Prengnancy

Man only provides the sperm. It is the mother who provides everything else to give birth to that loved creature, your child. The whole process of conceiving and delivering a child is the most natural of all processes. It is, however, so different with every woman that all problems associated with this process must be referred to a doctor or a qualified midwife for advice. This chapter provides only briefly some basic guidelines for pre and post natal care.

Pregnancy can last from 36 to 41 weeks. On an average, a pregnancy takes about 10 lunar months. Only about 4 per cent of the babies are, however, born on the expected due date. Do not upset so long as your loved one does not arrive before 36 weeks or after 41 weeks, both extremes being considered normal.

Pregnancy is the period for gaining weight. In the first three months you gain one or two kilograms (about 2 to 4 Ibs). Later, the gain could be a little less than half a kilogram a week. The total gain should not be less than 10 Kgs. (22 Ibs) and not more than 14 kgs (30 Ibs). Generally you get back to your normal weight within one year. If possible, a woman should be weighed as soon as she knows that she is pregnant. She should gain weight every month and be weighed every month.

Missed periods, breast changes, nausea, morning sickness, increased frequency of micturition, fatigue are some of the early signs of pregnancy .

Professional Advice

Mother-to-be should go to the local health centre or consult a physician as soon as she believes she is pregnant. They will check the progress of the pregnancy and deal with problems if and when they arise. High blood pressure of the expectant mother is dangerous for both the mother and the child. It must be checked at regular intervals. In case of anaemia, iron tablets will have to be prescribed. Two injections against tetanus should be given at correct stages. Malaria tablets should also be given where necessary. These professionals could moniter the growth of the baby and advise her on breast feeding, care of the new-born and timing of the next pregnancy.

A trained birth attendant would know how to keep the birth clean and reduce the risk of infection, how to cut the chord cleanly and safely. Such a trained person knows what to do if the baby is born in the wrong position or if too much bleeding is taking place or if the baby does not begin breathing straight way. She will also know when to call expert medical help. She could help the mother to start breast-feeding immediately after birth and dry and keep the baby warm after delivery. She could help the mother prevent or postpone another pregnancy.

If any complications are feared it may be advisable to move the mother temporarily close to a clinic or hospital so that the mother is within reach of medical help. Such complications may be closely monitored in all cases in which the timing of birth has not been properly planned or where a previous baby weighed less than 2 Kg at birth or where she had a previous difficult or a caesarian delivery or a premature birth or a miscarriage, abortion or a still birth. Special care has also to be taken where the mother-to-be weighs less than 38 kgs before pregnancy or measures less than 145 cm (4 ft. 9 inches) in height. Morning Sickness

A normal healthy body has a greater detoxifying process working during the night. If toxins are not taken care of at night, these make the pregnant women sick the next morning. Vitamin Bb6 especially helps in such detoxifying process. Foods rich in this vitamin are important for avoiding morning sickness. Those suffering from morning sickness during pregnancy should keep a banana or biscuits, cookies, crackers or dry toast by their bed side and eat the same before sitting up in the morning, that, is while still lying in bed. After eating, keep lying for 10 minutes.

This is likely to defeat nausea. Avoid greasy, fried or spicy foods. Get up slowly, avoiding sudden movements. Iron supplements can be left out during this period of morning sickness since they may contribute to an upset stomach. Cases of morning sickness are reported to have been cured by the use of rubber bands applied on the thumbs and the index fingers and by applying pressure on the webs between those fingers. During this period drink liquids between the meals and not with the meals. Eating small meals also helps. Gowen recommends raw peeled almonds as a snack during this period. To some women sipping carbonated water provides relief. Yam or sweet potatoes and ginger also help in this condition and so does chamomile herbal tea, taken in the mornings. Do not take any medication. Talk to other women who have suffered from morning sickness. Once you know it will go away, you come to terms with it. Morning sickness starts in the sixth week and stops after 3 months. Wataru Chashi of the Chashi Institute of New York City prescribes a daily all over massage as a preventive measure. Massaging the entire neck and stretching of the head away from shoulder is specially helpful. Studies show that women having morning sickness generally have a healthy baby.

