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Baby Massage Oils: Which One is Good for Your Child?
We’ve all heard that massaging your baby with oil is good for his development. But, have you ever wondered how these oils help and which ones are the most suitable for your baby’s sensitive skin? If yes, then read on.
Video: Baby Massage Oils- Which One is Good for Your Child?
https://www.youtube.com/watch?v=djmjzKfIB1M
Benefits of an Oil Massage for Your Baby
There are various benefits of an oil massage for a newborn baby. These are:
It makes your baby feel secure and safe, reduces crying, regulates breathing and keeps him warm.
It improves the blood circulation to the hands and legs.
Massaging makes digestion and bowel movements easier. This is especially beneficial for colicky babies.
A massage relaxes your baby and makes him less anxious.
It regulates his sleeping pattern.
In premature babies, massaging gives amazing results. It has shown to boost weight gain, stabilise the heart rate and increase brain activity.
Which Are the Best Oils for Your Baby’s Massage?
Although many types of oils are useful for your infant's skin, season-specific oils keep him happy all day long.
Oils That Are Good for Your Baby in Summer
1. Coconut Oil
Coconut oil should be used in summer as it has a cooling effect, is light in texture and easily absorbs into the skin. Being anti-fungal and anti-bacterial, you can rest assured that coconut oil is great for your baby’s skin.
2. Sesame Oil
Sesame oil is light and keeps your baby comfortable. This is the best baby massage oil that helps your baby develop strong bones.
Oils That Are Good for Your Baby in Winter
1. Mustard Oil
Mustard oil is very beneficial during the winter months. Note that mustard oil should be used in combination with other carrier oils. A carrier oil is used to dilute a concentrated essential oil so that it can be applied on the skin without the fear of side-effects. In North India, many people recommend heating the oil with garlic, fenugreek seeds, and carom seeds and then using the oil after it has cooled down.
2. Olive Oil
This oil is a popular choice among mothers. However, don't use the oil if your baby has sensitive skin or other skin problem.
3. Almond Oil
Almond oil can be used in any season as it's rich in vitamin E. It also smells great and makes your baby’s skin soft and supple. We recommend that you use only pure almond oil for your baby’s massage.
4. Sunflower Oil
While sunflower oil has been used traditionally, studies have shown that sunflower oil for baby massage can be linked to cases of eczema. To reap maximum benefits, use sunflower oil that has been specially formulated for massage.
Which Massage Oils Can Be Used for Babies With Dry and Sensitive Skin?
Any vegetable oil that is rich in polyunsaturated oils is the best oil for baby skin. These oils have a high content of linoleic acid which is great for your baby. Some vegetable oils that fit this bill include:
5. Chamomile Oil
Chamomile is a good choice if your baby has sensitive skin or skin rashes. This oil can help to cure colic and ensure your baby gets sound sleep.
6. Tea Tree Oil
This natural oil is well known for its antiseptic properties. You can mix a few drops of tea tree oil with a carrier oil and use it on your baby’s skin.
7. Calendula Oil
Calendula oil is also an essential oil that has a soothing effect on your baby’s skin and a mild smell that doesn't irritate your baby's nose.
8. Castor Oil
This oil is great for using just before giving a bath to your baby. It can also be used to treat dry hair and nails.
Whichever oil you choose, do a patch test on your baby first. Apply a small amount of oil on your baby’s skin and observe how it reacts. If you don't see a reaction in three hours, then you can safely use that particular oil.
How To Choose the Right Oil for Your Baby’s Massage?
Follow these tips before you settle on a specific oil for your baby’s massage time.
Ask your paediatrician for the oils that will suit your baby's skin type.
Use products specially formulated for babies. Products made for adults' skin aren't advisable as they can cause harm to his delicate skin.
Don't use oils that have a strong fragrance. Food grade oils are the right choice as they're safe even your baby licks it off his skin.
Essential oils need to be diluted with a carrier oil before application.
Avoid using mineral oils for your baby's massage.
Which Oils Are Bad for Your Baby’s Skin?
