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When my baby is born, we plan to give him a lick of honey before he suckles. It is a very common ritual in India to give honey after birth. Honey in children can cause diarrhea. In western countries but fortunately not in India it can also cause botulism – a life threatening form of constipation caused by bacteria in honey.
Do I need to clean my newborn’s umbilical cord stump at every diaper change The umbilical stump of the newborn falls off by the 5-6 th day.  After it has fallen off the raw stump should be cleaned with spirit thrice daily for three weeks. After every nappy change clean only if the stump is soiled. Definitely clean it after a bath of if potty has come out of the diaper and reached up to the cord.

I am a working mom and get only three months maternity leave. Is there an alternative to the breast pump? Can I start my baby off on semi-solids
Best option would be if you can extend your maternity leave on whatever grounds. See if you can work half day or work from home. Next best will be express breast milk as much as you can and store in a refrigerator. Last option will be to start some formula milk. The care giver at home who feeds the child should be good at maintaining hygiene and sterility. Semi-solids is not an option as they are recommended to be started after six months of age. In the times of your older child it was four months but now it is six months.
I have just given birth. When can I begin to take my baby out and where  A good time as is tradition in India is after six weeks. But a visit to your doctor or parents is ofcourse allowed. Initially take the child to a place which is not crowded and there are not many children or people. Children may be carrying some infection in their mouth and noses, which they may transmit to the newborn by fondling, kissing etc. After six weeks you can take her out to the park etc, but cover the stroller with a mosquito net. You can travel also, if you are confident in handling the baby by car or plane. Trains and buses are  avoided as they tend to be crowded. Market places best avoided till 5-6 months of age.
People say that coconut oil is cooling and mustard oil is warm, when applied to the skin or scalp.  In science there is nothing like cool oil and warm oil. People do use coconut oil in summers and mustard, olive and almond oils in winters. Medically also it does not make any difference which oil is used as it is not absorbed from the skin surface. It is only that the child may be allergic to mustard oil and we shift to coconut oil which is less allergic. Coconut oil does cause a little cooling probably due to a little amount of coconut water which evaporates on application and causes cooling.
When my house help’s child was born, she squeezed the girl child’s nipple area to remove some liquid  In a newborn it is very common to have breast engorgement which goes off in due course of time. This is due to the hormonal changes. It is not to be touched or squeezed. It looks very unlikely that breast tissue came out as only milk oozes out. Even if there has been any damage it is unlikely to interfere with the future functioning of the organ. If the nipple grows in an awkward direction it can be corrected surgically for cosmetic reasons.
Can I Breast feed if I have a cold  Common cold is a viral infection and spreads through air when you cough and sneeze. It does not pass through breast feeds. You do not have to stop breast feeding just cover your mouth and nose when feeding or when close to the child. In fact breast feeding will provide antibodies to fight the infection.
The only tummy time my 4-month-old son tolerates is lying on my chest or my husband's - he screams when I put him down on the floor  At this age tummy time should be only on parents’ chest / abdomen. On the floor or bed the child may vomit and choke. After a feed the child should be put on the shoulder and burped. After this lay the baby on one side or back but never tummy. Tummy time should be when the child is relatively empty stomach. You are doing perfectly fine and no tactics are required.

My 4-month-old daughter is rather cranky in the evening. People tell me it’s colic. Are all babies colicky  Most likely the child should be having a colic. There is an entity like evening colic in children two four months of age. Nobody knows the exact reason but it occurs at the same time every day usually in the evening. If it is in your case too anti-colic drops given at the start of the spasm every day does no harm. Rule out other problems like constipation, urine infection etc. Some children are more prone to this and as they say are more colicky. This could be due to the formula and a change of milk helps.
My in-laws put a lot of kajal in my baby’s eyes, to ward off the evil eye.
Kajal and Surma is put in eyes by a lot of elderly people  as they think it increase the size of the eyes. Large eyes are taken as a sign of beauty. It is not medically possible to increase or decrease the size of the eyes except plastic surgery. Kajal makes the eyes apparently look bigger. .Instilling of kajal can block the tiny pores of the gland of the eyelids and lead to conjunctivitis or sometimes stye formation.

Should let my baby use a pacifier  Pacifier in Indian conditions is a definite NO NO. It does make you rest in peace, develops good sucking muscles but the cons are many.  It is the commonest cause of diarrhea after bottle feeding. The child can develop buck teeth. Sweetened ones can cause dental caries. Moreover the child does not develop good communication and is just passively dependent on the pacifier.

My 6-month-old has sometimes rolled off the bed. He cries at the moment and then is fine. Will this have any long-term effect? Most of the children fall off the bed at least once at this age. Your child looks like keeps falling which is not good. Most of the time there is only external swelling which needs only cold fomentation and settles by 2-3 days. If there is internal injury which cannot be judged from outside can be dangerous. If the child cries excessively, has persistent vomiting or shows abnormal movements or has convulsions he should be taken to a hospital immediately for a CT scan.
My 6-month-old daughter has started developing a pink rash around on her face Pink rash around the face could be allergy to the food the baby is taking. Common allergens could be ready to use cereals, mango, apple etc. It could also be due to the saliva enzymes reacting with skin. Keep wiping while feeding or apply a barrier cream like Vaseline before starting to feed.
My 6-month-old has eczema. Will giving him a bath every day make it worse  Eczema is a common skin problem where the child is allergic to various allergens and develops skin rashes. It is very difficult to locate a specific allergen. Daily bath is a must as it cleans the skin and moisturizes it too. Care should be taken that no soap should be used or use dermatologist recommended soft moisturizing soaps only. Massage also if done should be done just before a bath and use very pure vegetable oils only.

