Gouri Hospital

Author: Dr. Arun Gupta.
M.D. New born & Child specialist
Ph-27495603, 27477030, 9811106056

What are vaccines? How they protect my baby? Are they really necessary? Are they safe? Which are the vaccines available? With arrival of a newborn in the family every parent is faced with these questions.

What are vaccines?

How vaccines work?

Are vaccines really necessary?

Are vaccines safe?

What are the commonly advised vaccines?

What is their schedule?

General Precautions

What are vaccines?

• Vaccines are injections or oral drops, given by doctor, in order to prevent diseases.
• You must understand that vaccines only prevent occurrence of a disease; they have no role in treating a disease.
• Vaccines are disease specific; vaccine meant for a disease prevents only that disease.

Top

How vaccines work?

Vaccines contain organisms, which arealtered in such a wayso that they are not capable of producing disease but when administered in the body they are capable of producing substances, which fight against disease. After a variable period of time of vaccination these substances called antibodies are produced and protect our body from that disease.

Top

Are vaccines really necessary?

Vaccines are the wonders of 20th century. Their impact on the health of society can never be overemphasized. Global eradication of dreaded disease, like small pox is the most outstanding example of their success story. With their use, control and eradication of diseases like polio, diphtheria, tetanus is now within our reach. With ongoing research in this field, we can hope to have vaccines for diseases like AIDS, malaria, diarrhea [commonly caused by virus called rotavirus] in near future.

Vaccination is absolutely necessary for every child. Because, prevention is always better than cure. It protects your child from many dreaded diseases, some of which have no cures like polio and hepatitis B. Apart from individual protection, they prevent spread of the disease in the society.

Top

Are vaccines safe?

Yes. Most of the vaccines are safe. In some children D.P.T. can cause fever, pain and swelling at the site of injection which is easily controlled by paracetamol syrup prescribed by your doctor. But, even this can be avoided by using newer variety of D.P.T. vaccine.

Rarely, a vaccine can cause allergic reaction, so you should be careful about following things:

• Do remind your doctor about any allergic reaction during past vaccination.
• It is preferable to wait at doctor’s clinic for 15-20 minutes after vaccination so that any allergic reaction can be treated immediately.
• Qualified pediatrician’s clinic or hospital setup should be preferred for vaccination so that any allergic reaction could be properly managed.

Top

What are the commonly advised vaccines? What is their schedule?

Following are the commonly used vaccines

POLIO VACCINE

• Protects from poliomyelitis, disease causing paralysis.
• The only vaccine given in the form of oral drops.
• First dose is given at birth. Starting from 6 weeks onwards 4 doses are given at monthly interval. 2 booster doses are given at 1 ½ and 4 ½ years.

B.C.G.

• Protects from tuberculosis; commonly known as TB
• Single dose is given at birth at left shoulder.
• A small swelling appears at the site of injection 4-6 weeks later, which gradually disappears.

D.P.T.

• It is a combination vaccine which protects from three diseases namely diphtheria, tetanus and pertussis [ kali khansi ].
• Starting from 6 weeks 3 primary doses are given 4-6 weeks interval. Two booster doses are given at 1 ½ and 4-½ yr.

COMPONENT DPT VACCINE-[ Tripacel]

Newer and safer variety of DPT vaccine .This vaccine has very low incidence of fever, swelling, excessive cry or convulsion unlike conventional DPT vaccine. Preferred over conventional DPT [whole cell vaccine].

MEASLES

• Protects from measles; also called khasara or chhoti mata.
• Single dose is given around nine month of age.
• Mild fever or small rashes may develop 5-6 days later which usually disappear spontaneously.

M.M.R..

• It is combination vaccine protecting from three diseases namely measles, mumps [ kanphed] and rubella [viral disease
  causing rashes ].
• Single dose is given at 15 months of age. A second dose is advised at 5-½ yrs of age.

HEPATITIS-B

• Vaccine prevents from viral hepatitis caused by hepatitis B virus.
• First dose is given at birth followed by second and third doses at the age of 1month and 6 month respectively. A booster is recommended at 5 yrs of age.

* Hepatitis b is one of the fastest spreading & deadly disease. Spreads by transmission from infected mother to her baaby, transfusion of contaminated blood or blood product, or use of unsterilised needles and syringes etc.

* Starting features are usually fever, jaundice, loss of appetite and weakness. Virus remains in the body for long time and may lead to liver cancer or cirrhosis. No effective treatment is available. Only way to prevent is timely vaccination. Must vaccines even for adults.

Hib

• Prevents from diseases caused by bacteria called hemofilus influenza type-b.
• Three doses are given at 2, 4 and 6 months followed by a booster at 18 month of age. this vaccine is not needed for children above 5 yrs of age.
• Hib is an important cause of meningitis [brain fever] in small children. It may cause pneumonia, infection of ear, bones or joints.

