VACCINATIONS during COVID time.

Most of the times parents ring up to ask weather they should postpone the vaccine because of danger of Covid 19. If you say no , they would again question " but will it be alright to take a risk of Corona ?" If you say yes wait for a few days , again the question will be " wont it harm if I delay"? All the concerns are genuine . The answers could be like this , do not postpone the vaccines unless you or your doctor are in qarantine so obviously you cant go . but if both are ok there is no reason to delay unless medical conditions like fever , diarrhea or any other illness warants a delay. How to ensure safety? Doctor must have sanitised the clinic and must have scheduled the children requiring vaccination in a different time slot not coinciding with diseased children. Doctor must have spaced the appointments , so you must go at appointed time only. The person taking child must wear a well fitting mask , any child above 5yrs old should also wear a well fitting mask. Dont take extra attendant. Do call the doctor from parking so that the clinic door windows are open and you can walk in straight without touching any object. Carry sheet from home which you can spread on designated area and sit down with the child. In the clinic do not talk . whatever questions are can be asked before reaching clinic on phone or after coming out on phone. The child should also be well conselled to keep quiet. Generally soothers are no good but at this time they should be used so young babies do not cry.Becase crying diseminates virus at high velocity even from asymptomatic patient. The spirit swab used for vaccine must be disposed of as biomedical waste in doctors clinic before you come out with baby. Paracetamol can be given for fever and pain after vaccination. So you vaccinated your child on time with all precautions. Now relax and keep consulting doctor as a part of TELEMEDICINE which is safe and eqqually effective.

PRACTICAL TIPS ON GROWTH OF CHILDREN.

Height :-

At birth average ht is 50cms

It should increase as follows 

1st 6 months   2.5 cms every month

Next 6 months  1.25 cms per month

1st year of life + 25 cms per year

1 to 2yrs     +12.5 cms per year 2 to 12yrs  +6.25 to 7.5 cms per year.

Birth height doubles at 4 yr of age & trebbles at 13yrs of age.

2to 4 yrs  ht in inches = ( Age in yrs x 2.5 ) +30 inches.

4 to 11 yrs in inches = ( age in year x 2) + 32 inches.

Height of adult in centimeters = twice that of child at 2yrs of age in cms + 2cms.

Weight

Initially birth wt is lost but is regained by 10th day.

It increases one ounce per day upto 6 months 

doubles birth wt 5 to 6 months

second half of 1st year 15 gm per day increase

birth wt trebbles by 1 year, quadruples by 2.5year of age.

weight in pounds 

3 to 12 months = Age (months)+11

4 to 8 yrs = 6 xage in years +12

8to 12 yrs = 7x age in yrs +5

weight after 1yr = ( age in yr +3 ) x5

Head Circumference :-

At birth 1.25 to 2.5 cms larger than chest. 1st 2 months same than smaller .

Chest :-

Barrel shaped at birth  transverse diameter i= Ap diameter

1 st year transverse is 25 % more than Ap

6th year Transverse 33% more than Ap

Upper segment : lower segment 

Upper segment is crown to symphysis pubis and lower segment is symphysis to sole.

At birth  Mid point is 1.8cms above umbilicus

At 2 yrs it is just below umbilicus because extremities grow more rapidly than trunk.

At 16yrs mid point is near symphysis pubis.

Sitting height at birth 70 % of total length.

                       at 3yrs 57%of total  length

                       at puberty 52% of total length

There are medical conditions in which sitting ht to total ht ratio falls.

Sutures & Fontanelle

Anterior fontanelle is 2.5cms x 2.5cms at birth , it closes between 9to 16 months 

Main sutures fuse by 6months.

Premature closure of sutures and fontanelle can be dangerou for growing brain which grows greatest in first year of life and 80% of total growth of brain is in first 4 years of life.

Melinisation begins after 3 months and is complete by 3yrs.

Heart is transverse in young infant , apex of heart is in 4th intercostal space , by 8 yrs it comes in 5th intercostal space. Upto 1yr heart is 55% of width of chestin adults it is 50% width of chest.

Urine  1st day is 15cc , 10th day is 100 to 300 cc.

There is no air in GIT upto 6hrs of life meconium is passed upto 3 days , transitional stools 4th to 7 days and later loose slimy green .

Tonsils  increase in size upto 5yrs of age and are mistakenly diagnosed by inexperienced doctors as enlarged tonsils and children are unnecessarily operated upon making children loose precious defense organ of body.

Pulse rate in new born to 1 year  per minute 120 & Bp 85/60

                                         2ys 110 , 4rs 100 , BP same  as above.

                                         6yrs 100  BP 90/60 , 8yrs 90 , BP 95/64

                                         10yrs 90 & BP 100/65 , 12 yrs 90 & BP 110/70.

       Ossification of centers , at birth 5 centers are present 2 in knee and 3 in ankle in talus , calcaneus  and cuboid   . At 6 months 2 carpal bones capitate and hamate appear.

Thus it is very important for a pediatrician to examine the child keeping all dynamic growth of child in mind and parents must realise that child is not just mini adult . Child needs pediatric expert.            

Parents towards children.

