When should the Influenza vaccine/flu shot be given to kids? Why annual influenza vaccine is needed?

Influenza is more commonly known as the flu. The influenza virus causes an illness that affects the respiratory system, causing symptoms such as fever, cough, cold, runny nose, and sore throat.  As the influenza virus can cause serious infections in young children, especially affecting the lungs and requiring hospitalization for oxygen, the sickness can be life-threatening. Hence to prevent this infection, the vaccine for Influenza or the flu shot (as it is called in common language) is recommended for kids above 6 months to 5 years.

Other advantages of influenza vaccination in children are preventing the spread of infection to other children as well as the elderly population (who may have more severe illnesses due to influenza infection), indirectly reducing school absenteeism, parenteral stress & work absenteeism.

Who should receive the Influenza vaccine and when?

Influenza vaccines are recommended for:

1. Children 6 months to 5 years of age. According to the Indian Academy of Pediatrics (IAP), primary vaccination requires two doses at 6 months and 7 months of age and after this every year annual influenza vaccine should be taken till 5 years of age before the peak season.

2. The high-risk children aged >5 years to 18 years,  By High risk we mean the children who have any of the following conditions: Chronic cardiac, pulmonary (excluding asthma), hematologic and renal (including nephritic syndrome) condition, chronic liver diseases, and diabetes mellitus, Congenital or acquired immunodeficiency [including human immunodeficiency virus (HIV) infection], Children on long-term salicylates therapy,  these children should take this vaccination to avoid further complication of the existing disease

What if my child has never taken the influenza vaccine?

For healthy children, less than 9 years of age who have never had a flu vaccination should take 2 vaccinations 4 weeks apart & for those above 9 years single dose is recommended.

Why do we need to take the annual influenza vaccine every year after primary immunization?

Since the nature of the virus gets modified every year because of genetic mutations (Antigenic shift and drift), the immunity doesn’t last for more than 1 year.  Hence annual influenza vaccination ensures that the baby is protected from the influenza virus during an outbreak.

The flu shot should not be taken if:
1. A baby is under the age of 6 months.
2. The baby has a thimerosal allergy.

Is flu shot safe?
The flu shot is considered to be very safe. It does not result in the flu. Few side effects include:

  1. Soreness of the place where the needle is injected. This doesn’t last for more than a couple of days.
  2. Body ache and mild fever for the first couple of days after the vaccination are done.
  3. There is little to no pain in the place where the injection is injected by the doctor.

Can pregnant women take the Influenza vaccine?

According to the WHO position document, influenza infection increases the risk of severe illness and mortality in pregnant women; the infection can also cause problems such as stillbirth, neonatal death, premature delivery, and low birth weight. Inactivated influenza vaccination should be given to pregnant women at any stage of their pregnancy.

This advice is based on evidence of a significant risk of severe disease in this group, as well as evidence that the seasonal influenza vaccination is safe during pregnancy and effective in preventing influenza in pregnant women and their young babies.

When do we take the Annual influenza vaccine?

The best time to vaccinate is before the onset of peak influenza activity. In India, limited influenza activity is usually seen throughout the year with a clear peaking during the rainy season all over the country. The rainy season in India is between June to August in all the regions except Tamil Nadu where it occurs from October to December. Hence, the optimum time to vaccinate is the pre-monsoon period, May-June, with the latest available strain, which is the Southern Hemisphere (SH) strain. WHO classifies India under the ‘South Asia’ transmission zone of Influenza circulation which is more aligned with the SH strains.

5 Simple ways to prevent Worm Infections in Kids

5 Simple ways to prevent Worm Infections in kids?

Worm infestation in the intestine is one of the common health issues that affect the health of children. Every parent takes that extra precaution to ensure that their child is protected. From giving only boiled and/or bottled water to multiple rounds of washing fruits and vegetables, everything is done. Despite these, when the child begins to complain of stomach aches, there is fear of a worm infection. Here are a few useful tips to prevent the infestation of worms in your child.

