Child Care
Complied by Dr. Shipra Gulati
Commonly asked question by mothers

Q1 What is new born care?

A
It implies Cord Care - keep the uendical card string healthy with dry and regular twice a day, cleaning with spirit or Betadine lotion.

EYE CARE - Clean the eyes of newborn boiled water swats.

TEMPERATURE - Newborn are prone to hydhermia low body temperature and can be dangerous for them. Newborns should be punk and warm always.

Q2 What feed needs to be given to the New -born?
A
This is most commonly query in the mind of new mothers. The establishment of successful breast feeding needs confidence and determination in the mother to feed their baby . Breast milk is the best milk for your baby up to age of 4-6 months he needs nothing more.

Q3 How do mothers know that their milk is sufficient for their baby?
A
Breast milk can never be less for your baby till all the age of 6 months.

If your baby shows how the following features it indicates breast milk is sufficient.
i) baby sucks suits for 15-20 min ( good sucking force)
ii) has a sound sleep for 2-3 hrs
iii) passes urine at least 5-6 times a day
iv) is playful & active
v) gains weight upto day 20 30 g/day.

Q4 Does the baby need water in summers in addition to breast milk?
A
Breast milk has enough water content to meet your child's needs. No extra water needs to be given to your baby upto 4-6 months.

Q5 What is right technique of breast feeding?
A
Any position in both mother and baby are compactable is the right position. But certain points need to be taken are of

• The breast tissue i.e the nipple and aredor should be taken by the baby in the month so that the baby's gums and lips press on the black portion (aredor) are behind the nipple.

• If the baby sucks only at nipple >> he gets no milk as the milk ducts run in the area behind the nipple hence it is necessary that arcola be also un introduced upto baby's -------------.

Q6 How long should I breast feed my baby at a time?
A
A baby should be fed till he keeps on sucking but on an average baby takes about 20 min to satisfy his/her demands.

Once the mother feels baby has taken adequate feeds and is still hungry, the feed from then next breast should be given.

Else alternative breats should be used every time.

Q7 What to do if it pains while I Breast feed?
A
Pains while breast feeding your child is due to wrong technique a result the baby keeps on suckling at the nipple and get no milk sucks more rigorously & a vicious cycle is set up. As a result the nipples become red cracked, may even bleed.

Q.8 What is to be for cracked and sore nipples?
A
First, to correct your feeding technique & express milk form the side pains more and feed that milk with katori and spoon (NO BOTTLE).

• Apply VASELINE ointment on the sore nipple or even some hard milk (i.e milk and coins in latter past of expressing ) and it open in air leave.

Q9 When can bottle feed be started in my child?

A
"NO BOTTLE FEEDS" are advocated for a child be it newborn or an elder baby

• Bottles are the culprits for infection in a baby . No matter how much hygiene we maintain, no matter how much we boil the bottles before feeding.

• Various studies report that babies who are put on bottle feeds have 6-8 times more chances of ACUTE RESPIRATORY INFECTION (ARI) and 10-12 times more chance of DIARHOEA (ACUTE GASTRO ENTERITIS).

Apart from this such babies/ children become bottle dependent and do not take any other diet other than milk in other words milk dependent which delays their growth.

Q10 What is EXCLUSIVE BREAST FEEDING?
A
All new borns should be exclusively breast fed till age of 6 months. This term means that the baby should be given breast milk and only breast milk till at least 6 months of age. No water, no to feeds, no ghutt is etc.

Q11 When should breast feeding be started?
A
Breast feeding should be started at the earliest i.e. as soon as mother is comfortable enough. On an average In normal vaginal delivery within ½ hour and caeser ear section by 24 hrs.

Q12 Should the initial milk secretions be discarded?
A
The milk on secretions on day 1-2 after delivery is called COLUSTRUM. Colustrum is very thick yellow coloured and nutirious very for the baby. It has many anti infective properties which are beneficial to the baby.

It should never be discarded and always he given to the baby.

Q13 What should be done for hard painful breast?
A
When the breast becomes hard and painful they are said to be ENGORGED. Engorged breast are due to milk accumulation in the breast (i.e. production is more extraction)

TREATMENT:
• Hot water fomentation
• Express milk manually preferable, and in extreme cases only should breast pump be used.
• Then breasts feed your baby
i.e. it is difficult for a new born to suck on a engorged breast.