TYPHOID

Presently available vaccine containing Vi antigen is given at 2 yrs of age. Repeat doses are given at 3 yrs interval.

Typhoid fever is fairly common in our country especially during summer and rainy season. It spreads through infected water, unclean vegetables etc. Vaccine does not provide absolute protection so food and water hygiene should always be maintained.

CHICKEN POX VACCINE

• Protects from chicken pox commonly known as chhoti mata.
• Single shot is given after one year of age. Very effective vaccine. Not needed in those who have already suffered from chicken pox.

Chicken poxis a viral disease characterized by fever, water filled rashes all over body and intense itching all over body. Usually disease is mild and self-limiting but may leave permanent scars over body. At times serious complication like involvement of brain and other organs by virus may occur, which are difficult to manage and may leave permanent damage.

HEPATITIS-A

• Protects from viral hepatitis caused by hepatitis A virus.
• First dose is given at 1 year of age followed by second dose 6 months later.

Hepatitis-A virus spreads through contaminated water, food, raw uncooked vegetables or unhygienic juices, ice creams, sugarcane juice, gol gappa etc from vendors. Faifly common disease during summers and rainy season. Presenting features area fever, jaundice, loss of appetite and weakness. No effective drug is available against virus. Mostly self limiting disease but complications may occur leading to liver failure.

Top

General Precautions

• All vaccines provide fairly good degree of protection still other routine preventive measures should be taken.
• Follow vaccination appointment strictly. If your child misses an appointment, get it done at the earliest. Delayed or missed doses may keep your child exposed to the disease and it may require rescheduling of further course.
• Vaccination can be given in presence of mild illnesses like cold and cough.
• In children vaccination is usually the part of general health checkup which involves child’s growth monitoring and timely supplementation of vitamins and iron. So it is advisable to get these done from a qualified pediatrician in your area.
• Some of the vaccines are relatively costly, but considering the cost of medical therapy for the disease and loss of school & working days by parents it is advisable to go for these vaccines.

Author: Dr. Arun Gupta.
M.D. New born & Child specialist
Ph-27495603, 27477030, 9811106056

What are vaccines? How they protect my baby? Are they really necessary? Are they safe? Which are the vaccines available? With arrival of a newborn in the family every parent is faced with these questions.

What are vaccines?

How vaccines work?

Are vaccines really necessary?

Are vaccines safe?

What are the commonly advised vaccines?
What is their schedule?

General Precautions

What are vaccines?

• Vaccines are injections or oral drops, given by doctor, in order to prevent diseases.
• You must understand that vaccines only prevent occurrence of a disease; they have no role in treating a disease.
• Vaccines are disease specific; vaccine meant for a disease prevents only that disease.

Top

How vaccines work?

Vaccines contain organisms, which arealtered in such a wayso that they are not capable of producing disease but when administered in the body they are capable of producing substances, which fight against disease. After a variable period of time of vaccination these substances called antibodies are produced and protect our body from that disease.

Top

Are vaccines really necessary?

Vaccines are the wonders of 20th century. Their impact on the health of society can never be overemphasized. Global eradication of dreaded disease, like small pox is the most outstanding example of their success story. With their use, control and eradication of diseases like polio, diphtheria, tetanus is now within our reach. With ongoing research in this field, we can hope to have vaccines for diseases like AIDS, malaria, diarrhea [commonly caused by virus called rotavirus] in near future.

Vaccination is absolutely necessary for every child. Because, prevention is always better than cure. It protects your child from many dreaded diseases, some of which have no cures like polio and hepatitis B. Apart from individual protection, they prevent spread of the disease in the society.

Top

Are vaccines safe?

Yes. Most of the vaccines are safe. In some children D.P.T. can cause fever, pain and swelling at the site of injection which is easily controlled by paracetamol syrup prescribed by your doctor. But, even this can be avoided by using newer variety of D.P.T. vaccine.

Rarely, a vaccine can cause allergic reaction, so you should be careful about following things:

• Do remind your doctor about any allergic reaction during past vaccination.
• It is preferable to wait at doctor’s clinic for 15-20 minutes after vaccination so that any allergic reaction can be treated immediately.
• Qualified pediatrician’s clinic or hospital setup should be preferred for vaccination so that any allergic reaction could be properly managed.

Top

What are the commonly advised vaccines? What is their schedule?

Following are the commonly used vaccines

POLIO VACCINE

• Protects from poliomyelitis, disease causing paralysis.
• The only vaccine given in the form of oral drops.
• First dose is given at birth. Starting from 6 weeks onwards 4 doses are given at monthly interval. 2 booster doses are given at 1 ½ and 4 ½ years.

