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Vitamin D Deficiency in Babies
Vitamins are micronutrients that are essential for the healthy functioning of human bodies. Vitamin D is a unique vitamin that is available through an environmental source - sunlight. When the good UV rays (UVB) from the sunlight fall on our skin, Vitamin D is produced in the skin and is then absorbed in the blood.
Video: Vitamin D Deficiency in Babies
https://www.youtube.com/watch?v=PXU-ejHNBz4
What is Vitamin D deficiency?
As the name goes, a lower level of Vitamin D in the body is termed as Vitamin D deficiency. Then what is Vitamin D insufficiency? Well, it’s the blood level of Vitamin D measured in the form of serum 25-hydroxy-Vitamin D (calcidiol) that determines it. A level below 25 nmol/L is a deficiency and between 25-50 nmol/L is insufficiency. When the level is above 50 nmol/L, there is evidence of benefit to the bones, muscles, the immune system, and the insulin secretion.
Why is Vitamin D important for babies?
Nutrition is very complex and needs a perfect balance for the optimal benefit. The body can compensate for slight deficiency and at times, even to an excess deficiency but only to an extent, especially in a growing baby. It is Vitamin D which will make your child able to play around without difficulty and with good strength and energy. The bones need calcium and phosphorous for strength, wear & tear and weight bearing. It is Vitamin D that makes sure that the bones aren't deprived of any. Vitamin D also makes the intestinal lining absorb calcium from food, process it in the blood and deposit in the bones. Calcium is important for the functioning of every cell in the body. It is responsible for opening the gates of the cells to receive molecules to produce energy and for initiating each muscle fiber contraction eventually giving power to your muscles. This helps us understand why Vitamin D is important for babies and its deficiency will affect them.
Type of Vitamin D you should give your child
Vitamin D supplements are found both as Vitamin D2 (ergocalciferol) and D3 (cholecalciferol). Although traditionally both D2 and D3 are considered to be equally potent, studies have revealed that D3 can be at least 3 times more potent compared to D2. Hence supplements that contain D3 are the preferred form for supplementation. In fact, in most countries now, this is the only commercially available type of Vitamin D.
Investigations:
Children with one or more risk factors for low Vitamin D, with or without the signs and symptoms, can benefit from the following investigations:
Serum Vitamin D (calcidiol) levels
Serum calcium, phosphorus and alkaline phosphatase.
In those with symptoms/signs of deficiency investigations regarding the following need to be done:
Parathyroid hormone (PTH)
Urine creatinine
Perform X-ray wrist, ankles and clinical photography
Vitamin D dosage for babies
The dosage schedule may be a low dose every day or high dose once a week or once a month for 1-6 months duration depending on the age of the child and whether the deficiency is mild, moderate or severe.
The standard dose is:
- Up to 1 year age: 1000-5000IU per day
- More than 1 year old: up to 10,000 IU per day
- The weekly dose is usually 50,000 IU and has better compliance.
- 6 monthly or annual 6L IU injections (usually not recommended for children)
The blood level is rechecked after 1 month in infants and after 3 months in the older children in moderate to severe deficiency. In mild cases, recheck is not necessary.
After the levels are in normal range, a maintenance dose of 400IU per day is continued for a considerable period.
With ongoing risk factor, once a year or so, keep checking the levels and continue the daily or annual maintenance dosing.
The forms of Vitamin D supplements available in the Indian market are:
Vitamin D3 – as oral drops 400 IU/mL
Syrup 400 IU/5mL
Oral tablets, 1000 and 2000 IU with blister packing
Powder form in a sachet with each sachet containing 60000 IU of Vitamin D3.
Supplementation of elemental calcium:
Higher doses of calcium are important in the early course of therapy. Later the doses are cut down to half for next 1 to 2 weeks. When the Vitamin D supplement dose has been reduced to 400 IU /day with normal blood levels, calcium supplementation is not required in most cases.
Causes of Vitamin D deficiency
The most important cause of Vitamin D deficiency is limited or no exposure to sunlight. However, even with ample sunlight, like in India, it is still prevalent. Why is that so? To understand other causes, you need to understand how Vitamin D is produced, processed, stored and utilized by the body.
