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| Sunday, 5 January 2003 |
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| News Business Features Editorial
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Compiled by Carol Aloysius Food and the pre-schoolers The New Year has just begun. This week hundreds of tiny tots will begin their first day in a preschool. The preschool period (2-6 year) is a very important period of growth both physical growth and in intellectual, and emotional development. This is also a period when a child's food habits and preferences will have a great influence on his eating habits in later life. Selective eating can make him vulnerable to diseases. The following article takes a look at the kind of food a preschooler needs and how best to ensure that he/she eats it. The preschool child's (2-6 years) growth is slow and irregular; and there may be a decrease in weight. His desire for food is erratic. His appetite wanes. Between the second and third years, he may not gain an ounce for weeks; even months. This "won't-eat era" should not alarm parents. It is expected in a normal child's development.
Appetite usually tends to improve as the child approaches school age. Preschool children's dietary requirements vary widely even within an age group; the small frame versus the large frame, the boy versus the girl, the short versus the tall. Calories The energy need of the preschool child is determined by his age, activity and basal metabolism. About 55 per cent of his total caloric needs go to metabolic activities, 25 per cent to physical activity, 12 per cent to growth needs, and 8 per cent to faecal loss. If his diet lacks calories his body will utilise the proteins for energy resulting in PCM - protein-calorie malnutrition. If protein is also not adequate, tissue reserves are used for energy and body-building needs. Protein About 1.5-2 grams/kg of body weight is required. Two-thirds of this protein should be of high biological value. Severe protein deficiency results in retarded growth, anaemia, pigmentary changes of the hair and skin, and edema. Vitamins and minerals An increase in the intake of Vitamin A, riboflavin, niacin, ascorbic acid, calcium, iron, iodine and sufficient supplies of vitamins A and D, phosphorous and fluorine (for tooth development) are needed. Adequate nutrition can be provided on a lacto-vegetarian diet if sufficient milk, eggs, and cheese are included. These foods provide good quality protein, vitamin B12, vitamin A, calcium, iron and other minerals. Green leafy vegetables supply folic acid and vitamin C needs. Children in this age group like to have a choice of, and to experiment with foods. They like finger foods such as bread, toast and sandwiches. They enjoy different textures in their food. They prefer cereals, and puddings of a jelly-like to a paste-like texture. Pre-school children prefer mild foods to strong-flavoured ones. Food with bright colours appeal more to them. Colourful utensils, cups, plates, saucers, and table mats also help. Introduce new foods one at a time. At this stage children prefer their food lukewarm. Children are great imitators. They enjoy doing things other members of the family do. A family member's dislike of a certain food may affect a child's attitude toward that specific food. Between two and three years of age, a child may show sings of stubbornness and rebellion. At four years, he tries hard to find a reason for everything. All these characteristics affect the child's attitude toward food. - (Herald of Health) Why immunise your child? Beginning this month the Ministry of Health will introduce a new vaccine - Hepatitis B into the routine infant / childhood immunisation program which has been cited by WHO as one of the best programmes in the world.
Phase 1 of the new program will cover the western, southern and N. Western provinces with an estimated target of over 170,000 infants. The following article discusses common questions about vaccination. Q: Is it true that vaccinated children may still contract a disease? A: Yes it is possible, since no vaccine is 100% effective. A small proportion of those who are vaccinated will remain susceptible to the disease. However, in the cases in which illness does occur in vaccinated individuals, the illness is usually much less severe than in those who were not vaccinated. Q: Haven't diseases like polio, tetanus, whooping cough and diphtheria already disappeared from most parts of Sri Lanka? Why do we need to keep immunizing children against these diseases? A: These diseases are much less common now, but the bacteria and viruses that cause them are still present. The potential problem is kept in check by routine vaccination programmes. In countries where vaccination rates have declined, the vaccine preventable diseases have reappeared. There have been recent outbreaks of whooping cough, measles and rubella in Sri Lanka, and a number of children have died. Cases of tetanus and diphtheria still occur. Do breast-fed children need a different vaccination schedule? A: Breast-fed children should be vaccinated according to the standard schedule. Breast milk contains small amounts of antibodies, but this does not interfere with the immunization process. Q: Does vaccination cause allergies? A: Some children are allergic to particular components of vaccines. However, vaccination does not provoke the development of a general allergic tendency. Q: What if a baby vomits the oral polio vaccine? A: It is quite