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Leg Development in your Newborn
Waiting for your little one to be on his feet? As parents we are eager to observe this milestone in our babies. We wait to watch our tiny bundles of joy take the first steps of life by standing on their own little feet.
Your little one will take his first steps only between the ages of 8 to 12 months. Initially they will require support by holding on to your fingers or things at home, but as months pass by they learn to take their steps alone. But right now, when your moppet is still an infant, he will need the opportunity to move and stretch his leg muscles in order to promote leg development.
When Does Leg Development Begin?
Leg development starts later than arms and upper body development. As a newborn, his leg muscles are still in the early stages of developing and could even display stiffness at first. He will not have too much control over his legs at this point. Gradually, with physical development and supported by your touch and gentle exercises, his leg muscles will get stronger. The stronger your baby’s leg muscles are the sooner and steadier on feet your baby will be. It is important for you to understand and encourage your baby to flex his leg muscles as he nears this important milestone.
Eventually, as your baby crosses 6 months, she will start using both her hands and legs to crawl. During this stage she will stretch, flex and strengthen her muscles to push herself forward. At about 8 months she will begin to hold your hands or hold on to objects to stand. At this point she has gained enough strength in her leg muscles to be able to bear weight and stay steady on her feet. At round 11 to 12 months your tiny tot will make her first attempts to take those tiny little steps to move forward.
Importance Of Leg Development
Leg development is one of the most important milestones in your baby’s life. For him to be fit and capable in the outside world, he needs to learn to sit, stand and walk. The strengthening of the leg muscles help in gross motor development which help babies sit, stand, and run. It also helps babies explore, be mobile, and interact with the environment. They can actively participate in activities with kids their age. Babies gain control and posture of their leg muscles by stretching and moving their legs.
Encouraging Your Newborn’s Leg Development
Although there is still plenty of time for your newborn to take his first steps, it is important that you encourage and engage him in activities that enhance leg development:
1. Tummy Time
A good idea is to give your baby frequent tummy times. Tummy time not just aids in the development of upper muscles, but it also enables your baby to bend her legs back from the knees and use it for forward movement. This way she will learn to crawl and walk sooner.
2. Leg Exercises
If your baby is experiencing stiffness in his legs, make sure you help him move around. Simple activities like a massage, a roller-coaster movement of his body, and gently cycling his legs are useful.
3. Play Time
Getting your baby a baby gym that lets him tug at things and use his limbs is a good idea to fuel his muscular development. Also make sure you let him move around in open and free, though protected, space at home.
Use the developmental milestones of leg development as a guidance to monitor your baby’s progress. Some babies achieve them sooner, and some push in a few months later. However, if you think something is amiss, you should speak to baby’s paediatrician to diagnose a developmental delay. Read more
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Mom of a 9 m old boy
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Epidural Failure: Reasons & Management
Epidural anaesthesia is one of the most common and effective methods of pain relief during labour. It is called 'regional block' because the epidural blocks sensation in one region of the body. During labour, it is usually from the nipples to the thighs.
What is Epidural Failure?
Several women are satisfied with how well they work as pain relievers. But there are times when the epidural might fail to provide complete pain relief. Epidural failure is more frequent than it is recognised.
What are the Causes of Epidural Failure?
Epidural failure is mostly caused due to the incorrect placement of the epidural. The catheter providing the anaesthetic should be kept in the epidural space - a small space found over the spinal cord. When the catheter is kept in the wrong position, the medicine will not reach the exact location. Some causes of epidural failure are:
1. Anatomical Catheter Location
Most commonly, epidural catheters are not placed correctly, causing failure; they could even dislodge during the treatment. Sometimes, the transforaminal migration of the tip of a catheter and asymmetric spread is reported during epidural analgesia. There are cases of the catheter not following the straight line when being inserted even after space was correctly identified. Other cases include the catheter leaving the epidural space at levels above or below the insertion site. The catheter might be displaced only a few centimetres during normal movement of the patient. Displacement of catheters can also occur due to changes in the epidural pressure and cerebrospinal fluid.
2. Patient Position
The position of the patient has a chance of affecting the needle placement as it changes the relationship between the soft tissues and osseous. The position of the spinal cord present inside the spinal canal can also not be easily determined using measures like weight, sex, or even height. If the patient is in a flexed position with the head down, the spinal cord at the thoracic shows anterior movement while the cauda equine and the spinal cord at the lumbar level moves posteriorly. The spinal cord in the dural sac changes its position due to gravity when the patient is positioned laterally. The sitting position when compared to the lateral results in lesser insertion time and provides higher accuracy at the first attempt. The distance between skin and the epidural space is higher in the lateral position.
