop: Normal healthy breastfed baby poop is seedy and yellowish green in color. The consistency is creamy and it is slightly runny. The seeds in baby poop are the unique characteristic of breast fed baby poop.In case, your breastfed baby has a more greenish stool than yellowish, then it indicates that the baby is getting more of fore milk which is the watery part of the milk that the baby gets while he begins feeding. This is followed by the hind milk which is thick and contains fat. If you do not feed at each breast for long enough then the baby will get only the fore milk which contains no fat. Once you notice such a poop in your newborn, make a conscious attempt and feed at one breast till you feel it is completely empty and then offer the next breast. Newborn bowel movements can be as frequent as after each feed and that is totally normal.
3. Formula Fed Baby Poop: Formula fed babies have brownish to greenish stools. The stool consistency is dense and butter like. There is a peculiar smell but not as foul smelling as babies who are on solid foods. Since formula is heavier to digest as compared to breast milk, the frequency of the stool is also less.
4. Solid food Poop: As soon as the baby turns six months, solid foods like fruit and vegetable purees are introduced. If your baby is breast fed along with solid foods, then the poop will be dark yellow to brown in color. There is a new characteristic and that is the smell. The stool will have a foul smell which will increase as you introduce newer foods to the baby. The consistency of the poop will be mushy. If the baby is unable to digest a particular food, it may lead to constipation and passage of small hard brown ball like poop. During weaning phase, it is best to give the baby only one new food at a time for at least 3 days so that you know if it suits him or not.When the intestines of the baby are not totally mature, you may see small pieces of undigested food in the stool. These pieces of carrots or reddish color due to beet etc are totally normal.
5. Iron fortified Poop: If your baby is on iron supplements, then the color of the poop will be greenish or black in color. If the color of the stool is such without intake of iron supplements, then it could indicate a GIT bleed. The doctor would like to rule out melena.

Abnormal Baby Poop

1. Constipation: Constipation is seen in the form of hard pebble like stools. The baby will have signs of discomfort when passing the stool with or without a little blood around the anus. Occasional pebble like stool in the diaper is not alarming. But if the baby has these kind of stools consistently, it can indicate milk or soy protein intolerance, sensitivity to some food, cows milk or formula that has been newly introduced in the diet. The child should be given plenty of water and fruits like prunes to help him with the constipation.
2. Diarrhea: Watery stools that contain more water than solids are called as diarrhea. Breast fed infants have runny stools resembling diarrhoea but it does not cause any kind of weakness.If the baby has exploding liquid stools that are greenish, yellow or brown the it could indicate an allergy or infection in the body. The water loss from the body during diarrhoea can lead to weakness in the baby and the water needs to be replenished with oral rehydration solution. The cause should be identified and the diarrhoea should be checked immediately. You may check the images of diarrhea in babies in online baby websites.
3. Poop With Blood Or Mucus: Little amount of blood could be as a result of a tear in the anus. Frank blood in the stool could be a sign of bacterial infection like dysentery. Blood in the stool can also indicate milk protein allergy.Mucus in the stool is seen as slimy or sticky strings along with the stool. It can be seen if the baby has a cold and has been swallowing mucous. If the mucous in the stool is excessive, it could be a sign of infection.
4. Black Poop: Blackish stools means that the baby is swallowing blood and it has been digested within the intestinal tract. It could be blood that comes out of the mothers cracked nipples. The only thing that needs to be ruled out for baby stool black is that the blood is not coming from the baby’s intestinal tract.Infant black poop that is firm in consistency, could be a sign of melena (digested blood that is coming from the baby’s intestines)
5. Pale Poop: If the baby has white poop (pale or chalky white) it is a sign of liver or gall bladder disease. These abnormal presentations mostly indicate a medical problem in the background and should be investigated at the earliest.

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During the first year of a baby’s life, there are loads of milestones that need to be achieved. With each new phase, comes a new excitement and challenge. When your baby is small, he is happy just eating and sleeping. But as he grows up and gets moving, he will explore the world around him and put things in his mouth, mostly whatever he can find. Here comes the new challenging task of keeping your little one safe and protecting him from unwanted trouble and how you can avoid extreme circumstances by learning the infant CPR methods!