My 7 month old who is always on a diaper has diaper rash that just won’t go away. The best way to treat a diaper rash is to leave the child open without the diaper for 2 days. Do it on a weekend. Till then apply a diaper rash cream just before applying the diaper. Also give a spare diaper to be changed halfway through in school. Do not apply powder.

When should I introduce semi-solids to my infant Weaning is the process of starting semi-solids / solids. Ideally breast feeding should be given till be given exclusively till the age of 6 months and semi-solids introduced thereafter. The age of the child is the determining factor and not the size of the baby. It is thought that the baby’s system is ready to digest non-milk products only after six months. Bigger babies may require more top milk feeds but solids should be started as like other babies. Mothers can produce enough milk for the biggest of babies for six months if they are motivated.

My 7-month-old baby does not like to have water in summers  A 7 month old if drinking enough fluids even if it is milk and is passing urine 10 times a day (24hrs) does not need extra water. Usually it is not recommended to give citrus fruits and juices to children less than one year of age specially if there is family history of allergy, asthma etc. Salt also should be restricted till 9-10 months of age. Moreover if the child is passing enough urine she does not need water that is why she is not drinking.
Giving calcium to newborns eases teething It is probably the commonest myth. Calcium helps in the formation of teeth and not in eruption. It does not have a pain killer property. The best source of calcium is Raagi (a cereal) and milk. If the child does not take adequate milk then probably calcium should be given.
I have a 6 month old baby and a new dog. My friend told me that dogs can cause allergies  
Animals like cats, dogs and cockroaches in that order are a known cause of allergies in children. The allergy can be skin allergy, running nose and sniffing or frank asthma. It is very difficult to pin point if the animal is actually responsible although the allergy tests available these days may be of some help.
My 7-month-old is trying so hard to crawl, but instead of going forward, she shifts backwards  It is very normal for a seven month old to shift backwards initially and then finally move forwards. Proper crawling will be only after 10 months, till then it is wriggling on the stomach. There is no way to encourage her to move in the right direction and this will happen on its own. .Don’t worry !.
My 10-month-old has started eating paper It is quite normal for children at this age to put everything into their mouths at this age, specially if they are actively teething. The only way will be to gently take the object away and distract the child. The only medical cause is iron deficiency so start giving an iron tonic if not started yet. This not a sign of Calcium deficiency.

My 10-month-old still does not have much hair on her head. Should I be worried?  
A normal newborn even with good hair at birth will loose hair till six months of age. Maximum loss occurs between 3-5 months both for mother and child. The hair start growing after that and by one year the child has a good growth. Some children do not have good hair by three years of age. Shaving the head does not help in better growth. See that the hair is clean, there is no lice or dandruff. Start the child on some multi-vitamin-iron tonic if not started till now.

Plenty of big ants after a while were the child had passed urine. It is very normal, still for satisfaction get a urine routine test done.
My 13 month old son tends to put everything in his mouth. Earlier we thought he was teething but now I am concerned Putting everything into the mouth is a normal stage of development – the oral stage as described by Sigmond Freud and can sometimes continue till 18 months. The child kind of feels the world through his mouth.  Initially because of the irritation of teething the child puts every thing into the mouth  and then it becomes a hibit. Try and gently take things out and distract the child. Iron deficiency could be one medical reason why the child is doing so – start on an iron tonic if required after consulting your pediatrician.

Can my 14 month old wear shoes  A child walks best when there are no shoes. This is easily achievable in hot Indian climates. In winters choose light shoes which fit smugly and do not skid on the floor. Velcro shoes should be preferred over slippers and sandals
My 15 month old started walking three months ago, and he’s still pigeon toed. Should I be worried?Your child is quite normal if he is still pigeon toed. Help him by massaging the lower back portion of the calf to relax the Achilles tendon. If the problem increases then a professional advice of  a pediatric neurologist can help in ruling out a neuro-muscular problem If everything is fine a few physiotherapy sessions can help.
We were planning to take our 16-month-old daughter on a holiday. How can we handle the flight A 16 month old is old enough to travel by air. It is a good opportunity to get over the fear of plane. Keep talking to her and distracted during the whole process of checking and boarding. Give her something to suck on while taking off and landing. Try a loly-pop if she does not take the sipper. If the ear starts hurting try hot-compress. Worst if she starts crying do not worry as crying itself opens the ear canal and equalizes the ear pressure. For smaller children we give Syrup Phenargan 5 ml half hour before the journey. It works as a sedative and helps in motion sickness too. She has made you anxious but most likely she will enjoy the trip.