3. Puncture Site
It is said that for the neuraxial puncture, the precise dermatomal level tends to be inaccurate when determined by anaesthetists. But most studies show that the site might tend to be more cranial.
4. Midline vs Paramedian
When comparing the midline and the paramedian approach, it is said that catheter insertion time is faster in the paramedian, and a higher occurrence of paraesthesia is in the midline group. Also, the spine flexion is less dependent on with the paramedian approach.
5. Localisation of the Epidural Space
The epidural space should be correctly identified to be correctly positioned. The loss of resistance using saline is one of the most widely used methods to ensure the proper position of the epidural needle.
What are the Chances of an Epidural Not Working?
Active management of epidural anaesthesia almost always has a complete success rate. Half of the failures are due to incorrect catheter placement, while the others experience sub-optimal analgesia through the catheter positioned correctly. It is seen that out of 2140 surgical patients, epidural failure rates for thoracic is 32% and for lumbar is 27%
Things That Can Help You During Epidural Failure
Epidurals can be hard, but when you know more about the reasons for failed epidurals, causes and management can be made easy.
1. Flipping from Side to Side
You can ask for the help of a delivery nurse when you want to move from one side to another because sometimes you will find that one spot is not as painful as the other. A general change in the position might feel helpful.
2. Increase or Change Medication
There is a chance of your anaesthesiologist deciding for an increase of the medication or a different medication. In such a case, it is not necessary to do the epidural again as the catheter will still be in position. This makes it easier to add or alter medications without additional pain or work.
3. Replace the Epidural Catheter
The problem might sometimes be with the way the epidural is placed. In such cases, the epidural should be done again.
4. Use IV Medication
This medication is used in conjunction with an epidural. You can ask for what is available. This medication can also be given as temporary pain relief. They usually take effect fairly quickly and help you during your contractions.
5. Call on Skills From Your Childbirth Class
You can always try out everything you learned about pain relief skills in the childbirth class, especially relaxing and breathing. There are chances of you not being able to change positions as it all depends on the epidural situation. It is best to talk to your nurse for advice about changing positions.
The most important thing is to try and remain calm, which can be difficult during labour. Other things can be done. You can prepare a checklist of every possibility, and potential issues should also be considered to make sure that you get enough pain relief.
Also Read:
Pushing during Labour & Delivery
Painless Normal Delivery - Advantages & Disadvantages
Understand the Stages of Labour & Childbirth Read more
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Taking Antidepressants While Breastfeeding - Is It Safe?
At some point during pregnancy, depression is a mood disorder that affects some women. The symptoms are so similar to hormonal imbalance that often it is not detected properly at the initial stages. An increased risk of premature birth, decreased fetal growth and low birth weight are some of the problems associated with depression during pregnancy.
Can Nursing Moms Take Depression Medication?
Researches have proved the potential hazard of birth defects on taking an antidepressant while breastfeeding. Healthcare providers, therefore have to make the treatment decisions by balancing the risks and benefits of any medication. According to some other studies, certain antidepressant medications are probably safe to take as a very insignificant trace of the drug passes through breastmilk to the infant.
Do Postpartum Depression Medications Affect The Breast Milk?
Stress, anxiety and hormonal factors trigger postpartum depression which is a common condition among women. It has been generally noted that stress and anxiety can affect the breast milk. The mental well-being of a mother affects the supply of milk and the supply takes a larger hit in those who are worried about the milk production. Stress even slows down the flow of breast milk, and that can definitely be imperative to the baby’s health.
Are There Any Negative Effects of Antidepressants on Breastfed Babies?
Antidepressants can react unpredictably with other medications. As a precautionary measure, antidepressants are not usually recommended to women especially during the early phase of pregnancy. Breastfeeding and antidepressants can heighten the risk involved. The potential complications that can arise are a loss of pregnancy or birth defects, miscarriages or premature birth. Depending on the symptoms, the baby’s age and the mother’s emotional attachment, antidepressants are prescribed by health providers.
Precautions to Take while Using Antidepressants When Breastfeeding
Antidepressant medication should not be considered as the only option for treating depression. There are many risks associated with antidepressants and lactation, but the risk of untreated depression is the greatest. One should be clear about the precautions to take while using any anti-depressants. Some of the tips are given below:
1. Require a careful analysis of the risk
Treatment of depression is complex, and the risk to the mother and the baby should be analyzed before giving any antidepressant to any pregnant woman.