Exercise

According to the American Journal of Obstetrics and Gynecology, 1985, moderate exercise, during pregnancy, may reduce the chance of having a miscarriage or a premature baby. Exercise strengthens the pelvic and abdominal muscles which help make the birth easier.

Regular exercise during pregnancy is essential. Walking is the best exercise in that body condition. Brisk and strenuous exercise should be avoided when tired, take a casual stroll. While sitting on a chair keep your knees wide apart and cross your legs at the ankles and not at the knees. Join an exercise class for pregnant women if available nearby.

A woman should not work full time after the 30^th week of pregnancy. During the last three months the heart is working 33% harder than normal. It needs some relief. Avoid high heeled shoes in pregnancy because they shift the body weight forward, thus placing additional strain on the spine and back. Avoid prolonged sitting. Get up slowly after lying down. During pregnancy you need 9 to 10 hours of sleep. Try to lie on your left side with your knees bent inwards Mid-day rest is the answer to fatigue in early pregnancy. Do not wear undergarments tight about the waist. Link has been established between fetal anomalies, childhood malignancies and X-Ray examination during early pregnancy. X-ray examination must therefore be avoided. Exposure to smoking, active or passive, must also be avoided. Such an exposure could lead to even a still birth. Drinking alcohol and using narcotic drugs has similar consequences and must be shunned. Do not take any medicines during pregnancy unless prescribed by a doctor who is aware of your pregnancy position.

During pregnancy, the presence of breast milk is no cause for alarm. Wash away any dried milk with warm water so that your nipples do not become itchy, irritated or sore. If the gain in weight is less than 10 kgs or inside of your eyelids is pale or there is unusual swelling of legs, arms or face, medical advice may be sought immediately.

There are occasions when faintness comes while lying on your back. It only means that the uterus has fallen against the main blood vessels at the front of your spine and has interfered with enough circulation to those vessels. The drop in circulation makes you faint. Solution is very simple. Lie on your side and not on your back. The weight of the uterus shifts and normal circulation is restored.

Nutrition

Proper nutrition is very important for a good pregnancy. It was in 1941 that evidence was provided for the influence of pre-natal diet on the health of the new born infant. During pregnancy, iron, vitamin C and calcium are required in larger quantities. Take food rich in these minerals and vitamin C. Milk and milk products are good, fruits and vegetable juices may also be taken. Vitamin C may, however, have to be taken as an added insurance only when recommended by a doctor. Drink lots of fluids. Do not restrict salt too much during pregnancy unless so directed by the doctor, you may have to add 15 to 20% to your calories because of the pregnancy. Iron rich foods may be necessary to keep red blood cells properly oxygenated. 500 to 1000 mg. Of extra calcium is also necessary. Muscle cramps are generally due to insufficient calcium intake or insufficient exercise.

Smoking, alcohol and even strong drugs must be avoided. Bananas are reported to improve the complexion of the child and parched gram and almonds during pregnancy add to the intellect of the child. Intake of milk and pulses is very necessary during pregnancy. These have high food value. Vitamin C and bioflavonoids (also called Vitamin P) when taken regularly during pregnancy, reduce the risk of abortion considerably even in habitual cases. Vitamins C and P make the pregnancy very easy. These vitamins are contained in the white underskin and the segment parts of the citrus fruit and not so much in its juice. Lemon, grape, plum, grapefruit, apricot and cherry contain vitamin P. Avoid vitamin supplements. Draw vitamins and minerals from natural foods.

Folic acid (Vitamin B family) is very important for easy pregnancy. It abounds in fresh vegetables, legumes, milk egg and brewer's yeast 75% of this is lost in cooking lasting more than 15 minutes. Large volume of research shows that antibiotics can cause folic acid deficiency. Birth control pills also cause folic acid and vitamin B6 deficiencies. It is therefore, desirable to get on a programme of good nutrition before getting pregnant. British Medical Journal reports on how folic was given to a group of women who had delivered malformed babies in previous pregnancies and with folic acid, the incidence of deformity was reduced considerably. W.H.O. estimates that outside U.S.A. one-third of all pregnant women in the world have folic acid deficiency.