B.C.G.

• Protects from tuberculosis; commonly known as TB
• Single dose is given at birth at left shoulder.
• A small swelling appears at the site of injection 4-6 weeks later, which gradually disappears.

D.P.T.

• It is a combination vaccine which protects from three diseases namely diphtheria, tetanus and pertussis [ kali khansi ].
• Starting from 6 weeks 3 primary doses are given 4-6 weeks interval. Two booster doses are given at 1 ½ and 4-½ yr.

COMPONENT DPT VACCINE-[ Tripacel]

Newer and safer variety of DPT vaccine .This vaccine has very low incidence of fever, swelling, excessive cry or convulsion unlike conventional DPT vaccine. Preferred over conventional DPT [whole cell vaccine].

MEASLES

• Protects from measles; also called khasara or chhoti mata.
• Single dose is given around nine month of age.
• Mild fever or small rashes may develop 5-6 days later which usually disappear spontaneously.

M.M.R..

• It is combination vaccine protecting from three diseases namely measles, mumps [ kanphed] and rubella [viral disease
  causing rashes ].
• Single dose is given at 15 months of age. A second dose is advised at 5-½ yrs of age.

HEPATITIS-B

• Vaccine prevents from viral hepatitis caused by hepatitis B virus.
• First dose is given at birth followed by second and third doses at the age of 1month and 6 month respectively. A booster is recommended at 5 yrs of age.

* Hepatitis b is one of the fastest spreading & deadly disease. Spreads by transmission from infected mother to her baaby, transfusion of contaminated blood or blood product, or use of unsterilised needles and syringes etc.

* Starting features are usually fever, jaundice, loss of appetite and weakness. Virus remains in the body for long time and may lead to liver cancer or cirrhosis. No effective treatment is available. Only way to prevent is timely vaccination. Must vaccines even for adults.

Hib

• Prevents from diseases caused by bacteria called hemofilus influenza type-b.
• Three doses are given at 2, 4 and 6 months followed by a booster at 18 month of age. this vaccine is not needed for children above 5 yrs of age.
• Hib is an important cause of meningitis [brain fever] in small children. It may cause pneumonia, infection of ear, bones or joints.

TYPHOID

Presently available vaccine containing Vi antigen is given at 2 yrs of age. Repeat doses are given at 3 yrs interval.

Typhoid fever is fairly common in our country especially during summer and rainy season. It spreads through infected water, unclean vegetables etc. Vaccine does not provide absolute protection so food and water hygiene should always be maintained.

CHICKEN POX VACCINE

• Protects from chicken pox commonly known as chhoti mata.
• Single shot is given after one year of age. Very effective vaccine. Not needed in those who have already suffered from chicken pox.

Chicken poxis a viral disease characterized by fever, water filled rashes all over body and intense itching all over body. Usually disease is mild and self-limiting but may leave permanent scars over body. At times serious complication like involvement of brain and other organs by virus may occur, which are difficult to manage and may leave permanent damage.

HEPATITIS-A

• Protects from viral hepatitis caused by hepatitis A virus.
• First dose is given at 1 year of age followed by second dose 6 months later.

Hepatitis-A virus spreads through contaminated water, food, raw uncooked vegetables or unhygienic juices, ice creams, sugarcane juice, gol gappa etc from vendors. Faifly common disease during summers and rainy season. Presenting features area fever, jaundice, loss of appetite and weakness. No effective drug is available against virus. Mostly self limiting disease but complications may occur leading to liver failure.

Top

General Precautions

• All vaccines provide fairly good degree of protection still other routine preventive measures should be taken.
• Follow vaccination appointment strictly. If your child misses an appointment, get it done at the earliest. Delayed or missed doses may keep your child exposed to the disease and it may require rescheduling of further course.
• Vaccination can be given in presence of mild illnesses like cold and cough.
• In children vaccination is usually the part of general health checkup which involves child’s growth monitoring and timely supplementation of vitamins and iron. So it is advisable to get these done from a qualified pediatrician in your area.
• Some of the vaccines are relatively costly, but considering the cost of medical therapy for the disease and loss of school & working days by parents it is advisable to go for these vaccines.

People have different attitudes and beliefs towards health and disease, which are mostly based on their traditions & customs. They also differ in their faith and understanding of medical science.
As doctors we always try to educate them the concept and working of modern medical science. There are so many steps between taking a prescription and stopping of medicine. A proper understanding of these steps, is absolutely essential. More often than not, success or failure of the treatment depends on these small things.