Infants under the age of one get into trouble pretty often. They put things in their mouth, stick up little toys up their nose or ears, fall from stairs, get entangled in wires and cords or have things fall upon them. Of all these the most troublesome is putting things in their mouth, as they can choke on them.

You can only wish that you never have to use techniques like infant CPR but as a mother, you must know what is to be done in case your baby chokes on something. This piece of information might help you save a baby’s life someday.

What is Infant CPR?

CPR is cardiopulmonary resuscitation and it is the most important first aid for infants. CPR is a life saving procedure to revive a child who shows no signs of being alive – unresponsive or not breathing. The procedure involves chest compressions and artificial breaths which kick start the circulation of oxygen rich blood within the body. If the brain is unable to receive oxygen for a few seconds, there may be serious complications. This is prevented by circulation of the oxygen rich blood till the emergency team arrives and takes over the situation.

Indications for CPR

• The child may be chocking due to some obstruction in the airway. This could be due to a food bolus or a small toy that the baby may have put in the mouth.
• Allergic reaction causing swelling of the mucous membrane in the throat that obstructs breathing.

Steps To Perform CPR On An Infant

1. Check for Response: The first step is to check for signs of responsiveness and breathing. Call out the child’s name loudly and then tickle the sole and look for any sign of breathing on the chest wall. If there is no response, have someone call the emergency services and begin the infant CPR yourself. Before you begin, ensure that the child is not bleeding from anywhere. If there are signs of bleeding, then control the bleeding first. Lay the child on a firm surface on the back and begin the infant CPR process.
2. Chest Compressions: To give chest compressions, keep one hand on the forehead of the baby and the other hand on the chest. Place two fingers on the centre of the chest, below the nipple line. Give the compressions with uniform strength. The movements should be smooth and not jerky. After each compression, let the chest wall come back to normal. Give 30 chest compressions at a time.
3. Rescue Breaths: Keep one hand on the forehead and straighten the airway. Keep the other hand on the chin so that the mouth is open. Now take a deep breath and blow air into the nose and the mouth of the baby for one second. Look for signs of breathing on the chest wall. If the chest wall does not rise, then it indicates that the airway is blocked. Repeat the rescue breaths till you see the chest wall rising. After a few breaths, check the mouth for any object that could be the cause of the blockage.

Protocol for CPR

Check for signs of choking: Check if the child shows signs of chocking that is coughing and gasping for breath as if something is stuck in the throat. He may turn blue. In such cases, turn the baby so that his head is lower than the chest and his back faces you. Now give back thrusts so that the lodged piece comes out. After that you may give chest rubs alternatively. This will ensure that any small piece or food that is stuck up is coughed out. If this doesn’t work, proceed to infant CPR.

CPR Ratio: You must continue to perform CPR in the ratio of 30:2 that is 30 chest compressions and two rescue breaths. You must do so until the emergency personnel arrive and take over the situation. If you notice any signs of life, you can stop doing the CPR.

AED: CPR can also be stopped once an AED (automated external defibrillator) is available on the site and ready for use. After two minutes of CPR that is 5 sets of chest compressions and 2 rescue breaths in between, you can either continue or take the help of some other person.

CPR Training and Certification

There are numerous online cpr training courses available these days to train healthcare professionals and accessory medical staff. Different institutions offer courses like cpr bls certification, cpr1st aid certification, cpr trainer course, basic first aid certification and bls certification classes.

The main aim of these online cpr courses is to equip the person with the ability to handle an emergency situation either alone or with a team. The persons who make use of these courses are EMTs, paramedical staff, medical personnel, lifeguards and other healthcare personnel who are in charge of the emergency department.

There is a BLS(basic life support) course that is offered by the National CPR foundation. This course aims to teach life support techniques for adults and infants. There are online modules that the student needs to complete and at the end of the course is a test for assessment. Once you clear the test, a grade is allotted to you. You are given a BLS certification that you can print online as a proof of your successful completion of the course. This certification gives an edge to healthcare providers and medical personnel as it increases their scope of services. It makes them more capable of dealing with emergency situations and better infant child care.

