SOME COMMON COMPLICATIONS OF INFANTS
A mother should be fully conversant with some of the disorders detailed hereunder and take preventive or corrective steps so that the disorders do not assume serious proportions.
HICCOUGH/HICCUP
Some children, though not all of them, develop hiccoughs after taking milk, and it is quite natural and does not constitute a disease. But if hiccoughs last for a longer span and continue unabated, it does exhaust the little one, especially when his breathing gets interrupted; and in this condition, a doctor must be consulted for medical advice. Generally, such hiccups subside automatically after a few minutes when no treatment is called for. According to some experts, a hiccough is a healthy sign for a baby, and the same disappears if some lukewarm water is given to the infant.
WEEPING
It is no disease but merely a pointer to some discomfort felt by the baby, like—
• Pain in stomach.
• Locking up of wind in the abdomen and gurgling sound.
• Constipation.
• Redness and swelling of the anus due to acidity.
• When the bladder is empty but has not been voided.
• Fever or pain in the body.
• Nappy rash.
• Cold bed or exposure to cold or when his clothes get saturated with stools or urine.
• Pain in the ear.
In some cases,, a child may weep without any visible and/ or apparent cause. But, it is the height of imprudence to attribute every weep of the child as a demand for feeding. If a child draws up his legs and does not bear his abdomen to be touched with a hand, even when mild pressure is applied or simply touched, it invariably points to colic pain in the abdomen, which might bloat. Some children are relieved after passing the wind. In a few cases, even stools may be passed by wind. But colic pain generally disappears by the 3rd month.
The baby will also cry if urine or stool is not passed. This situation can be easily countered by the passage of urine/stool. If the stools are hard, he will have pain while passing stools, and there may be some redness also in and around the anus. Give some water (boiled and then cooled) after regular intervals. It will help to pass urine and soften the stools. A glycerine suppository (meant and prepared especially for children) may be inserted into the rectum in acute cases of constipation. But it should not be a habit-forming device. Otherwise, the child will not pass stools unless given a suppository.
If there is a pain in the ear, the child will try to touch his ear. Pain in the ear can also be due to some injury or blockade of the nose or wax accumulation. Do not touch the ear—rather, have the child examined by a specialist.
Baby’s nappies should be changed as soon they become spoiled by sweat, stool or urine. When it is winter, the child will cry more due to cold and wet nappy; even otherwise, if a child lies in wet clothes, he will develop itching, rashes and pain.
NASAL BLOCKAGE AND COUGH
Blockade of either or both the nasal passage causes breathing problems, especially when the child has to breathe through his mouth. If there is a cough also, it will make even mouth-breathing difficult. If the cough is stingy and tenacious, he won’t be able to cough up the sputum and, thus, feel choked. When all these problems combine, the child feels gagged, suffocated and tired. To cure these complications, insert saline water in each nostril or use Nasivion paediatric nasal drops. Give 2.5 ml (1/4 TSP) of Tyxylix syrup after an interval of 4-6 hours. Vicks Vaporub or steam inhalation will facilitate the passage of mucus by liquifying the phlegm. If the child vomits while coughing, exhausts and faints, his body turns blue. It points to whooping cough/bronchitis/ broncho-pneumonia, which a child specialist must treat all.
VOMITING OF MILK
Almost all the infants vomit 2-3 spoon quantities of ingested milk, and nothing unusual exists. Vomiting may be caused by feeding with milk in excess of the requisite quantity, putting pressure on his stomach, moving him to and for, letting him lie on his stomach, or keeping his head low. If such undesirable situations are not allowed, no vomiting may occur. If the child has pain and irritation in his throat and coughs frequently, even then, he may vomit. If the child could belch, no such vomiting can occur. Uncurled milk is simply a regurgitation and flows from the side(s) of the mouth. But if there is yellow or greenish vomit, consult a doctor. But repeated and frequent vomiting is a severe complication that a specialist must investigate. The pyloric orifice is at fault in a few children, which may cause vomiting. Surgery should be resorted to as an ultimate option.