Things to be watched at doctor’s clinic

Precautions to be taken at the chemist shop

How to make Doctor your friend & get maximum out of him

Things to be watched at doctor’s clinic

Make sure that prescription is written clearly

You should be able to read names of the drugs as well as other instructions. Clarify if any doubt. Dispensing of wrong medicine by chemist due to misinterpretation is very common and could lead to dangerous consequences. Similarly dosages should be understood clearly. Ingesting 5 ml drug instead of 0.5 mls or 1 spoon full [5.0mls] for 1 ml is very frequent.

Ask how to prepare the medicine

Drugs are usually in form of tablets, capsules, syrups or drops. Tablets are of two varieties, one has to be swallowed directly, and others called dispersible tablets have to be prepared by adding water to it. Syrups may be ready diluted or be in dry form, which is to be prepared by adding water. Regarding preparing liquids instructions are written on bottle. Read them carefully. Mostly there is a mark on the bottle upto which water is to be added. Some bottles do not have mark but are supplied with measuring cup to add water.

Quantity of the drug to be given

Measurement of quantity is easy for tablets and capsules. Syrups and drops are supplied with measuring cup or dropper. Cups are marked at different levels like 2.5ml, 5.0ml and 10.0ml. Likewise droppers are also marked like 0.2ml, 0.4ml, 0.6ml, 0.8ml and 1.0ml. Always use these cups and dropper for accurate measurement. Alternatively one can use a disposable syringe, which are available without needle. Measurement is very accurate and it is very convenient to give medicines using disposable syringe.

Some doctors write medicines in spoons rather than mls. Do remember mostly TSF is meant by a teaspoon full and is equal to 5.0ml. But commonly available spoons at home vary in size any thing from 2.5ml to 7.0ml so quantity of drug given may not be the desired one. Always use measuring cup, dropper or disposable syringe for accurate dosages.

Frequency of the dosage

Frequency of the dosage is usually determined by the type of drug and the severity of the disease. For different frequencies doctor use different abbreviations or symbols. Some of the commonly used abbreviations are OD –once a day, Bid – twice a day [12 hrly], TDS-three times a day [8 hrly], QID- four times a day [6 hrly], SOS- whenever required, HS- at the bed time. Make yourself familiar with these abbreviations and whenever in doubt clarify from your doctor.
Timing of the dosages should be chosen in such a way that as far as possible proper interval between two dosages is maintained and it doesn’t disturb child’s routine. E.g.- BD dosage could be given at 8 am and 8 pm while TDS dosage could be given at 7 am, 3 pm and 11pm.

Relation to meal

Always ask whether drug should be given empty stomach or full stomach. Some drugs work better with empty stomach on the other hand there are drugs that can cause gastric irritation when given with empty stomach.

Signs of deterioration

Ask about the signs and symptoms to be watched during the course of the medicine. Presence of certain signs like adequate frequency of urination during loose motion, or return of appetite during the course of jaundice are reassuring signs showing improvement. On the other hand
presence of certain signs during the course may indicate worsening condition like failure to passing urine or drowsiness during loose motions and fast breathing and bluish discoloration of lips during the course of pneumonia. Be watchful about these signs because they require immediate medical attention.

Side effects of the drugs

No drug is free from side effect but mostly they are innocuous [harmless] and require no treatment. Like red colored urine by some anti T.B. drugs and black colored stool on oral iron therapy. But some times severe allergic and other problems may occur, so ask your doctor about side effects to be observed and reported.

When to report back for recheck

In most of the mild illnesses patient is called back at the end of the course but timing and the frequency of revisits is determined by the severity and the type of the disease. In some long-term treatments where drugs are to be given for long duration [e.g. treatment of T.B. or treatment of epilepsy] periodic checkups at monthly or bimonthly interval is needed . It is to see the progress of the disease as well as watch for the complications of the disease and side effects of the medicines.

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Precautions to be taken at the chemist shop

Cross check the medicine given and medicine written on the prescription.

Never accept a substitute

Happens very frequently. Chemist will give you all possible reasons like—it is the same medicine with different name, company has closed, not available any where etc. check 2 or 3 chemist and if still not available call back your doctor and ask for substitute or alternate medicine.

Always insist on bills

Never accept medicine without proper bill. A proper bill with batch number will at least work as deterrent to chemist for giving wrong medicine.

Check the expiry date

Do not accept medicines whose expiry date is very close.

Take full course

Very often it is seen that medicines are not given for full duration prescribed. This habit should be discouraged because insufficient dosage is not able to cure the disease, which may resurface later. Apart from this insufficient dosage is the main reason for development of resistance in which drugs become ineffective. Estimation of full course is easy with tablets and capsules. But in case of syrups and drops single bottle may not be sufficient, so calculate the total dosage required and buy full course.

