Dr Saurabh Khanna is an expert Neonatologist and Paediatrician adept at managing critically sick neonates and premature babies, neonatal emergencies and child health. He is a national level trainer for NRP. As a Neonatologist & Pediatric Intensivist, he has earned a reputation for being an expert clinician in Pediatrics and is known to be a veteran in the field. Dr Saurabh has an experience of more than 15 years including 12 years as an expert neonatologist and paediatrician. He has previously associated with Fortis Hospital (Shalimar Bagh, Delhi), Jaipur Golden Hospital and Fortis La Femme, (GK, Delhi)
Managing asthma in children | Tips to control asthma symptoms
Asthma is a relatively common chronic lung disease that can develop even in infancy. This chronic condition has become increasingly common in the past decade. It is believed that the increase in air pollution, environmental smoke etc. might have contributed to the rising incidence of this problem. It is believed that in India, approximately 6% of children have asthma, this statistic may not be accurate as even today, a large number of cases go unreported or undiagnosed. In this article, we will learn about Asthma in children, how to identify its early signs and the best ways to manage this condition in children.
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Asthma is a chronic condition which causes inflammation in the airways and lungs, especially when you inhale any “triggers”. Triggers are any stimuli which can increase the inflammation in the lungs and airways, making it difficult or impossible to breathe. These triggers range from inhaling pollen, infections, second-hand smoke etc.
Asthma can affect people of any age; however, childhood asthma has unique challenges associated with it. This is because the “patient” (child) does not really understand the condition to take precautions and care that adults with the condition would. It can also decrease the quality of life of the child as it can severely limit their lifestyles such as participation in play and sports. It can also interfere with their normal sleep. Hence as parents, it is extremely important to know the early signs of the condition and get the proper care to keep the symptoms under control. Asthma attacks can be extremely dangerous and might require hospitalisation.
Causes of asthma in children is still quite unclear. Research suggests that it could be a combination of genetic and environmental factors such as inherited allergies, parents with asthma, ethnicity, any infection affecting the airways during childhood, second-hand smoke inhalation, air pollution etc. Underlying conditions such as childhood obesity, GERD also have been linked to childhood asthma.
One of the main challenges with childhood asthma is that the child himself/herself will be unable to identify the symptoms or early signs of asthma. Many children will start showing signs of asthma before the age of five. Here are some of the early symptoms of asthma in children that you should watch out for:
These symptoms will worsen when the child is exposed to any triggers. Such instances are called asthma “flare-ups”. These triggers can be any of the following and vary from child to child:
In some cases, you may have to rush your child to the hospital for emergency treatment. If you notice the following signs, take your child to the emergency room immediately:
Asthma is a chronic condition, and treatment protocol is aimed at managing the symptoms and flareups. This includes:
If the child becomes overly dependent on short-acting medications and has to consume them too often, long term medications can be used to manage the symptoms over time. These include inhaled corticosteroids, leukotriene modifiers, long-acting beta-agonist, cromolyn and oral corticosteroids. Consult your child’s paediatrician before giving your child any type of medication, long term or short term.
Most of the aforementioned medications are generally administered via metered-dose inhalers. You can use attachments such as a valved holding chamber with a mask or a nebulizer to make it easier for your child to use the inhaler.
Read: Vaccinating your child – What you need to know?
For parents with asthmatic children, managing symptoms of asthma as well as preventing future flareups can be quite difficult. It is also extremely important to take steps during childhood itself to stop further inflammation of the airways and lungs. The following tips can help you stay ahead and let your child live and play to the fullest:
An asthma action plan will help you react faster and better to any asthma symptoms as and when they manifest. Your child’s paediatrician is the best person to help you come up with this plan. The plan should include step by step instructions about the short-term and long-term medications and when to take them, things to do between flareups, how to identify and manage triggers as well as how to identify when a trip to a hospital is required.
Diligently recording asthma attacks as well as the treatments that your child is undergoing will help you identify what triggers your child’s asthma as well as what form of treatment is working best for him/her. These records will also help your child’s doctor determine whether short-term medication or long-term medication is best suited for your child. The record should include:
Identifying and minimising exposure to all the stimuli which trigger an asthma attack in your child is perhaps one of the most essential aspects of long-term management of asthma. Taking into account the environmental factors in play whenever your child experiences an asthma attack can help identify if they are triggered by dust, pollen, animal fur, smoke, infection etc. In some cases, excessive crying or laughing can also cause an attack. The following steps can help you minimise this risk:
As your child grows older, teaching them what to stay away from, how to react to asthma attacks and precautions to take is extremely important. You can also do an allergy panel to identify what other allergens can be harmful for your child. Routine visits to the paediatrician would help in monitoring your child’s condition and prevent it from becoming worse. You can book a consultation and a comprehensive health check-up for your child under the care of our paediatric experts at the CK Birla Hospital, Gurgaon.
Read: What makes kids picky eaters and what may help them get over it
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What makes kids picky eaters and what may help them get over it
Picky-eating toddlers are common in every family. Generally, the peak age for fussy eating behaviours in a child is 3 years. A survey on the topic carried out on 4,000 children concluded that the majority of the kids are picky eaters at one time or the other. But, just the condolence that your child is not the only picky eater will not work for you.
You might feel the stress once your kid gets into the habit of throwing tantrums at the dinner table. Before looking at the tips for your fussy-eating toddler, it is necessary for you to know the root cause of the problem.