If your baby dry or sensitive skin or excema, avoid using mustard oil, clarified butter, and olive oil. These oils are high in a substance called oleic acid. This substance is said to make the top layers of your baby’s skin more permeable. This, in turn, makes the skin drier.
Things You Should Do Before Starting With a Massage
Creating a suitable environment is as important as the massage oil itself. This is how you can prep up the room before you start massaging your infant.
Shut the doors and windows. Put the pet in another room. Turn your phone on silent.
Set the room temperature to around 24 degrees C.
Play soft and relaxing music.
Lay your baby on a towel or changing mat.
Have the massage oil bottle, hand towels, a change of clothes for both, and a diaper bag at hand.
Tips To Keep in Mind While Massaging Your Baby
Here are a few points you should keep in mind while giving your infant a massage.
Most babies fall asleep after a massage, so ensure that massage time precedes his nap time.
Massage your baby only if he likes it.
Don't apply too much pressure while massaging your baby.
Test the temperature of the oil before using it on your little one. The oil should neither be too cold nor too hot.
Ensure that your hands are warm, clean and dry.
Use cold pressed oils as these are neither refined nor have any additives.
Learn the techniques you can adopt for massaging your baby. You can ask a trusted elder in your family or watch YouTube videos on the same.
Avoid storing large quantities of oil as they may turn rancid.
Check the expiry date on the bottle before buying.
FAQs
1. Can I Apply Oil on My Baby in Hot and Humid Weather?
You can give an oil massage in hot and humid weather provided the oil is applied before bath time and rinsed off properly after. This will make him comfortable.
2. Should I Oil My Baby Before or After Bath?
In India, the traditional oil massage is followed by a bath. This works well for heavier oils that leave a thick residue that can be washed off.
There are many benefits of massaging your baby with oil. One of the best is that it is an unbeatable bonding experience with your baby. Babies crave their mother’s touch and this is the perfect opportunity to increase the health and development of your baby. Use oils according to the season and do not hesitate to talk to your doctor about any concerns you have. Massaging your baby with oil is one of the oldest practices in India. It promotes healthy growth and bonding with your baby. Make sure you use pure oil as your baby’s skin is very delicate. Just to be sure, get approvals from your doctor regarding the oil you choose.
Also Read: Essential Oils for Babies and Kids Read more
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Cervical Incompetence
Cervical incompetence or cervical insufficiency is the condition in pregnant women, where the cervix becomes weak and opens up during the early stages of pregnancy. Typically, the cervix opens when the baby is about to be born and not before that. However, in women with an incompetent cervix, it opens up much earlier, posing the risk of premature birth.
What is the Cervix?
The cervix is the bottom-most part of the uterus that connects it with the birth canal called the vagina. During pregnancy, the cervix remains closed, acting as a door for retaining the baby inside the uterus. Only when the baby completes full term does the cervix efface (thins down) and dilate (opens up) to let the baby out through the birth canal in a normal vaginal delivery.
What Does It Mean to Have Cervical Insufficiency?
Cervical insufficiency is a condition in which the cervix becomes weak and opens during the early stages of pregnancy itself. As the baby grows inside the uterus, it gains weight and starts exerting its weight on the cervix. If the cervix is not strong enough, it gives in to the pressure applied by the developing baby. An incompetent cervix can lead to having a preterm baby or even a miscarriage, especially during the second trimester, if not diagnosed in time. It is not a very common condition and occurs in only one in hundred pregnant women.
Causes
There are various causes for incompetent cervix in pregnant women. They are,
Malformations of the cervix from birth, which could mean a deviation from the normal shape of the cervix or the uterus that the person is born with.
Any damage to the cervical walls made during a procedure on it, like dilation and curettage (D and C), biopsy for cancer detection or LEEP treatment for cervical cancer.
Any trauma to the cervix during a previous childbirth.
Previous exposure to Diethylstilboestrol (DES), used to avoid miscarriages during pregnancy, is known to cause problems in the reproductive tract
History of second-trimester miscarriages, without any known reason.