Causes
Worm infections are a reality, and a child can get a worm infection by one of the following routes.

  1. By eating unclean/undercooked/infected food: There could be eggs of these worms on vegetables and fruits, and if not washed thoroughly, chances of infection are high. Also, if seafood such as fish is infected with these, improper cooking of these can lead to infections.
  2. Walking barefoot on infected soil: This is the most common way to get worm infections when children walk barefoot in damp soil.
  3. Drinking contaminated water: Some worms breed in water bodies like lakes and puddles. Playing in these areas or eating with hands contaminated in these areas can lead to infection.
  4. Contact with an infected person: Either through unclean hands or fingernails contact of an infected person, the worm infection can reach the child.

Whatever the source, once these worms enter the body, they multiply and continue to grow in the child.

Symptoms

Symptoms that are commonly seen in children are as below.

  1. Refusal to eat, both due to stomach pain and the loss of appetite
  2. Weight loss, due to reduced food intake. Additionally, the worms consume a large portion of the consumed food, reducing what is available for the child
  3. Anemia, which is especially with hookworms
  4. Blood in stools
  5. Itching around the anus, from where the worms could have entered the body
  6. Skin rashes or urticaria
  7. Sleep disturbances, due to the above symptoms
  8. Frequent urination or pain during urination

Stool testing is done to confirm the presence of worms.

Treatment

The good news is that treating worm infections is quite easy and simple. A course of anti-parasitic or anti-worm medicine (most commonly used being albendazole) is often used to get rid of the worms.

Prevention

  1. Deworming is termed as the process of removing a present inside the intestine by giving antiparasitic medication at regular intervals. WHO recommends 6 monthly deworming for children and adolescents under the age group of 1-19 years in countries like India. Please take deworming medicine only after consulting your doctor.
  2. Keep your surroundings clean. Don’t let your child walk barefoot on the soil, ask them to wear slippers or shoes while playing outdoors.
  3. Make sure your child practices healthy habits and maintains hygiene. Most important is to wash hands before and after taking food, going to the washroom, or after entering the home from outdoors.  
  4. Wash the raw vegetables & fruits properly before your child consumes them. This will helps in removing the eggs of the worms which are often attached to the soil on the vegetables.
  5. Let your child always have boiled clean water. Cut their nails regularly. Keep them short and clean as soil may get stuck in the nails, and with it eggs of the worm can go into your child’s body.

Vitamin D: The Sunshine Vitamin

Vitamin D is perhaps the single most powerful nutrient in the known universe for preventing influenza. ~ Mike Adams, natural health researcher and author.

Why does my child need vitamin D?

We all know that Vitamin D helps the body absorb minerals like calcium and phosphate as well as bone mineralization (that means it helps in depositing calcium and phosphate in bones), which helps in building strong teeth and bones.

If children are deficient in vitamin D, it can lead to rickets, which is a disease that can lead to bone deformity and fractures, at the same time children who are deficient in vitamin D tend to become stunted.

Apart from bone health recent research has shown that vitamin D plays a very important role in immunity. It has been seen that a good vitamin D status reduces the risk of respiratory infections like flu and ear infections. Vitamin D also helps in preventing children from getting asthma and allergy symptoms.

Why there is such high prevalence of Vitamin D deficiency in children?

According to recent research, most children (50-90%) in India are deficient in Vitamin D, there are multiple reasons why this is happening. first of all, although vitamin D is very important it is not usually available in normal foodstuff, food like fatty fish, liver & eggs which are a good source of Vitamin D, are generally not consumed in sufficient amount to meet the daily requirement of children at a growing age.

We get the majority of our Vitamin D from the sun. Sunlight helps our skin convert cholesterol to cholecalciferol which is the active form of vitamin D. But nowadays, because of our lifestyles our children spend very little time outdoors and mostly they spend a lot of time in front of computers, and mobile screens and play indoor games which have reduced exposure to sun and failure of our body to make vitamin D.

