I published " tips for parents to deal with anemia" in health education section of widely circulated news paper in North India.
To my surprise , the problem of Anemia is common even in children of doctors, even the doctor mothers! The reason being their inability to convince their elders in the family ,to do things which they consider as scientific , who are the care takers for their children when they are away for work.
There are many emails from such doctors asking me to suggest to them how to deal with this problem .
I did not ever imagine that financial independence and even post graduate education of women could not empower them to do the right things for their own children.
The children of pediatrician mothers are wearing charms and are putting black spot on cheek to ward of evil and are visiting temple for measles to be over !
How should we transform education into everyday practice , is the real issue rather than making people just literate!
Health education for children needs to convince grand parents and other care takers on the scientific approach. There are many issues but at present I am too shocked to address the problem fully.
Friday, September 25, 2009
Tuesday, August 25, 2009
Anemia in Children: Tips for Parents
ANEMIA IN CHILDREN , WHAT SHOULD PARENTS DO?
National Family Health Survey reported that about 80% children are anemic even in the grain producing states Punjab and Haryana. We need new strategies to save children from this significant morbidity.
Anemia is a state of low hemoglobin in the body, the causes can be many.
The most common is iron deficiency . A normal weight new born is born with sufficient stores of iron to last him first 6 months of life if all goes well with him.
. In India majority of children are born low birth weight and premature for which mother,s malnutrition is also one of the important factor.
Such children have low stores of iron and they need supplementation of iron surely from the age of 2 weeks. The iron of human milk is better absorbed than other milks.
Mothers milk must be continued in all infants for innumerable scientific advantages to the baby as well as mother.
The home made food appropriate for the age of the baby should be supplemented. Parents often do not accept the fact that grains and pulses have more iron and other nutrients, these need to be given rather than the top feeding of diluted milk by bottle. Bottle feeding even in best circumstances result into several maladies the most dangerous being diarrhea which forms the vicious cycle with malnutrition and anemia.
In the first year of life most babies visit for Well baby checkup and or at least five times for vaccinations.Doctors can always detect anemia and take corrective measures if vigilant
. What parents do not realize is that they do not take advise on anemia seriously. They feel that it is just a tonic which is prescribed which they give irregularly and stop at their own inconvenience. Anemia has to be realized by parents and doctors as a disease , the treatment has to be given with calculated doses , expected hemoglobin rise is calculated and the treatment would continue for additional 3 months even after the hemoglobin is appropriate. This is in order to replenish the stores in the body.
The careful pediatricians have a side lab in their clinics where hemoglobin can be assessed just in 10 minutes with just a prick and the treatment is evidence based. Parents don't have to make additional trips from clinic to the lab for the results and revisits for the prescription based on same results.
In the second year of life child has to gain just 2kg of weight therefore his requirements are not as much as he needed in the first year to become 10kg from the 3kg at birth.
There is a natural reduction in food consumption pattern but parents expect children to eat more all the time and " chalo dudh to pee lo atleast , nahin peena padega" They insist on milk all the time filling the little stomach of children with milk rather than grain based food, do force feeding , the nutritional requirement becomes a perpetual struggle between the two , children are learning denial and at times the force feeding becomes an attention seeking device. These wrong trends can continue throughout resulting into undernourishment and anemia.
As young as 2 go to school, which is surely a form of child abuse by parents ,separation anxiety and stress of discipline even if it is a play school is a subject requiring a national attention , can also result in malnutrition due to several factors even though they are fed in the school.
The school going children are always in a rush in the morning . Its a sight to see parents holding a half finished glass of milk even on bus stand. Its universal that all children go to school without proper breakfast.Its also a scientific fact that breakfast should be like a king and early so that brain gets glucose for proper function. The first meal of child is in the school in the break at 11am which is too little for several things including food. The schools have started insisting on healthy food but the reality is different. Parents ought to be educated and in turn educate children that food is mainly for nutrition , enjoyment is a state of mind. A child who breaks fast at 11am , is again confronted by parents forcing food at 2 after the school. The class 8 onward children are again at a rush at this time for forced tut ions by overambitious parents. Its a hard fact that even younger children and children from weaker section of society are going for tut ions.
Children are perpetually in fabricated indoors from home to school to tuition to television , video games , computer even though it is essential.
Such circumstances result into low immunity making them susceptible to ailments resulting in low utilization of iron due to stress of infections.
when majority of children go to school without breakfast , why can the first period not be devoted to eating the food brought from home rather than waiting till 11am. thus children would surely be hungry at 2pm after school .
Parents find it difficult to tackle the food fad ism of children . It is the parents who unknowingly are responsible for such habits in children besides the peer pressure of course. Now a days in well to do homes it is a common sight on the dinning table that instead of appreciating the flavor and presentation of food it is the " not for me " attitude of mothers which children are facing at each meal. Imitation of finicky attitude is child's natural reaction. Thus they also learn to be choosy. Dieting means eating balanced food and utilizing it by sports and active life style rather that becoming the couch potatoes. Undernourishment is low as well as overweight. even obese children could be anemic.
Parents ought to realize that children at all ages need balanced diet , especially so during the period of growth spurts till adolescent age. It is these healthy teens who will be healthy mothers and would not produce low birth weight newborns breaking the cycle of nutritional anemia.
In the name of nutrition and exercise young children are going to gyms rather than playing outdoors and are consuming protein powders prescribed by trainers which is a wrong trend and must be stopped.
Iron deficiency even without anemia results in fatigue , restlessness , poor attention span , learning disabilities , poor arithmetic and linguistic abilities , irritability , hyperactivity and pica ( tendency to eat mud and other abnormal objects).
