How to minimize the risk of giving birth to an Autistic child?

It is a blessing for a mother to birth a healthy baby. Life becomes shattered when parents discover that their young one is affected by Autism. Pregnancy is a vital journey, which if completed with certain cautions can help avoid such a mishap in parents’ life. Many environmental factors have been correlated with Autism.  Many studies conclude that, Autistic babies are genetically wired to be autistic, but the development of disease is generally associated with some triggers present within the baby’s immediate environment. This may happen within the mother’s womb or soon after the baby is born. Mothers need to shield their delicate unborn and newborn babies from dangerous effects of toxins and pathogens, known to cause developmental defects in the baby’s brain .

What is autism?

Autism is an array of closely related neuro developmental disorders ( ASD- Autism Spectrum Disorders ) that appears during the baby’s early years of growth. It can hamper the baby’s ability to reach social milestones like smile, babble, learning to talk, play and interact with others.

Causes of Autism?

Autism may or may not run in one’s family. It was earlier believed that autism is caused mainly by genetic defects and are hereditary. Recent studies show the Excessive levels of folate as well as high levels of Vitamin B12 in expectant mothers seemed to raise the risk of autism spectrum disorders in children according to a recent study from the Johns Hopkins Bloomberg School of Public Health. But the recommendation of folic acid supplements with diet for pregnant mothers remain the same owing to the benefits of this vitamin in fetal development. There may be other factors in high-risk mothers, like having slow metabolism or not being able to metabolize vitamins well, responsible for this correlation.

Tips to Pregnant mothers to minimise chances of developing Autism :

 Proper nutrition 

A well- balanced nutritious diet during pregnancy is a must. Very low birth weight and anemia in a newborn baby are associated with autism.

Multivitamins 

Take the recommended amount of 400 micrograms of folic acid daily from at least a month prior to conception to help prevent neural birth defects such as Spina bifida and may be Autism.

Don’t take more than 1,000 mcg per day of folic acid unless your doctor advises you to. This is particularly important if you are completely vegetarian and do not even consume milk products. The rationale behind this precaution is that vegans are at risk of being deficient in vitamin B12 (mainly found in animal products) and taking excess folic acid will mask this deficiency leading to Anemia.

“Multivitamins should always be taken with doctor’s consultation when you are carrying a baby.”

Hydration

Keep yourself hydrated with enough liquids and water throughout the day. Since, Folic acid is a water- soluble vitamin, normally excess amount is easily flushed out of the system through urine, when the optimum amount of water is consumed.

Avoid antidepressant medicines

Some women develop depression during the First trimester or later. Antidepressant pills can increase the risk of autism development in babies. Depression if left untreated can also affect the child born to a depressed mother. Medicines of all sorts should be taken as per the gynecologist advice only during the pregnancy.

Prevent infections

It is best to maintain a healthy lifestyle and fitness regime during pregnancy. It also makes sense to stay away from sick people. Rubella virus infection is known to cause several birth defects along with autism in the fetus. Congenital Rubella syndrome can be prevented to occur in babies by Rubella vaccine given to women of childbearing age or as early as women become pregnant.

Stay away from chemical pollutants

Healthy diet consisting of fresh vegetables and fruits is recommended during pregnancy. But, wash them properly to remove the layer of pesticides that may be present on their surface. Avoid packaged foods like microwave or oven ready meals loaded with preservatives. Look for BPA free plastic ware and bottles only for family use. Limit the use of non-stick pans. Avoid using perfumes, moisturizers, body wash gels etc. 

Don’t  get your home painted 

Avoid exposure to toxic chemicals and fumes are released from fresh paint or solvents used for painting the house while pregnant and breastfeeding.

Please take care of all these things while pregnant to give birth to a healthy baby. You may save a child destined to become autistic by these lifestyle changes.