Requirements of proteins, folate and some important minerals during pregnancy can be roughly summed up as follows:

Following special foods help during pregnancy:

1. Roasted peanuts with jaggery (Gur) and cow or goat milk help considerably.
2. Thyme and its tea, in cases of normal births, speed up delivery and make it easy.
3. Four or five grams of dry ginger with liquorice (Mulathi) taken with milk at night would reduce the risk of abortion.
4. Molasses, parsley and amaranth taken during pregnancy ensure easy confinement and a healthy child.
5. Vitamin E supplements of i.u. 400 help in cramps during pregnancy. These supplements are not recommended as a routine.

Craving for clay or chalk etc. during pregnancy should be curbed. Giving boiled beans with sugar helps in this. Drinking a large draught of cold water and sometimes even licking of a little honey help to curb this craving (American Medical Association ?Book of Women Care' page 89).

In later stages of pregnancy caffeine is not excreted from a women's body. This retained caffeine reaches the fetus and excessive use could be harmful. In the last 3 months, tea, coffee and other caffeine drinks must be restricted.

The husband and family of a pregnant woman should ensure that she has more of the family food everyday and more rest than usual during the day time, especially in the three months before the birth.

Pregnancy problems

Dr. M. Stoppard in her "Every Woman's Medical Handbook" deals with various pregnancy problems as under:

1. Abdominal pain: There could be so many causes of abdominal pain in pregnancy. A hot water bottle or heating pad will generally relax muscles. Do not take pain killer. If pain is severe or persistent, please consult your doctor.
2. Backache: Concentrate on good posture. Watch your footwear. Check your mattress. Exercise to strengthen the spine. If the baby is in the occipite posterior, get down on all fours to take the pressure off the back.
3. Constipation: Take plenty of dietary fiber and lots of fluids. Regular exercise, no laxatives. Dried fruits and bran are indicated.
4. Cramps: massage the affected part firmly. For leg cramps, flex your feet hard, pushing your heels away from you.
5. Cravings: Eat whatever you feel like but no fattening things.
6. Fainting: If you feel faint, lie down with your feet slightly elevated. Avoid standing for long periods and do not rush around.
7. Flatulence: Avoid fried foods. Peppermint and hot milk drinks may help. Try not to gulp air. Chewing gum causes you to take in air.
8. Fluid retention: If there is swelling of feet, rest with your legs up and avoid standing. Avoid salty foods.
9. Heart burn: Avoid fatty foods and acidic fruits. Have a hot milk drink before going to bed. Raise the head end of the bed to prevent reflux. Try not to take antacids.
10. Hemorrhoids: Eat a high fiber diet to keep your stools soft and easy to pass. If the hemorrhoids itch, apply soothing cream or ice packs. Don't have hot bath.
11. Insomnia: Wear natural fabrics in bed to avoid overheating at night. No sedatives. Loose and light clothing, a hot drink or an unexciting book could also help.
12. Rashes: Keep yourself clean and well dried. Apply talcum powder to folds of skin.
13. Rib pain: Prop yourself up so that the ribs are not compressed. The pain will disappear when the baby drops into the pelvic cavity.
14. Sweating: Wear light natural fibers and don't exert too much.
15. Vaginal discharge: Wear a panty liner for comfort. See your doctor if you notice any brown or irritating discharge.
16. Edema: Headache, blurring of vision, severe vomitting, high fever and watery discharges need urgent medical advice.
17. Fetal movement: Absence of fetal movement for 48 hours should be reported to the doctor.

If you are mentally and physically relaxed, childbirth will be less painful. Try to urinate as soon as possible after delivery. You may need to urinate frequently in the first few days. This is the way your body eliminates any fluids. Do not worry about your first bowel motion. This does not normally occur for about two days after delivery. Breast feeding may be associated with pains when uterus contracts to pre-pregnancy size. Start exercise even before you get out of bed. To strengthen your abdominals, lie on the bed, with your knees and your hands flat on your stomach. Squeeze buttocks together and press your back into the bed.