On exposure to UV-B in the sun rays, the epidermis (upper layer of the skin) converts a cholesterol called provitamin D3 into Vitamin D3 that enters the blood and is transported to the liver. Vitamin D coming from the food/supplements is also absorbed from the stomach and sent to liver. The the liver converts it into the more potent form of calcidiol which is still inactive. It is then transported to the kidney where it is converted to calcitriol - the active ready to act form. So now it is easier to understand that in case of good sunlight, the Vitamin D deficiency can still result in following circumstances.
Reduced Vitamin D synthesis: Dark skin, Ultraviolet rays blocking agents like sun screen lotions and clothing, latitude (e.g. in the UK the UVB in sunlight is not very effective), season, air pollution, children and adolescents with disabilities which limit the time they spend outside, the lifestyle habits of indoor games, air conditioned housing, tinted glasses, photosensitive skin conditions, etc. result in reduced Vitamin D synthesis.
Reduced intake of vitamin in food: Strict vegan diet, dietary habits (low intake of foods containing Vitamin D), exclusion diets (e.g. milk allergy), etc.
Reduced maternal Vitamin D stores: Exclusive breast feeding where the mother doesn’t have enough Vitamin D stores in her body to nourish the child
Malabsorption: pancreatic insufficiency, Celiac disease, biliary obstruction which prevents proper absorption of the vitamin
Defective synthesis: Chronic liver disease, kidney disease, etc. Can obstruct proper functioning of the organs that are required for production and absorption of Vitamin D
Increased degradation: Drugs such as anticonvulsants, anti- tuberculosis, steroids which can be an obstacle to the process of Vitamin D production or absorption
Signs and symptoms of Vitamin D deficiency in babies
The signs and symptoms vary as per the age:
Infant Vitamin D deficiency:
1. Stunted growth and developmental delay: Despite no known health problems and despite good food intake, your child is not up to mark as per the height, weight, and other developmental milestones.
2. Irritability, lethargy: The baby is no more playful and attentive and is abnormally cranky and irritated most of the time without any known cause.
3. Seizures: One of the causes of seizures in an infant is Vitamin D deficiency and needs immediate medical attention.
4. Tetany: It is a state of hypocalcaemia i.e. low level of calcium in the blood. There are many causes of calcium deficiency like poor dietary intake, poor absorption, Vitamin D deficiency, abnormal parathyroid hormone secretion, abnormal kidney function, etc. The baby will have apneic spells (episodes of sudden breathlessness), wheezing, muscular weakness, and seizures.
5. Cardiomyopathy: As low Vitamin D affects all the muscles in the body, the muscles in the heart also become weak.
Vitamin D deficiency in Children:
1. Aches and pains: They will complain of frequent pain in hands, legs, body not proportionate to the physical development milestones of the child.
2. Muscle weakness: Muscle weakness causing delayed walking, difficulty climbing stairs, etc.
3. Rickets: Knock knees, progressive bowing deformity of legs, waddling gait, abnormal knock knee deformity, swelling of wrists and costo-chondral junctions, prolonged bone pain (>3 months duration)
4. Poor growth: Poor Growth despite a healthy diet, active lifestyle and no previous medical conditions can indicate a Vitamin D deficiency
5. Easy fractures: Easy fractures from minor injuries can be indicative of calcium not being absorbed properly due to Vitamin D deficiency
6. Frequent lower respiratory tract infections: Vitamin D plays a significant role in pulmonary functions and immunity development and frequent infections can be due to a deficiency of the same.
7. Delayed anterior fontanelle closure: The anterior fontanelle is a diamond shaped opening on the front part of the head. It is a gap between the skull sutures which gradually closes by 18-24 months of age. Due to impaired bone function, this will be delayed.
8. Delayed dentition: Like a delay in all other milestones, there is a delay in dentition or tooth eruption as there is not enough calcium.
9. Abnormal bone profile or x-rays: X-ray of the wrist or the ankle or the chest will show swelling of the bones and the abnormal bending of the long bones due to low calcium levels.
10. Abnormal blood tests: Low plasma calcium or phosphate level, raised alkaline phosphatase
Treatment for Vitamin D deficiency
Vitamin D stores in the body require a long time to deplete after the synthesis has reduced or stopped. So naturally, it will also take a long time to replenish. The aim of the treatment is to restore and maintain Vitamin D levels ≥ 50 nmol/L.