safe to repeat the dose. Q: Are any other vaccines available in Sri Lanka? A: Yes. Hepatitis B, Haemophillus influenzae B, Varicella (chickenpox), Mumps vaccines and some other vaccines are available in Sri Lanka only in the private sector. Decisions about administering these vaccines to children should be taken after consulting your family doctor. Q: What immunizations do you give to a child with no immunization records? A: If there is no satisfactory verbal or written record of immunization, the child should be given immunizations from then on as if they were never previously immunized. Q: Should a child with diarrhoea receive oral polio vaccine (Sabin vaccine)? A: Yes. Oral polio vaccine should be given and an additional dose should be given at the next clinic session i.e. soon after the child has recovered. Q: For how long after a significant febrile illness should vaccination be delayed? A: Vaccination should be delayed until the child has recovered. Q: Does immunization cause asthma? A: No. There is no evidence that immunization causes or worsens asthma. It is especially important that children with asthma be immunized like other children, as catching a disease like whooping cough and make an asthma attack worse. Q: Should a child be immunized if the child's mother is pregnant? A: There is no problem with routine vaccine administration to children whose mother is pregnant. In fact, even Measles / MR / MMR vaccine given to the child of a pregnant mother will reduce the risk of her being infected by her offspring if she is not immune. Measles, MR and MMR vaccine viruses are not infectious. Q: What if a child has a chronic disease? A: In general, children with chronic diseases should be immunized as a matter of priority. Care is needed, however, in situations where the child's illness, or its treatment, may result in impaired immunity. Q: What if a child has had a fit or has epilepsy? A: Stable neurological disease is not a reason to avoid giving pertussis (whooping cough) or DPT vaccination. A child may develop a fever after administration of any vaccine; parents should be warned of this and advised to give the child paracetamol (a medicine to treat fever). It should be remembered that the fever following measles vaccine occurs 5-10 days after vaccination. A family history of fits or epilepsy is not a reason to avoid vaccination. You may also consult the family doctor. Q: Should allergic children be immunized? A: Asthma, eczema, hay fever and allergies are not contraindications to any vaccine. An important exception is genuine severe egg allergy. A history of an anaphylactic reaction to egg (generalized hives, swelling of the mouth or throat, difficulty in breathing, wheeze, low blood pressure, or shock) is generally a contraindication to influenza, yellow fever, and Q fever vaccines. Measles / MR / MMR can be given to such children under close observation, as anaphylactic reactions to these vaccines are exceedingly rare, even in children with proven severe egg allergy. Q: Isn't natural immunity better than vaccine-induced immunity? A: While vaccine-induced immunity may diminish with time, 'natural' immunity, acquired by catching the disease, is usually lifelong. The problem is that the wild or 'natural' disease can kill or leave a child permanently brain damaged. Children or adults can be re-immunized if their immunity from the vaccines falls to a low level-vaccines are many times safer than the diseases they prevent. Q: Can too many vaccines overload the immune system? A: There is no evidence that this occurs in standard vaccination programmes. All children and adults confront enormous numbers of antigens (substances that provoke a reaction from the immune system) each day, and the immune system responds to each of the antigens in various ways to protect the body. Vaccine antigens have an advantage over their corresponding wild antigens in that the immune response (such as making antibodies) to the wild antigens is usually evident only after a notable illness has resulted. With vaccine antigens, however, the 'illness', if it does occur, is usually insignificant. Q: How can you help a child's immune system function properly so that it can fight off infections? A: Eating, sleeping and exercising adequately will help keep the child's immune system functioning well. Vaccination has an important role to play in protecting children from specific diseases. Q: Will there be problems if more than one vaccine is given at the same time? A: The vaccines recommended for use in infants and children (DPT, hepatitis B, poliomyelitis, MMR, and Hib) can safely be administered at a single visit, as long as they are given in separate syringes at different sites. Combined vaccines, requiring only one injection, are likely to become available in the next few years. Q: What if a dose was missed? A: The immunization course should be resumed. No extra doses need be given. Q: Should premature babies have their vaccinations delayed? A: Babies born prematurely should receive BCG when they are fit to be discharged from hospitals. They should also receive their 1st doses of DPT and OPV, two months after birth, unless they are very unwell. Q: Should vaccination be postponed if a child has a cold or a chest infection? A: Babies with minor coughs and colds without fever, or those receiving antibiotics in the recovery phase of an acute illness, can be immunized safely and effectively. Vaccination should only be postponed if a child is very unwell or has a high fever. In such cases, vaccination should be arranged for a week or two later. Q: Should children be given a particular vaccine if they have already had that disease? For example, is a past history of measles, rubella or whooping cough a contraindication to vaccination? A: No. It is safe to immunize against these diseases even if there is a