NAPPY RASH
The term applies to red skin due to keeping the nappy too tight or saturated with urine. Add some boric acid (500 mg to ½ tumbler) to water, wash the skin, and dry up with a soft towel or cloth. You may apply some baby cream or Vaseline. In summer, the child often sweats a lot—in that condition, also do as is advised above. Never tie a wet nappy to the child, as it may cause itching, irritation and other skin diseases.
SKIN INFECTIONS
A child’s skin, being too sensitive and tender, is easily affected. His face, hands, feet, and neck may become itchy, develop cracks, and redden. As a first step, a child must not be handled, touched or carried by any person suffering from a skin infection. If a child is breastfed for the first 5-6 months, he will improve his defence mechanism. Still, even then, no local or oral medicine should be administered explicitly advised by a specialist. Avoid kissing the child on the mouth and cheeks.
SUMMER RASHES/ERUPTIONS
During summer, small pimples appear on the face, neck, and shoulders, in skin folds which can be treated by keeping the child at a moderately cool temperature, with minimum clothes on the body. Apply Johnson’s baby powder over the whole body. Sprinkle this powder freely over the baby’s whole body but make sure the powder does not fall into the eyes, ears and nostrils. Do not use powder in excess, as it may cause dryness to the skin, nor apply any other oil, ointment, or cream. Simple hygiene and keeping the infant’s skin dry will offset the emergence of many skin problems.
THRUSH
It is a fungus disease that appears in the mouth of infants. There could be white spots inside the cheeks, tongue, gums or soft palate, due to which the child has pain and feels restless and gives up milk. A dirty and unwashed nipple and the feeding bottle cause it. Consult some doctor for treatment.
CRADLE CAP
Sometimes white, greyish or light brownish crusts appear on the head, known as cradle caps. Massage the head with baby oil or olive oil so as to soften the crusts, which will get removed when the child’s head is shampooed. If no relief is noticed, consult your doctor.
WATER FROM EYES
A thin tube permeates from the eyes to the nose, which, at birth, remains either blocked or underdeveloped, due to which water flows from one or both eyes. This tube is known as the ‘lachrimal or tear duct ‘. Though there is no harm to vision, it disturbs the child and his parents. Generally, this duct opens on its own within 6-9 months. At times, the infection may also be the cause when some mucus may appear, thus agglutinating the eyelids. Wash the eyes with lukewarm water and drop off Soframycin eye drops ( diluted) in each eye. It is better to consult a doctor to ensure if there is some other complication or not.
SWELLING OF NIPPLES
Swelling can occur in both male and female children. Sometimes when nipples are pressed, some milk also oozes out due to the hormonal effect that the infant imbibes from the mother. It is nothing unusual or unnatural, as it disappears as the age advances.
WEIGHT OF A CHILD
A child’s weight gradually decreases after birth, but again 42 starts increasing after 10-20 days when it (weight ) again measures up to the original weight (what was actually at the time of birth). A child gains 28 gms (about one ounce) daily during the first three months. Generally, a child’s weight almost doubles between 5-6 months, but at the end of one year, his weight is thrice the weight that was actually at his birth time. Weight gain is faster and quicker in male children than the female children. The weight of every child should be weighed after every fortnight during the first 3 months and thereafter once each month. Growth patterns and weight gain/loss depend on many mental and physical factors, which vary from one child to another. The following table will give an idea of weight—
+ 5% weight, when compared to the above table, should be taken as expected, but any deviation on the higher or lower side, should also not cause any anxiety. If a child is active, mentally sound, alert, and has no physical problem, there should be no cause for undue anxiety, as growth pattern differs in each child. Some healthy-looking children have been seen to be less mentally alert and vice versa. But, a close watch must be kept on sudden weight loss or gain. If there are abnormal growths, consult your doctor and follow his advice.
GROWTH PATTERN
Ist Month—Can be breastfed or bottle-fed; he sleeps most of the time and weeps when hungry, has to pass urine/ stools, and keeps his fist closed.