Chemist is not a doctor

Never take professional advises from chemist. They are always very keen to use there superficial knowledge and try ‘ hit & trial ‘ method. This could prove extremely dangerous. Similarly do not discuss the usefulness and effects of the drugs with the chemist. At the best they will confuse you.

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How to make Doctor your friend & get maximum out of him

• Always take the appointment. It saves your time and also confirms the availability of the doctor.
• Note down all your queries on a paper. It ensures that you do not forget any important question and do not face embarrassing situation of “something else was to be asked, I can’t recall it”.
• Do not forget to take previous prescriptions and related health documents along. Keep them in a file in proper sequence. It helps your doctor in quickly referring to previous health status.
• You may have your beliefs and customs regarding health and disease. Do not hesitate in clarifying from your doctor. It is better to ask a ‘foolish’ question now then make a mistake later.
• Do not compare health and development of your child with other children. Age of attainment of physical milestones [weight, height etc] or developmental milestones are not fixed. There is always a range of age during which they can be attained. As long
  as they are to the satisfaction of your doctor there is nothing to worry.
• As for as possible call doctor only during clinic hours. Avoid calling at residence especially during odd hours, unless really needed. Remember your doctor also needs rest. Use mobile no. only for real emergency.
• While calling your doctor keep old prescriptions ready for immediate reference. Always keep a “working” pen and a paper ready. Holding on the telephone line and calling ‘ Chhotu’ to search for a pen could be embarrassing for you and irritating for your doctor.
• While calling doctor do not hold crying baby and keep the volume of T.V. or Music system low.
• As far as possible do not seek telephonic consultation, because improper advice due to misinterpretation of facts could prove dangerous.
• Do not ignore the problems and delay consultation especially at the weekends, because on Sundays and holidays your doctor
  may not be available, and may cause lot of inconvenience to you.

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Arrival of the baby

Keeping baby comfortable

Breast feeding the baby

Baby massage

Care of the naval

How baby grows

Vaccination

Arrival of the Baby

After a long wait of nine months, when finally your baby arrives, you have some questions in mind, such as how your babies are born and what happens immediately after their birth? Actually when babies are born:

• They are wet and naked. They have come from a warm and comfortable environment of their maternal womb, so .
• They are immediately dried up, cleaned and kept under a warmer, so that a temperature can be maintained for them.
• They are examined, to check if they are breathing normally, and all other things such as weight, height, heart sound, visual reaction, hearing
  screening, reflexes, and umbilical stump are normal.
• They are given the Injection of vitamin K, to prevent any kind of bleeding.
• If everything is alright, baby is shifted to the mother’s room.

Baby with mother-“rooming in”

All normal babies are “Roomed In” or kept with mother. It helps in initiating breast- feeding and also keeping baby warm and
comfortable.

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Keeping Baby Comfortable

As a parent of a newborn, you try your best to keep your baby comfortable in this new world. Following are the answers of some common questions:

What should be the optimum room temperature?

• Unlike adults, newborn babies do not have adequate
  mechanism to generate or shed heat, so they are required to be kept
  under optimum temperature.
• By enlarge the room temperature which is slightly warm
  or uncomfortable to an adult is usually comfortable for the baby.
• During winter baby should be fully covered with woolen.
  Socks, hand gloves and cap should be used to prevent heat loss. Room
  should be kept warm with room heaters.
• During summer baby should wear loose and soft cotton
  clothes. Room should be properly ventilated and kept cool by using cooler
  or air conditioners.

How to asses whether baby is comfortable or not?

• When comfortable, baby’s hands and feet
  should be reasonably warm to touch and sole and palm should be pink
  in color.
• If baby is too cold, sole and palms tend to get bluish.
• If baby is sweating overhead and neck it means he is
  over clothed or room temperature is too high.

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Breast
Feeding The Baby

Breast-feed is the ideal food for your child because of
its nutritional composition. Following are the facts associated with the
breast-feeding:

How to go about it ?

• Baby should be put to mother’s breast as soon
  as possible, preferably within half to one hour.
• Do not give anything else like honey, water or
  top milk.
• Initial watery yellow milk called colorstrum is good
  for babies health and should never be discarded.
• Adopt a “Semi-demand” approach. If baby
  demands feed him otherwise offer every 2-3 hrly.
• Babies have a tendency to fall asleep after few sucks,
  don’t worry. Try to tickle him gently to keep awake.
• Babies should be fed exclusively by breast for first
  4-6 months. During this period they do not require any supplements including
  water.

Is my baby getting enough milk?

• A cranky baby, a baby who puts hands inside
  his mouth or who makes sucking movements doesn’t always mean
  a hungry baby.
• Mother’s milk is always adequate for nutritional
  requirements of a baby.
• Be sure your baby is getting enough milk if he….