How much vitamin D does my child need?

Infants up to 12 months old need 400 international units (IU), or 10 micrograms (mcg), a day. Children older than 1 need 600 IU, or 15 mcg, a day.

As Vitamin D is a fat-soluble vitamin and can be stored in the body for prolonged periods, your child doesn't have to get enough vitamin D every day. Instead, aim to get the recommended amount as an average for a few days or a week.

What can we do to correct the Vitamin D deficiency?

Nutritional sources like Fish, eggs, and liver can be included in the diets regularly, and for vegetarians, fortified cow milk, yogurt, and butter are important sources. But in reality, dietary sources are not going to be enough for small children, hence realizing this fact AAP has recommended daily supplementation of at least 400IU of vitamin D, especially for exclusively breastfeeding children to ensure adequate vitamin D intake at this growing age. You should take help from your physician to choose a good quality vitamin D3 supplement for your child. Choosing Vitamin D3 is important as it is the active form of Vitamin D.

Sun exposure can also contribute to vitamin D build-up in the body, in general, it is said that sun exposure between 10 am to 3 pm is quite effective in the synthesis of vitamin D, in winters about 30-40min and in summers 5-10 min is sufficient for getting the adequate vitamin D, so you can let children play in the daytime to get the benefits of the sunlight. 

To sum up, Vitamin D is essential for bone strength as well as immunity which helps children fight infections, as natural sources are fatty fish egg, butter yogurt, and fortified milk formula, as well as sunlight and most important to remember is young children need supplementation of vitamin D3 to meet their daily requirements.

What to do if my child has missed vaccination due to Lockdown (Covid pandemic)?

vaccination

Child Vaccination during Covid times

As the situation goes towards normalization and lockdowns being relaxed, a lot of parents are worried about what can be done about the missed vaccines and how best to reschedule their child’s vaccination. In this situation we need to do a 'catch-up vaccination', to bring the vaccination routine back on track. Catch-up vaccination is the practice of giving a vaccine to one's who did not receive it at the recommended age. Sometimes a vaccine is missed because of various reasons. No matter what is the reason, it’s important to make up missed immunizations, to protect your child from diseases, which can cause severe illness and sometimes can be life-threatening.

Most of the time, your Paediatrician will just resume the vaccine schedule after minor adjustments. In reality, catch-up vaccination is quite a common practice wherein if your child has missed a vaccine, they can resume their vaccination schedule with some modification thereby preserving all the benefits of vaccination. There is no time limit for it and parents can consult their pediatrician anytime and re-start the schedule if they weren’t able to go out due to Covid.

The Indian academy of pediatrics (IAP) has recommendations on how to adjust the schedule in case a child has missed his vaccine dosage for a particular disease. If for any reason, your child gets additional doses of a vaccine, this is also not a concern.

Always bring your immunizations record with you to all of your child's office visits. Make sure the healthcare provider signs and dates every immunization. To avoid getting exposed to other patients, try to pre-fix appointments with your pediatrician and visit the clinic at a time when it's not crowded.

Teething in babies and managing the bad days

Isn’t it exciting to see the first little tooth popping in your baby’s mouth!!! Well, then wait around, as there are many more making their way out of your little one’s gums in the years to follow. While teething in babies may irritate them, it is equally challenging for mothers to manage their babies while undergoing the process.

All babies are different, and most babies would have the first tooth making its appearance before he/she turns one year old; you may get anxious to find ways to soothe your baby. Let us see some valuable tips for managing the teething in your babies.

When does teething start in babies?

Although the teething may vary in every baby, typically, the process begins when your baby is between six to eight months old. The teething process starts with the appearance of the lower two incisors in the front, followed by the upper two. It continues with the eruption of the lateral incisors around nine to thirteen months, followed by the premolars during the thirteen to nineteen months and then the canines when the baby is approximately sixteen to twenty-two months. The molars appear later, and by the age of three, most children will usually have all teeth.  

