Is your Child REALLY Underweight ?

Weight gain is a universal concern. All parents want their kids to be healthy and an appropriate weight is very reassuring to most parents because  this means that their kid is growing & developing in a healthy way. However there are many misconceptions in the society regarding weight of infants and toddlers .  Concerns about childhood weight gain are a very common cause of consultation in my Growth Clinic. 

Are You Worried?

If you are worried that there is something abnormal and your child is not gaining weight, stop thinking and  first evaluate whether  in reality the weight is less or not.

                       Normal weight at different ages for Indian Children

	BOYS	GIRLS
6 months	6.5-10 kg	6-9 kg
1 year	8-12 kg	7-11 kg
18 months	9-13 kg	8-13 kg
2 years	10-15 kg	9-15 kg

In further doubtful cases , for a thorough evaluation only weight doesn’t give the complete picture and other parameters like weight for height have to be plotted on a Growth Chart and assessed that can be done by a

 Growth Specialist

So is your Child REALLY underweight?

If your child actually falls in the underweight category, evaluation is needed. In a child who is otherwise not having any medical problems and doesn’t need medications very often, the underweight situation is usually due to a lack of adequate calorie intake. Ensuring adequate food intake is the first step and often the only step needed to bring your child in the normal weight bracket for his/her age.

I shall discuss the common issues in young child feeding and the common problems parents face while feeding tiny tots in subsequent blog posts. So watch this space .

In case you have any specific worries and queries, please feel free to write in the comments section. We ll try to address them. 

Happy Growing 😊..

Dr Uppal, Saurabh

Childhood Growth & Hormone Specialist







Dr. Uppal is a Pediatric Endocrinologist and Director at ENDOKIDZ Centre for Growth, Diabetes, and Hormones for Children at Jalandhar, Punjab India.

If you have any concerns about your height, Consult your family doctor or your Child's pediatrician and request them to assess the child height and plot the child's height on a GROWTH CHART. If the height is less than what is expected at that age, your doctor may refer the child to a Pediatric Endocrinologist.

Is Your Child Growing Normally??

     

           A parent's frequent question in my Growth clinic is,

                                                       " Doctor, is my child growing up all right?" 

          while this question has numerous answers depending on the child in question, there are certain basic facts every parent must know about growth. 

        Let's discuss the first part of the growth series

    Growth is the miracle of childhood.. 

      How a little bundle of joy at birth transitions and transforms into an adult human is truly a remarkable feat of nature,,,

 Growth is universal

        Every child grows. And hence we tend to take it for granted.... until something goes wrong and the child stops growing well.

       But do you really need to wait before your child comes up with a serious growth problem?

                               The answer is NO...

Can you pick up a problem before it becomes severe?

                                                          

                               The answer is YES..

 Can you monitor the child's growth yourself?

                                The answer is YES. 

What is growth

Growth means increase in height and weight of the child

Why do you need to look at your childs growth carefully
 

       To put it in simple words, growth is the sum total of all the body processes. If growth is alright, it means most of the body processes are going well so you can stop worrying about your kiddo’s health

As a law of nature

A Well Growing Child is a Healthy Child

What does good growth tell us

1.  Nutrition intake is good

2.  All Hormones are fine

3.  Metabolism is co-ordinated

4   Illnesses arent ‘consuming away’ the child's inner body.

5.  Child is in psychosocial well being (happy kids grow better)

        

         A child who is not growing well has a deficiency or a disorder.Height is nature’s early warning sign, a VISUAL ALARM for parents and physicians not increasing in height  could indicate certain invisible problems are going on inside the child’s body

So how can  you know that your child is growing normally?

1.   Is he/she not outgrowing clothes every year?

2. Is the shoe size not increasing every year?

       3.   Is he/she among the 3 shortest children in class?

       4.    Is he/she not growing atleast 5 cm per year

5.    Is he/she also much leaner or chubbier than classmates?

         If the answer to any of these questions is yes, this child needs to be looked at carefully. the growth parameters need to be measured and marked and followed up regularly.