Various options are:
1. Supplements:
- Daily low-dose supplements
- High-dose intermittent therapy
2. Ensure adequate Calcium Intake.
For the children who dislike cow milk, yogurt, cheese and fortified soy dairy are useful sources of calcium. Consider medicinal supplements if intake is poor.
3. Sun exposure
Children and young people with dark skin can tolerate intermittent exposure in the sun and do not need sunscreen. Hats and sunglasses can be used. Encourage outdoor activity.
Supplements: Who should take supplements?
1. Exclusively breastfed infants without any signs or symptoms.
2. Breastfed infants of mothers with Vitamin D deficiency having at least one or more risk factors.
3. Infants on full formula feed who are not receiving adequate Vitamin D from the formula. Checking Vitamin D levels or adding daily supplements in babies with risk factors is recommended.
How to give baby Vitamin D:
Vitamin D is available as tablet form and as a liquid form and is also available in combination with calcium. You can powder the tablet or open the capsule and mix with the food.
How to prevent Vitamin D deficiency in children?
In general, along with the supplementation if necessary, adequate sunlight exposure and consuming foods rich in Vitamin D will help augment the prevention strategy instead of mere supplements. Approximately, 5-15 min of sun light exposure to the hands for light skinned children and 30-45 min for dark skinned children is helpful and natural. Preferably early morning sunlight is better as it has lower levels of harmful UV rays.
Maternal Vitamin D:
- The most important aspect that determines the Vitamin D level in infants is the Vitamin D status of the mother. Pregnant women should check their Vitamin D levels during the first trimester of their pregnancy. If found to be low it is best to be treated with 3000-5000 IU until it is more than >20 ng/dL followed by 400 IU /daily.
- High dose of Vitamin D (400-6400 IU) administered every day to breast feeding mothers protects the child from Vitamin D deficiency without causing Vitamin D toxicity to the mother of the child.
Preterm infants:
-A supplement of 400-800 IU/day starting at birth is important as there is a possibility of inadequate transfer of Vitamin D from the mother.
-Other problems associated with prematurity like poor feeding ability, immature gastrointestinal tract affecting the absorption and in some cases liver and kidney impairment and should be tackled accordingly.
Infants:
Ensure adequate Vitamin D in child diet. It is usually appropriate to start supplements without investigations for exclusively breastfed infants with at least one other risk factor without symptoms/signs. Most of the infant formulas have 400 IU/L. Hence, the formula fed infants may also need supplementation unless they are given at least 1 L of formula per day.
Toddlers and adolescents:
Children who are at risk like dark skinned children, children veiled from sunlight, have reduced or no exposure to sun light or the ones that have an underlying medical condition for which they are on the above mentioned drugs should be given 400 IU every day to prevent deficiency of Vitamin D.
Best foods of Vitamin D for babies
Though plants synthesize Vitamin D, that form of vitamin cannot be utilized by the human body. So the only foods sourcing Vitamin D are animal foods. Unfortunately, the only animal food that babies consume, that is milk (cow’s milk: 3–40 IU/L) is not really a rich source of Vitamin D. Here comes the role of fortification (adding extra nutrients to food).
Fortified foods Rich in Vitamin D
Fortified milk 400/L
Fortified infant formulas 400/L
Fortified orange juice 400/L
Fortified soy milk 400/L
Fortified rice milk 400/L
Fortified Margarine 60/tablespoon
Fortified Cereal 40 IU /serving
Tofu fortified (⅕ block) 120
Fortified oil
The best foods that the older babies can consume are:
1. Oily fish such as salmon, mackerel, and sardines, cod liver oil, liver. Frying fish reduces active Vitamin D content by ∼50%, whereas baking does not affect the Vitamin D content of fish
2. Organ meats
3. Egg yolks (20–25 IU per yolk)
Are there any risks if I give my baby too much Vitamin D?
Yes. Too much Vitamin D can cause toxicity.Vitamins B and C which are water soluble (excess gets excreted out of the body). Vitamins A, D, E and K being fat soluble get stored in the body and cause problems if in excess.
Conclusion: Even in a tropical country like India there is growing evidence of Vitamin D deficiency in adults and paediatric population. With adequate consultation from the paediatrician, it is best to combat the issue with proper care right in the beginning by adding vitamin D in the child’s diet to avoid any ramifications later on. Read more
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Is Your 19 Month Old Toddler Trying to Assert Independence?