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The common reasons why infant cataracts may occur in a new born are inherited diseases, metabolic anomalies, diabetes, trauma or as a complication of certain drugs.

Types of Congenital Cataracts

(a) Anterior polar cataracts: This type of infant cataract is located in the anterior portion of the eye and is generally associated with the inherited or genetic traits. Since it is located in the front of the eye, it required surgical intervention.

(b) Posterior polar cataracts: They are located in the behind portion of the lens of the eye and are usually well defined.

(c) Nuclear cataracts: Nuclear cataracts are located exactly in the centre of the eye and are the commonest form of congenital cataracts. They obstruct the vision to a great extent and so surgery may be required.

(d) Cerulean cataracts: These cataracts do not cause vision problems but they are associated with small bluish dots on the lens of the eyes. They are seen associated with inherited tendencies and are present in both the eyes of the baby.

Causes of Congenital Cataracts

1. Use of tetracycline injections in pregnant mothers to treat certain infections lead to increase in the chances of cataracts in newborns
2. Congenital cataracts can occur as a complication of the following disorders if contracted by the mother during her pregnancy-
   • Rubella is the commonest cause of infant cataract in babies
   • Chicken pox
   • Herpes simplex and Herpes Zoster
   • Cytomegalovirus infections
   • Toxoplasmosis
   • Syphillis
3. Trauma or history of injury to the mother during pregnancy can be responsible for causing cataract in the baby. When trauma is considered as one of the cataract causes, child abuse must be ruled out to ensure safety of the child.
4. Congenital cataracts may also occur due to a protein deficiency in the pigment formation of the lens of the eye.

Symptoms of Congenital Cataract

• The symptoms of cataracts in babies are different than those in adults. The baby is not able to see the people or the things around him due to the clouding of the lens by the cataract. The vision can be completely restricted if the cataract is present in both the eyes.
• The pupil of the eye is greyish white in colour. The normal colour is black
• When taking a picture there is a red glow in the pupil due to the reflection of the light. This is absent in babies with cataract. This is one of the accidental signs of cataracts which we often tend to miss.
• There are rapid and abnormal eye movements which are called as nystagmus.

Diagnosis of Infant Cataract

Vision Screening: The best way to detect infant cataract in babies is by subjecting them to early vision screening tests. Red reflex screening should be done for all babies within the first few days after birth and then again at the vaccination check up around 6 to 8 weeks. This testing is carried out in a dark room using an opthalmoscope. Preschoolers between the age of 3 and 5 are also subjected to vision testing. Absence of red reflex and any small opacity are the signs that the baby needs to be evaluated by an ophthalmologist.

When the child is older around three years of age, coloured cards and lights can be used to check for visual acuity. When visiting an ophthalmologist, a detailed examination is done and many factors like presence of cataract in older siblings, history of diseases that the mother suffered from during her pregnancy etc are noted.

Biomicorscopy or portable slit lamp examination are carried out to assess the exact location and severity of the cataract. Other anomalies of the retina and cornea and changes in the intraocular pressure can also be picked up.

Other tests that may be required to rule out medical conditions that are responsible for causing the cataract are:

• TORCH test for toxoplasmosis, rubella, cytomegalovirus and varicella
• Screening for venereal diseases like syphilis
• Lab tests for measuring the values of calcium, phosphorous etc
• Blood glucose tests
• Urine examination

Genetic testing is also a very useful method of detection as most of the congenital cataracts are autosomal dominant mode of inheritance.

If the retina cannot be examined due to the location of the cataract, then ultrasonography or B scan is carried out. If the retina is visible then complete retinal examination is carried out.

Treatment of Congenital Cataracts

If the cataracts are mild and do not obstruct the vision then no treatment is required but if the infant cataract is present in such a way that it obstructs the vision, then infant cataract removal surgery is required. In most of these surgeries, a new iol-intra ocular lens is put within the eye and the cloudy lens is removed. If the lens is not inserted then the child will need to wear contact lenses all his life to compensate the poor vision.

If one eye is normal and the other is weak then to encourage the use of the weaker eye, a patch may be applied on the good eye. This helps to prevent amblyopia.