     I must stress here that every child must have his/her own growth chart.It is a paper which has markings of ideal height and weight at all ages. Each visit to a pediatrician must have a recording of height and weight done on the growth chart.

      I shall cover the topic on how to plot a growth chart yourself in the coming days.

   Happy Growing 😊..

Dr Uppal, Saurabh

Childhood Growth & Hormone Specialist







Dr. Uppal is a Pediatric Endocrinologist and Director at ENDOKIDZ Centre for Growth, Diabetes, and Hormones for Children at Jalandhar, Punjab India.

If you have any concerns about your height, Consult your family doctor or your Child's pediatrician and request them to assess the child height and plot the child's height on a GROWTH CHART. If the height is less than what is expected at that age, your doctor may refer the child to a Pediatric Endocrinologist.

                    

Mangoes are Sweeter This Season

This is not an educative or an awareness post. Maybe its more than one....

    Diabetic kids occupy a big chunk of my Pediatric Endocrinology practice .. and my heart and soul. There isn't a day that passes without me playing their pancreas and teaching their parents to play the same role. Challenging as it is, it has its own share of sweet rewards something i ve experienced this mango season.
                          Emotion is a really big part of Childhood diabetic care and one emotion thats so strong in kids I ve realised is the desire to eat a mango.... You wont appreciate it untill u meet a kid who cant eat one. 

But this season has been different. Families who have learnt advanced carbohydrate counting are seeing a joy they missed for years together, the joy of their tiny tots devouring mangoes and still having their blood sugars under control... I meet diabetic kids who love me now for I let them eat mangoes and their parents who often have tears of joy when they tell me this is the first season after years that they have brought mangoes to their house and hence themselves eaten them after years. 

Children with diabetes need not miss out on the sweet delicacies of life.
 All they need to learn is how to balance insulin with food. 
                                                                                                    whatever food it may be.. 



and now everytime I eat a mango myself, the reminiscence of all these kids makes them taste sweeter.......



happy to help :-)

Dr Uppal

How Much Sleep Should your Child be Getting Every Day?

Sleep is very important for all of us.As a Growth Specialist I stress a lot to parents about healthy sleep to ensure healthy growth in childhood. A very common question i Get asked is "Doctor, How many hours my child should sleep"? Lets answer this question today




Sleep is an essential part of our daily schedule . Not just children but all adults should give due importance to sleep in their lifestyles. research has been telling us for many years that sleep is the time where the body rests and repairs itself. 


When we sleep our heart rate slows down , the muscles relax and body temperature falls, all are means to repair and rest tissues. For children sleep has an added importance as Growth Hormone secretion is maximum during deep sleep. Hence the highest growth rate is during night-time deep sleep.

Our Brains never sleep. Sleep is the time when the brain cleans itself .In this process, new connections are made between the brain cells that help us remember what we learnt during the day. Hence a child who sleeps well remembers well what he learnt during the day and with a fresh brain next day will learn better in school.

 Do We Know How much to sleep?

in the past the recommendations of sleep duration were NOT based on solid research. but finally last month The American Society of Sleep Medicine has come out with Scientific Research based recommendations . these have been published in The Journal of Clinical Sleep medicine in the  June 2016 issue

How Much should your child sleep every night?

To promote optimal health, the recommendations advise the following amount of sleep (per 24 hours) on a regular basis:

• Infants 4 to 12 months: 12 to 16 hours of sleep (including naps);
• 
  
• Children 1 to 2 years of age: 11 to 14 hours (including naps);
• 
  
• Children 3 to 5 years of age: 10 to 13 hours (including naps);
• 
  
• Children 6 to 12 years of age: 9 to 12 hours; and
• Teenagers 13 to 18 years of age: 8 to 10 hours.

In developing the recommendations, the expert panel reviewed 864 published scientific articles on the relationship between sleep duration and health in children, evaluated the evidence by using a formal grading system, and arrived at the final recommendations after multiple rounds of voting.These are by far the best scientific recommendations available to this date.