At 19 months don’t expect your toddler to be the same sweet darling angel. This is the age where as parents you will see a whole new beastly side of your little one emerge. Toddler asserting independence comes as an essential phase in their growth and development.
There comes a time in a toddler’s life when they acquire a new found freedom. This sense of individuality begins to develop when they realize that they are their own separate beings who can be left alone to do things their own way. At around 16 months of age their physical skills and mental and emotional thought processes begin to kick in and by 19 months you'll have a little monster on your hands.
Ways to Cope With Toddler Milestone Independence
1. Acknowledge their Independence
The most important thing to remember when dealing with a tempestuous toddler is not to allow yourself to be unfazed by their “I’ll do it my way” behaviour. It’s a phase all toddlers go through and acknowledging this independence is the first step in helping them along the way. So if your little one insists on wearing a particular outfit, let them. If they want to feed themselves, leave them to it irrespective of the mess they make. It can’t hurt to allow them their say every now and then.
2. Be Consistent When Setting Rules
Children thrive on rules and regulations provided there is a consistency to it. You can’t let your toddler know that he has to be in bed by 8 at night only to bend the rule on any other given day when it suits you. That will only give rise to a much more adamant and defiant toddler declaring independence from parents
3. Meet Them Halfway
When you find your toddler asserting independence a loud no isn't always the answer. Sometimes meeting them halfway can do the trick. For instance, if your toddler hates the outfit you have chosen for her, let her decide what she wants to wear. Let her know that she will only be entitled to one choice. That way you'll have given into their demands but on your terms.
4. Foster a Cconducive Environment
Exploring rooms and making a go at gadgets and breakable items are nothing but a toddler showing signs of independent behaviour. Stopping or yelling at them in the negative won’t help matters. It helps to create an environment that’s suitable for your little explorer. That would mean keeping breakables away from their reach and baby-friendly items within, covering electrical sockets and maybe even hiding electrical gadgets if it comes to that.
A 19-months-old child asserting independence is a necessary part of a child’s learning process. It’s a good thing that they want to do things on their own. There is a lot that children learn when left to make their own choices. We all learnt that way after all, didn’t we? Read more
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Paediatric Medulloblastoma
Cancer in children is an unfortunate but harsh reality that some parents must deal with. Though cancer may sound like a death knell for some people, there have been rapid advances in medicine that offer hope. This is because people with cancers that were fatal a decade ago have a high survival rate when the cancer is detected early. This article is going to focus on paediatric Medulloblastoma which is a type of brain cancer in children.
What is Medulloblastoma?
Medulloblastoma is a cancerous brain tumour that can begin while the child is still a foetus. It affects the bottom region of the brain that specializes in motor/cognitive functions and often spreads down to the spinal cord. If the tumour disseminates without being checked, it can lead to death. Fortunately, there have been many advances in medicine, mainly on the surgical front, and has helped to raise the survival rate to 70-80% (early treatment).
How Common is Medulloblastoma in Children?
Medulloblastoma is relatively rare when compared to the other illnesses suffered by children. This can be gaged by the fact that there are many types of brain tumours that afflict children at the rate of about 2.5-4 per lakh children. Out of these brain tumour cases, eighteen percent of the cases are attributed to medulloblastoma. 60% of Medulloblastoma cases end up as clinical trials due to vast potential in finding new treatments options that can manage a cancerous tumour.
Stages of Medulloblastoma Tumour
The responsible tumour is categorized into stages to help assess what treatment option is best suitable for the child.
1. Standard Risk Tumour
These are tumours that are still in their nascent stage and have not spread to other parts of the brain or spinal cord. In most cases, these tumours can be completely removed or removed to such an extent that only slightly more than half an inch remains.
2. High-Risk Tumour
These tumours have normally spread to other parts of the brain and spine. Tumours that are more than 1.5 cm even after surgery are also put in this group.
3. Recurrent Tumour
This tumour is one which re-appears despite treatment. Just like other cancers, this is possible for medulloblastoma as well. While your child being successfully treated is a source of joy, it is good to have follow-ups to see if a tumour has grown again. Early detection means that a recurrent tumour can be successfully nipped in the bud.