My 1½-year-old son drinks only milk. The commonest cause of child liking only milk is bottle or breast feeding you have not mentioned anything about that. All these children who are hooked to these sucking addictions feel it is a waste of time to sit and eat. Moreover they are not well into chewing habit. So immediately stop if you are doing any of these. If the child is not on the bottle and still drinks only milk then it is pure laziness of chewing. Only way out will be to gradually shift to semi-solids and then solids like we do at weaning time. Children who are only milk feed can be iron deficient so please give some iron supplements.
I am going back to full-time work and would be enrolling my 2-year-old in day care. How can I prevent my baby from catching an infection  Once the child starts going to school / day care you have to be prepared for recurrent respiratory infections. That will happen to any child anywhere in the world. The average number of times a child will get is almost one every month. Only way to avoid is to find a good day care centre which is open, ventilated and has less children. Have a look on the general hygiene and cleanliness of the personnel.

My son is almost 2 and goes to play school. When should I start de-worming? Two years is a good time to start de-worming. It is given as a single dose of Albendazole.
It is available in a 10 ml bottle and the whole bottle is given in one go. If the child actually passes worms in the stools in the next 2-3 days given another bottle after 15 days, otherwise repeat the dose after six months. Although other medicines are also available but this is the most commonly used because of convenience.

My 2-year-old son’s foreskin balloons out when he passes urine. Is this normal? Ballooning of fore-skin in a 2 year old is not normal. It is because of very tight/pinhole fore-skin opening and the urine exerting pressure behind it leading to ballooning. You must see a pediatric surgeon at the earliest to get the opening dilated or sometimes even circumcision done. If you do not get it rectified it leads to back-pressure, urine infections and eventual damage to kidneys.
I have a 2 year old daughter. What’s the best way to take her temperature  Taking temperatures in small children can be quite cumbersome. Although rectal temperatures are the most accurate but can cause injury if not handled properly. Ear thermometers are a good alternative but are expensive. Easiest would be to use normal thermometers in the axilla kept for 2-3 minutes. Clean the tip after and before every use with spirit or Savlon.
My 2 year old screams his head off when he is taken to the pediatrician   It is very normal for a child between the ages of 9 months to 2 years to cry at the sight of strangers especially foes like us. Try and explain in simple words that this time you are not going for an injection before you start from the house but sometimes can be of little help. Do not worry as he will soon grow out of this and as it is after two years there are no injections till five years.  The child also outgrows his fear as now he is meeting more and more new people in school, park etc.

My two year old still vomits every now and then  A two year old may vomit normally after crying or even laughing. It is probably because the sphincter between the food pipe and stomach has not developed completely as yet. With time it will become normal probably by five years. Do not worry – do not let her cry specially after liquid feeds like milk. See a pediatric Gastro-enterologist if it continues.

My daughter 18 mo has a bad habit of thumb sucking especially when she is hungry or wants to sleep  At 18 months age thumb sucking may be normal if it happens only for sleeping or when hungry. It gives the child some form of solace and gratification. It may be left as it is. If it happens throughout the day then certain things may be tried with variable success. Distracting the child and physically removing the thumb is the first step. Apply a thick leucoplast bandage or try applying a bitter lotion Femite. As a last resort we have tried applying a plaster bandage also. If psychological insecurity is thought of a psychologist may be of help.

When the child is sick (measles, chicken-pox, viral fever) he/she should not be given a bath.
When the child has fever the best way to bring it down is to give him a bath. If the child cannot tolerate the cold water, luke-warm water may be used. Measles and chicken pox are also a kind of viral fevers and bath can easily be given. Exceptions can be in real cold winters, child suffering from pneumonia or in chicken pox if the
Milk and banana should not be given when the child has cough as these are 'cold' foods.
This is a common myth propagated by the doctors of alternate systems of medicine. If the child has dry cough and not too bad like in viral or allergic sore throats giving warm milk and banana poses no problem. The concept of cold and hot foods is more to do with the temperature of the food than effect of it. However, new scientific research has found that milk and specially banana have certain mucous producing substances like serotonin which may increase phlegm formation.
My child is prone to coughs and colds. Should I give him the flu vaccine  Cough and cold in children could be due to allergy or infections. When the child enters school the frequency of these are more as the body is coming across newer bacteria and viruses and this is how the immunity develops. Most of the children will outgrow this by the time they are five. Influenza group of viruses are responsible for 20-30 % of all viral episodes. By giving the vaccine you may be reducing that percentage of viral infections. It is worth taking the vaccine only if your child is prone to virus associated wheezing episodes. The vaccine has to be given every year in around September.