Q 14 Danger signs in a newborn When should be take my baby to the doctor?
A
The first year of life or infancy is the most risky period for babies. Upto initial 2-3 months of age, babies may show sudden deterioration if their behavior is ignored. Therefore it needs a high degree of suspicion so as to prevent such mishaps. Certain behavioural changes or indicators which might help us are :
• A baby who is dull, lethargic, inactive but was otherwise active
• Not accepting BF well
• Passing urine 5 times/day
• Has fever, vacant stare, abdominal distention, passing frothy, green coloured stools, water in nature
• Vomiting espllow coloured
• Appears palein colour blueish ANY BABY WITH ANY OF THESE FEATURES
• Should be immediately taken to a doctor for immediate medical attention.

Q15 How to prevent my baby from getting infectious?
A
• Exclusive BF.
• Maintain personal hygiene very well especially by the mother, wash your hands each time you touch your baby, nails should be clean and cut, clean your breast with clean water before each feed.
• Avoid too people to man handle baby.
• people with any form of infection like cold, cough should not enter that room.
• If mother has cold cough-she should breast feed the baby while using a mask. • Room should be well lit (no dust catching objects like stuffed toys) and no flower.
• Floor should be wet mopped.
• Get your BABY VACCINATED as advised by your pediatrician.
• Any change in behavior noted by the mother.
• abnormal behavior noted by mother.


WEANING

It is the introduction of foods other than breast milk in a child at the age of 4-6 months.
(1) Liquids like soups - Weaning, food include, dal soup, rice water, vegetable soup, chicken soup, orange juice, mixed fruit juice, apple juice etc.
(2) Liquids of thicker consistency like Custard, Suji kheer, daliya pudding, porridge.
(3) Semi Solid foods like Khichery, rice with dal, rice and curd, CERELAC, NESTUM.
(4) Mashed fried potatoes with a punch of salt, breed butter soft
(5) FRUITS - Banana, chiku mango, apple crushed

ALL WEANING FOODS SHOULD BE INTRODUCED ONE AT A TIME STARTING WITH LIQUIDS THEN PROCEEDING TO A THICKER AND THICKER CONSISTENCY.
FOODS LIKE ANIMAL MILK (INCLUDING BUFFALO MILK), EGGS SHOULD BE PREFERABLY STARTED AFTER AGE OF ONE YEAR TO MINIMISE CHANGES OF ANIMAL FOOD ALLERGYS.

NECESSITY OF WEANING
As the child groups the demand of body increases, the requirement also increase . As a result Breast milk may not be sufficient to sustain the demands of the growing body of your baby.

Also milk is deficient some constituents like iron & vitamins, which are essential for growth of the child. Therefore weaning foods are introduced.

Weaning foods should be preferable home made in hygienic conditions and fed with katori and spoon .

One food should be introduced at a time.

IMMUNISATION SCHEDULE
AGE VACCINE DUE ON GIVEN ON MAKE
Birth BCG      
  OPV (Oral Polio Vaccine)        1st Dose        
  Hepatitis B Vaccine                1st Dose      
4 Weeks OPV                                     2nd Dose      
  Hepatitis B Vaccine               2nd Dose      
8 Weeks DPT                                      1st Dose      
  OPV                                      3rd Dose      
  Hib (Haemophilus Influenza)    1st Dose      
12 Weeks DPT                                      2nd Dose      
  OPV                                      4th Dose      
  Hib                                       2nd Dose      
16 Weeks DPT                                      3rd Dose      
  OPV                                     5th Dose      
  Hib                                        3rd Dose      
6 Months Hepatitis B Vaccine                3rd Dose      
6-9 Months Measles Vaccine      
12 Months Chicken Pox Vaccie      
15 Months MMR (Measles, Mumps, Rubella)      
18 Months DPT                                     Booster 1      
  OPV                                     Booster 1      
  Hib                                       Booster 1      
2 Year Typhoid (Vi)      
2 Year + Hepatitis A Vaccine                           1      
  (2 Doses at 6 Months interval)             2      
4-5 Year DPT                                     Booster 2      
  OPV                                     Booster 2        
5 Year Typhoid (Vi)       
8 Year Typhoid (Vi)       
10 year DT / TT       

Note : Vaccination is to be started only once the weight of the neonate increases to 2 kg. in premature-low-birth weight child.