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In the very first place, you should know that there are different environmental influences and biological factors that can make kids move away from healthy eating habits. We will have a look at them below:
The home eating environment has an important role to play in influencing selective eating behaviours in a child. Simply put, children get accustomed to eating foods that are frequently on their dinner table. They become familiar with and even start accepting general food groups and specific dishes that the family eats together.
For example, if your child gets into the habit of having salty pasta with a bit of variation in spices, veggies, and proteins, he or she might not like having anything other than that. In the same way, if you offer dessert at the end of a meal, your child will always expect sugary treats after meals. So, the kid will ultimately develop an irresistible craving for sugar.
Several studies over the years show that people have this natural bend towards salty and sweet snacks – and children are no exception. Given a choice, a child of almost any age will reach out for innately satisfying food. This can be something sweet or salty over something bitter, bland or sour.
Regardless of the causes behind your picky-eating toddler, the question remains, what do you need to do? Some tips that can help you out are as follows:
Rather than having lunch with the entire family at 1 pm only to switch to 2 pm the next day, meals and snacks should be offered at a set time regularly. The best way to go about this is to allot a particular time for meals and at least two snack-times during the entire day.
In between meal times, your child should just have water and nothing else. This way, he or she will remain hydrated and not be full before mealtime. So, you will have a hungry child at the table.
Your kid’s willingness to taste a certain food will completely depend on the environment. Low-stress and pleasant mealtimes can be of good help here. Work on making mealtimes social, regular, and happy occasions. Do not worry about spilled food or drinks on the floor.
When preparing healthy food for picky eaters, starting small will help to a considerable extent. Guide your child on trying out new food and praise him for making an attempt. Do not force your kid into trying any food he doesn’t want to. Ignoring your fussy eater will encourage him or her to keep away from this habit.
Snacks and meals are essential for children. Therefore, they should have them properly and in adequate proportions. Distractions like computers, mobile phones, and television might not help them develop healthy eating habits. Mealtime should typically involve having food and interacting with the entire family.
Books, toys, music and TV are for playtime and not for mealtime. Make sure your child is away from these distractions if you want to change their fussy eating habit.
Of course, you must look for variety in the food you serve. But this does not mean you must make compromises on choosing healthy food for picky eaters. Try offering different types of fruits and vegetables along with foods high in their protein content such as deboned fish and meat. Serve these to your child at least twice during the week.
An important tip for fussy-eating toddlers is to guide your child in exploring new food textures and flavours. Also, work your way out in minimising waste. If you are introducing them to any new food, start with small quantities. You also need to wait for at least one week before offering the same food all over again.
Ans: Always keep in mind that kids love choosing what they want to have for a meal. So, it will work for you to ask your child about his preferences.
Of course, you must plan a balanced meal for your kid while taking his choices into account. If you factor in your child’s food preferences every day, with time, he will stop being a picky eater.
Ans: Picky eaters will change their habits only if they get small portions of healthy food regularly. Parents have to acknowledge that improving food habits in children is a gradual process and requires a fair amount of time.
To make the process easier, you can play into your child’s tendency to imitate you. As a parent, you can be a role model for their healthy eating habits. Your toddler will learn to eat things you eat and soon give up the habit of being a fussy eater.
Picky eaters are not just children who do not like to eat fruits or vegetables. They may also have a habit of eating the same food repeatedly. So, you need to follow these tips for picky eaters and toddlers and plan accordingly to change their practices.
As a parent, it is quite natural to be concerned about the health and diet of your child. Understand that being selective around food is normal during the developmental stages of a toddler. Patiently guide your kid on the path towards healthy and nutritious eating.
If nothing seems to be working, consult a pediatrician. They can help in troubleshooting problems and ensure that your child has a balanced and nutritious diet regularly.
Related Read: Taking Care of Your Fussy Eating Toddlers
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What to expect when your baby is in the NICU
While a NICU is rarely part of a birth plan, knowing what neonatal services are available at the place where you are giving birth, should something be required, can help put parents at ease. For example, it is much easier for the neonatal team to communicate with obstetricians and maternal fetal medicine doctors a lot before the baby is born. This communication continues as the baby receives care from many specialists in the hospital, and then follows the infant after being released from the hospital, easing the transition of care from medical specialists to the baby’s new paediatrician.
Every parent’s experience in the NICU is different and hospitals support NICU parents. One thing that mothers recall from their NICU days is that when they started the journey, they just didn’t know what to expect once they got there. Some common tests that the parents might notice their baby undergoing are the bilirubin test, oxygen level tests, sugar level tests, blood tests, and urine tests. Even though these tests can be daunting to parents, try and remind yourself that they are necessary for your baby’s advancement and proper growth. Infants get measured every day.
Breastmilk can often help babies that are born early. Sometimes mums whose babies are in the NICU are not yet strong enough to nurse, but mums can still pump milk and have their babies consume it. The hospital often has staff that can help new mums pump milk or even try nursing if their NICU babies seem healthy enough. There are certain NICU units which also have a milk donation center where other mothers donate their breastmilk to tiny infants in need of the power.
NICU doctors and nurses play an important role in monitoring the baby’s growth and development. The Neonatal Care at the CK Birla Hospital provides expert neonatologists to ensure that the treatment is as comfortable for the baby as far as possible. Research has shown that babies nursed with Development Care approach are healthier, develop faster and go home earlier.
Consult top neonatologists at the Department of Neonatology & Paediatrics to learn more.
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