Since my child is a fussy eater and the only thing he likes to eat are eggs. Even in summer we give him an egg a day  Eating eggs is not a problem even in summers. It is a complete food and is a good source of proteins fat and iron. In medicine there is nothing like warm food, and even if there is hot and cold food in Ayurveda the child is not going out in the sun for long – these days children live in AC rooms only.
      My 15-month-old child has seven teeth in his upper jaw and five in lower jaw, he  sometimes has bad breath  Since your child already has 12 teeth it is high time you start brushing. Start with a baby brush and children’s toothpaste. Brushing should be done both in the morning and bed-time the latter is more important. Use a very small amount of toothpaste – the size of a wheat grain as she is most likely to swallow it. Give the child the brush and you better not do it as it is uncomfortable for the child and may hurt the gums after which he will not open his mouth. The child will initially just chew on the brush which is good enough. Once the child is two years plus proper brushing movements can be taught.
The nebulizer is worse than giving my child oral medication
Nebulizer is a device by which a medicine is vaporized using an air pump. The child inhales the vapour which is directly deposited in the airways of the lungs. By taking oral medicine the drug goes into the stomach then into the blood stream. Blood then travels all over the body including the brain, heart etc where it is not required. The medicine is only required only in the lungs. Since the drug is traveling various other organs where it is not required it has side effects on these organs. Because of the dilutional effect larger doses are needed for the same effect. As the nebulizer vapour goes into the lungs directly it has no other organ side effects and doses used are very small as compared to oral dose. As low doses are used it can be used for longer periods as compared to oral medicine. Similar is the case when we use an inhaler and a spacer device. It takes even less time, convenient to carry and use and is equally effective.
White spots on the face or in the nails are caused by calcium deficiency.This is again a very common myth propagated by our own household self doctors. The link between the white spots and calcium is only probably the colour. The actual reason could be allergic to maybe sun or Pytriasis alba a kind of fungal infection. These white spots generally disappear after 2-3 months, if not seek the help of a dermatologist.
My 3-year-old daughter has a lot of hair on her back and legs  It is most likely that the 3 year old has genetic excess of hair. If it runs in the family especially on the father’s side do not do anything now. When she grows up you can try the new modalities of permanent hair removal. If the hair growth is increasing specially on the face hormonal imbalances should be thought of and a pediatric endocrinologist consulted.

My 3-year-old son is not toilet trained yet.
Toilet training actually means that the child is able to inform before doing the job. Some children are selective in the sense that they inform for urine but not stools. This could be the case when the child is constipated. It is quite normal for some kids to not inform even till five years of age. One should not make an issue of it otherwise the child becomes more stubborn and makes it like an attention seeking device. As a first step treat constipation if any by diet and medicines if required. Secondly rule out urinary infections by a simple urine test. Gently try and explain to the child about the right place to urinate and not hold urine for long periods. If the problem does not resolve by five years then urodynamic studies have to be done. This is to see for bladder capacity and function.
My 3¼ year old son is very reluctant to consume dairy products  Consumption of dairy products is very important in the growing ages but he can still survive without them. He needs 500 ml milk till the age of 10 years which can be given in any form of milk. If he does not like any milk product try giving him raagi cereal which has 3 times more calcium than milk. If everything fails give him some calcium tonic.

My child does not eat enough. How can I make him eat more?Each child like an adult has a different metabolic rate and have a different structure of the body.  Accordingly the requirement of energy is different. On child may take small amounts and be energetic through out the day and the other may eat more and still be thin. As long as the child is within the normal range of height weight parameters and gaining according to the normal accepted standard for that age you should not worry. All medicines for apetite stimulation are temporary and may side-effects on long term use. To make him eat more, better will be that you make him increase his physical activity and should be allowed to play as much as he can. De-worm the child regularly and check for anemia.

After joining nursery school, there is a definite change in my 3-year-old daughter’s demeanour. She continues to be cranky even months after joining.  It is a case of separation anxiety. Some children do take a long time settling in school. This is more so in first born and children from nuclear families. You will have to leave the child in school and disappear. During non-school times also try to leave her with friends and relatives to get her used to the idea of staying alone without you. As a last resort a child psychiatrist may be of help.

What is good about health drinks like Horlicks, Bournvita, etc
These health drinks have mainly different proportions of carbohydrates and proteins along with added vitamins. They mainly increase the calorie content of milk, increase the vitamin content and for the child change the taste.

Egg in which form is more nutritious: boiled, omelette or some other way
Egg is equally nutritious in all forms but avoid giving raw eggs for the fear of transmission of infections like Salmonella. Omlette has slightly more calories because of the extra added ghee.
What is a balanced diet for my two year old.
A balance meal should have two cereals, one helping of fruits/vegetable some protein like dal/egg and half a litre of milk in any form every day. The cereal fruit etc has to change every day according to likes of the child.  A specific dietitian’s chart cannot be prescribed as all children are different and will not take what you want so only a broad outline can be made as above.
My 2 year old has been detected as lactose intolerant, how do I give milk Lactose intolerence affects almost one-fourth of the Indian population to varying     degress. It may rarely be present at birth or develop anytime later in life. The only solution is to have curd / yoghurt . Another alternative is to drink Soya milk. The child at this age needs around 500-600 ml of milk per day which can be easily given in the form of curd / lassi etc.

I have noticed he very upset at loud noise. If he hears any loud sound as the pressure cooker he starts crying.  Some children have a hyperacusis problem i.e. they respond abnormally to loud noise. The only way is to avoid exposure to loud noise. If you have to take him to such a place put cotton plugs into the ear before going. If you feel there is something really abnormal an ENT check-up and hearing test will help if it was not done at birth.