Toddler less social ? Red flags to be watched for Autism:

Gaurav is a healthy one-year-old toddler. But his family is worried as he rarely gives any response to their loving gestures. Most of the time he looks dull and aloof of the people around him. His elder sister was different at this age. She played peek-a-boo together with her father, started babbling and mimicked her grandfather’s claps. Gaurav may be a very different child; he has not yet begun to smile seeing his parents . His parents always wonder if something is wrong with him or he’s just not a friendly baby. they’re going to take him to a pediatrician soon. Gaurav might have Autism.

Diagnosing autism early

No parent will ever want to associate his or her beloved child with this disease. But, some unfortunate genetic defects and environmental factors can cause Autism. Instead of feeling vulnerable, keep faith in your judgment and assess your child’s growth from time to time. Autism can be caught as early as eighteen months and treatments specific to a child can be started at a tender age to lessen the effects of disorders. As a parent you are in the best capacity to notice the earliest ‘red flags’ of Autism. You know your child the best and can’t just expect a doctor to diagnose this disease based on a 15-20 minute visit. Well-informed parents along with an experienced pediatrician can improve the quality of life of an autistic child to a great extent.

Keep an eye on child’s development

Autism is not a single disability, but a spectrum of close-knit disorders ( Autism Spectrum Disorder) involving child’s social interaction, emotional stability, and empathy towards others, communication with peers and parents and flexibility in behavior.

It is important to know what social, emotional and cognitive milestones, to expect with every stage of your baby to spot the developmental delays and early signs of Autism. A baby looking absolutely healthy and physically active may have an underlying disease, which might deteriorate his/her quality of life later. Early attention to child’s deficits can signal the parents and other caregivers to timely facilitate the process of learning and growth of the child in an efficient manner.

All children are different and so is the effect of this neurological disease on their behavior and social skills. Two kids of the same age may be diagnosed with the same disease but may present very different symptoms.

Every child develops at a different pace and there is a broad window of age allotted to achieve a particular milestone. But, if you are concerned about any delay above a certain time period, bring it to your child doctor’s notice immediately.

Sometimes, a child starts communicating and socializing normally in about the first 2 years of life, then stops being vocal entirely. Child becomes dull and stops enjoying games like peek-a-boo and patty cake. If you notice that child has suddenly stopped babbling, laughing, playing games, clapping or waving bye-bye; consult with a pediatrician seriously. ‘Regression’ is a major red flag or warning sign of Autism.

Early intervention is critical

Autism is hard to diagnose before 24 months but early symptoms surface between 12 and 18 months. If parents can spot the early signs, then it can be detected by 18 months. There is a very ripe possibility that intensive treatment started at such a tender age could help revamp the brain and reverse the symptoms of Autism to a great extent.

Young brain till the age of 6 years is amazingly pliable. It can be molded and shaped on the basis of a child’s exposure to varied experiences and training. Although autism has genetic roots, some learning techniques specifically designed according to a child’s shortcomings can help him/her immensely to lead a normal life. Earlier the help is extended to an autistic child, better are the results of therapy.

Measles (Rubeola)

Signs and Symptoms

Measles symptoms appear 7 to 14 days after contact with the virus and typically include high fever, cough, runny nose, and watery eyes. Measles rash appears 3 to 5 days after the first symptom

Measles isn’t just a little rash. Measles can be dangerous, especially for babies and young children. Measles typically begins with high fever (may spike to more than 104°),cough,runny nose (coryza), and red, watery eyes (conjunctivitis).

2-3 days after symptoms begin: Koplik spots

Tiny white spots (Koplik spots) may appear inside the mouth two to three days after symptoms begin

3-5 days after symptoms begin: measles rash

Three to five days after symptoms begin, a rash breaks out. It usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, trunk, arms, legs, and feet.Small raised bumps may also appear on top of the flat red spots.The spots may become joined together as they spread from the head to the rest of the body.When the rash appears, a person’s fever may spike to more than 104° Fahrenheit.

https://www.cdc.gov/conjunctivitis/

Make your home safe for babies

Babies are very curious by nature. They have high energy bundles. It becomes important to make their surroundings safe. They might get serious injuries in their zeal to try everything new. It’s impossible to keep a baby isolated in one room. We must take precautions and secure everything in place and take away the potential hazardous things out of reach of kids. So, the moment your baby is mobile, look around your home from his/her point of view and start baby proofing it.