Lumbar Puncture: Signs and Symptoms
Medulloblastoma mainly affects the Cerebellum and so results in a deterioration of those functions handled by it such as:
Poor Vision
Reduced motor function which can affect complex actions such as writing.
Poor balance accompanied by dizziness and difficulty in moving from one room to another.
Once the medulloblastoma spreads to, the symptoms can change with problems that crop up such as:
Inability to control the excretory system and unintended releasing of the bowels.
Pain in the back.
Diagnosis
If your child displays any of the above symptoms, please head to a reputed hospital as a clinic would be ill-prepared to handle such a case. The doctor who is referred is a paediatric oncologist who specializes in these matters. The following tests are done to understand what type of a tumour your child is dealing with and the appropriate treatment required.
Neurological Exam
This constitutes a physical examination where the doctor will assess the motor function of your child. A review will also be done of your child’s family history to investigate the extent of the disease.
MRI Scan
Using radio waves and magnetic fields, the doctors can map out the brain in high resolution without subjecting the brain to ionizing radiation.
Biopsy
This is when a small sample of the tumour tissue is extracted from the body to be examined by a pathologist. This can be done mainly through surgery.
Lumbar Puncture
In this procedure, your child would be given an anaesthetic after which an injection is inserted into the spinal canal to collect the fluid. This spinal fluid is analysed and checked for tumour markers and cancer cells.
Risk Factor Associated with a Higher Risk of Medulloblastoma
While the exact cause of Medulloblastoma has not been discovered as of now, doctors have been able to identify some groups that have a higher risk of getting Medulloblastoma. This includes:
Gender
Boys have a slightly higher chance of developing a malignant (cancerous) tumour with a ratio of 1.8:1 when compared to girls.
Age
80 % of all cases of Medulloblastoma occurs in children who are yet to complete 15 years of age. Out of this, about 50% of the cases took place in children who were less than 6 years old.
Genetics
Though most medical studies have confirmed that there is no genetic connection, some people who have Gorlin’s syndrome or Turcot syndrome may develop Medulloblastoma.
Treatment
Below are some of the treatment options available. All o the risks and side effects so please discuss with your oncologists in detail so that you can make an informed decision.
Surgery
This procedure involves removing a part of the skull (craniotomy) to get to the tumour. There has been a quantum leap in the surgical equipment used such as cortical mapping which helps surgeons steer clear of sensitive regions of the brain.
Radiotherapy
This employs the use of radiation to kill the cancerous cells. One of the major drawbacks of this procedure is that it cannot differentiate between cancer cells and healthy cells, killing all in its path. Proton therapy is a popular therapy that is used as its precise delivery of radiation causes minimal damage to the surrounding tissue.
Chemotherapy
This is the use of drugs or medicines to finish of the tumour cells. It is used as a second line of attack to kill any remaining cancer cells after surgery. Many use this form of treatment in addition to radiotherapy as well. It is administered through IV or a pill form.
Stem Cell Transplant
This form of therapy involves the removal of stem cells from the child’s body prior to chemotherapy/radiotherapy and its subsequent re-introduction. This method becomes handy when children need to go through rigorous amounts of radiation or chemotherapy. High doses of radiation is known to destroy the stem cells, therefore the absence of stem cells during the therapy will prevent its destruction and can then be safely infused into the child’s body.
Immunotherapy
This type of cancer treatment works on the principle of using your child’s antibodies to destroy the cancer cells. It is relatively safe and has fewer side effects when compared to traditional cancer killers like radiation and chemotherapy. However, much of this is still in the clinical trial phase and will take some time to before it is available for everyone.
Side Effects of Treatment
For a child with Medulloblastoma, life expectancy can often depend on the severity of the side effects. Methods such as radiation for instance, may be too strong for a child of a tender age to handle.
Paralysis
Aggressive chemotherapy treatments such as the Milan protocol are known to cause paralysis in children from the neck down. While minimizing the tumour, the treatment can also cause the nerve cells in the brain and spine to die.
Skin Problems
Radiotherapy leaves many patients with dark, dry and itchy skin once treatment begins. This will linger on until a few weeks after treatment. Some of the remedies for this include:
Avoid putting perfumes that has contact your child’s skin.
They can wear loose garments and avoid anything too tight.