My 2-year-old’s skin scars very easily. Every time she falls down or scratches, it leaves a dark-colored patch. Why is this and can it be cured?The tendency to form scars is an individual skin characteristic. Some skins are more delicate than others and are more scar prone. These are inherited tendencies and cannot be changed. Sometimes local antiseptics can stain the skin due to local allergy so apply another antiseptic next time to rule that out.
While going to school my daughter only has a glass of milk in the morning. Is this okay? Your child is the majority of other children who drink only a glass of milk in the morning. Quite a few children have so much of school anxiety that they cannot even drink milk. The child in any case should take something for the lunch break and eat it too – not give it to friends! If the child has stomach ache after the morning milk give him a banana or egg or a cereal.

My 3-year-old does not chew food properly, he just gulps everything
 Some children are  bad eaters and are lazy to chew. They are on likuid or blended food for a long time. Children who are on bottle and breast feeding are also more into sucking and avoid chewing. If the child is on breast / bottle feeds stop it immediately. Besides this nothing much can be done except probably making the food more tasty and attractive. Please do not scold or hit the child for  this it will get worse.

My 3-year-old daughter is having a lot of difficulty picking up language.  
At three years of age a late talker has to be taken seriously. First person to see is an ENT specialist to rule out hearing problems. If he suspects any you might have to see an audiologist for accurate hearing test. If hearing is normal then a child psychiatrist will have to rule out dyslexia. If everything is fine speech therapist can be of help.

My son is 3yrs old. Suddenly, since the last two months he has been peeing in his pants. in the night he does not wet the bed.Your child has some kind of a behavioral problem. This could be due to some stress at school due to teachers, maid or peers. A visit to school and discussion with the teacher will help. Meanwhile get a urine routine and culture test done to rule out an urinary infection. If nothing seems to help an opinion from a child psychologist can be obtained.
     My 3½-year-old daughter is prone to vomiting while travelling for more than a few kilometres in a train, car or bus.  Yes the child may have motion sickness in the plane also. The problem is usually genetic, has no cure but fortunately becomes less with age. Till then avoid giving food specially liquids one hour before the journey. Before long journeys or hilly rides Promethazine (Phenergan) can be given half hour before starting. When going in a car ask the child to look straight on the road not look out of the window.
My 3½-year-old son is becoming fussy over small things. He doesn't want to go to school and starts misbehaving he has to go. At this age if the child suddenly changes his behaviour it is definitely psychological. There must have been some incident in house or school which has made him withdraw into his shell. A one to one lonely talk will help in bringing out his feelings. You can take the help of a child psychologist if the problem persists.
Whenever I feed my 4 year old son, it takes me at least one hour because he keeps the food in his mouth. Approximately thirty percent of children will be choosy or picky eaters. These children have other priorities and eating is not the aim in life. They are lazy to chew and would keep things in their mouth as if they finish you will put another morsel. Try and make the same things a little more spicy and tasty, keeping in mind that the child gets a balanced diet of cereals, fruits, milk etc. These children will gradually grow out of it by 10-12 years.
I have a 4-year-old son and I notice that he breathes through his mouth at night. The wheezing sound you hear over the chest is probably a conducted sound created by a blocked upper respiratory tract. It could be blocked nose, weak soft palate muscles, or enlargement of adenoids. These are soft tissue growths like tonsils but situated behind the nose. Get an X-ray of the neck done to rule out their enlargement. ENT opinion is required if the problem persists.

My 4-year-old’s speech is still not very clear. Should I approach a speech therapist At four years of age if the speech is not clear one must see a speech therapist. If not corrected now the child can develop complexes due to peer group teasing. I hope the child does not have any ENT problems or hearing deficits.
My child gets a morning cold when she wakes up. It disappears in an hour or so. Morning cold and sneezing is a common allergy seen in children and adults. Usually there is also a family history of some form of skin or respiratory allergy also. If the block nose and sneezing happens only in the morning and the child is fine and is not bothered throughout the day, nothing needs to be done. Otherwise an oral anti-allergic for two to six weeks can be tried during the allergic season. If still not under control nasal spray in once or twice daily can be used. In short if the problem increases see an ENT specialist.
My 4 years old child loves the AC but when he sleeps with the AC  It is not possible for the AC to be causing cold and fever daily morning. AC is a kind of necessity in the hot humid months for having a restful sleep. See that the temperature setting is not too cold – 25 deg is fine with an infant or 22 deg for older child. Cold everyday in the morning could be an allergic cause. Fevers is not possible every day because of AC and look at other causes of recurrent infections like bad habits and contact people like maids or friends in the park or school.

My 4-year-old son complains of pain in his legs at night  Common pain at this time is growing pains. It is a common problem in this age group the exact reason of which is not known. It usually happens late evening or early sleeping time and sometimes can be really bad. People have been experimenting with Vitamin E, Calcium etc but the child actually grows out of it. See that the child is not overweight and rule out Vitamin D deficiency by doing a blood test or X-ray of knees.