Signs and Symptoms
Pregnant women with an incompetent cervix, usually start experiencing some mild symptoms during the second trimester between the 14th and 20th week. Women who have not had a previous episode of miscarriage due to cervical incompetence may sometimes miss these subtle symptoms. It is very important to discuss with your doctor immediately if you experience any of the following symptoms.
Spotting or mild bleeding from the vagina
Feeling of pressure in the pelvic area
Cramp-like pain in the uterus
Back pain
A clear white coloured discharge from the vagina that turns into pink colour over time
During a regular check-up, the doctor usually checks for the length of the cervix and also for any cervix dilation, to rule out a case of insufficiency.
Complications
When a woman with incompetent cervix is not given timely care and treatment, she may face many complications in her pregnancy such as:
Having a pre-term baby- If the cervix opens up during the later stage of the second trimester, there are high chances of the baby being born much ahead of time. In such a case, the baby will require life support and incubator until it grows to a stage where it can function independently.
Stillbirth – A pregnancy loss that happens after week 20 if the pregnancy is called stillbirth. When the baby is born very young it usually does not have the growth and development to survive outside the uterus.
Miscarriage – Babies born to mothers whose cervix becomes weak between the 18th and 22nd week usually have a miscarriage. A fetus cannot survive if it is born before 23 weeks of pregnancy.
While these complications exist, timely remedial measures such as medications, surgical procedures and rest can help many mothers to successfully deliver their full term babies.
How Often Does It Happen?
Incompetent cervix is not a very common condition among pregnant women, and only one in hundred expecting mothers have a weak cervix.
How is the Diagnosis Done?
The doctor usually conducts certain tests during the second trimester to check for any signs of cervical incompetence in a pregnant woman. These tests are conducted based on a previous history of having a pre-term baby or miscarriage, mild symptoms of incompetence or as a general wellness check-up. The diagnosis is usually done in one of the following ways,
Transvaginal Ultrasound: It is a cervical incompetence radiology testing method, where a thin transducer is inserted inside the vagina to capture ultrasound based images of the cervix. The ultrasound of the vaginal area gives an idea about any discrepancy in the length of the cervix (below 2.5 cm), the presence of the foetal membrane in the vagina and the dilation of the cervix. This is usually done around week 15 of the pregnancy.
Examination Of the Pelvis: To check for any prolapsed foetal membrane, i.e. a protrusion of the foetal membrane inside the vagina, the doctor physically examines the cervix. The doctor also can assess the condition of the cervix and the presence of any physical damage in the cervix through this examination. If the doctor feels the foetal membrane in the cervix, it implies that the cervix has opened before time.
Amniocentesis: If the above two tests suggest an incompetent cervix, the doctor generally performs an amniocentesis. It is a simple laboratory procedure, where a small portion of the amniotic sac is drawn to check for any kind of infection in the sac surrounding the foetus.
Treatment
If the doctor diagnoses the cervical incompetence at a less critical stage, he or she generally chooses to treat the expecting mother through one of the following treatment strategies.
Supplementation with Progesterone:
Progesterone is a natural steroid hormone that is administered during the second trimester to prevent miscarriages and premature births. It is usually given as weekly shots or as preparations that can be inserted through the vagina. This treatment option is however not successful in containing multiple pregnancies.
Continuous Monitoring:
For women who have had a history of incompetent cervix or those who have damages in their cervix, the doctor usually examines the length of the same every once in two weeks through an ultrasound scan. During this continuous assessment, if the cervix begins to open up, the doctor immediately conducts a surgery to stitch the cervical opening called cervical cerclage.
Cervical Cerclage:
This is a surgical procedure, administered by doctors on women whose cervix is likely to open up prematurely. In this procedure, the doctor stitches the mouth of the cervix together, in such a way that it withstands the pressure of the developing foetus in the uterus. This greatly helps in containing the baby inside the womb. Doctors even perform this procedure on women with a previous history of this condition, before their cervix becomes weak. This is done as a precautionary measure. However, this treatment option has some restrictions.