Start from the living room,where your baby spends most of his/her time playing? Make sure all the electrical appliances are securely placed and they may be even anchored for extra protection. Babies try to climb over appliances and may topple the big objects over them, causing serious injury. Big furniture items should be moved closer to the wall to provide extra space for the novice mover. Little ones have special interest in poking their finger inside the sockets and pulling the naked chords of TV, Fridge etc. You may use outlet covers for switches and cord organizers for exposed chords to avoid the danger of electrocution.

Position the unstable tall floor lamps, behind the sofa set. Keep breakable vases and your favorite cutlery out of reach in a locked cabinet to preserve them from breakage and save your baby from getting hurt. Use corner guards to prevent injuries to your kid.

Safety latches for drawers are also available in the market now, to keep stuff out of reach.

 Keep the cleaners, detergents and other harsh chemicals used in everyday cleaning, high enough out of your child’s reach. Kids like to taste and touch everything new. Plastic and paper bags can pose a suffocation risk when your baby tries to wear them on small heads. Sharp knives and scissors should always be out of sight from toddlers . Small appliances like toasters, mixer grinders and coffee makers should be unplugged after use and placed inside the cabinet .Use refrigerator latches to avoid child’s exposure to cold waves and spilling of contents and heavy bowls over him.

Stock medicines, even vitamin supplements in a cabinet high enough for the young one to reach and keep it locked at all times. Mothballs and other pest poisons should be nowhere in sight of the young ones. Try to remove toxic things, which may pose a risk of choking away from your baby. Keep a cabinet with toys and other harmless lightweight household items, accessible to the baby to distract him from the “banned” area.

Soft, cuddly toys and pillows should be removed from the cot while the baby is sleeping, as they may cause suffocation. Remove the mobiles or hanging toys above the cot, once your baby can come to a crawling position.

Don’t leave the crawling baby unattended on high beds and changing tables. You can keep a mattress on floor to be used as daybed and playing area

Balconies having short railings with wide openings can pose a serious falling hazard from high-rise apartments. Install a plastic garden fencing or wired mesh above the railings to make them secure for. Use window guards to prevent falling out of them. Install safety gates in front of the staircase to stop them from crawling up and down, alone. 

Avoid giving hard candies and small toys like marbles, blocks, buttons, craft items etc. to the baby. Store toys in open boxes or boxes with light lids to avoid pinching of small fingers.

Be vigilant and careful about your house’s environment  to give your baby an uninhibited and safe abode, where they can thrive and learn well.

Baby’s head out of shape?Let’s explore

Babies have soft areas called fontanels on their skull  to facilitate birth by pressing through the narrow birth canal. That is the reason, the newborn baby’s head looks abnormal. A premature baby has a more abnormal shaped head than a full term baby due to lesser-developed bones. Twins have a higher probability of getting born with abnormal shaped heads because of less space available inside the uterus and less amniotic fluid available which restricts the fetus activity inside the womb. Lying at one position applies pressure on soft areas which results in an irregular head shape of the unborn fetus.

Soft areas remain open later in young babies to adjust the growing brain. Fontanels are fragile but are covered with tough membranes. Day to day massage and touching while bathing, dressing and holding the baby does not cause harm to them. Gradually, the bones in the baby’s skull get enough mineral deposits to entirely fuse together and fill these gaps. As the baby grows, the back fontanel (the small one) will close first anywhere around 6 weeks to 4 months of age. The second fontanel, which is larger, is present on the front portion of the baby’s head and takes at least 18 months to close normally.  The odd shape of head due to birth evens out on its own as these gaps closes.