2nd Month—Smiles when looked up; can lie on his stomach and raise his neck.
3rd Month—Smiles more
4th Month—Turns its head to the direction from where sound is coming; smiles when looked at or when called and creates noises.
5th Month—Tries to catch toys or colourful objects and is attracted by dark colours, especially red, green, yellow and blue.
6th Month—Starts cutting lower teeth (two), raises its head from the pillow, laughs and smiles, can sit (but only when support is provided), can turn to another side, and holds the feeding bottle.
7th Month—Tries to put all things into his mouth, intently watches and hears with great interest what others talk about, and can sit for a few minutes without support. If held and supported by his arms/hands tries to get up and dance/jump and can take water or milk with a cup.
8th Month—Starts speaking ‘ Ma-Ma’ ‘Pa-Pa’ ‘Da-Da’ etc. cuts two (frontal) upper teeth.
9th to 12th Month—Can sit without support, starts toddling, can stand with some support, laughs heartily and feels happy with child-like responses when fondled or called. Some kids try to walk and can point to some object with a pointed finger, but some fall tottering while trying to walk. At the age of one year, some children learn to walk alone or with support. Some children start standing and walking, even without any support.
12-15 Months—Can himself get up and walk, learns to play with toys, starts speaking words like’ Dada, Mama, Papa etc.’, starts to understand, holds a spoon, and tries to eat.
18 Months—An 18-month-old child can walk, go and down the stairs, can throw and collect a ball, sit in the chair without any support, starts to imitate his mother and other elders, does not resist changing clothes, can remove his socks, attains control over urine and stools but may pass urine at night (Enuresis), which is quite common in winter.
24 Month—A two-year child can run, can himself get into a chair, can call his mother and express his demands (like calling his mother, demanding milk or rejecting some object piteously), watches his toys and other playthings with interest and rapt attention, listens to voices intently, can ascend stairs without anybody’s support. As I have already stated, growth pattern differs in each child. The above progressive stages are merely indicators of the general stages of a child’s development. Some children cut their teeth early or late; some learn to walk, while others do not respond. Patterns also vary from child to child. Personal care, nurturing hygiene, and a peaceful and calm environment in the family are key to a child’s mental and physical development. Remember parental love, affection, attachment and care help in the faster growth of a child. If your child does not measure up to the laid-down stages of development, you better consult a doctor for proper guidance and advice.
DIARRHOEA
Passing stools 2-3 times a day should be taken in normal stride, but if the child passes loose and watery motions in much quantity and with greater frequency, it constitutes a disease caused by some infection. As a first step, boil his bottle, nipple, and spoon thoroughly. Excessive discharge of water and salts causes utmost weakness. This water-salt deficiency and imbalance may even endanger the child’s life. Apart from infection, even cow’s milk, buffalo’s or tinned milk may also cause the onset of loose and watery motions. Still, a change-over to soybean milk or the milk suggested by a doctor may prove agreeable and suitable. If the child is breastfed, his mother’s milk may be continued, but other types of milk should be stopped forthwith, nor any other feed served. To meet the deficiency of water and salts (called ‘disturbed electrolytic balance’ also), give an electoral powder ( I TSP to 250-300 ml of water—boiling the water first and then letting it cool down) in 2-3 TSP after every 10-15-20-30 minutes gap, depending on child’s condition. If the electoral powder is not readily handy, prepare a liquid preparation as suggested below.
Water (boiled and then cooled): one cup
Sugar………………………………2 TSP
Table Salt…………………………One Pinch
Repeatedly serve the said mixture and do not give any other feed/drink for the first 24-28 hours or until stools regain standard colour and consistency. The normal feed can be resumed after a period of 24- 28 hours or when loose motions have stopped. Mix half the quantity of milk to half the quantity of water, then feed. Coconut water is an ideal food and a good substitute for milk.
There may be colicky pain, or the child may vomit and nauseate also (Though about pain and nausea, you have to rely on specific symptoms as the child won’t be able to tell how and what he feels)—in such situations, medical advice is called for.