A Woman Would Not Be Eligible for Cervical Cerclage Under the Following Conditions:
If she is carrying two or more foetuses in one pregnancy
If the dilation of the cervix has reached 4 cm
If there is irritation in the cervix
If there is any rupture in the foetal membrane
Prevention
There is nothing much you can do to prevent having an incompetent cervix, before conceiving the baby. However, once you become pregnant, you can follow these simple steps to achieve a successful pregnancy.
Get the nutrients right: You can eat lots of fresh fruits, vegetables, and nuts to get the required amount of nutrients during pregnancy. Calcium, iron and folic acid are very critical in ensuring good health for both the mother and the baby.
Consult your doctor regularly: If you have a history of miscarriage or of delivering a preterm baby, you must make sure that you have a regular check-up with your doctor. The doctor will periodically monitor the condition of your cervix through ultrasound and suggest the necessary precautions for a safe delivery.
Limit physical activity: If you are at the risk of having cervical incompetence, then try to avoid any exertive physical activity. You can opt for bed rest, especially after the second trimester.
Avoid sexual activity: You doctor might advise you to avoid sexual activity throughout the pregnancy if you have a weak cervix.
Management of Cervix Incompetence
Learn more about this medical condition and about the precautions that you can take to overcome this problem and achieve a successful pregnancy. Those who have a history of cervical incompetence tend to feel guilty or depressed and go through a lot of emotional stress. Proper care and support from the doctor and the concerned family members can go a long way in keeping the woman stay positive through the pregnancy. Cervical cerclage is a very effective strategy for dealing with incompetent cervix and the success rate of these methods are very high in successfully delivering full-term babies.
Also Read: Cervix Position in Early Pregnancy Read more
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Parenting - an Epitome of Patience
As soon as a women becomes a mother her way of thinking completely transforms . Her focus shifts to child completely. A sense of motherhood fills her heart & mind. Nothing in the world seems more imperative than her baby. I feel that being a mother is an enormously enriching experience and truly a blessing. My baby will soon turn two years & I have experienced & learnt that parenting means patience. Sometimes you have to be that epitome of patience when you know that your child is going crazy & aggressive the reason for which may seem non-obvious. It could sometimes take a lot of mental strength to deal with an infant as for an infant only crying is a medium to express his/her discomfort.
One has to hold on to the temper & keep patience all times to understand the baby's needs. Showing aggitation on baby may worsen the situation & could also lead to the child developing an aggressive behaviour which no parent would want. I feel that there is no need to scold or shout at a child on something he/she has very little control or is at a developmental / learning stage. You need to show & guide them the way no matter how many times you'd to teach them. Every child has it's own speed. Good parenting is not a cake walk. One has to invest a good quantum of time with their own babies to understand them, their behaviour inorder to bring the best out of them.
But undoubtedly, a child brings significant bliss to one's life & family. You teach your baby & you also learn at the same time. I am thouroughly enjoying my each & every moment with my baby. I feel it's a whole new world when I'm with my baby & I'm sure it's the same for everyone. I take this opportunity to wish all the parents a happy parenting & wish them a lots & lots of fun with their babies.
