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| Sunday, 14 March 2004 |
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Features |  |
| News Business Features Editorial
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Compiled by Carol Aloysius Common ailments of the new born A baby's refusal to take his milk, throwing up after a feed, developing sudden rashes on his body, are among some of the many childhood illnesses that cause concern to the new mother.
Q: How does a mother know when her baby's naval cord is infected? A: Spreading redness around the naval is one indication. Another is that the baby will be off feeds and have a temperature. There may also be a discharge from the naval. Don't wash the area. If the discharge is 'smelly'there may be an infection, and it will be necessary to take the baby to a paediatrician and even hospitalise the child to get medical attention. There are times when after the cord has fallen there is excessive healing tissue forming in the naval like a lump. This is called 'umbilical granuloma'. If it causes continuous oozing it will need to be cauterised. Q: What is thrush in new borns? How is it caused? A: Thrush can be identified when there are white cotton or curdled milk like collections on the tongue, inner side of the cheeks, and roof of the mouth. These patches do not rub off easily and if it is not treated it can spread to the diaper area and cause monilial diaper rash which can irritate the baby. Gentian violet is an old fashioned but effective treatment. A common cause is the rubber teat of feeding bottles which are not properly cleaned. Q: Why do most new born babies squint? A: Most new borns have a squint because they are unable to focus. Usually it takes from one month to six weeks at the latest two months for a baby to be able to focus. If on the other hand a child does not seem to be focusing his eyes on what he sees around him, parents should consult an eye specialist and test the child's vision. Q: What causes some children to develop rashes on their bodies? A: Rashes and birthmarks are very common in babies. White spots (milk spots) on the nose, forehead and cheeks (milia) are normal and disappear within a few months. Then you get red spots with a tiny white in the middle on the face, legs and neck area which we call new born acne. This too is self limiting and will eventually disappear. Diaper rashes is also quite common. This is a red and itchy sometimes mildly oozing rash that occurs in the area of the napkin in infants and is mainly due to irritation by urine, stools, water and sweat within the diaper. Frequent changes of diapers, washing with plain water after passing urine or keeping the area dry can prevent this rash. Heat rash or seat rashes also occur in hot and moist climates. The rash usually starts around the neck, forehead, chest and back. The treatment is to bathe the baby him more than once a day or sponge the affected area with a towel soaked in cool water and apply a soothing powder, and don't overwrap the child. Birthmarks: The most common birthmarks found in new born babies is the Mongolian rash, a bluish grey rash on the buttocks, neck and arms. This will look alarming but will clear up within two years. Red patches are less common and seen on the neck (sometimes referred to "stork bite") nose and elsewhere on the face. A raised bluish red patch may be present at birth and may grow into a small lump resembling a strawberry by the age of three weeks. This is called haemangioma. It will gradually disappear leaving a skin coloured flat patch by the age of 3-6 years. If the red marks on the face are large consult a doctor. Q: Many new born babies spit out or vomit their feeds frequently. Why is this? A: There can be several reasons for this condition, which may be either minor or serious. First it is important to identify the causes for spitting up or vomiting. If the vomiting is forceful, i.e. Projectile vomiting it can be serious because it can indicate a block in the upper intestinal tract. The most common block is pyloricstenosis. This conditions require surgery and can be identified with a scan. Children who suffer from this condition do not gain weight. This is why every paediatrician wants to know the child's weight since birth. If the child continues to spit up despite gaining weight, the problem may not be a surgical problem. In a thriving baby who is gaining weight well, the common reason for spitting up is when he is overfed. Still another cause is shaking the baby too much to lull it. If the baby is shaken very vigorously or roughly, it can also lead to intra-cranial haemorrhage. Q: Any other causes? A: Yes. The baby may be having Gastro Oesophagal reflux. When milk enters a baby's stomach, there is a physiological valve at the junction of the oesophagus and stomach which prevents the milk from backing up even if the baby is held upside down! Some babies have a defect in the valve resulting in Gastro Oesophageal reflux. For this condition you need to see a paediatrician who will recommend medication to control the reflux. The child will eventually outgrow this condition in the first year of life. Q: Why do some babies get a sticky discharge from their eyes? How long will this last? A: Basically there are three conditions that cause this; (a) Neo natal Conjunctivitis (b) Chlamydia Trachomatis. (c) Infected blocked tear duct. In Conjunctivitis the symptoms are redness and discharge from the eye. The irritation of the inside covering of the eyes is called conjunctiva. This is caused by trauma following say a forceps delivery or injury. Infection is mostly bacterial. But serious infections could be gonococcal conjunctivitis and hepatic infective conjunctivitis. In general treatment these infections can be prevented from birth by using eye drops like silver nitrate or tetracyclin or erythromycin. In the case of an infected blocked tear duct, the eye is not involved at all and is not red. There is only a discharge which is either clear or a greeny yellow discharge. The tear duct is located on the side of the nose draining tears from the eyes and nose and can easily get blocked in new born babies as the tear duct is very small. The block can also occur when the baby catches a cold. Since the tear duct may be infected and discharge is not clear you may have to use antibiotics drops with a difference. You need to first massage the side of the nose to clear the tear duct from all