Cataract eye surgery is the commonest treatment for infant cataracts. Congenital cataracts should be operated by experienced paediatric ophthalmologists (eye surgeon). The correct age for operating unilateral cataracts is 6 weeks and for bilateral cataract, the ideal age is 8 weeks. Anaesthesia is required for most surgeries in infants. General anaesthesia needs to be given and so there is a risk of apnea in very small babies. So they should be kept under observation for a day or two. In older children, the procedure can be done on outpatient basis.

Post cataract surgery some minor complications may occur. The number of complications are inversely proportional to the age of the baby.

Complications After Cataract Operation

1. Glaucoma is the commonest complication after an eye surgery that can cause a risk to the vision of the baby. It can develop months to years after the surgery. The intraocular pressure needs to be kept in check for these babies.
2. Inflammatory complications may occur immediately after the surgery
3. Bacterial keratitis may occur if the lens applied is very tight. Malpositioning of the intra ocular lens may also occur in some cases.
4. Retinal detachment
5. Strabismus can occur along with congenital cataracts.

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• Difficulty in reading
• Difficulty in writing
• Inability to remember what is taught to him
• Problem in paying attention
• Difficult concentration
• Poor co-ordination skills
• Inability to stay organised
• Difficulty in understanding the concept related to time
• Inability to follow directions

Signs that your Child has a Learning Disability

The signs of the disability will be manifested depending on the existing problem. The following are some signs that you could look out for in case you suspect a learning disability in your child.

1. Difficulty in completing any task
2. Lack of concentration in any work
3. Inappropriate behavior during social interaction
4. Abnormal responses in school surroundings
5. Inconsistency in performance at school
6. Problems in learning and accepting new things
7. Inability to understand new words and concepts
8. Unable to perform simple math calculations
9. Concept of time is very difficult to comprehend for these children.
10. Immature way of talking
11. Speaking irrelevantly

When observing a child for the above signs, it is very important to note that one child will not have all these signs. Each type of disability will manifest its own signs. Even two children with the same learning disability will manifest the symptoms differently.

Similar signs called as language learning problems can be seen in a child who is exposed to a new language or a second language that is not his mother tongue. All such factors need to be taken into consideration. The final assessment of a learning disability needs to be done by a professional expert.

Types of Child Learning Disabilities

(a) Dyslexia:

Children with dyslexia have a difficulty in associating words with their sounds. Recognizing words and their spellings is also slow and difficult for them to comprehend. Dyslexia is a common learning disability in kids that comes to light when the child begins going to school. The following are the common signs of dyslexia in a child.

• Delay in speaking
• Poor verbal expression of the things that they need. Example a word is replaced by “thing” rather than actual word.
• Difficulty in learning new words both in reading and pronouncing
• Lack of coordination between written and spoken words
• Inability to understand what the other person is saying
• Slow in learning or picking up new songs and rhymes
• Child will learn to read at a very slow pace
• Difficulty in following instructions and directions
• Plenty of spelling mistakes while writing
• Poor recall memory especially for the numbers, names or addresses known by him
• Unable to distinguish right and left sides
• Writing reverse images or confusing between similar sounding words
• Difficulty in learning foreign languages

(b) Dyscalculia:

This condition is associated with a difficulty in understanding the basic concepts of mathematics, calculations and numbers. The common manifestations are as follows:

• Difficulty in understanding the concepts of mathematics
• Unable to write the sequence of steps in a math problem
• Difficulty in understanding the concept of time sequences.
• Inability to understand the steps in a mathematical problem or calculation
• Difficulty in making cash transactions
• Mathematical problems that are long and extensive are difficulty for them to read and to understand.

(c) Dyspraxia:

Dyspraxia is a disability where the child has difficulty in motor coordination and making good hand eye coordination. Their skills are gross and there is lack of fineness. The following are the common presentations of dyspraxia-

• Clumsiness and dropping things from the hand often
• Difficulty in organizing oneself and things
• Inability to perform small tasks that require good hand eye coordination like solving puzzles, stacking blocks, cutting something etc
• Poor sense of balance
• Sensitivity to loud and abnormal sounds
• Sensitivity to touch. Even clothes that are irritating or itchy cannot be tolerated

(d) Dysgraphia:

This is a condition where the child has poor writing skills. There is abnormal anxiety when holding the pen and so the child is unable to maneuver it properly leading to poor handwriting.