history of prior infection. Vaccination of an individual who is already
immune to measles boosts immunity and carries no risk. In addition,
diagnosis of measles and rubella without laboratory confirmation is very
unreliable, so children who appear to have had these diseases should
certainly be immunized with Measles, MR or MMR vaccine. Source:
Epidemiology Unit, Dept. of Health Services. Gout: common type of arthritis Gout is a common type of arthritis that occurs when there is too much uric acid (sodium urate) in the blood, tissues, and urine. Uric acid is the end product of the metabolism of a class of chemicals known as purines. In people with gout, the body does not produce enough of the digestive enzyme uricase, which oxidizes relatively insoluble uric acid into a highly soluble compound. As a result, uric acid accumulates in the blood and tissues and, ultimately crystallizes. When it crystalizes, uric acid takes on a shape like that of a needle and, like a needle, it jabs its way into the joints. It seems to prefer the joint of the big toe, but other joints can be vulnerable as well, including the mid-foot, ankle, knee, wrist, and even the fingers. Uric acid is more likely to crystallize at lower temperatures, which may explain why roughly 90 per cent of gout attacks affect cooler extremities like the big toe. Acute pain is usually the first symptom. Then the affected joints become inflamed, almost infected-looking - red, swollen, hot, and extremely sensitive to the touch. Repeated attacks of gout over a long period of time can lead to joint damage. It should be noted that uric acid is not a fundamentally harmful substance, but a powerful antioxidant, almost as effective as vitamin C, that helps to protect cells from oxidative damage. It is only when levels become abnormally elevated that it becomes problematic. Approximately 70 per cent of people who suffer from gout produce too much uric acid, and 30 per cent cannot properly eliminate it from their bodies. About 25 per cent have a family history of gout. Elevated levels of uric acid in the blood can also be an indicator of poor kidney function. Uric acid is a by-product of certain foods, so gout is closely related to diet. Obesity and an improper diet increase the risk of developing gout. Gout has been called the rich man's disease, since it is associated with too much rich food and alcohol. But in fact it affects people from all walks of life, most commonly men between the ages of forty and fifty. It may be inherited or brought on by crash dieting, drinking, certain medications, overeating, stress, surgery, or injury to a joint. Approximately 90 per cent of the people who suffer from gout are male. Uric acid kidney stones may be a related problem. Diagnosing gout can be difficult when the symptoms appear in the joints
- several other diseases can mimic gout, including rheumatoid arthritis
and infections. Pseudogout (false gout), another form of arthritis,
produces joint inflammation, redness, and swelling in the larger joints
(usually the knees, wrists, or ankles) caused by the development of
calcium pyrophosphate dihydrate crystals in one or more joints. The best
way to get a definitive diagnosis of gout is for a physician to insert a
needle into the affected joint, remove some fluid, and examine the fluid
under a microscope for the characteristic uric acid crystals. Recipe for wealth and happiness by Neville Perera, Assistant Medical Officer Health is synonymous with happiness and contentment. A healthy person radiates confidence wherever he goes. Most of us are born healthy. but we simply do not obey the rules of nature. The result is that diseases overtake us. Exercise regularly. Healthy exercises give elasticity to the mind and vigour to the body. Exercise may be mild or strenuous, depending on your age and stamina. Walking, running, playing outdoor games are all good. Your blood circulating is increased and you will live longer. Avoid whatever that does not suit you. If you are allergic to some food, chilly weather or even dust, better be on the guard. Tobacco is no friend of good health. Cigarette smoking is fast becoming No. 1 killer. Do not become a slave to drugs. Lead a clean life free from tension. Laughter is the best medicine. Cultivate a cheerful attitude to life and work. Be optimistic. Accept success and defeat with the same spirit. Remember that others have faced worse ordeals. Control your emotions and feelings of anger, jealousy and self pity. Most ailments are related to your mental attitude to things. Take care of your diet. Try to eat a balanced and sensible diet. Include at least one item from each of the these 3 groups: milk group, the vegetable-fruit group and the rice-cereal group. That will give you the much needed vitamins and proteins. Keep fat and spices to the minimum. Happiness - a mood of contentment, joy and hope. money cannot buy happiness. Start the day with a glass of water. Drink at least six glasses of water. Have a sumptuous breakfast, good lunch and a light dinner. If you are suffering from a minor ailment, do not fret about it. Freedom from worry, perhaps, it is the best tonic for keeping healthy.