Sometimes, the baby’s head looks perfect earlier but becomes flat or misshaped later during the first year, due to the baby sleeping and lying down continuously in the same position. When the back of her head becomes flat, the disorder is called ‘brachycephaly’ and if the flat area is observed on one side of head, the medical term given is ‘plagiocephaly’. Both are positional cephalic disorders. Frequent repositioning of the baby while sleeping and lying stimulates the pressed or flattened areas of the baby’s head to come back to shape naturally. Baby pillows are specially filled with loose mustard seeds filling in India to provide a maneuverable base for head while sleeping. Pillows with depression in the center also work great to ease the pressure on the resting head.

Babies should always be put on their back to sleep to avoid the risk of Sudden Infant Death Syndrome (SIDS). During the first 5 months, the baby is mostly on her back, even while playing. If you find one side of the baby’s head flat, change the position of mirrors and toys, your baby loves to look at, to encourage him to keep the head on alternate side. Keep changing her position while feeding also. Sling can be tried to make the little one sleep to relieve the pressure points on the delicate head. Baby bouncers and rockers with colorful toys can also be used to provide the alternate playing and feeding position.

Re-positioning  has a great deal of positive effect to even out the odd flat areas of the baby’s head. If the problem is not sorted out till the age of 6 months, consult your child’s doctor. Timely medical intervention till the first 2 years of life can cure the problem completely.

Positional Plagiocephaly is seen commonly. Almost 1 in every 2 infants suffers from it but 1 in 10 need medical treatment for it. Thankfully, it does not affect the brain and neurological growth of the child. If left untreated, it might spoil the appearance of your little angel for life. Custom fit cranial helmets are made according to your baby’s head size to allow enough room for growing the skull. Wearing the soft Helmet for 23 hours a day ensures the presence of a corrective external force on the baby’s growing skull at all times to promote rounding of the flattened shape. However, this therapy is a viable option only before the child turns 2. Earlier the therapy is started, the faster you can expect good results. Doctors advise to start this treatment as early as 4 months.

In some cases,the abnormal shape of the head occurs due to a birth defect- ‘Craniosynostosis’. In this, one or more joints of the baby’s skull close or fuse prematurely (before 2 years) which doesn’t  allow full growth of the brain. Its treatment involves cranial surgery to separate the fused bones. After surgery, if any other abnormality is not there, the brain is expected to grow properly. Helmets may be advised to the child post surgery for support. An experienced doctor diagnoses this defect by physical examination. Symptoms which distinguish it from positional cephalic disorders includes absence of a soft spot at birth, early disappearance of fontanels, seizures, bulging eyes, raised hard ridges on skull, unusual head circumference and shape, visible scalp veins,slower head growth, irritability, excessive crying, vomiting, poor feeding habits and developmental delays. The symptoms are milder sometimes and the disease can go undiagnosed for several years till complications like blurred vision and feeling of increased pressure on the head develops.

Human Papillomavirus (HPV) Vaccination & Cancer Prevention

Human papillomavirus (HPV) is a very common virus that can lead to cancer. While there is screening for cervical cancer that can detect cancer early, there is no recommended screening for the other cancers caused by HPV infection, like cancers of the back of the throat, anus, penis, vagina, or vulva.

HPV vaccine provides safe, effective, and lasting protection against the HPV infections that most commonly cause cancer.

Who Should Get HPV Vaccine?

HPV vaccination is recommended for all preteens (including girls and boys-not in India at the present moment) at age above 9 years. All preteens need HPV vaccination, so they are protected from HPV infections that can cause cancer later in life.Only two doses are recommended if vaccination started at age 9 and through age 14. For girls and ladies above 14 yr to 45 yrs of age, 3 doses are required.

What Types of HPV Vaccines Are There?

Two HPV vaccines are available in india—quadrivalent HPV vaccine (Gardasil®, 4vHPV), and bivalent HPV vaccine (Cervarix®, 2vHPV)—have been licensed for use. All  HPV vaccines protect against HPV types 16 and 18 that cause most HPV cancers.

How Well Do These Vaccines Work?