ADVANTAGES OF A NICE SLEEP 

Sleeping the recommended number of hours on a regular basis is associated with 

1. overall better physical health 
2. improved attention,
3. improved behaviour
4. better learning,
5. better memory,
6. better emotional regulation,

On the other hand sleeping fewer hours than recommended is associated with 

1. lack of attention
2. Bad behaviour
3. learning problems.

Children who sleep less are also at a higher risk for accidents, injuries, hypertension, obesity, diabetes, and depression.Teenagers with disturbed sleep are more likely to engage in risky behaviour and be prone to suicidal tendencies.

However, sleeping more than the recommended time is also associated with risk of reduced school performance, irritability, obesity  and hypertension .

So we are clear on this. Children should sleep as per the recommended times and stay healthy , happy and grow well..

A lot of parents have trouble making their kids fall asleep. I ll address sleep habits and sleep hygiene in my upcoming articles.

   



see u soon..

Dr Uppal Saurabh 

PS: Any queries you have or any topics you would like me to cover can be posted on my facebook page ENDOKIDZ ( link in the top right corner of this page)

How Much Sleep Should your Child be Getting Every Day?

Sleep is very important for all of us.As a Growth Specialist I stress a lot to parents about healthy sleep to ensure healthy growth in childhood. A very common question i Get asked is "Doctor, How many hours my child should sleep"? Lets answer this question today




Sleep is an essential part of our daily schedule . Not just children but all adults should give due importance to sleep in their lifestyles. research has been telling us for many years that sleep is the time where the body rests and repairs itself. 


When we sleep our heart rate slows down , the muscles relax and body temperature falls, all are means to repair and rest tissues. For children sleep has an added importance as Growth Hormone secretion is maximum during deep sleep. Hence the highest growth rate is during night-time deep sleep.

Our Brains never sleep. Sleep is the time when the brain cleans itself .In this process, new connections are made during the brain cells that help us remember what we learnt during the day. Hence a child who sleeps well remembers well what he learnt during the day and with a fresh brain next day will learn better in school.

 Do We Know How much to sleep?

in the past the recommendations of sleep duration were NOT based on solid research. but finally last month The American Society of Sleep Medicine has come out with Scientific Research based recommendations . these have been published in The Journal of Sleep medicine in the  June 2016 issue

How Much should your child sleep every night?

To promote optimal health, the recommendations advise the following amount of sleep (per 24 hours) on a regular basis:

• Infants 4 to 12 months: 12 to 16 hours of sleep (including naps);
• 
  
• Children 1 to 2 years of age: 11 to 14 hours (including naps);
• 
  
• Children 3 to 5 years of age: 10 to 13 hours (including naps);
• 
  
• Children 6 to 12 years of age: 9 to 12 hours; and
• Teenagers 13 to 18 years of age: 8 to 10 hours.

In developing the recommendations, the expert panel reviewed 864 published scientific articles on the relationship between sleep duration and health in children, evaluated the evidence by using a formal grading system, and arrived at the final recommendations after multiple rounds of voting.These are by far the best scientific recommendations available to this date.

ADVANTAGES OF A NICE SLEEP 

Sleeping the recommended number of hours on a regular basis is associated with 

1. overall better physical health 
2. improved attention,
3. improved behaviour
4. better learning,
5. better memory,
6. better emotional regulation,

On the other hand sleeping fewer hours than recommended is associated with 

1. lack of attention
2. Bad behaviour
3. learning problems.

Children who sleep less are also at a higher risk for accidents, injuries, hypertension, obesity, diabetes, and depression.Teenagers with disturbed sleep are more likely to engage in risky behaviour and be prone to suicidal tendencies.

However, sleeping more than the recommended time is also associated with risk of reduced school performance, irritability, obesity  and hypertension .

So we are clear on this. Children should sleep as per the recommended times and stay healthy , happy and grow well..