1. Remains contented and happy
for 2-3 hours after feed.

2. Passes
urine at least six times a day.

3.Shows
satisfactory weight gains i.e. App. 30 grams per day during first 4 months.

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Baby Massage

Benefits

• Improves blood circulation .
• Improves muscle tone.
• Improves texture of the skin and reduces dryness.
• Enhances neuromotor development by sending sensory
  signals to brain.

How to go about it?

• Baby should be at least 15 days old and 3 kg
  before massage is started.
• Any mild oil can be used.
• Prefer non-scented and non-irritating oil. Avoid mustard
  oil.
• Room should be warm enough and draught free.
• Before applying rub hands between palms to maintain
  temperature.
• Use gentle pressure, do not apply undue force.
• Use rhythmic movements first from trunk towards
  periphery of limbs and than in reverse direction.
• During massage make passive movements of joints.

Watch out

• Do not rely on housemaids for baby massage. Vigorous
  and over zealous massage and exercise by maids have known to cause soft
  tissue injuries and fractures.
• Do not instill oil in ears or nostrils of the baby.
• Do not try to ‘raise the ghunti’ by putting
  finger inside mouth.

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Care of the Naval

• At birth blue colored G V paint is applied over the
  cord.
• Cord dries and falls off in 5-10 days after
  birth.
• Clean stump with surgical spirit twice a day.
• Do not apply any ghee, oil or powder over the stump.
• If discharge continues or stump becomes red- consult
  immediately.

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How Baby Grows ?

• Normal birth weight for a full term baby is
  2.5 kg to 3.9 kg.
• They loose 5-8% of weight during first 3-4 days.
• Regain birth weight by 7-10 days.
• Normal weight gain is 25-35 grams/ day for first 4
  months.

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Vaccination

• Vaccines are oral drops or injections given to protect
  baby from various communicable diseases.
• Vaccines have no role in prevention of a disease.
• Initial vaccines like Oral Polio, BCG and Hepatitis
  B are usually given before baby is discharged.
• Baby’s Growth parameters and Vaccination data
  are recorded in a heath card. It also shows dates for future check ups
  and vaccinations.

Top

Author: Dr. Arun Gupta.
M.D. New born & Child specialist
Ph-27495603, 27477030, 9811106056

Babies at birth may not look as you might have imagined. Their head shape may
look odd. There skin may have some sticky substance. Eyes may be puffy. It may
have some red marks as well. Don’t be dismayed. These are normal for the baby.
And with time, these will change to the expected features.

As your baby grows during the initial weeks, you will find many events, which
may seem alarming and cause lot of anxiety. But, most of these are normal and
with passage of time disappear and require no treatment. Some of the events
are:

Head

Eyes

Skin

Breasts

Genitals

Stools

Urination

Sneezing

Regurgitation of milk
[vomiting]

Jaundice

Head

• May look little elongated. This due to birth pressure
  and should look normal in two weeks.
• There could be soft boggy swelling ,over the head, which
  pits on pressure. It is due to compression around the presenting part
  of the head, during the delivery. Called ‘ Caput’ it usually disappears
  in 2- 3 days.
• At
  times, swelling over the head may be due to leaking of blood, under the
  outer covering of the skull bone. Its  well defined ,soft and mostly
  on one side of the head, over one of the skull bone. Called ‘Cephalhematoma’
  usually disappears in 6-8 weeks.
• There
  is a soft spot, on the top of the head called ‘fontanel’, here bones of
  the head have not joined yet. Its size is variable and it pulsates with
  heart beat. It  takes about 12 to 18 months to fill this spot. One
  must consult doctor, if it closes before six months or remains open after
  2 years of life.

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Eyes

• Eyelids are puffy [swollen] at birth due to pressure of birth. This swelling
  will disappear in couple of days.
• Watery
  discharge from one or both eyes is normal during initial months. This is
  due to blockage of duct responsible for drainage of secretions from the
  eye. Consult your doctor if secretion turns yellowish, which could be due
  to infection.
• Red
  spot in the eyes, over white portion is due to leaking of small amount of
  blood.   It may look alarming, but is totally harmless and
  will disappear in 4 to 6 weeks.

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Skin

• Red
  colored spots and rashes appearing on second or third day are very
  common. Starting from face they may spread and involve whole of the
  body. No treatment is required and they disappear in next couple of days.
• Scaling
  and peeling of skin especially on the hand and feet is common and
  clears in few days.
• Blue
  colored spots over lower back and extremities are virtually seen an all
  babies.  Termed as ‘ Mongolian spots’ are of no significance they usually disappear
  between 12- 18 months.
• Red
  colored birthmarks called stork bites seen over eyelids, forehead and back
  of the neck; take about one year to go.
• Strawberry
  like birthmarks, tend to increase initially but eventually disappear by
  the child is five.
• Milia
  are white or yellow pinhead spots seen on the nose are due to retention
  of secretions; disappear spontaneously.