Trust your doctor and discuss your health problems with him. Curing diabetes : The Ayurveda way Diabetes Mellitus was a disease that was known even to ancient ayurveda physician living in Sri Lanka and India, over three thousand years ago. Ancient manuscripts such as the Yaga Rathnakaraya make reference to this disease, described as one of twenty varieties of urinary disorders resulting from "provocation of the body humours." The ayurveda way to treat this disease is by getting at the root of the cause for diabetes, instead of merely offering symptomatic relief. In Ayurveda induces revitalisation of the physiological functions. Since the quintessence of Ayurveda is healthy living, it could be aptly considered as a way of life. Owing to its unique efficacy and safety profiles, perhaps the wheel is coming full circle and the current trend is a return to Nature. Diabetes Mellitus was known to ancient Ayurveda physicians some 3000 years back. The association of polyuria with a sweet tasting substance in the urine was first reported in sanskrit literature dating from 5th to 6th century A.D. at the time of two notable Indian physicians Sushvutha and Charaka. Sushvutha describes diabetes in two groups. 1. Congenital and other due to 2. Injudicious way of life. Ayurveda also refers to two types of urinary disorders: 1. Natural due to genetic factors 2. Dietetic Indiscretion. The patient suffering from the former is thin and drinks too much. Treatment of this disorder consisted of herbal remedies. Several herbs and minerals with synergistic or even antagonistic actions can be combined to obtained a comprehensive product, which is both efficacious and safe. Furthermore, each ingredient may work on the body in its own specific way. To achieve this proper processing according to the tenets of Ayurveda is required. Ayurveda uses a myriad of herbs that possess antidiabetic properties. -Dr. B.P. Rathnapale You & Your Doctor by Dr. Sampath Nanayakkara Honeymoon Cystitis Q: I married two months ago. Since then I got three attacks of urine infection, the first one being just one week after my wedding. I never had such problems until after marriage. During the attacks I experience severe burning pains while passing urine. My doctor says it is a normal thing to get after marriage. I am worried! Please let me know whether I am having a serious problem? - Worried newly Wed A: Your symptoms and the mode of presentation of your illness suggest that you are having a condition called "Honeymoon Cystitis". This condition is seen so frequently among women just after their first sexual experience. It is thought to be due to repeated friction and often slight injury around the opening of the urethra (urethra is the short tube which leads from the urinary bladder to the exterior, and through which the urine is passed out). The urethra of the female is very short, as such, germs can easily pass through it into the urinary bladder causing infection of the bladder itself. Usual symptoms are pain during urination, more frequent urination some times may even disturb sleep, lower abdominal pain, feverish feeling. All patients who have this problem should consult a doctor and get your urine investigated before attempting any drug treatment. Self medication is very dangerous. If not treated promptly and properly it can lead to serious complications at a later time such as kidney problems and high blood pressure. Disappearance of symptoms does not indicate that the infection has been eliminated. It should be confirmed by a post treatment urine test as well. **** Good cholesterol Q: Is there "good cholesterol" which has beneficial effects to the body? If so, how can we increase such cholesterol in the blood? What is the best dietary supplement to take? - A Housewife A: Yes, there is "good cholesterol". Which is called HDL (High Density Lipoprotein). The best thing to get your HDL elevated is - Exercise Daily. Out of all, Olive Oil is the best dietary supplement which help to increase your blood HDL. Olive oil contains vitamins A, D, E and K as well. HDL helps to clear the arteries from blocking. Recent studies have shown that olive oil has beneficial effects against Heart disease, Breast Cancer and Prostate Cancer. |
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It could be harder on the parents than on the child. At this time
parents must be careful not to foster poor eating habits by urging,
forcing or even bribing the child to eat.
Along with the vaccine a new auto Disable syringe will also be
introduced which will replace the syringes now in use.