What are the signs of teething seen in the baby?

Every baby is unique and will show different teething symptoms. The common signs of teething are as follows:

Are there any side effects of teething?

Most babies will show mild symptoms of teething. Although most pediatricians believe that teething does not cause vomiting and diarrhea, some babies may experience the following:

What are the home remedies to soothe my baby during teething?

Some teeth might give you a tough time to manage, while others may pop out without any problem. Try to soothe your baby during teething with the following home remedies:

When should I see a doctor?

As soon as you see the first teeth coming out, you should take your baby to a pediatrician, who will recommend you to visit a dentist. The dentist will give you the best advice and tips to take care of your baby. If any of the symptoms bother you, you should see a pediatrician for an accurate diagnosis.

How often should I brush the baby’s teeth and what should I use to brush them?

You should brush your baby’s teeth soon after the first tooth appears using fluoride-containing toothpaste. You may take grain size toothpaste on the baby toothbrush and brush the teeth. It is necessary to monitor the brushing until the child turns six.

Teething is a significant development in your baby’s growth chart. Avoid giving any medication without the doctor’s advice. You may soothe your baby using simple tips and manage the teething. Teething is a normal process that causes some pain, discomfort, and behavioral changes in babies. It is easier to manage the teething days with your paediatrician’s advice.

Breath holding Spells. How to manage at home?

When children stop breathing which in some cases leads to blackout (unconsciousness) and is for a short interval that lasts up to 1 minute is called Breath holding Spell. When a child is having emotions of anxiety, or fear or anger, it leads to breath holding spells. Breath holding spells are not in control of the kids as they are involuntary reflexes. Breath holding spells are common in infants who are 2 years of age. However, it can happen in healthy children between 6 months and 6 years old. They can be more prevalent among children with a family background of BHS. They are not convulsions even if they appear like so.There are two types of breath holding spells:

Breath holding spells cannot be determined by carrying out a specific test. Sometimes anemia may be responsible; however physician takes the decision after hearing all symptoms and patient history.

Symptoms of breath holding spells

What to do when your child is having breath holding spells?

During a breath-holding spell, you do not need to do something most of the time. Till the spell is over, your child should remain lying down. Do not panic, stay calm, and carry out the following tips during and after breath holding spells:

Usually, children with breath-holding spells resume breathing after a minute. Get emergency attention if this is your child's first breath-holding spell. Although breath-holding spells aren't dangerous, having your child checked out is good. If breath-holding spells are regular, it is best to see a doctor. A doctor will decide whether a breath-holding spell or another medical disorder looks like one.

Usually, breath-holding spells are caused by either a difference in the breathing of the infant or a slowing in the heart rate. These responses can be caused by anxiety or intense feelings. As said above, iron deficiency anemia can cause breath-holding spells for kids. So, to check for anaemia, a doctor may do a blood test. Anemia treatment can help reduce the number of spells that occur. Breath holding spells will scare the parents, but they are generally harmless.

Parenting in COVID time-What parents can do?

COVID-19 pandemic has affected the entire world. Countries are implementing temporary shutdowns to prevent social gathering, decrease mortality, and curb the growth of the virus. Since, educational institutions are closed, and social gathering has been prohibited, children have been staying inside home for the past 11 months depending upon internet for social networking. It should be understood that children of any age needs exposure to practical life situations to gain experience and increase their social circle.

Children may get depressed because of not able to move out from their house and enjoy the nature. Online education has been practiced recently; however the need to discuss and socialize with other fellow mates is a natural instinct of humans. Thus, children may feel low, lethargic, or may be feeling negative energy towards life because of confinement within the walls of their house.

As a parent, it is your responsibility to understand your child during these tough times and help him/her to develop social skills. Moreover, this COVID-19 has led to job loss of many people. If you are a parent to a child and have lost your job recently, please do not panic and stress your child out although it is understandable that you must be going through a financial stress. Go easy on kids. Below are some of the parenting tips during the time of pandemic.