Apply a good moisturizer on their skin every day to combat the dry skin.
Temporary Side Effects
Radiotherapy and Chemotherapy have many short-term side effects such as hair-loss, dry mouth, fatigue and tiredness. Your child will quickly recover from these once the afore-mentioned therapies are completed.
Long-term Side Effects
Cancer survivors from radiation and chemotherapy may have long term neurological damage. This could affect their memory, cognitive ability and problems with growth.
Taking Care of a Child with Medulloblastoma
Palliative Care
While treatment goes on, your child would go through side effects of the symptoms that can be painful and traumatising. Most cancer centres come equipped with physiotherapists, dieticians and counsellors who can help improve the quality of life of your child. Relaxation techniques, proper nutrition as well emotional support can ensure a satisfactory recovery.
Terminal Care
If the tumour has progressed too far with little chance of recovery, it is important to have an open conversation with the doctors involved. Many of them have been trained to deal with these situations and would provide valuable council during this time. Keeping your child out of pain should be the primary objective along with ensuring that their lives continue to be as normal as possible. This means arranging for part time school if possible and being allowed to be socially active.
Early diagnosis of the disease can often lead to a good prognosis. As a parent, it is important that you guide your child through this difficult time in their life. Apart from the treatment itself, palliative care can significantly strengthen not just your child but your entire family.
Also Read:
Meningitis in Children
Brain Tumours In Kids Read more
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7 Ways to Help your Friend Get Through Divorce
Did your bestie just tell you that she’s getting a divorce? She must be devastated and heartbroken. Drop everything and rush to her side. This is the time when she needs your love, understanding and support the most. Even if you aren’t sure what to say, don't let it deter you from going to your friend. You can actually do a lot of things to make her feel better.
How to Help a Friend Going Through a Divorce Manage Life Easier
1. Plan a girls’ night out
There's nothing like an outing with female friends to take the mind off the worst of troubles. Call up a few of your close mutual girlfriends and go to a club or restaurant. A night of dancing, giggling and gossiping will definitely help your friend forget her pain for some time.
2. Let her vent
When helping a friend through a divorce, be ready to listen to her lament about her problems. You might have to hear it for a long time. But, you know what? Allowing her to release her bottled up emotions will make her feel better and slowly learn to move on.
3. Listen and validate
At times your friend might be bogged down by the fear of what her future will hold and whether she made the right decision to get a divorce. She may also worry about society's reaction to her divorce. Your job is to reassure her and extend your full support.
4. Plan a short getaway
What your friend needs is a time-out from all that’s going on. Plan a holiday and if she’s game, call a few close friends. Make sure you don't take her to a place where she and her ex-husband have been to. Choose a good resort with nice food and a relaxing view to get her mind off her troubles.
5. Mind your tongue
You might feel angry at your friend's husband for having put her into this predicament. But avoid the blame game and don't join in if she complains about her soon-to-be ex-husband. Your advice for your friend going through a divorce should be to let bygones be bygones.
6. Be patient
Your friend might start taking you for granted and expect you to pamper her. She may expect you to prioritize her needs over all else. Remember, this is just a passing phase, so humour her. Keep your cool if she gets upset and passes nasty comments.
7. Shopping
Shopping is a great way to raise dwindling spirits. Make her feel better by taking her to the nearest mall and trying on clothes and accessories to distract her.
There’s no answer to what to say to a friend going through a divorce. Most times, you just listen. But there’s a lot you can do. The support that you extend to her should be ongoing. Even after she’s over her pain and moved on, check on her every once in a while to make sure she’s doing fine. Read more
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Pregnancy Should Be a Delightful Experience But Here, It's Something Else...
As we all know pregnancy is a beautiful period. A woman goes through a lot of physical changes which we all know about. But there are so many psychological changes in a woman which are very difficult to understand, that she goes through as well, and it's equally difficult to make other people understand it.
Because of this, sometimes woman faces a lot of difficulties during and after pregnancy. Here are some situations which become too stressful or out of control when a woman is pregnant:
She wants to go outside and enjoy but faces family restrictions.
She wants to work but the family denies her the chance.
She wants to go to her parents' home but is not allowed to go.
She wants to wear fitting clothes but is not allowed to show her baby bump.
She wants to go to the parlour but is not allowed.