Baby's feelings during the first few minutes of his life are very important. Upon delivery, place the new born on the mother's abdomen to reassure it that the environment is warm and friendly. Caressing and touching of its back by the parents will relay love and affection to the baby. In the first few days rock the baby often. It has lived in a moving environment for nine months. The stillness after birth frightens it. Carry it around in order to soothe its body panic.

Question of regaining your figure after delivery is very important for you. During the pregnancy, stretch marks in the shape of wavy strips appear on the abdomen, thighs and sometimes even on breasts. This is mainly due to rapid and excessive weight gain. Watch your weight. Do not gain more than 10 Kgs (22 ibs) if you want to get back to your original weight afterwards. Simultaneously continue to massage the vulnerable parts of your body with oil. Moreover, from the seventh month when breasts begin to enlarge, use nursing bras and wear them day and night.

Girls who are healthy and well fed during their own childhood and teenage years, have fewer problems in pregnancy and childbirth. So special attention should be paid to the health, feeding and education of adolescent girls. The first pregnancy should wait until at least the age of 18.

Avoiding births by having an illegal abortion can be very dangerous Illegal abortions carried out by untrained persons in India kill an estimated 30-50,000 women every year. Government has made provision for medical termination of pregnancy under supervision on request.

Last 8 to 10 weeks

Important of the last 8 to 10 weeks of pregnancy is sought to be highlighted by the investigations undertaken by the psychologist Anthony De Casper of the University of North Carolina at Greensboro. He is investigating the ability of the new borns to digest the sounds voices and even information "they" heard during the final weeks of pregnancy. Among other things he created an experiment in which babies less than 2 days old could "tell" which sounds they preferred to hear. They showed sucking preference when "known" sounds were made. Many mothers have stated that their new born babies seemed to prefer the same type of music that was played during their late pregnancy.

The premise of their research gets support from the epic Mahabharata in which it is mentioned that when Abhimanyu was in the womb of his mother in later part of the pregnancy, his father Arjuna described the intricacies of the fort Chakravyuha to his pregnant wife, telling her how that fort was to be entered and how it could be exited. When Arjuna was describing the route of exit, Abhimanyu's mother had fallen asleep with the result that though she heard all other details, she did not hear the latter part to know how to exit therefrom. Abhimanyu, in womb, in later part of the pregnancy, heard and digested all that information. When fighting on battle ground of Kurukshetra he used that information for entering that human fort but did not know how to exit and was killed. The trend of the research of Anthony De Casper draws lot of validity from the above mentioned story from the Indian epic Mahabharata. Whatever be the case, it does no harm of the expectant mother lives the last two months of her pregnancy the life that she would like her child to lead after birth. Leading a highly intellectual, spiritual, virtuous life, getting inspired by the lives of greatmen, following a regulated life with exercise and nutrition, playing music and practising fine arts or whatever else be the liking of that expectant mother, you could charter the life and style of your healthy child. Try it, plan and lead a good style of your healthy child. Try it, plan and lead a good life. You would not a loser whatever be the result of De Casper's investigations.

Inteligence

All the essential brain structures like cortex develop before a baby is born. He is born with millions of brain cells called neurons. Heredity and pre-natal nutrition plays an important part in determining the quality of those cells. These cells have to be wired to other cells to regulate life. For regulating the basics of life like breathing, action of the heart to pump blood to the system, some of the brain cells are already wired on birth. Most of the other cells have to be stimulated to reach out to such cells which show extra intelligence. Millions of such connections are formed. It is in the first two years of the baby's life that there is a explosion of brain growth with millions of such connections coming into existence. During this period cells which do not get connected and all those which are not used, get discarded. There is a built in programme of activating various systems of the body. At age one month the baby responds to your tone and follows a moving abject with his eyes. At 2 months he smiles and stares at objects. At 3 months he is more aware of his body and responds to conversation by smiling and moving. At 4 months the baby is curious about all sights sounds and people and recognises various objects like breasts and bottles. At 5 months his concentration is developing and makes movements to attention: At 6 months he makes sounds and puts out his arms to be picked up. Knowing the above mentioned activation programme of the baby, if we provide stimulation to the brain cells in those areas, the results will be encouraging. As an example, we know that on birth the focussing ability of the baby is upto 20-25 cm and he follows objects with his eyes., you could provide stimulation to the brain cells by holding the baby at a distance of 20-25 cm from yourself. Sudden appearance of a well-focused figure tickles him and he concentrates on that figure. Concentration is the name of the game. Brain cells are wired to other cells. His world which was a confused blur of sight and sounds at first now gets an attractive profile. The more he sees that well-defined figure, the more he starts concentrating and then observational ability continues to increase. If such a growth occurs in all areas, the intelligence quotient rises fast.