HPV vaccination works extremely well. HPV vaccine has the potential to prevent more than 90% of HPV-attributable cancers.

https://www.cdc.gov/hpv/index.html

Chickenpox/Varicella Vaccination

Chickenpox is a very contagious disease caused by the varicella-zoster virus (VZV). It causes a blister-like rash, itching, tiredness, and fever. Each year, chickenpox caused about 4 million cases, about 10,600 hospitalizations and 100 to 150 deaths.

Two doses of the vaccine are about 90% effective at preventing chickenpox. When you get vaccinated, you protect yourself and others in your community. This is especially important for people who cannot get vaccinated, such as those with weakened immune systems or pregnant women.

Some people who are vaccinated against chickenpox may still get the disease. However, it is usually milder with fewer blisters and little or no fever. 

Who Needs Chickenpox Vaccine

Children under age 13 years should get two doses

  • First dose at age 12 through 15 months
  • Second dose at age 4 through 6 years

The second dose may be given at an earlier age if it is given at least 3 months after the first dose.

People 13 years of age and older who have never had chickenpox or received chickenpox vaccine should get two doses, at least 28 days apart.  

Getting Vaccinated After You Are Exposed to Chickenpox

You should get the chickenpox vaccine within 3 to 5 days of being exposed. Even if more than 5 days have passed since you were exposed, vaccination with two doses is still recommended to protect against future exposures. You need 2 doses of vaccine separated by a minimum of 28 days.

Pneumonia kills one child every 39 seconds; 127,000 died in India last year

The disease is preventable but still kills more children — 800,000 under the age of five last year — than any other infection

Pneumonia is the world’s deadliest child killer, with a “forgotten epidemic” claiming one young life every 39 seconds, international health and children’s agencies warned Tuesday.

The disease is preventable but still kills more children — 800,000 under the age of five last year — than any other infection, they said in a statement to mark World Pneumonia Day.

Five countries accounted for more than half of the child pneumonia deaths — Nigeria with 162,000, India 127,000, Pakistan 58,000, the Democratic Republic of Congo 40,000 and Ethiopia 32,000.

What makes it so deadly?

Pneumonia is caused by bacteria, viruses or fungi, and leaves children fighting for breath as their lungs fill with pus and fluid.

Children with weakened immune systems and those living in areas with high levels of air pollution and unsafe water are most at risk.

The disease can be prevented with vaccines and is easily treated with low-cost antibiotics if properly diagnosed.

“This is a forgotten global epidemic that demands an urgent international response,” said Kevin Watkins, chief executive of Save the Children UK.

https://www.business-standard.com/author/search/keyword/bs-web-team-pti

Hepatitis A Questions and Answers

What is hepatitis ?

Hepatitis means inflammation of the liver. When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can cause hepatitis but a virus often causes hepatitis.  The most common hepatitis viruses are hepatitis A virus, hepatitis B virus, and hepatitis C virus.

What is hepatitis A?

Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. It can range from a mild illness lasting a few weeks to a severe illness lasting several months. Although rare, hepatitis A can cause death in some people. Hepatitis A usually spreads when a person unknowingly ingests the virus from objects, food, or drinks contaminated by small, undetected amounts of stool from an infected person.

How serious is hepatitis A?

Most people who get hepatitis A feel sick for several weeks, but they usually recover completely and do not have lasting liver damage. In rare cases, hepatitis A can cause liver failure and death; this is more common in people older than 50 and in people with other liver diseases.

If I have had hepatitis A in the past, can I get it again?

No. Once you recover from hepatitis A, you develop antibodies that protect you from the virus for life. An antibody is a substance found in the blood that the body produces in response to a virus. Antibodies protect the body from disease by attaching to the virus and destroying it.

Symptoms

Older children and adults typically have symptoms. If symptoms develop, they can appear abruptly and can include:

Fever,Fatigue,Loss of appetite,Nausea,Vomiting,Abdominal pain,Dark urine,Diarrhea,Clay-colored stools,Joint pain,Jaundice (yellowing of the skin and eyes)

Most children younger than age 6 do not have symptoms when they have hepatitis A. When symptoms are present, young children typically do not have jaundice but most older children and adults with hepatitis A have jaundice.