2. Careful observation after taking medicine
Sometimes mothers experience withdrawal symptoms. The infant then requires careful observation for a few days to identify and treat the symptoms found in the baby.
3. Interaction with other medicine
Antidepressants can interact with other medicines, and so the doctor has to be careful in working out the combination and constantly monitor the patient.
4. Stay in constant touch with the health providers
Individual patients tend to respond differently to different medications. One should be careful about the diverse adverse effects of such medicines.
Antidepressants That Are Safe to Take During Breastfeeding
Studies have proved beyond doubt that certain antidepressant medications are safe to take while nursing as a very little amount of the drug slips into the breast milk.
Certain selective serotonin reuptake inhibitors are generally considered safe during pregnancy.
Serotonin and norepinephrine reuptake are also considered a safe option during pregnancy.
Bupropion medication is used for both depression and smoking cessation. This medication is not considered a first-line treatment for depression during pregnancy.
Tricyclic antidepressants are a class of medication which is considered only when a woman does not respond to other first and second line medications.
Antidepressants That Should Be Avoided When Nursing
The healthcare provider should minimize the baby’s exposure to medication by prescribing a single medication (monotherapy) at the lowest effective dose, especially if the patient is in the first trimester of pregnancy.
Selective serotonin reuptake inhibitors paroxetine are discouraged as it sometimes causes fetal heart defects.
Monoamine oxidase inhibitors are also discouraged as they are known to limit fetal growth.
Antidepressants during the last trimester can cause the baby to experience temporary discontinuance symptoms like jitters, irritability, respiratory distress etc.
The crux of it is to understand that if a pregnant lady is feeling depressed, she should consult the health care provider. It is not easy to treat depression during pregnancy or the postpartum period. The risks and benefits of taking medication should be weighed carefully during this period. One should try to make an informed choice with the help of the healthcare provider – ultimately creating the best chance for long-term health.
Also Read:
Is It Safe to Smoke while Breastfeeding?
Getting Tattoo while Breastfeeding
Eating Antibiotics during Breastfeeding Read more
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6 Things You Must Do To Keep Children Germ-Free This Winter
Coughing, sniffing, fever, spots on the skin - there is no end to the problems that seem to come along for our kids every winter. These diseases seem to simply float through the air and attack our children! Well, most of these infections can be blamed on germs. They travel through air, water or touch from an infected person to a healthy person. When they invade the body, they can manifest in the form of several diseases! As parents, protecting kids against such potential infections becomes one of our primary responsibility. But how can you keep these pesky germs away?
Keeping a little baby away from germs seems to be a mammoth task. He is so delicate and sensitive that there is no end to our anxiety. But when your baby grows up, the problem only gets worse! Kids are explorers and can go around the entire house scouting and hunting to satisfy their inquisitive nature. This activity exposes them to dirt, dust or pests that could be the carriers of infectious micro-organisms. This is why we as parents must undertake certain measures to keep germs far away from the little ones.
The good news is that it does not take a complicated arsenal to build a germ-free house. All you need to practice is a little hygiene, and you can go a long way in protecting your family against common diseases.
This winter, make sure you follow these practices to keep germs and infections far away from your children:
1. Hand-Wash After These Activities
Washing hands is of prime importance and must become a house-rule - both for children and adults! Not washing hands can give access to germs who take advantage of the body's lowered immunity during the winter season. When your child is little, you can keep his hands clean by periodic sponging, wiping, and moisturising. But when your baby grows up, he needs to be taught the importance of hand wash. Plus, if you have both a tiny baby and an active toddler at home, you need to be doubly careful. Make sure the children in the house (and adults!) wash hands after:
Playing with mud
Playing with a pet
Putting hands in the mouth
Going to the toilet
Before and after eating food
It should be made a point and a strict rule for every family member to wash his hands properly after all the above mentioned activities are carried out. No exception!
2. Play Area Precautions
Keep the play area in the house clean and tidy. The floor of the play area should be wiped everyday with a disinfectant. All the toys should be given a regular wash to bust off the dirt particles settling on them. For the cloth toys, a regular hot-water cleaning regime is required to disinfect them.
3. Sneezing and Coughing
These two are the biggest problems many children face in winter - and also the biggest source of problems! When kids sneeze or cough, they dispel germs into the air which can travel into the body of another baby in the house, or some other family member. Since this is a common problem in winter, it is essential to try and limit the damage. If your kids are old enough, teach them to cover the mouth while coughing or sneezing, and not to sneeze or cough on anyone’s face. Also, they must wash hands if they sneeze or cough into their hands - every time. Around your child, practise these 'good manners' yourself or you may end up spreading germs involuntarily!