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Breasts

One or both breasts may become
swollen around 4^th day. Little milk may also come out. Perfectly
normal condition. Swelling disappears in about 2 weeks. Never try to squeeze
or massage.

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Genitals

In baby girl, bleeding from vagina,
may occur third day onwards; usually disappears by 7^th day.

In baby boys, skin around the
tip of the penis is adherent and non-retractable, which may persist for 2 to
3 years. Do not try to retract it forcibly.

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Stool

• A
  newborn baby should pass stool within first 24 hrs.
• After
  that stools for first two days are dark green and sticky called meconium.
• 3^rd day onward color becomes yellowish, semisolid to watery in consistency and
  there is a tendency to pass stool after every feed. They may pass stools
  upto 15-20 times a day. This is quite normal and termed as transitional
  stool. No treatment is required.
• On
  the other hand, some babies do not pass daily, some may even pass at the
  interval of 5 or 6 days. As long as baby is active , accepting feeds regularly,
  passing urine frequently and his abdomen is not unduly distended there is
  nothing to worry.

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Urination

• Most babies pass urine within 48 hours of birth.
• After
  about a week,  urine frequency increases, it may go
  upto 20 times a day, but it should not be less than 6 times
  in 24 hours.
• Babies
  usually look uncomfortable or cry just before passing urine. This is a normal
  reaction from feeling of distended bladder.
• Watch
  out – if baby dribbles, has thin stream of urine or has excessive cry during
  urination. It could be due to some obstruction. Consult your pediatrician.

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Sneezing

Most newborn babies sneeze ,
they do it in all  kind of weathers. Sneezing is not a sign of cold. They
do it to clear respiratory passage of mucus and secretions. It’s a sign of good
health so one should not worry.

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Regurgitation of  milk [vomiting]

• Most
  newborns have a tendency to throw out small amount of fresh or curdled milk
  especially after the feeds. This occurs due to a condition called aerophagia
  where babies swallow air while taking feeds. When this air comes out it
  brings some milk with it. Condition is aggravated, when baby is on bottle
  feeds and size of bottle teat is too small or too large.
• As
  long as baby is active, accepting feeds well, passing urine adequately and
  gaining weight properly there nothing to worry.
• Proper
  burping after each feed is the best remedy to prevent excessive vomiting.
  To burp one should hold baby in lap or against the shoulder and tap her
  back gently for about 5 minutes. If he doesn’t burp don’t try too hard ,
  baby may not require it. After burping, place baby in right lateral posture
  with head slightly above the body.

But watch out

• Vomiting could be indication
  of serious underlying problem if;
• Vomiting is forceful
• Is associated with abdominal
  distention
• Vomitus is of green color

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Jaundice

• Yellowish discoloration of eyes and body.
• Starts on 2^nd or 3^rd day of the life.
• Increases till 5^th to 7^th day  and than gradually
  subside by 11^th to 14^th day of the life.
• Mostly It’s a harmless condition called “physiological jaundice”.
• Occurs due to elevation of a substance in blood called bilirubin.

What is to be done:

• Usually no treatment is required, but consult your pediatrician.
• No role of sun exposure.
• Its not caused by eating yellow colored foodstuffs like papaya or mango.
• It has no relation to
  wearing yellow clothes.
• No need to keep the
  household tube lights on.

But jaundice could be dangerous
if:

• Appears within 24 hours or after 72 hours of birth.
• Persists beyond 2 weeks of age.
• There is intense yellow staining of abdomen, thighs or sole.
• Urine is dark colored or, stool is pale or white in color.
• Baby is lethargic and not taking feeds.

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Arrival of a new baby in family brings lots of joy and happiness. Friend, relatives and neighbors pour in with greetings and well wishes. Along with greetings, come lots of advise regarding baby care. At the end of the day mother finds herself confused and bewildered.

These advise are largely based on traditional believes, carried through generations. Some believes and practices have good effect, but others may have rather adverse effect on baby’s health. One should listen to the advise offered but should clarify from pediatrician before applying them.

Myth-Baby should not be fed for first few hours after birth

Myth-Baby should be given honey, jaggery or butter at birth

Myth- After birth initial milk of mother should be discarded

Myth-Mother and infant should not be allowed to go out for first 40 days

Myth-Baby should be supplemented with gripe water and Janam ghutti

Myth-Application of kajal or surma is good for baby’s eyes.

Myth-Sneezing means cold

Myth-lactating mother should not be given ‘cold’ and ‘heavy’ foodstuffs

Myth- loose motions and fever are normal during teething.