Parents are overambitious when it comes to children.
Firstly they start running for treatment of infertility even though the partners have been together for very less time as per the medical norms to call it infertility.
When the lady conceives they are overenthusiastic about having a male baby and ready for female feticide.
After the birth they want the child to be a superman therefore want to leave no stone unturned for that.
They try to interfere with the normal development. For example they try to toilet train the little baby by taking him to sink to pass urine where
as the actual age for toilet training is two years. They make the baby to sit with support as early as three months whereas actual age of sitting with support is 6 months..
whenever someone visits parents very enthusiastically ask the little baby to say bye to visitors whereas the actual age to say bye is 9 months.
They want to introduce walker prematurely. They force the children as young as 18 months to the school . Actually the age for mature grasp , holding the pencil and scribbling , making a line , vertical stroke and circle is all much later, making a triangle is learnt at 5yrs of age.
At all ages children are victims of parental anxiety , anger & foul language for not coming first.
In summer vacations forcing them to join hobbey classes weather the like it or not.Parents keep the time table of children so tight that there is no opportunity  for exploring creativity , self learning , learning from environment , grandparents or anything they like.
Throughout childhood they are grilled towards a career oriented path chosen by parents ,running for tutions rather than enjoying the school life Admission into professional college by hook or crook is the sole aim.
parents mostly  have an authoritarian approach "finish this milk before you step out ,I will see how you dare do this " if not this approach of bribe is there. "no tv for you if you do not come first.
punishment rather than logic " just be locked in the bathroom till you say sorry. Projecting father as terror "ok let your  father come he will slap you tight " Taunts " money doesn't grow on  trees , how dare you waste money"
In these trying times of lockdown ,parents are most anxious about syllabus completion , online classes.
So much so that some parents are on anti anxiety medicines.
All parents  always wish the best for their children but unknowingly they harm children's personality development by these unintentional mistakes.

Children are like flowers do not leave them to chance.

Children are like flowers do not leave them to chance.

So much can be done to keep them healthy and to make them good human beings.

All parents do every thing possible for children .

Yet diseases are increasing , stress in children is increasing ,drug abuse is increasing

crime is increasing,and so many other undesirable things are n rise.

where are we  going wrong n upbringing of our flowers.

Its time to ponder     and review.

we are responsible for vaccinating them , for giving them clean environment

for inculcating clean habits in them, for value based education rather than just

improving their percentage, for teaching them human dignity,,for their skill development.

LETS DO I NOW.

ARISE AWAE AND DREAM NO MORE.

DO NOT FORGET THE ROUTINE Vaccinations !

The routine vaccination to protect a baby starts when the baby is in mothers womb. The mother gets two shots of Tetanus toxoid in pregnancy so that newborn does not suffer from Neonatal tetanus which is a fatal disease and is still found in many developing countries.
BCG vaccine to prevent Tuberculosis or at least its complications is given at birth preferably . It can be given at later age also in susceptible population,
Polio drops are given at birth and at least three times in first year ,
repeated as boosters at 18months and 5 yrs of age.
Hepatitis B vaccine is given at birth and repeated at 1 and 6 months of age,
The DPT (diphtheria , whooping cough, tetanus ) vaccines are also given three times in first year and repeated at 18 months and 5 yrs of age. This booster is also repeated at 10yrs and at college going.
The whooping cough component in vaccine comes as acellular form
and is preferred by many.    The inject able polio   vaccine is combined with DPT and is available separately also.
The injectable Polio is additional to oral polio and is not to replace oral polio vaccine. The success of eradication of Polio from India is due to Pulse polio program by oral polio vaccine.
Measeles vaccine is given at 9 months of age, The MMR that is Measles Mumps and Rubella   at 15 months of age and repeated at 5 years and 15 years of age,  
Though there are vaccines available for Rotavirus diarrhea, some strains of pneumonia, Chickenpox , Hepatitis A and Hib meningitis and influenza for specific situations but the MOST essential vaccines should never be missed.                                                    

Children are like flowers they need tender care!

 Today while going through my old papers i found a handwritten note of a child to me whose parents
used to bring him to me for his aliments.
I still remember how he had secretly handed over the note to me while sitting on the examination couch
away from attention of his parents.
The note read like this"Doctor jee , please don't let my parents know that I am writing to you.
Please give strict instructions to my parents to let me eat what I like and not be a bully all the
time for everything. I promise to you I will eat healthy food and pizza only sometimes but only
if my parents are not kill joy. They have no other talk with me except Don't do this and do this.
Doctor please trust me , strict instructions to my parents can make me alright."
I can not remember what I might have done but I do believe that parents cant take children for
 granted and bully them all the time. Your children are only through you , they are not for you to
 fulfill all your unfulfilled dreams. They are like flowers , fresh , fragrant and full of joy giving abilities
provided they get loving tender care !

Enteric fever

Enteric fever or Typhoid fever is reemerging with resistant bacteria .
Its certainly a disease of in sanitation.
It is transmitted by 5 Fs  ie FLIES < FLUIDS < FECES < FINGERS.and FOOD
Open defecation as is still practiced in many parts of the world results in flies and also contamination of drinking water. Hand washing frequently can be a very scientific method of prevention of infection.
Cut fruits and open food can attract flies contamination resulting in typhoid.
Its a fever which can result into many complications and is getting difficult to treat as bacteria are acquiring resistance.
It can be best prevented by practicing sanitation and hygiene.
Its best prevented by very effective vaccine available against ths disease.
Children are precious inculcate practice of  sanitation and hygiene to avoid many dreaded diseases of insanitation.