4. Keep These Objects Away From The Child
In winter, when the immunity of the body dips, it is easy to get germs from regular household objects. As a rule, some objects must be kept at a distance from the child. These include:
Nappy buckets
Unwashed fruits and veggies
Dustbins with open lids
Brooms and dustpans
Dirty laundry
It is likely that some of these objects may really interest your child. Kids find the strangest things intriguing and end up being fascinated by these things more than with their toys! Please keep them away. Ensure he does not end up playing with them!
Warning: Toilet and Bathroom Precautions!
These two are two areas of the house that are rife with germs. Don't allow your child to touch or play with old soap-cases, cleaning material or the toilet seat. Another sure-shot way of germ-busting your kids is to flush only after closing the lid of the seat. Teach your family members also to flush only after shutting the lid of the toilet seat. Flushing with the lid up can launch germs into air, and those can then land on faucet handles, doors and other things in the washroom.
5. Breast-feeding
No match to this one - it is a sureshot way of keeping your child germ-free and infection-free! The antibodies present in breast milk are essential for the baby as it helps in strengthening his immune system. It also enhances the child’s brainpower and reduces the risk of developing the highly prevalent insulin dependent diabetes in children during their later ages. (Also, if you're feeling under the weather in winter, owing to seasonal blues, this is a great idea for moms to feel better owing to the hormonal rush!)
6. The Right Diet and Sleep
The body needs added strength and immunity to fight against germs in winter. Make sure you serve these fruits and vegetables in the meals: green leafy vegetables, carrots, beans, oranges and apples. They must be included in their daily diet, as they provide vitamins and minerals necessary for growth and development. Also make sure to clean your child's lunchbox regularly, as it can serve as carriers of germs from the playground or daycare. Use a disinfectant to clean them properly.
Together with the right diet, adequate sleep is also essential. A child should have good, sound sleep of a minimum of 8-10 hours in a day. Most of the metabolic reactions take place in his body while he is asleep. Not getting this sleep makes his body more susceptible to a germ attack, followed by illness.
As your child grows up, generate more awareness about germs. Teach them that washing hands properly, brushing teeth, having a bath twice a day and wearing clean clothes are some rules to be followed to remain healthy and germ-free. So, fear not, moms. Just follow these easy steps and those harmful germs will stay away from your darlings! Read more
Dr Ghouse has added a new answer
Guardian of 0 children
2 hours ago
Q. hi sir/mam i had taken nerothrestrone prevent-N one tablet of 5mg when i was unaware of my pregnancy to delay my periods only one dosage was taken by me and i scanned fewdays and heartbeat came but there is the gap of 2weeks in my edd according to lmp and esg is there any problem please reply i am so tensed
Read moreDr Ghouse
Paediatrician
1 hour ago
A. it's okay no problem now. 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
Dr Ghouse has added a new answer
Expecting Mom due in 2 months
2 hours ago
Q. #asktheexperts advice some parenting hack.
Dr Ghouse
Paediatrician
1 hour ago
A. regarding what ok repeat question. 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
Nikitha has added a new answer
Father of a Newborn child
1 hour ago
Q. #asktheexperts what is the best time to keep baby in the sun and for how long?
Nikitha
Mom of a 9 yr 5 m old boy
1 hour ago
A. hello in the morning around 7 to 9:00 a.m. for 10 minutes you can get your baby exposed to the sunlight which would be safe on baby so the child will also get the vitamin d naturally which should be good and nothing to worry about
Dr Ghouse has added a new answer
Guardian of 0 children
1 hour ago
Q. currently I'm in 25th week of my pregnancy. I would like to when is my 7th month or red trimester is going to start?
Dr Ghouse
Paediatrician
1 hour ago
A. you had to complete 28 weeks ok. 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
Dr Ghouse has added a new answer
Guardian of 0 children
1 hour ago
Q. #asktheexperts I am having vaginal infection from last 2 months my doc have given me antibiotics meds but still I am having it …. 8 months pregnant I am ….is anything I am doing wrong that’s y I am having this infection
Dr Ghouse
Paediatrician
1 hour ago
A. ok cd. 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
Dr Ghouse has added a new answer
Expecting Mom due this month
1 hour ago
Q. Hlo sir / madam
I m 36week 6 days pregnant
My baby’s head doesn’t fix into the pelvis
Lightening or baby dropping not happend
My AFI is 18 (mild polyhydroaminous)
What should I do?? Normal delivery possible?
Dr Ghouse
Paediatrician
1 hour ago
A. your treating doctor will advise accordingly ok. 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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