the pus that is collected. Only then should you use the tear drops. Using the eye drops before massaging the nose will not be of any use as it will not enter the tear duct. Q: Will this condition disappear soon? A: It should clear in a few days, but could recur again if the child catches a cold. The same procedure should then be adopted. However, if this problem persists beyond one year, it is necessary to take the child to an eye specialist where surgery may be needed since it can lead to scarring of the tear duct. If the tear duct is permanently blocked, surgery will be of no use. Q: Why is it necessary to burp a baby after a feed? Why do some babies take a long time to burp? A: When a baby sucks on the bottle or at the breast, the chances are that he will swallow air. This makes the stomach get bloated and the baby will cry and not drink milk and will vomit. He will also not gain weight. This is why it is important to burp a baby. Most common way is to put the child over the shoulder or else seat the baby up leaning forward a little and hold his head against the left upper end and pat him gently on the back. If the baby doesn't burp after 3 to 5 minutes, it means the child may not have a burp. To make sure, lay the baby on the right side and the excess milk will come out of his mouth when he falls asleep. Q: What is the best position to keep the baby when he is asleep? A: The best position would be on the side or the back and not the stomach as the chances for cot death syndrome are higher in the latter position. Q: Do you recommend anything that can make it easier for mothers to prevent babies from vomiting or help a baby with a stuffy nose. A: I suggest that all mothers get a baby nasal asphyrator. This is ideal if the baby vomits or has a stuffy nose to suction out all the secretions. I also recommend the government to import normal saline nose drops in baby sized plastic bottles that are squeezeable. Q: Any general piece of advice to new mothers? A: I would like to tell every new mother that most of your problems with a new born are minor problems that require common sense and practical solutions. As a general rule I also advise them not to ask friends and relatives for advice, but to seek the advice of their family practitioner who is the best person to help them. ###### "Puberphonia" - Thin voice in a male! by Ms. Savithra C. Panagoda, Speech Pathologist & Audiologist. An "appropriate" voice is considered an asset to any individual in highlighting his/her personality. Why do you think "being appropriate" is important? In order to serve the purpose of an effective communication, a good voice is always expected to be within specific criteria in terms of pitch, loudness and clarity, but pitch being the marked demarcation between genders (approximately) 128 Hz in males and 225 Hz in females), is hence considered the most important among all. We all know that, irrespective of being a male or female, all children have quite a similar voice, up to a certain age. Then why this voice change in adulthood? During adolescence, the larynx (voice box) achieves adult dimensions, which is mainly evident with boys, with vocal folds doubling in size and dropping the pitch by an octave into the male register. This is called "voice mutation." Occasionally, despite the normal growth and development of secondary characteristics, the adolescent still retains his pre-pubertal voice (childhood voice) even after puberty. And this condition is known as "Puberphonia' or "Mutational falsetto." What leads to Puberphonia? When the growth of the boy's larynx is age appropriate and the movements of the vocal cords, is unimpaired, the failure of voice mutation is always attributed to be psychogenic. Now the word "psychogenic" should NOT be misleading you to suggest a 'mental illness' as in today's terminology. Following are a few explanations suggestive of the type of psychogenic causes leading to this particular condition. . Fear of assuming a full share of adult responsibility. . Over-protection leading to fear of losing maternal protection and attention. . Unusually early "breaking" of voice which renders the boy self-conscious, thus making him reject the new voice. . Hero worship of an older boy or man with a strong feminine inclination etc. Symptoms and features of the disorder include an unusually high pitch, often associated with pitch breaks, inadequate loudness and sometimes fatigue during speech. With the constant use of this "foreign" pitch, patient could even develop "vocal nodules" at a later stage, leading to a hoarse voice. But in some cases, patient would adjust himself into an effortless voice, where an extreme high pitch would be the only manifestation. What are the remedial options? Victims of Puberphonia are not uncommon, and majority of the patients are well motivated to achieve an appropriate post-pubertal voice, because usually they are been made painfully aware of the social and career disadvantages of the persisting "unbroken" voice. But the existing problem here is that most of us are not really aware of the remedy, available for that. Despite the possible psychogenic or pathological reasons, speech therapy certainly can bring about good results in terms of necessary pitch change in patients with the above disorder. But it should be also emphasized that treatment is unlikely to be successful if the individual has no real desire to change the voice, due to fear or shyness at twitching over to a new voice, even with counselling. However, normal laryngeal growth and vocal cord length ensures that the male voice can be produced quite easily if the patient is cooperative enough for the session. But this can also become an exceptionally difficult task in cases with high pitch persisting past adolescence and into maturity. In a summery, Puberphonia is a pitch disorder occurring due to inadequate voice maturation, which could bring direct influence on your individuality, but could be treated within no time depending on the patient's motivation and other associated factors. With this in mind, I think it is clear to all, that if you look for the appropriate intervention, this is NOT a life long threat to your personality any more. ###### Chinese Medicine - a cure for all ills by K. W. A. Jayawardene. The practice of treating through acupuncture which has been handed down over thousand of years offers relatively a simple technique for treating a large number of illnesses.