A lot of parents have trouble making their kids fall asleep. I ll address sleep habits and sleep hygiene in my upcoming articles.

   



see u soon..

Dr Uppal Saurabh 

PS: Any queries you have or any topics you would like me to cover can be posted on my facebook page ENDOKIDZ ( link in the top right corner of this page)

Thumb-sucking in your child; Should you be worried?

All Children suck their thumb/fingers at some age or another. Some of them even suck their toes or forearms. this is usually  very annoying for parents and caregivers and a lot of my patient's parent's have considerable anxiety regarding this habit in their kids. But is this anxiety correct? 

lets examine this habit and know more about when should you worry about it.




To a large extent thumb sucking is a developmental feature which means it parallels different stages of brain development.

 Newborns may suck their fingers if they get hold of them. Then this habit goes off to come back again at around 3- 5 months when the child can put finger to mouth and objects to mouth, Then he/she will suck at about any object. then  again  for a few months this habit disappears and comes back with each new tooth, as the child rubs his gums during tooth eruption.

 It often becomes associated with sleep and child may use this to go to sleep. The association with sleep also goes off by itself by 3 years of age.

Do all children do this?

About half of all children suck their fingers at one year of age,some more than others.The peak age for thumb sucking is 18-21 months. 

Does thumb sucking cause any harm? 

If thumb sucking disappears by 3 years of age, its perfectly ok.. 

Possible harm to teeth or skin may occur only if the habit persists beyond 4-5 years of age. All it can cause is a little soreness of the skin. Not to worry.

When should you be worried?

Worry after 2-3 years of age if

1) thumb sucking is excessive

2) occurs during the day also ( off and on in the night is ok)

3) occurs continuously throughout the night

4) thumb sucking restarts after a long time without it

         then look for a cause.........

                                                       most common causes are

                                                                                   1) boredom

                                                                                   2) insecurity

                                                                                   3) jealousy

So search for the cause and remove it... Your kid will be fine

Should you give any special treatment? 

• Devices to stop thumb-sucking are no longer advocated for use. They can cause psychological disturbances in the child
• Dont put any bitter substances on the fingers. Its cruelty to the child and will confuse the poor kid
• No treatment is required for the child younger than 2-3 years especially if thumb-sucking occurs in sleep as this is normal
•  Child will certainly grow out of it. 
•  Never use threat of punishment. It will certainly harm your child
• Never shame,ridicule ,tease the child 

The danger is not in thumb sucking, but what parents try to do about it.

The majority of thumb-suckers will grow out of the habit by five or six years. 

So relax.......... Dont trouble the kiddo........ 

Happy to help :-)

Dr Uppal 

IS YOUR INFANT VOMITING AGAIN AND AGAIN?

IS YOUR INFANT VOMITING AGAIN AND AGAIN?

Recurrent vomiting can be a worrisome sign in first few months of life. However not all recurrent vomitting is a pointer to disease or needs treatment. most of the children throw up milk in the first few months of life, its considered normal upto one year of life. the reason is that their swallowing reflexes as well as tummy reflexes to keep milk in tummy are not very mature.

how can you know that the vomiting is simple throw back of milk( regurgitation)?

1) child throws-up after feed
2) milk comes out "as such"
3) milk comes out both from mouth and nostrils
4) child is otherwise happy and playful
5) if you find that adequately burped( dakaar) the chances of vomitting become less

if the child looks sick, unhappy, has fever, is not feeding well , crying excessively or not gaining weight then this vomitting is serious and needs doctors advice,
 

How to reduce regurgitation episodes

1) ensure adequate burping (dakaar) . some kids may need rocking upto 45 minutes

2) if still kid throws-up, make them lie down on bed or lap with RIGHT SIDE DOWN for 15 minutes. this position makes milk go further down the tummy

3) dont overfeed the kid. crying doesnt always mean hunger...




                                                       Happy to help :-)



Dr Uppal