A baby is born with a definite number of brain cells but his brain almost doubles in weight in the first 12 months. This increase in weight is due to the growth of connections between the different cells used in thinking. The greater and stronger the connections between the brain cells and the faculties, more intelligent will that baby be in later life.

The physical body operates through the five cognitive sense organs, namely, the senses of sight, hearing, touch, smell and taste. The entire world is perceived through these sense organs. If the intensity of this perception increases, there is intellectual growth. In practical terms, we have to find out how we could stimulate the brain cells relating to different senses so that strong connections could grow amongst the cells resulting in higher efficacy and higher intelligence.

Some examples of stimulation that could be provided to the brain cells are given below:

The child is held at the focussing distance from the eye and you look attentively at the face. Brain connections bring the recognized pattern into focus and the child starts separating what is known from what is not known or what is the same.

Whenever parents speak to the child in full sentences, it helps in increasing the vocabulary of the child in the second year. It is interesting to weight this against the folklore of certain parts of India where mother, when left alone with the child, fodles him and continues talking to him in complete sentences, full of adoration and love. Such one-sided talk is, all the time, producing connections of brain cells relating to vocabulary.

Bed time songs and lullabies help your child's brain development. It had been realised centuries ago and the mother's songs and lullabies, especially during the first two years, have added to the brain power.

A child lying in the crib has his eyes fixed on various articles. He has great curiosity about these articles which he satisfies by touching, handling and tasting. Such a curiosity should be encouraged. It establishes many links amongst the brain cells and thus increases intelligence.

At age 2 you may tell your child that this colour is white, black or red and separate the colours while naming them. Though the child cannot utter the name of the colours but very soon he will be able to get you the correct colour you ask for. Such an exercise is simultaneously linking appropriate brain cells, increasing his store of intelligence.

When you appreciate your child's achievements, it not only pleases the child but also produces connections between the front cortex and the seat of emotions. When you thus make the child happy, many neurochemicals are released in the brain which strengthen the circuits of neurons.

The neural network develops tremendously during the first two years of the child's life. It continues to develop thereafter into teenage and adulthood also. In the early years there are millions of neural networks available and therefore learning new languages or skills is easy but not so in later years when such networks are not available easily.

The American Psychological Association appointed a team to examine hereditary, i.e., genetic versus environmental influences on intelligence. That team reported that both the genes and environment played important roles in determining the intelligence of the child. This stands to reason because the quality of the brain cells is determined both by the genes and by pre-natal nutrition. Stimulation of these cells depends on the environment including the effort of the parents. Proper stimulating atmosphere for casual learning alone will update the I.Q. of the child.

It now stands established that if your baby as a grown up child, talk to him in proper language, cut jokes, make fun, laugh, sing, dance to him, read books to him and all that when he cannot talk and sometimes not even respond, such parental attention helps in constructing the complex brain circuitry so essential to intellectual development. Early stimulation develops intelligence in the child. It would be appropriate to provide such stimulation relating to senses of smell, taste and touch, also showing how various tastes touches and smells are different.