PARENTING TIPS

Screen time in children- How much is safe ?

Although television, smart phones, internet, and video games will keep your child occupied for an infinite time, you don't want them to get so much screen time. That said, in today's screen-filled world, setting limits on TV and video games for children isn't always easy. Here are 10 tips that parents should use to determine how much screen time for their children is fair.

Healthy way to use Electronic Gadgets

Before correcting children and setting discipline in them to limit screen time, it is necessary that as a parent you should have control on yourself. You should not be binge watching your favorite amazon prime or Netflix web series whole night and set a precedent for your children. Better to correct yourself on healthy use of electronic gadgets and then guide your children.

Educate Yourself on Electronics

As a parent it is very much important for you to be updated what goes in the world of technology. Children today are much faster in getting accustomed to new technology than their parents. Try to know what keeps your child glued to the screen of the smartphone or television. Try to understand what he/ she is watching or playing. It may happen that your child may be watching any restricted content or playing violent games which have negative ratings and in return will damage his/her health. Thus, be updated with the news going in the world of gaming and networking.

The discipline of “Technology-Free Zones”

Make a discipline that certain places of your house are technology free zone and there should be no use of any electronic gadgets unless necessary. You can take example of family dining together. While eating food, there should be a rule that no one can use any sort of electronic device to watch movies or play games or indulge in social media.

Time table of screen timing

Keep stringent rules inside the house on the discipline to use smartphones, playing video games and watching television. Children below 18 years of age should not be given personal smartphones. Make a rule that video games and watching television is permissible only for 1 hour or 2 hours in a day and not more than that. Check if your child is neglecting his/her studies because of watching television or playing videogames for longer duration. Make your child understand to not watch movies or play videogames after dinner at night.

The power of Locking system

To protect your children from viewing graphic content on the Internet and on TV, there are resources you can use. There are parental controls on most routers, web servers, and TVs that you can set up to filter or restrict inappropriate content. There are also built-in settings or applications that you can download that allow you to build content filters if your children have smartphones.

Encourage Other Activities

It's simple for children to become dependent on technology for entertainment with a wealth of applications, sports, tablets, and movies available just with the click of their fingertip. Encourage your child to look for activities that don't need a tablet to get involved. Creating interest in them to play outdoors, reading a book, or even pulling out an old board game is appreciated. It will also help to create (and enforce) a routine that is observed by everyone in your household. It can help to illustrate your preferences and will avoid arguments by making it transparent to your children when they are allowed on screens and when they are not.

Keep Your Child’s Bedroom Screen-Free

Children are very smart. They can be good in your face and can do the mischief at your back without getting noticed. This also happens when you put too many restrictions on them on viewing television or playing videogames. Children will secretly carry mobile phones to their room and watch movies or when you are not around them. Thus do not keep television or laptop in the bedroom of your child and also teach your child not watch movies at night for too long time on smart phones. Make sure that your child does not carry smartphone to his/her room.

How Much Sleep Do Children Need?

Sleep is a vital action for the growth and development of the human body. When it comes to children, sleep is very much essential for their overall growth. Sleep prepares the body to generate immunity against many diseases. It also makes the child physically and mentally strong. Therefore, cultivating good sleeping habits is critical for the overall health of your child. The amount of sleep a child need varies according to their age and from child to child.

Below are the broad guidelines that will educate you on the sleeping requirements of children based on their age.

Newborn Babies

Newborn babies require adequate sleep to grow and develop. Though they can have variable sleep patterns, generally newborns can sleep about 14-17 hours in a day.

They usually sleep in bursts of 2-3 hours and then tend to wake up for feeding. Sometimes they can sleep for up to 4 hours at a stretch. They might go straight back to sleep after feeding or they might stay awake long enough for a short play. Newborns sleep through the day and night, and sometimes they are more awake at night than daytime. The centers of the brain that control day-night sleep cycles haven’t matured yet.