Myth-Belly button is protruded because doctor pulled the cord

Myth-Baby’s warm head means fever

Myth-Baby should not be fed for first few hours after birth

It is believed that baby doesn’t require anything for few hours after birth. Sometimes its Bua who has to perform initial ceremony, so feeding is delayed till she arrives. At times, feeding is delayed till the sun sets.

Fact- baby should be fed as early as possible. It could be started in within labor room itself. One should not worry about outflow of milk in initial stage, because good milk flow starts only after baby suckles the breast. Delayed initiation of feeding could lead to decreased milk flow. Lack of milk to baby may lead to fall in baby’s blood sugar. Delayed feeding also hampers production of vitamin-k which may cause increased bleeding tendency in baby.

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Myth-Baby should be given honey, jaggery or butter at birth.

Mostly given by elder person at home, believing that baby would acquire good qualities and virtues from that adult.

Fact- it’s a harmful practice. It delays initiation of breast feeding .These food stuffs may not be hygienic,
leading to infection to the baby.

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Myth- After birth initial milk of mother should be discarded.

Widely prevalent mis believe that initial milk is dirty and is harmful so should not be fed to the baby.

Fact- Initial yellowish , watery milk called ‘colostrum’ is very nutritious and gives infant adequate calories and nutritional substances during early hours of birth. It also contains lots of ‘ antibodies’ which built infants resistance and helps him fighting against diseases. So initial milk should always be given to the
infant.

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Myth-Mother and infant should not be allowed to go out for first 40 days

Mother and infant are kept indoors for first 40 days believing that they might catch cold and fall sick if exposed to outer environment.

Fact- the practice of keeping mother and infant in a closed , ill illuminated room , which is deprived of fresh air and sun rays is harmful because it increases the chances of infection. There is no harm in keeping indoor but room should be clean, well illuminated and properly ventilated. A normal child has the capability to fight infections and to adjust to the environmental changes. So there is no harm in taking outdoors. If infant is not sick , there is no harm in welcoming visitors but be careful lest some of visitor may be suffering from any communicable disease.

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Myth-Baby should be supplemented with gripe water and Janam ghutti.

Janam ghutti and gripe water is supposed to be good for hajma [ digestion] and the liver of the baby. They are also believed to help during teething .

Fact- these substances should not be used . Their contents are not standardized. Most of them contain sedatives like alcohol, morphine etc which may be harmful. They can cause infections and loose motions too.

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Myth-Application of kajal or surma is good for baby’s eyes.

Kajal use is very common and widespread. Kajal is supposed to make eyes beautiful and big. It is also believed that kajal improves eye sight.

Fact- kajal and surma should not be used. They have no beneficial effect on the contrary they
can cause infection or allergy in eyes. Surma contains lead ,which not only harms eyes, but gets absorbed through blood and affects other organs too.

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Myth-Sneezing means cold

Fact- Mild coughing and sneezing in newborn period are not signs of cold or sickness , they rather are signs of good health. They sneeze or cough to clear there nose and respiratory passage of secretion.

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Myth-lactating mother should not be given ‘cold’ and ‘heavy’ foodstuffs

It is believed that if mother eats should not be given ‘thandi’ [cold] things like ice-cream, rice, curd etc. rajma, gram, chhole, kadhi taken by mother are also believed to cause pain in baby’s stomach.

Fact- mothers milk quality remains relatively stable irrespective of kind of food taken by mother. There is no truth in belief that ice-cream, rice or curd will cause cold or pneumonia in child. Likewise,
so called heavy foodstuffs like rajma, gram or chhole have no adverse effect on baby’s health. What
is important is to give well balanced nutritious diet to the mother with ample amount of fluids.

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Myth- loose motions and fever are normal during teething.

Fact – loose motions and fever have no relation to the teething process. During teething infant may have discomfort and irritation in gums, to relieve that he has a increased tendency to put various
things in mouth. These articles, if not clean, may carry germs and would lead to infection of throat or abdomen. So medical advises should be taken for any episode of loose motion
or fever.

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Myth-Belly button is protruded because doctor pulled the cord

A large no of babies have their umbilicus protruded during early infancy. Most people believe its because doctors pulled the cord during delivery.

Fact – is that it is not due to wrong cutting or pulling of the cord. Mostly it is genetically determined. Do not try to keep it compressed by applying tape or coin over it. In about 20% of babies it is due to a defect or weakness in the wall of abdomen called umbilical hernia. Nothing is to be done and this protrusion usually disappears by the age of one year.

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Myth-Baby’s warm head means fever

Fact - Average temperature of a newborn baby is 98.2 F but it varies between 97.6 and 99.5. Usually head appears warmer than rest of the body. But if baby is otherwise well and temperature is with in normal range one should not worry.

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