Some other examples of the manner in which the brain cells could be stimulated to reach out to other cells, which show extra intelligence, for wiring, are given below:

1. Playing visual games with children of a few months, e.g. by making faces within 20 to 25 cm of the chid's eyes. Not only will it amuse the child but very soon the child will start copying by making similar faces. That will ensure that the wiring of the brain cells has been effectively accomplished. Another visual game could be to have a few coloured ribbons tied and kept near a window or a fan so that the child could watch ribbons fly in the breeze. Occasionally the fan could be stopped and occasionally he could touch the ribbons. Those ribbons will "speak" their own language to the child and effectively wire some more brain cells.
2. Mirror plays: In the third or fourth month, a big unbreakable mirror could be hung over the crib or on the side of the crib, just out of his reach. The child will be fascinated to see and control the response of the reflection by just moving some parts of his own body. He will soon come to various conclusions that with one type of movement, the reflection behaved in one way and for moving the reflection in another way, he had got to move his body limb in a particular fashion. That will teach the laws of cause and effect to the child at that young age and wire his brain cells accordingly.
3. Jingle bell music: Attach small bells to a band on his wrist so that the movement of the wrist jingles the bells and those sounds fascinate him. Then you hold that wrist and move it in a manner to create a rhythmic music. Ask and help him to create some sort of rhythmic sound sometimes. And sometimes tie that band to one of his lower legs and watch how he responds to the changes. Such a learning exercise will connect and wire some more brain cells in a meaningful manner.
4. Book handling: At 4 or 5 months let the child handle small booklets with coloured printed material as much as he wishes. Those books may soon become as toys and then as friends. Wiring of the brain cells will make the child book-friendly.
5. Visits: Most rewarding experience comes to him visits to shopping centres, zoo, busy play grounds, musicals etc. before the age of two. From birth till the age of two the child spends 20% of his time staring at the world around him. Looking at things which are on the move, interests him the most. Music attracts him because it wires the auditory brain cells effectively. His visits to places which are most frequented by people satisfies his visionary brain cells. If the visit is leisurely and not fast moving, it allows the child time to observe, analyse and digest information more effectively and more completely. And if, during such a visit, you continue talking to him in complete sentences, explaining what he sees, even if he cannot grasp half of what you tell him, the results are stupendous. An hour spent in this way, at age 2 or less, could be equal to 20 hours spent that way at age 10. At age 2 or less, millions of his brain cells are availability of such cells may be only 5% of what it was at age 2. You must find time to take him out to such places between the ages of 1 and 2, almost once a week. And if, for some reasons, he occasionally becomes the centre of attraction during such visits, the fall out could be enormous. According to Milton in Paradise Regained, "The childhood shows the man, as morning shows the day". Let your child show his brilliance in his childhood even.

These are some of the example of stimulating the brain cells for creating a meaningful wiring system. Many other games or occasions could be organised by devoted parents in those impressionable months.

Organic and hormonal causes can also affect the intelligence quotient. Organic cause could be physical brain damage caused by insufficient oxygen reaching his brain during birth. Hormonal cause could be due to deficient functioning of the thyroid gland. Results of these causes could be minimised by early diagnosis and proper treatment.

Hygiene

Personal aspects of hygiene involve considerations of food, water, exercise, work, sleep, cleanliness and care of some vulnerable parts and vulnerable functions of the body. Question of breast-feeding and feeding of kids have been discussed elsewhere in this book. Some other items of importance for children are dealt with in this chapter.

Food Preparation and Consumption

Food which has not been cooked on fire has great importance for the health of the child. Cooking plays havoc with enzymes and some vitamins and minerals. For consumption of the children, the food has to be softened or mashed and that may require cooking in some cases. This cooking should preferably be done in earthenware or stoneware utensils. Enamelled vessels come next. Brass or copper vessels which have been properly tinned may be a good third. Keep food preparing surfaces clean. Keep it away from flies, rats and animals. Steaming, boiling or baking are acceptable forms of cooking. Roasting is bad, if the colour of the roasted thing changes. Frying is the worst. Cut the food just before cooking. Cook for the shortest time possible but cook thoroughly using a tight fitting lid. The cooked food should preferably go directly from the fire to the table. The strategy should be never to leave the food at temperatures between 5C (41F) and 63C (195F) when harmful bacterial can multiply rapidly, for more than 90 minutes at a time. The food should either be kept heated or kept cooled.