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. Read more
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शुरुआत एक नवीन पहल की (भाग-4)
क्रमश:.........*********......भाग-3 से
इतने में अनुपमा को पता चल जाता है कि उसकी सखियॉं उससे मिलने आईं हैं, तो वह अपने कमरे से बाहर आती है और अपनी सखियों के गले से लिपटकर बहुत जोर से रोने लगती है, मानो जैसे बहुत दिनों बाद मन में समाया गुबार निकला हो। पति के निधन के बाद ठीक से रो भी नहीं पाई थी बेचारी, एक तो कंवल छोटा था और सास-ससुर ताने देते हुए अपने बेटे की मौत का दोषी अनुपमा को ही ठहराने लगे। उन्होंने ये तो सोचा ही नहीं कि दोनों के विवाह को ज्यादा दिन हुए भी नहीं थे! और तो और उन्होंने अपने जनमते बच्चे का मुहं तक नहीं देखा था।
अचानक देश की बॉर्डर पर हमला हो जाने के कारण उनको देशसेवा की खातिर आवश्यक रूप से जाना पड़ा! पर हॉं वे जाते-जाते छोटे भाई राजीव को जरूर गले लगाते हुए बोले कि अपनी भाभी की हमेशा ही सहायता करना। आखिर वे फौजी आदमी जो ठहरे, एक तो उनकी हमेशा ही जान जोखिम में ही रहती और किसी भी समय कुछ भी हो सकता है! यह उन्हें अच्छी तरह से पता था और माता-पिता किस तरह से पुरानी कुरितियों में जकड़े हुए हैं, यह भी निश्चितता के साथ पता था और वे इस परिवर्तनीय समाज में अपनी विचारधाराओं को बिल्कुल भी बदलने वाले नहीं हैं, यह उन्हें पूर्वविदित ही था।
नवविवाहित अनुपमा अपने फौजी पति के सपने को पूरा करने के उद्देश्य से विवाह के दो माह उपरांत ही गर्भवती हो गई क्योंकि पति का उज्जवल महत्वपूर्ण सपना था, जो उन्होंने परसौनी गॉंव में एक-दूसरे को पहली बार पसंद करने पर ही सोच रखा था कि! विवाहोपरांत पहली संतानोत्पत्ति चाहे बेटा हो या बेटी, उसे सुसंस्कृत रूप से प्रशिक्षित करते हुए देश की सेवा की खातिर फौज में ही भर्ती कराएंगे।
फिर भी जिंदगी के हर पायदान पर खट्टी-मीठी परिस्थितियों का सामना डटकर करने वाली अनुपमा अबोल रहकर ही अपनी ससुराल में झूठे समाज और सास-ससुर की रूसवाईयों तले इस परिवर्तनीय युग में भी दबी ही जा रही थी। एक विवाहोपरांत पति का सानिध्य पूर्ण रूप से न मिल पाना, पारिवारिक रिश्तों की गइराईयों को न जान पाना और अचानक ही पतिदेव का शहीद हो जाना! इन्हीं सब कठिनाईयों के बीच अनुपमा ने फूल जैसे पुत्र कंवल को जन्म दिया, तत्पश्चात मॉं, भाई और देवर राजीव का ही सहयोग रह गया अब उसकी वर्तमान जिंदगी में।
कंवल के जन्म लेने से ससुराल में धीरे-धीरे अनुपमा वर्तमान जिंदगी को स्वीकारते हुए ढलती जा रही थी और उसके पालन-पोषण के साथ ही नौकरी करने की ठानकर ही वह घर से बाहर निकली ताकि पतिदेव के साथ सोचे हुए सपने को साकार कर सके! वैसे भी घर में रहकर क्या उखाड़ना था उसे। उसने सोचा कि भले ही दैनिक वेतन भोगी कर्मचारी के रूप में अनुभव लेना पड़े पर जिंदगी में अब एक नई शुरूआत के लिए पहल तो करना ही पडेगी न? और इस मुहीम में देवर राजीव का नितांत सहयोग था, जैसे कंवल की देखरेख, अनुपमा को मानसिक और आर्थिक सहयोग के साथ ऑफीस छोड़ना और लाना! फिर भले ही सामाजिक रूप से वह योग्य हो या न हो, उसे तो अपने भाई को दिए वचन की लाज रखनी थी।
यह सब अनुपमा की मॉं और भाई विजय से विदित होने के पश्चात तो राजी और वत्सला के रोंगटे खड़े हो गए! साथ ही सोचने लगीं कि इतनी कठिनाईयों से गुजरने के बाद भी अनुपमा पूर्ण आत्मविश्वास और हौसले के साथ अपनी जिंदगानी को जी रही थी क्यों कि उसकी मॉं जो उसके हौसला अफजाई के लिए हरदम साथ थी। तभी उस दिन अनुपमा ऑफीस में किसी के भी बोलने की परवाह किए बिना ही अपने देवर के साथ घर को हो ली।
.......... ।।।।।।।।। क्रमश: अंतिम भाग-5 की ओर ।।।।।।। ..............