• Disinterest in writing and drawing or any activity using the pen or pencil
• Loss of interest when asked to write
• Poor handwriting which is difficult to understand
• Difficulty in writing words or thoughts in a correct sequence.
• These kids learn to read normally but writing is a problem
• When writing they may skip words or completely omit some words.
• Writing mirror images of the words
• Confusion in writing between similar sounding words like “b” and “d”

How To Help A Child With A Learning Disability

Children with learning disabilities like ADHD-attention deficit hyperactivity syndrome, dyslexia, dysgraphia etc are differently-abled and they surprise their parents about how much they can and cannot do. The challenging task as parents, is to help them cope with their day to day activities without a feeling of inferiority or isolation. Schools for children with learning disabilities help such children to overcome their problems by different and unique teaching techniques.

A child with dysgraphia is made to learn writing of alphabets on sand, clay and other surfaces rather than in a book. The concept of shape of the alphabet is made clear to them. Gradually they are transitioned to a book and pencil. Such methods help the child to overcome the disability.

However in more severe cases of child learning disabilities, the concepts of space and time are disturbed and so the parent must deal with utmost patience and talk to the child before, during and after a particular task. Activities like brushing, bathing must be explained and performed without any rush or hurry. The child should be given simple instructions like close the door, bring a book etc so that they feel useful.

Children who have motor skills disability need to be seen by an occupational therapist who helps them perform fine motor movements to help improve their coordination. This includes peg blocks, matching shapes and holding a pencil.

Children who have difficulty in coping with social situations should be exposed to pretend and play situations so that they can prepare themselves in advance for what is coming.

All such children need constant and loads of appreciation for whatever they do. This not only helps to boost their confidence but also makes them more productive. A good self esteem is very essential to help them grow.

Center for Learning Disability are places that help the parents to deal better with children having child learning disabilities. To handle children who are stubborn and at times violent, parents need to be trained and counselled as to how they can handle the situation most effectively.

The main aim of treating children with such child learning disabilities is to make them capable of carrying out their daily activities.

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The other common presentations of autism are Asperger’s syndrome where the child has above average intelligence. Pervasive Developmental Disorder or PDD is a condition where the child has some symptoms of autism but not all of them. These different presentations are just a finer classification and the symptoms are very close to each other. Gradually all these may be considered under a single diagnosis.

Causes and Pathophysiology of Autism

Neurological disorders like Parkinson’s have a definite pathophysiology where in the underlying cause can be identified at a molecular level. Autism does not have any such definite mechanism. Then what causes autism? Studies have shown that autism is a result of changes in the development of the brain immediately after conception. The changes in the brain are affected and enhanced by environmental factors.

Autism affects various parts of the brain that control emotional behavior and actions. Depending on the part of the brain affected, the predominant symptoms will appear.

• The amygdala is a part of the brain that controls emotional and aggressive behavior
• Cerebellum controls the motor activity, body movements and coordination of muscles used for speaking.

Another important pathology in autistic disorders is the affection of the immune system. In autistic children, the immune system is altered right from embryonic life. Studies have shown that if the pregnant mother is exposed to infections that affect the body’s immunity, the normal brain development of the baby gets disrupted. This is because a healthy immune system is very essential for proper neuro-development.

Symptoms and Signs of Autism

(a) Communication: Defects in communication begin in the first year of life in the form of delayed or no babbling, unresponsiveness and use of gestures to communicate. As the child grows, the words and small sentences do not come. Instead there is only repetition of words or use of random words when you try to strike a conversation with them. These are often the earliest signs of autism in children.

(b) Social Interaction: Autistic children have slow social development in the form of recognition, smiling and reacting to people and surroundings. In school such children are slow in making friends or keeping friends as they find it difficult to express themselves.

(c) Behavior: Children with autism exhibit repetitive behavior like rocking, spinning around etc. They like to do the same things over and over again. This is true for playing, talking or any other activity that they start. Their interests are restricted and they do not feel the need to learn anything new. Many children also have a habit of injuring themselves like picking at the skin, head banging etc.