While reheating the food, temperature of more than 75^oC (167^oF) must be reached to ensure that all harmful bacteria are killed. Use turmeric (haldi) in the child's food after he is one year old. It has many curative properties.

Spend some time in preparing the child for eating. Clean him. Change the napkin after he has been handled for urinating and bowel movement. Wash his face and hands. This routine should be so fixed that once you start with it, the child fells that all this is prelude to feeding. He gets ready for that and starts looking forward to it. Thereafter play with the child for a few minutes in such a way that both of you are laughing and giggling. That is the best time to start feeding him. That will draw the best quality milk from your breasts and that will be absorbed and wonderfully by the baby.

Clean Water

Many diseases are water borne. For continuing in good health it is necessary to have a plentiful supply of safe piped water from a tube-well or a deep hand-pump. Water provides no calories or vitamin but it is very important for the working of the body. A child should drink water between meals in hot weather. Most foods have lot of water in their composition and the child gets most of his water needs in milk etc. But if the child shows need for water then do give him as much as he wants. Water should be boiled for 5 minutes and kept in a sterilized bottle for the baby's use. There is no harm letting children drink all that they feel like drinking.

Where safe water supply is not available and the water has to be drawn from a well, that well should be covered. The mouth of the well should have a cemented apron sloping outwards with a pucca drain carrying the spilt water to some distance for disposal. Animals should be kept away from that source of drinking water. No latrines or soak pits should be allowed near that source. The buckets and ropes for drawing water should be clean e.g. by hanging up buckets rather than putting them on the ground. The home containers of water must be kept clean. Water should be taken out of those containers with a clean ladle or cup. No body should be allowed to put his hands into the container or to drink directly from it. Keep animals out of the house.

It is important that all water drawn from a source other than a safe piped supply should be boiled for about 5 minutes to kill all germs. It should be cooled before drinking. This is very necessary in case of children whose immune system is not yet well developed. If boiling is not possible, store drinking water in a covered container of clean plastic or glass and leave it standing in sunlight for two days before using it.

Environmental Hygiene

Unsafe disposal of faces is one of the major causes of spread of disease. Many illnesses are caused by those very germs which are found in faeces. These germs get into water, into food, utensils and to the surfaces used for preparing food. Latrines should be built and used. If it is not possible to use a proper latrine, people should defecate at designated places away from habitation, paths, play grounds and sources of water supply. After defecating, the faces should be buried right at that very place. So the place for defecating should be so selected that the burial of faeces can be effected right at that place. The faeces of babies and children have as many dangerous germs as the faeces of adults. If children defecate at unusual places, the faeces should be cleared up immediately and either buried or put down in the lartrine. Latrines should be cleaned regularly and kept covered and clean. The faeces of animals should also be kept away from houses and water sources. In case of ?gobar' of the cattle it should be either used in the gas plant or in a manure pit duly covered by earth or made into cakes for fuel use at a secluded place.

Wash your hands with soap and water every time they are used or become dirty. Dirt brings germs onto the hands and via the hands get into the food and the mouth. It is especially important to wash hands with soap after defecated. In villages if soap is not available, people take some earth and rub on their hands and wash the same with water. That does not serve the purpose because the earth used has lot of germs. If soap is not available then only alternative thing that can be used for cleaning the hands is the ashes of burnt wood unmixed with the neighbouring earth.

Children put their hands into their mouths quite often. So it is important to wash a child's hands often especially before giving him food. A child's face should be washed every time he makes it dirty. This helps to keep flies away from the face and prevent eye infections. Soap may be used for such a cleaning of the face but not too often.

Household refuse is a great source of spreading infection . Food scraps and peelings from fruit and vegetables attract the flies and the flies spread the germs. Every family should have a special pit where household refuse is buried or burnt every day if there is no arrangement for collection and removal of such refuse by the municipality or the local body concerned.