There is a myth prevalent in parents that mud eating is due to deficiency of calcium , they resort to self prescribing and injections for this by self style doctors.
The fact is this that the iron deficiency is an easily preventable disorder by partnership of parents and doctors. The iron administered in oral form is best absorbed and corrects anemia effectively , inject-able iron is not needed in general.
Anemia is prevalent in spite of ongoing strategies of nation , its time to make new strategies.A lot can be achived by partnership of parents and doctors.
National Family Health Survey reported that about 80% children are anemic even in the grain producing states Punjab and Haryana. We need new strategies to save children from this significant morbidity.
Anemia is a state of low hemoglobin in the body, the causes can be many.
The most common is iron deficiency . A normal weight new born is born with sufficient stores of iron to last him first 6 months of life if all goes well with him.
. In India majority of children are born low birth weight and premature for which mother,s malnutrition is also one of the important factor.
Such children have low stores of iron and they need supplementation of iron surely from the age of 2 weeks. The iron of human milk is better absorbed than other milks.
Mothers milk must be continued in all infants for innumerable scientific advantages to the baby as well as mother.
The home made food appropriate for the age of the baby should be supplemented. Parents often do not accept the fact that grains and pulses have more iron and other nutrients, these need to be given rather than the top feeding of diluted milk by bottle. Bottle feeding even in best circumstances result into several maladies the most dangerous being diarrhea which forms the vicious cycle with malnutrition and anemia.
In the first year of life most babies visit for Well baby checkup and or at least five times for vaccinations.Doctors can always detect anemia and take corrective measures if vigilant
. What parents do not realize is that they do not take advise on anemia seriously. They feel that it is just a tonic which is prescribed which they give irregularly and stop at their own inconvenience. Anemia has to be realized by parents and doctors as a disease , the treatment has to be given with calculated doses , expected hemoglobin rise is calculated and the treatment would continue for additional 3 months even after the hemoglobin is appropriate. This is in order to replenish the stores in the body.
The careful pediatricians have a side lab in their clinics where hemoglobin can be assessed just in 10 minutes with just a prick and the treatment is evidence based. Parents don't have to make additional trips from clinic to the lab for the results and revisits for the prescription based on same results.
In the second year of life child has to gain just 2kg of weight therefore his requirements are not as much as he needed in the first year to become 10kg from the 3kg at birth.
There is a natural reduction in food consumption pattern but parents expect children to eat more all the time and " chalo dudh to pee lo atleast , nahin peena padega" They insist on milk all the time filling the little stomach of children with milk rather than grain based food, do force feeding , the nutritional requirement becomes a perpetual struggle between the two , children are learning denial and at times the force feeding becomes an attention seeking device. These wrong trends can continue throughout resulting into undernourishment and anemia.
As young as 2 go to school, which is surely a form of child abuse by parents ,separation anxiety and stress of discipline even if it is a play school is a subject requiring a national attention , can also result in malnutrition due to several factors even though they are fed in the school.
The school going children are always in a rush in the morning . Its a sight to see parents holding a half finished glass of milk even on bus stand. Its universal that all children go to school without proper breakfast.Its also a scientific fact that breakfast should be like a king and early so that brain gets glucose for proper function. The first meal of child is in the school in the break at 11am which is too little for several things including food. The schools have started insisting on healthy food but the reality is different. Parents ought to be educated and in turn educate children that food is mainly for nutrition , enjoyment is a state of mind. A child who breaks fast at 11am , is again confronted by parents forcing food at 2 after the school. The class 8 onward children are again at a rush at this time for forced tut ions by overambitious parents. Its a hard fact that even younger children and children from weaker section of society are going for tut ions.
Children are perpetually in fabricated indoors from home to school to tuition to television , video games , computer even though it is essential.
Such circumstances result into low immunity making them susceptible to ailments resulting in low utilization of iron due to stress of infections.
when majority of children go to school without breakfast , why can the first period not be devoted to eating the food brought from home rather than waiting till 11am. thus children would surely be hungry at 2pm after school .
Parents find it difficult to tackle the food fad ism of children . It is the parents who unknowingly are responsible for such habits in children besides the peer pressure of course. Now a days in well to do homes it is a common sight on the dinning table that instead of appreciating the flavor and presentation of food it is the " not for me " attitude of mothers which children are facing at each meal. Imitation of finicky attitude is child's natural reaction. Thus they also learn to be choosy. Dieting means eating balanced food and utilizing it by sports and active life style rather that becoming the couch potatoes. Undernourishment is low as well as overweight. even obese children could be anemic.
Parents ought to realize that children at all ages need balanced diet , especially so during the period of growth spurts till adolescent age. It is these healthy teens who will be healthy mothers and would not produce low birth weight newborns breaking the cycle of nutritional anemia.
In the name of nutrition and exercise young children are going to gyms rather than playing outdoors and are consuming protein powders prescribed by trainers which is a wrong trend and must be stopped.
Iron deficiency even without anemia results in fatigue , restlessness , poor attention span , learning disabilities , poor arithmetic and linguistic abilities , irritability , hyperactivity and pica ( tendency to eat mud and other abnormal objects).
There is a myth prevalent in parents that mud eating is due to deficiency of calcium , they resort to self prescribing and injections for this by self style doctors.
The fact is this that the iron deficiency is an easily preventable disorder by partnership of parents and doctors. The iron administered in oral form is best absorbed and corrects anemia effectively , inject-able iron is not needed in general.
Anemia is prevalent in spite of ongoing strategies of nation , its time to make new strategies.A lot can be achived by partnership of parents and doctors.
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