While playing around the house, my 4-year-old knocked his head on the dining table and developed a bump on his forehead.  Such kind of injuries are superficial and due to oozing of blood underneath the skin. Immediate cold fomentation and maybe a mild pain killer is all that is required. Internal injuries are detected only by a CT scan and clinical examination or an X-ray are of little help. CT is not required in all injuries and is limited to major falls, fractures of the skull bone or if the child shows certain symptoms like persistent vomiting, drowsiness, irritability or convulsions.

A number of children are using sanitizer these days  Also, is there alcohol in these products which is not good for kids? Hand sanitizers are a very good alternative to soap and water. They are usually alcohol based in the form of gel or liquid or foam. For good efficacy it should have minimum 60% alcohol and take 10-15 seconds for drying. The advantage is that it can kill resistant bacteria and some viruses which soap cannot. Hands which are grimy or muddy should be washed first with water and then sanitized. Sanitizers also have the convenience advantage and can be carried in pockets and purses. The alcohol does no harm to the skin as it evaporates in 10-15 seconds. Only side effect may be a little dryness of skin which is compensated by glycerin or oils added to the sanitizer. The dryness caused is also less than what is caused by soap.
My 5-year-old child often complains of headaches. What could this possibly be Common causes at this age are eyesight related, ENT problems, migraine and rarely blood-pressure. First get a thorough eye check by an eye doctor not from optical shops. Get an ENT check if the child has continuous running nose or snoring problems. If you have a family history of Migraine it should be strongly considered even at this age. Ofcourse one blood pressure measurement is mandatory. If all is clear see a pediatric neurologist.

My daughter now 5, got all her milk teeth before 2 years. However, I could not brush her teeth properly and she got cavities by 2½ years.  Now her two lower front milk teeth have fallen and new ones are coming out. However, nobody of age we know has lost milk teeth. Is it too early to lose milk teeth  It is within the normal age range to lose teeth at this age so do not worry, nothing is abnormal with your child. Some people have poor teeth structures and composition and are prone to carries more than others. You have to be very careful about dental hygiene from the very beginning. Regular dentist checks from now, will help in preserving the teeth. These days sealants and cements are available with the pediatric dentists to improve the strength of these teeth. You get a second chance with milk teeth but not this time.
My son had his anti-tetanus shot when he was 5, now he's 7 and he got hurt last week at the playground the slides (some part was rusted)  A child who has been taking vaccinations regularly does not require tetanus shots. In the immunization schedule DPT is given in the first year thrice and repeated at  18 months and 5 yrs. The T in DPT is tetanus and has enough strength to see you through till 10 years. At 10 yrs Tdap is given which acts like a booster and covers you for another 5- 10 years.5yrs for major injuries and 10 yrs for minor cuts and wounds. Although extra TT in between may cause no harm if given accidently but it is not required.

My 6-year-old son complains of stomach ache almost every day.  
The commonest cause of stomach in India by the book is worm infestation.  The commonest cause in my practice is constipation. This could be a result of irregular bowel habit or incomplete evacuation. Irregular bowel habit leads to hardening of stools and again incomplete evacuation. Retention of stools leads to fermentation and flatulence and stomach ache. Remedy lies in regular bowel habit daily preferably in the morning. Advice to drink plenty of fluids, increase intake of  fibre like green vegetables and fruits. The child has to avoid junk food rich in maida like noodles past, biscuits and white bread, have more of whole wheat products. Figs, prunes and honey are natural remedies for constipation.

My 7-year-old has had a few episodes of wheezing and breathlessness. He has even had to have an Asthalin puff on occasion. Does this mean he has full-blown asthma? Technically speaking any child who has had more than three episodes of wheezing is asthmatic. You may call it by various other names like viral bronchitis, allergic bronchitis etc but physiologically they are all the same and treatment is the same. Your child seems to have mild intermittent Asthma as he has required Asthalin puffs on a few occasions, so has a chance to grow out of it also unless you have a strong family history.
      At the end of a tiring day, my 7-year-old son sometimes complains of ankle pain. Is it true that these are ‘growing’ pains Ankle pain is generally not the site for growing pains and 7 years is generally not the age. Get an X-ray of the ankle to rule out bony growths. Use special footwear which have extra padding at the ankle. If the pain continues see a paediatric orthopaedic doctor.
My son is 7 years old. He often gets confused between green and brown.  Colour blindness is a problem usually seen in boys. The commonest form is red/green when the child cannot differentiate between red and green. Most often the colour blindness is mild i.e. the child cannot differentiate between shades close to red/green like brown. You need to check it by going to an eye doctor. He has Ishiara charts in which the child has to read numbers written in different colours. Do not worry, as these milder forms do not interfere in his daily activity and as it is there is no treatment and you cannot do anything about it.