Excess rest is not allowed as old myths say that doing household work will help in promoting a normal delivery, so she works even if her body doesn't allow her.
Husband denies to take you along with him to parties.
If a woman is not doing household chores then she can't expect to go to a party, because if she is not well for doing work at home then how she can go for a party?
Don't talk too much.
Don't watch T.V.
Don't laugh in front of others.
Don't show that you are having a good pregnancy.
Comparison - We used to do this in our time but you are not doing it now!
Lots of advice and suggestions.
The pressure of normal delivery.
The pressure of giving birth to a baby boy only!
The experience is different for every woman. Some may have everything perfect during their pregnancy, but I think that ratio of women is very less, because in our Indian society the list of things to deny a pregnant woman has been passed down for generations, and that is without any logic. I just want to ask one question - Is this pregnancy or some kind of torture? If you are feeling good and normal, then why should you be denied anything?
A woman should be physically healthy and that is important, but this is not in their hands because there are a lot of internal changes that happen which leads to many problems. But the woman also has the right to live psychologically well, and this can only be possible if she lives in a happy environment.
Disclaimer: The views, opinions and positions (including content in any form) expressed within this post are those of the author alone. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The responsibility for intellectual property rights of this content rests with the author and any liability with regards to infringement of intellectual property rights remains with him/her.
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Akifa Tahreem has added a new answer
Expecting Mom due in 7 months
7 hours ago
Q. hello doctor, I'm 3 weeks pregnant. can we sleep on our belly or which side We can sleep on during pregnancy...
Akifa Tahreem
Mom of a 7 m old boy
6 hours ago
A. no you can't sleep in your tummy
Dr Laxmi Chavan-Sawant has added a new answer
Trying To Conceive
4 hours ago
Q. @ask_the_expert
#ask the expert
I am having pcod problem.
when should I check pregnancy test at home?
Dr Laxmi Chavan-Sawant
Ayurvedic Gynaecologist
3 hours ago
A. If you have missed your periods you can wait for one week more and then do a urine pregnancy test to know about the pregnancy result and consult with your doctor according to the result for medication
Dr Priyanka Kalra has added a new answer
Trying To Conceive
4 hours ago
Q. I am having pcod problem.
At which day should I take pregnancy test
Dr Priyanka Kalra
Obstetrician and Gynaecologist
2 hours ago
A. after 2 weeks. do ultrasound n necessary tests after consulting a specialist. without proper check up we can't advise or help you.. Avoid shirt cuts when it comes to health if mother n baby. ok.
Dr Laxmi Chavan-Sawant has added a new answer
Trying To Conceive
4 hours ago
Q. I am having pcod problem.
when should I take pregnancy test?
Dr Laxmi Chavan-Sawant
Ayurvedic Gynaecologist
3 hours ago
A. after missed your periods you can wait for one week more ,then you can do a urine pregnancy test to know about the pregnancy result and consult with your doctor according to the result for medication
Dr Laxmi Chavan-Sawant has added a new answer
Trying To Conceive
4 hours ago
Q. I am having pcod problem.
but having regular cycles below 35 days. some time it will extended upto 40 days.
so when should I take pregnancy test at home?
Dr Laxmi Chavan-Sawant
Ayurvedic Gynaecologist
3 hours ago
A. If you have missed your periods you can wait for one week more or else you can do a urine pregnancy test to know about the pregnancy result and consult with your doctor according to the result for medication.
The best treatment to have Regular periods is by having a healthy lifestyle with regular daily walking or jogging along with mild exercise and meditation whenever possible. as medications will only act till you are taking them
Dr Ghouse has added a new answer
Expecting Mom due this month
1 hour ago
Q. Done my first routine blood test ..it shows thyroid border line.its my 6 week running as per USG.
but prior to that my thyroid level was always normal I did check up every year and got it normal .this time it shows borderline high in 6 week pregnancy.
is it something to worry.plz guide
Read moreDr Ghouse
Paediatrician
46 mins ago
A. it is better to follow your doctors advice for treating the thyroid deficiency. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
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1 min ago
#babyphotochallenge
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Check out this new Memory
Swetha
Mom of a 3 m old girl
1 min ago
Here it’s me Sannidhi !!! Now I can manage my neck on my own hurray !!!!
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