If you notice a child who has such behavior, it does not mean that the child is autistic. However if the child has autism, these behaviors are exaggerated and very frequent in occurrence.

Diagnosis of Autism

The diagnosis of autism is done mainly on the basis of autism symptoms and not cause or pathology of disease. There are no diagnostic tests, blood tests or scans that can confirm autism. The appearance of the signs can be anywhere between 6 months to 3 years of age. ABA or applied behavior analysis can be useful in such cases. The following are the diagnostic features of autism spectrum disorders.

• Deficient communication
• Difficulty in social interaction
• Repetitive behaviors like spinning around, flapping of hands etc
• Lack of emotional and social reciprocation
• Functional impairment due to which the child cannot do day to day activities like wearing shoes, picking up stuff on his own
• Continuous preoccupation with objects
• Use of language in a way that cannot be understood
• Restricted interests and activities
• Physically the child may grow normally, but there is clear mental growth restriction

Red Flags of Autism

Most of the parents will notice one or more of these red flags by the age of 18 months and few of them will notice it by 24 months. The following red flags if present, mean that the child has to be subjected to further more detailed evaluation to confirm the cause of the developmental delay.

• No use of hand gestures for pointing or waving a bye by 12 months of age
• Absence of babbling even when the child is nearing one year of age
• No use of single words by 16 months
• No two word phrases by 24 months of age
• No eye contact
• Loss of an acquired skill at any age
• In babies, there is no response when their name is called out

Management of Children with Autism

There are no treatment options for autism or cure of autism as it is a lifelong disease. The main aim of management is to help the child and the family to cope with the situation and be able to perform day to day activities with ease.

Giving the child a lot of one to one time is the most helpful tip. The child should be given a chance to interact with peers who are his age and do not have autism. It can have positive effects on the child. The child should be encouraged and made to feel comfortable at all times. The chance and opportunity should be created for an autistic child to interact with people and participate in games, simple play or even playground activities.

Speech therapy autism and language therapy can help a child who has difficulty in articulating the speech and speaking clearly.

Occupational therapy autism proves beneficial for those children who have only physical disabilities like difficulty in coordinating movements. He will be taught things like dressing up, washing, wearing shoes etc. These minor changes help to boost the confidence of the child greatly.

Provide lots on encouragement at each step or whenever your child achieves a new thing. Special needs autism schools are also a good option to think about.

In some autistic children who are very violent or aggressive (Having ADHD-attention deficit hyperactivity disorder), medications may be required. However these will not be able to cure the problem itself but will make it easier for the caretakers to handle the child. Anti convulsive medication will be given if the child has associated epilepsy.

Alternate therapy and gluten free diet may help the child to some extent. But there are no studies that can prove the efficacy of such therapies.

Counseling sessions for the family and care givers are very important to help them cope and manage the child well. Siblings need to be separately counseled so that they can grow up without feeling ashamed or insecure of their brother or sister.

At home, ensure that the child’s routine is simple and predictable. New routine changes and change of place or surroundings can upset them very easily. Also give them some simple tasks that they can help you with. This feeling of being useful helps to boost their confidence and makes them feel important.

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It is very common for babies to get a cold. Most of the cold and cough infections are transmitted by viruses. There are so many types of viruses that can cause the infection. The viral infections are common when the immunity of the body is low. Other factors like sudden change in the climate, exposure to draft of cold, temperature changes, touching contaminated objects are the commonest precursors to getting a cold. If you were to count how many times you have got a cold in your lifetime, you would not remember. So for your baby to develop a strong immunity against viruses, he too will have to cross over these minor infections, including baby common cough and cold. The only important thing to differentiate here is that the cold is viral and the baby does not have an associated throat or ear infection that requires specific medications.

In babies, colds are common because they tend to touch everything and also put things in their mouth. Contaminated surfaces can be easy sources of the infection. The immune system of babies is also immature making them prone to getting infections. Cross infections like toddler cough cold are also very common in kids going to preschool where they catch the infection from another child who has the cold.