This energy followed on quite precise routs along a network of meridians or 'channels' (jing mo). Distributed along this network, at certain specific locations, are the controlling energy centres, the acupuncture "points", of which more than 800 have been recognized. These points are the entrance and exists for vital and blood, regulating the function of the whole body. Those classified are the "jing" points, and those not yet classified, "gi", points - extra-ordinary points. Some are located on the human ear. In therapy, needles are inserted into acupuncture points in various parts of the body to treat a variety of disease. From 1938, these were used for analgesia in surgical procedure. The needles are left in position for any thing from 15 to 30 minutes during treatment and much longer periods during surgical operations. They are manipulated in twirling or push/pull movements manually or activated by pulsed electric stimulation. More recent approaches include ultrasound and lasers. Acupuncture like effect can also be obtained by deep finger pressure, so called acu-pressure. The toning up this way involves summing up energy into a zone of deficiency from areas where there is in excess and driving away energy from areas where it is in excess thereby restoring the state of balance and putting the individual in harmony with himself and with his environment.
Among them are the diseases of the upper respiratory tract, respiratory system, diseases of the eye, skin, and of the mouth, gastrointestinal diseases, neurological and musculoskeletal disorders. It also has been found efficacious in the treatment of coronary artery disease by increasing the circulation in the coronary arteries and improving the function of the left ventricle. Acupuncture analgesia Acupuncture analgesia (taking away pain) rather than anaesthesia (taking away sensation) has been found to be useful in over 100 different types of surgery, including abdominal surgery, brain surgery, open-heart surgery, ear, nose and throat surgery, pneumonectomies etc. It also is frequently used in dental extractions. The principal action of acupuncture (and of moxibustion) is to regulate the function of the human body and to increase resistance by enhancing the immune system and the antiphlogistic, analgesic, antispastic, antishock, and antiparalytic action of the body. Moxibustion and Cupping Moxibustion is a localized heat therapy, represents a special form of point stimulation and involves burning pieces of drug plants generally the mugwoot (Artemisia moxa) leaf either on the head of the acupuncture needle so as to conduct heat into the body or on the surface of the skin, until heat becomes uncomfortable for the patient. Recently, moxa "cigars" have become available so that the burning herbs do not have to be placed on the skin. The cigars can be used as a localized heat source anywhere on the body. Another common method of treatment is cupping. A glass or bamboo cup is filled slightly with alcohol, ignited, and quickly inverted over the swollen area. The flame is quickly extinguished due to lack of oxygen, and a slight vacuum is created that exerts negative pressure on the skin beneath the cup. This method is used to treat bursitis, arthritis, and other inflammation disorders. As far back as 1400-1200 B.C., Chinese had a notion of preventive medicine, Bathing, bath tubs, washing, sweeping, lavatories and drainage trenches were mentioned in the oracle-bone writings. Inoculation against smallpox was practised in China from ancient times. Even today people are educated to combat disease by themselves and not to rely exclusively on health workers. ###### Healthy tips Be careful what you put into your mouth. Make sure everything you eat is fresh, and clean. Do not eat processed or frozen food as far as possible. Water is a great cleanser. It helps the body wash out toxins and the lethal chemical of stress. Unless the doctor forbids it, drink eight glasses of warm water every day. Avoid stimulants like coffee, aerated drinks and cigarettes. Light herbal teas are a great replacement. Reduce the intake of salt - your body needs only one-fifth the amount of salt usually used in Indian food. Reduce intake of all oils as much as possible. Eat generous amounts of fibre, fresh fruits and vegetables. Stop the old coffee drinking habit. Have a glass of fresh fruit juice instead. Avoid beverages like soda, coffee, colas and so on. Cut out all deep-fried food from your diet. Cut down on products like soft drinks, ice-cream, candy and cookies which have high sugar content. Never skip a meal, even if you're on a diet. Eat a fresh fruit or drink vegetable juice instead. Include food with high fibre content - plenty of fruits, vegetables and grains - in planning your diet. Wash vegetables thoroughly in clean water before chopping. Steam or boil vegetables, rather than frying or sauteing them. Retain peels of potato, cucumber, carrot and tomato while cooking. Don't rush through your meals. Set aside enough time to appreciate, enjoy and digest your food. Make every meal an enjoyable experience. Set dishes out attractively and chew slowly to appreciate the full flavour of the food you eat. |
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News | Business | Features
| Editorial | Security Produced by Lake House |
Dr.
Ajith Fernando, Consultant Paediatrician, Park Hospitals Pvt. Ltd,
discusses some of these common childhood ailments and their treatment with
Observer staffer Carol Aloysius
In
ancient times, the Chinese considered the body as a field of energy (shi),
which channelled though certain lines of force called 'currents'.
According
to Chinese belief, this balance which allows free circulation of energy is
vital for good health. It has been found some 70 diseases can be treated
with acupuncture alone and some 200 when used in combination with herbal
medicine.