Can hepatitis A be prevented?

Yes. The best way to prevent hepatitis A is through vaccination with the hepatitis A vaccine. To get the full benefit of the hepatitis A vaccine, more than one shot is needed. The number and timing of these shots depends on the type of vaccine you are given. Practicing good hand hygiene – including thoroughly washing hands after using the bathroom, changing diapers, and before preparing or eating food – plays an important role in preventing the spread of hepatitis A.

Who should get vaccinated against hepatitis A?

All children at age 1 year and all adults.

Will the hepatitis A vaccine protect me from other forms of hepatitis?

No, the hepatitis A vaccine will only protect you against hepatitis A. There is a separate vaccine available for hepatitis B. There is also a combination hepatitis A and hepatitis B vaccine that offers protection for both viruses. There is no vaccine for hepatitis C at this time.

Can hepatitis A vaccine be given to people with compromised immune systems, such as hemodialysis patients or people with AIDS?

Yes. The hepatitis A vaccine is inactivated (not “live”), so it can be given to people with compromised immune systems.

Is it harmful to have an extra dose of hepatitis A vaccine or to repeat the entire hepatitis A vaccine series?

No, getting extra doses of hepatitis A vaccine is not harmful.

What should be done if the last dose of hepatitis A vaccine is delayed?

If the second dose has been delayed (more than 6 months since the first dose was given), the second, or last dose, should be given as soon as possible. The first dose does not need to be given again.

Pneumonia shot In Adults?

Pneumonia vaccines help prevent invasive pneumococcal diseases. How often a person should get the shot depends on their age and overall health.

Pneumonia is an infection that causes inflammation in the lung’s air sacs. The inflammation can cause the sacs to fill with pus or fluid. Typical symptoms include cough, fever, chills, and difficulty breathing.

There are two types of pneumonia: bacterial and viral. Bacterial pneumonias are more common and result in a more serious illness. 

Pneumonia is common among young children and older adults. People over the age of 65 years are most at risk for serious illness or death.

Types of pneumonia shots

A pneumonia shot will not reduce pneumonia. However, it helps prevent invasive pneumococcal diseases, such as meningitis, endocarditis, empyema, and bacteremia, which is when bacteria enter the bloodstream. Non Invasive pneumococcal disease includes sinusitis.

There are two types of pneumonia shots available. Which type a person gets depends on their age, whether or not they smoke, and the presence of any underlying medical conditions.

The two types are:

  • Pneumococcal conjugate vaccine (PCV13): Healthcare providers recommend this vaccine for young children, people with certain underlying conditions, and some people over the age of 65 years.
  • Pneumococcal polysaccharide vaccine (PPSV23): Healthcare providers recommend this vaccine for anyone over 65 years of age, people with certain underlying conditions, and people who smoke.

PCV13 protects children and others against 13 different strains of bacterial pneumonia. PCSV 23 protects older adults and others who need it against 23 different strains of bacterial pneumonia.

When should a person get the shot? 

How often a person should get the pneumonia vaccine depends on their age and overall health. 

The CDC recommends the following schedules:

  • Infants should receive the PCV13 vaccine at 2, 4, 6, and 12–15 months.
  • Adults only need one dose of PCV13.
  • A single dose of PPSV23 is sufficient for anyone who needs it, such as those over 65 years of age and people with underlying health conditions.

A person under the age of 65 years should receive the PPSV23 vaccine if they smoke, are receiving chemotherapy treatment, or have any of the following conditions:chronic heart disease, asthma, alcohol use disorder, HIV, Hodgkin disease

A person can get both vaccines if they have any of the above conditions or any of the following:cerebrospinal fluid leak, cochlear implants, anatomic or functional asplenia.

If people need to have both vaccines, they should get them on separate visits.