My son is 7, and often wets his bed at night, unless we wake him up at midnight and take him to bathroom. Your son has the problem of nocturnal enuresis. This is the passage of urine at night without the child knowing it. The child does not do it deliberately it just happens. It is because some children form more urine at night. In other children the child goes into very deep sleep and the brain is not aroused when the bladder is full. Some children do not develop control at all and they have never been dry – this is not a behavior problem it is developmental and could be genetic. If the child has been dry for more than six months and starts wetting again then it is a behavior problem. For behavior disorders counseling helps. For primary enuresis where the child has never been dry other modalities like wet alarm and medication has to be tried. Simple measures like passing urine before going to bed and not drinking fluids for two hours before going to bed are hopefully being already done.
Is cod liver oil good for kids Cod liver oil is derived from liver of Cod fish. It is a rich source of Vitamin A and D. It used to be very popular in earlier days as it was though to increase immunity. It would be a better idea to have natural source of the vitamins like coloured vegetables and fruits  and natural sunlight. These two vitamins are fat-soluble so can be stored in the body if taken in excess amounts. Overdose can cause hypervitaminosis leading to headache and blurring of thought. It would be good for your children if they have deficiency of these vitamins not otherwise.
Our 7-year-old daughter has nightmares that wake her up. Should we be worried? All children after 8-9 months and adults can have nightmares. Your seven year old can be disturbed in sleep and if she gets up frequently she may not be alert in school the next day. To minimize these episodes make her sleeping time more peaceful and comfortable. Light music or a nice story at bed-time will help. For an hour before sleeping she should not be watching television or reading a scary story book. Talk to your daughter alone if something is disturbing her mentally – friends, teachers etc. If it increases to alarming proportions you can seek the help of a child psychiatrist.
My 7-year-old daughter refuses to take any medicines—even syrups. Some children really trouble taking medicines. Best would be to give the medicine empty stomach when the chances of vomiting are less and follow up with something the child likes like a chocolate piece or a sweet. The medicine can also be mixed in any liquid like milk, honey etc. Check out with your doctor before mixing as some cannot be mixed like milk and iron tonics but most medicines are compatible.

My 7 year old daughter bites her nails constantly. How can I get her to stop  A 7 year old is now grown up enough to know that it is not good for her health and stop the habit immediately. Probably it just happens when she is tense or engrossed in a involving TV programme. Apply a bitter commercial solution commonly available in the market thrice daily for 4-5 days – helps for most of the children. Some children may need the help of a child psychiatrist for ruling out underlying psychological problems.

My 8-year-old’s sweat has begun to produce an odor. Why is this and what can I do to prevent it
Your child has started being adolescent. This is the age when apocrine sweat glands develop. These are the glands which cause odour and are present in the axilla and in genital region. To avoid bad odour, best is to observe good hygienic habits like twice daily bath and use of antiseptic soaps. Use of deodorants discouraged at this age.
My daughters, 8 and 5 years, have got lice in their hair.  Lice in hair can be treated by applying 1% Permethrin rinse. Apply all over scalp and leave it for 10 minutes. Repeat after 15 days. If the infestation is severe we can give oral tablet of Ivermectin also. Please treat the source of infection like the maid in the house unless she has got the lice from school. Hairs have to be chopped off only if there is development of eczema because of persistent scratching.

My 8-year-old daughter often complains of pain in her legs at night.
Pain in legs at night could be growing pains although this is not the typical age group. If the child takes adequate amount of milk or its products, Calcium deficiency is unlikely. If the diet lacks in fruits and vegetables give a multi-vitamin tonic. Finally a deficiency of Vitamin D has to be ruled out. This can be done by a X-Ray of the knee joint or better by doing a blood level of Vitamin D-3. Till then if the pain is severe give some Paracetamol or do a local legs’ massage.

My 8 year old daughter still wets the bed at night, at least 4 times a week At this age 3-5 % of children may still be wetting their bed at night. There could be a family history also of either parent doing so at this age. As it could be embarrassing for the child get routine urine test, x-ray of the spine and an ultrasound done. If everything is normal, lots of things can be done with the consultation of your pediatrician like positive charting, bed-wetting alarms etc. These days there are very safe medicines and nasal sprays also available. The problem with medicinal treatment is that there is always a chance of a relapse after the medicines are stopped.

My 8-year-old daughter often complains of pain in her breast area. Your daughter is growing up into a young lady. What she is having is thelarche – the onset of puberty. It starts as pain in the breast forming a small painful lump. After a few months it can come on the other side too. After 5-6 months the lump becomes softer and proceeds to breast enlargement. If it pains really badly do a little hot fomentation and give a pain killer if required. Growing pains usually occour in the legs at bed time or soon after going to sleep.
What can I do for the absolute bad breath from my 8 year old Bad breath is usually caused by bad oral hygiene and consequent bacterial overgrowth. Brushing of teeth twice daily – last thing at night and first thing in the morning is a must. Stop the bottle if still on bottle feeds. Listerine / Betadine / Hexadine gargles or mouth wash at bed time also help. Sweet candies etc should be discouraged. Consult a dentist to rule out dental caries.