Symptoms of Common Cold

The infant cold symptoms may begin with a runny nose with clear watery discharge which can later on become thick and yellowish green as the cold ripens. Cough is also common and it may be dry cough or loose with rattling of phlegm in the chest. Infant dry cough needs to be differentiated from whooping cough where the baby keeps coughing. It is considered as a  more serious problem. In more than half the colds, fever is an accompanying symptom. In babies fever can lead to anxiety in the parents. This is how you can differentiate if your child is playful and normal when the fever drops and gets cranky when the fever sets in, then it is most likely to be a cold. If the child is unwell and not normal even after the fever has come back to normal, then it is most likely to be something else.

If the child has some other infection, the above symptoms may show up but in addition there will congestion of the chest on examination and at times diarrhea and vomiting. If the running nose is followed by a fever, then it is most likely a baby common cough and cold.

Another form of cold and cough is allergic. If the baby is allergic to something example animal dander, pollens or dust then the presentation will be slightly different. The common infant flu symptoms are itchy and runny nose, watering from the eyes, sneezing and itching on the skin. Allergic colds are mostly never accompanied by fever.

Home Remedies To Tackle Cough And Cold

When an adult gets cold and cough, he normally takes the over the counter medicines that are commonly used. But the same cannot be done for infants and toddlers as children’s cough medicine is not the same as adults. For a baby you can try the below home remedies to help him recover from a cold. They are safe and will not harm your baby in any way.

1. Hydration: During a cold, the best thing you can do is keep the hydration and fluid intake high. If the baby is less than 6 months then give more breast milk and formula. After the age of six months, you can add some boiled and cooled water and juices. Older kids and toddlers can be given warm liquids like chicken soup, hot chocolate or warm milk. Good water intake helps to maintain the body temperature especially if your baby has a fever.
2. Saline Drops: Saline drops are best remedy for baby stuffy nose. In colds, the nasal mucous membrane gets swollen and so the child has difficulty in breathing at night, eating and even swallowing. The salt present in saline drops helps to shrink the swollen membrane and also makes the mucous thin. This provides relief to the baby as he can breathe freely. In small babies, the runny mucous should be removed from the nose with the help of a suction bulb. Use saline drops three to four times a day and before going to bed at night.
3. Position during sleep: When your baby has a cold, keep the head end of the bed slightly raised. This can be easily done by placing a folded blanket under the head. This will prevent the nose from getting blocked and help the baby to breathe easily. Apply a drop of eucalyptus oil on the pillow where the child will sleep. The smell will help to open up the blocked nose and help the child sleep better.
4. Honey: Honey is one of the best natural cough remedies. It should be given to children only above the age of one. Below one year, the baby is at a risk of developing an infection called botulism. Honey and ginger juice mixed together is a very effective toddler cough medicine. It works better than other OTC medicines like cough syrup for kids.
5. Use Humidifiers: Using a humidifier will help the air to become humid and so the baby will be able to breathe better. Cool mist humidifiers work better.
6. Fevers: If your baby has a fever along with the cold, you can give acetaminophen after consulting your pediatrician. The dosage to be given is decided on the basis of the weight of the baby. So you should use the measuring spoon or dropper given with the medicine and give the exact dose that is advised. Giving more quantities can harm the baby’s liver. Give the baby adequate fluids during a fever as he will be losing a lot of body water in the form of sweat. If you feel that the fever is rising and the baby is uncomfortable, you can try cold sponging. Use a rectangular cloth piece and dip it in cold water and place it on the forehead of the baby. This is more useful when the fevers are very high but you can try it.
7. Foods: When your little one is unwell, he will be eating less than normal. It is all right and there is nothing to stress about. When you are unwell, the same happens with you too. At this time you can offer the child foods that are easy to swallow as they may have a sore throat too. Soft foods like yogurt, puddings and applesauce can be tried. If the child is older then you can try giving warm liquids like chicken soup or warm milk. Milk with a pinch of turmeric is a well tested home remedy and is very effective to fight colds and throat infections.
8. Medications: If the cold does not resolve in a few days and the baby is restless and very irritable, then the doctor may prescribe some decongestants or anti allergic medications depending on the age of the child. Cold medicine for babies should always be given after consulting the doctor and you should never give them the medicines that are used for adults.

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