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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My First Breastfeeding Journey and the Problems I Faced
I have been blessed with a baby girl recently. During pregnancy, I planned that I would breastfeed my baby for 2-3 years. After my baby was born, the nurse handed her over to me to feed her. However, to my dismay, I couldn’t feed her as my breasts were not generating milk. I examined after 2-3 hours but was again disappointed. The following morning, my husband told the nurse about my condition. She suggested I feed the baby with formula milk.
My mother-in-law consoled me, saying that milk would come out with massaging the breasts. On the third day, my breasts felt heavy, and I later found from the doctor about breast engorgement. I purchased a breast pump, and my mother-in-law massaged the breasts with oil to reduce the engorgement.
After five days, I could finally feed my baby with pumped milk; however, the milk pumped was insufficient for her. I almost cried all day and wondered how it could happen to me. I was sad as my daughter could not feed on breastmilk while I knew that was the best form of nutrient for her. I researched this on the internet and consulted and pediatricians who suggested I avoid formula milk. It was a greater concern as I did not want to allow my baby to go hungry. She cried a lot throughout the day for food, and I was unable to bear that pain.
Later, one of my friends suggested using a nipple shield, which turned out to be a blessing for my baby and me as she started latching the shield. After some time, the milk started coming to the breast. However, another problem that persisted was my little child was latching the shield and not my breast. I was anxious and extensively researched on the internet to find a solution to it. Finally, I bumped into a great idea in a YouTube video which I started following. I prepared formula milk in a bottle and then brought my baby girl close to my breast as if to feed. My husband or mother-in-law poured a few drops of formula milk on my breast. This worked like magic as my little girl started latching. The technique proved to be a blessing, and now she latches on my breast by God’s grace. I could finally stop feeding her formula milk and continue breastfeeding her for as many days as possible.
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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Rashmi has added a new answer
Expecting Mom due in 7 months
38 mins ago
Q. #asktheexpert Ma'am I am two months pregnant now....can I continue breastfeeding my 17 month old baby ?
Rashmi
Mom of a 9 yr 7 m old girl
37 mins ago
A. No I’m afraid you’ll have to quit breastfeeding your child because it is not advisable to feed your child when you’re pregnant with the second child is not healthy for you neither for your coming child so you’ll have to skip and quit onto your breastfeeding
Dr Vandan H Kumar has added a new answer
Expecting Mom due in 6 months
25 mins ago
Q. #asktheexpert is continuous urinary irritation is normal in summer during pregnency
Dr Vandan H Kumar
Paediatrician
24 mins ago
A. in this case it is important to rule out urinary tract infection for which urine report as well as urine culture needs to be done.
in the report if it is found that there is positive urine culture then dr gives antibiotics for around 14 days after which culture report is repeated to see if the infecdtion is gone.
kindly take plenty of fluids to drink to and maintain hygiene of the urinary area and contact your doctor for relevant examination and investigation
at the earliest d
Dr Ghouse has added a new answer
Guardian of 0 children
21 mins ago
Q. why my vaginal area and back pains during pregnancy
Dr Ghouse
Paediatrician
16 mins ago
A. because of the pressure of gravid uterus. 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
18 mins ago
Q. #asktheexpert water leak from baby eye....what is that
Dr Ghouse
Paediatrician
15 mins ago
A. blocked naso lacrimal duct kk. 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
11 mins ago
Q. loop of cord is seen round the neck in growth scan is it a problem at the time of delivery
Dr Ghouse
Paediatrician
9 mins ago
A. single Loop okay no problem wait. 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 Sameer awadhiya has added a new answer
Guardian of 0 children
9 mins ago
Q. #asktheexpert My baby is 4months old he is having fever after vaccination . how many days would the fever remain? can I give him medicine
Dr Sameer awadhiya
Paediatrician
9 mins ago
A. Post vaccination swelling may be a common thing specially after DPT vaccine which may be painful for two or three days and the swelling may remain fheven up to month so if it is not causing any pain or other symptoms nothing to worry.
Swelling can be reduced by giving ice fomentation locally and paracetamol can be given for fever or pain.
Thrombophobe ointment can be applied in acute pain and swelling .
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