My 8-year-old frequently complains of ankle pain, which passes in a few minutes. Ankle pain in an 8 yr old could be Synovitis or epiphysitis of the calcanium bone. These are inflammations of the heal bone or tissues around it. An X-ray of the ankle and check by an orthopeditian is required. Till then make him wear special shoes with extra cushioning.
My 8 yr old still grinds teeth in his sleep  Teeth grinding or Bruxism as it is medically called is a habit sleep disorder and NOT related to worms in any way. People when they talk of worms they mean the common thread worms and round worms in the intestines of children. It occurs in deep phase of sleep and is a disorder like sleep walking and sleep talking. Nobody knows the exact reason but there are many theories. A common one is that it is a kind of expression of hidden emotions or happenings of the day. Not many treatments available but if it is a great source of disturbance to others sleeping with the child a dentist can prepare a mouth guard to be inserted in the night. The guard also helps in prevention of teeth damage.
What is sunstroke and what is a good way of preventing it  Sun stroke is an extreme condition with high mortality rate. It is a medical emergency and needs hospitalization. What is commonly seen in heat exhaustion. It is caused by excessive perspiration and thus low blood pressure. This leads to exhaustion and black outs. The patients present with vomiting low grade fever and drowsiness. It is best managed by rest in a cool room, plenty of fluids and extra salt. The best method is prevention by drinking plenty of fluids before going out and using a shade like an umbrella.
My 9 year old boy gets nine hours sleep a night and still wakes up very tired  In terms of duration of sleep nine hours is enough for a nine year old but maybe he is not relaxed enough during the sleep. It could be due to food stimulants like tea, coffee chocolates or exciting movie before sleeping. It could be lack of proper breathing due to nose block or enlargement of adenoids.. Get his hemoglobin and eyesight also checked for his drk circles.


My 10-year-old is gaining weight  At this pre-adolescent age it is normal to gain extra weight before gaining height. It is important that she does not gain over and above what is normal. Adolescents at this time may have psychological problems and tend to overeat. They also tend to be lazy, sleep more and thus gain weight. Hormonal problems like low thyroid functions can also start at this age so keep a watch on other symptoms like dry skin, hoarse voice and constipation.
Are artificial sweeteners okay for kids  Artificial sweeteners are mainly used to reduce the calorie intake for weight reduction. The common ones used are saccharin, aspartame, sucralose etc. Although not proven definitely ever they have been linked to bladder cancer and brain tumours. Till it is proven beyond doubt that they are safe it is better to restrict their use. Best way to lose weight for children to eat less cheese and chocolates and play more physical games.

My 10 year old daughter is a very fond of coffee and she takes it on a regular basis Drinking tea / coffee at such a young age is not a good idea. It can cause acidity in the tender stomach, over stimulate the child cause sleeplessness and anxiety and it is obviously addicting. Once in a while having cold coffee is fine but try and avoid giving after evening hours.

Can my 10 year-old listen to music through ear phones  Technically he can listen to music with ear-phones 5-6 hours in a day (Hope he is not reading this). The volume is more important. A volume of more than 90 decibel for even a short duration can be dangerous. 90 dB is a sound volume when a person talking at a 3 ft distance cannot be heard. Ear canal insertion ear phones are more dangerous than normal head phones. Continuous exposure to noise leads to gradual hearing loss.
Can my 10 year old start using contact lenses A 10 year old is absolutely not ready for contact lenses. Contact lens wearing is not only an art but requires a lot of care in terms of handling and hygiene. If not taken proper care the child can land up with severe eye infections. She should continue with glasses for another 5-6 years.

My son is 10 and spends lot of time on the computer. Can it harm his eyes Computers have become a part of our lives including for a ten year old as he may be getting a lot of school projects to be done with the help of a computer. So he has to spend that much time that is necessary.  A specific time frame has not been established as it depends on a lot of factors like lighting, posture and the kind of monitor used. LCD screen are less stressful as compared to the old CRT monitors.   Approximately it is said that for a growing child breaks after every 30 minutes of viewing are a must. Maximum of two hours in a day of Computer, TV and video games combined have been proposed. As it is more than this the child will no time for physical activities and interaction with parents and peers.

My 11-year-old son is very athletic and has been complaining of knee pain after basketball practices and games.
At this age the bones need extra calcium. Increase milk intake to 750 ml per day. Get him a good pair of shoes with thick and soft heal soles for cushioning as he plays on hard court. If the pain persists get an X-ray of the knee done and see an orthopaedic doctor to rule out OS disease. Ibuprofen and knee bands are only temporary and not cure of problems.

12-year-old wants to wax. Is this okay for her skin? Are there any precautions I should take before and after?
The skin at 12 years is hardy enough to withstand waxing, but an individual skin can be different. Make sure that the person doing it is hygienic and washes hands before starting the procedure. Try and use your own wax and cloth. Afterwards keep a watch on the area for 3-4 days. If there are red spots or pus like dots (pustules around hair follicles) apply an antibiotic ointment like Soframycin thrice daily for 5-7 days.
My 12-year-old got her period one month, and then it stopped. is quite normal to have irregular cycles in the first 2-3 years of the onset of menarche. The cycles may be irregular and may vary in terms of days and blood loss also. It may be very painful too. You nay need to see a Gynaecologist and maybe get an ultrasound done if the variation is very much out of proportion.

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