When your child is less than one year of age

When the infant is about 4 months old, his/her confusion about day and night gradually decreases. This is when you can note the beginning of normal sleep cycles. Most babies have a routine sleep and wake cycle by the time they are 6 months old. A human baby needs at least 15 hours of sleep a day at this age. The purpose here is the development of healthy sleeping habits.

When your child is less than 1-3 years old

Infants generally reduce their daytime naps after they turn one year old. However, 11-14 hours of good sleep is what children of one year old require. It is perfectly fine if your child takes a 1-3 hour afternoon nap. Make sure to put them to bed early so that they can get a full night's sleep.

When your child is 3-6 years old

When the kid grows older, naps eventually get shorter. Children going to kindergarten and are mainly pre-schoolers require 10-13 hours of sleep a day. Parents should teach their children to fall asleep by themselves at this age and should not depend on an adult anymore to put them to sleep. When they wake up in the middle of the night, they can still learn to fall back asleep on their own.

When your child is 7-12 years old

A pre-teen wants 10-11 hours of sleep a day, but only 9 hours is the average sleep they get. At this age, the challenge is not to allow bedtime to arrive very late. Children have a set time to get up until they start going to school. A late bedtime would, however, give them insufficient sleep.

When your child is 12-18 years old

Children of this age are mainly teenagers. They in general require 8-9 hours of sleep in a day. Parents should make sure that their children should not sleep less than 7 hours of sleep. Late-night watching television or playing games should be restricted. Even, before bed, stop making them have caffeinated beverages. A variety of health risks, as well as behavioral conditions such as ADHD and cognitive issues, may result in insufficient or insufficient sleep. It is also necessary for your child not only to follow a normal sleep schedule but to have restful sleep as well.

What to do if your child has seizures?

 Few things make a parent feel more scared than watching their child have a seizure. It is often a very traumatic experience and causes a lot of stress. Seizures or fits are quite common during childhood. Almost 10% of all children have a single episode of seizure in their lifetime. Most of the seizure episodes last only a few minutes and stop on their own & are seldom life-threatening. Here a few steps you can take if your child has a seizure episode to prevent injury.

Identify the seizure episode – Seizures can have many forms especially in children, oftentimes parents fail to recognize seizures which leads to delay in getting medical attention.

These are a few signs that your child might be having a seizure:

Things to do if your child has a seizure:

Always keep an emergency number in your child’s pocket so that if you are not with them when they experience a seizure, any other person can contact you immediately. If someone is nearby, they will take the child to the hospital and can contact you. If you as a parent is with your child and the child experience seizures, follow these steps to keep your child safe and then call the doctor:

  1. Gently place your child on the floor or ground, and remove any nearby objects.
  2. Lay your child on his or her side to prevent choking on saliva (spit).
  3. If your child vomits, clear out the mouth gently with your finger.
  4. Loosen any clothing around the head or neck.
  5. Make sure your child is breathing OK.
  6. Don't try to prevent your child from shaking. This will not stop the seizure and may make your child more uncomfortable.
  7. Don't put anything in your child's mouth. A person suffering from episodes of seizure cannot swallow and forcing could cause injuries or block the airway.
  8. Don't give your child anything to eat or drink, and don't give any medicine pills or liquid by mouth until your child is completely awake and alert.
  9. Try to keep track of how long the seizure lasts.
  10. Your child may be sleepy or may take a while to get back to normal after the seizure. Stay with your child and let your child recover after the seizure until he or she is awake and alert.

Get Emergency help or visit an ER if your Child:

Key takeaways for parents

Seizures have many causes and are fairly common in children, so don’t panic if your child has one.

Follow safety measures as suggested above to avoid injuries and keeping the child safe, and reach to a nearest medical facility if the seizure doesn’t stop in 5 min or happens recurrently.

Note: The pictures have been downloaded for free from Royalty free getty images, Unsplash and Pexels.

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