Exercise

Baby after he learns to focus on distant objects also, is always on the move. Even before be can crawl he has worked out his own highly individual way of morning round. Never discourage him from his first attempts at being mobile. Give his curiosity and spirit of adventure free rein. He needs your praise and support to go ahead. At about one year, with strength coming to his leg muscles, he would start attempts to stand and then to move with standing support and ultimately to walk. He is continuously making greater efforts. These efforts provide adequate exercise to that lump of flesh and bones, that he is. Still you can encourage your baby's physical development from a very early age by playing simple exercise games. Foe example let the baby lie on his back. He may be encouraged to hold your thumbs. Stretch one arm to the sides and then back across his chest and repeat. The bay will be happy if he can see you doing that and follows your movements. Such movements create a subconscious impression also on the psyche of the baby that there is something like exercise in which movements of the limbs are appreciated and help the body.

Baby Massage

Massage is a delightful activity which interests almost all babies intensely. Massage of the baby has all those benefits that it has for adults. It is one of the most intimate ways of showing your love for the baby. Massage is often a very effective way to calm an excited toddler.

Body massage improves blood circulation to all parts of the body and eliminates the unwanted toxic matter of the body tissues. Massage helps the body to heal itself. Evidence suggests that massage is beneficial to a baby's health and well-being. Dr. Yehudi Gordon, an eminent obstetrician, believes that massage helps to reduce colic, constipation, diarrhoea, coughs, colds and irritability.

Use a light vegetable oil such as sunflower oil or almond oil etc. Avoid such baby oils which are mineral oils and so are not easily absorbed by the skin.

There are no special techniques or sequences for massaging a baby. Just do what comes naturally and you will soon find out what your baby likes the most. Keep your movements smooth, slow and gentle. Glide hands lightly across his tummy in a criss-cross motion. Stroke clockwise in a circle round the navel for colic and stomach aches. Stroke and squeeze arms and legs working from his thighs down to the knees and around to his calves and ankles. Gently massage his neck from his ears to his shoulders and from his chin to his chest.

Massage not only soothes an unsettled baby, it can help calm your nerves as well. Babies need touch. Research has shown that a baby would rather be stroked than fed.

Bed Wetting

Bed wetting at night can happen to a child of any age and is very common in children upto the age of five. Boys are more prone. Most children grow out of this by that age without any special help. Be sure that the child's embarrassment about such an accident is not acute. He should, therefore, be not threatened or put to shame. No fuss should be made of the accident. Instead express confidence that he will soon be staying dry again. Child should feel that he has full parental support in this matter. Offer praise when the child has a dry night.

Parents should require the child to urinate before he goes to bed and also be woken and asked to urinate when the parents go to bed. He should not be taken for urination half awake. He should be told that the next time for urination is the next morning on waking. If a bed side pot is necessary, it should be purchased when the child is also present. Subtle effort is needed to prevent him from feeling guilty. Keep him is drapers till he is ready to stay dry.

There should be a couple of discussions between the child and the parents on the subject. Your tone and attitude should express lack of anxiety. Do not scold or draw his attention to any accident. Do not compare him with others of his age. Be sympathetic.

Bathe the child before going to bed in a bath with some epsom salts added to the water. This will relax him, settle his nerves and draw off some acidity. This may, in due course, ensure a dry bed. A few trials may help you to decide how to proceed further in this behalf.

Thumb Sucking

Where the babies have not had enough sucking at the breast or bottle to satisfy their sucking needs, they take to thumb sucking. This sucking helps babies relieve physical and emotional tension. When a toddler gets too excited and needs to calm down, he starts thumb sucking. Dr. David Levy has pointed out that babies who are fed every three hours do not suck their thumbs as much as babies fed every four hours. When babies learn new skills such as sitting up, crawling or walking, thumb sucking would increase during the frustrating learning period and decrease when the new skills are actually learnt. The thumb sucking could increase to as much as four hours a day.

The sucking need is the strongest in the first three months. From then on it tapers off. When sucking continues after six months, it is for comforting and not an expression of sucking needs. Thumb sucking is generally given up by 6 years of age. But in one case known to the writer, thumb sucking continued till his death at age 70 years. As a practising lawyer he was sucking his thumb when he was not arguing.

One can worry about the effect of thumb sucking on the baby's jaws and teeth. But it seems nothing much can be done to prevent it. It may be a mistake to try to deprive a child of thumb sucking in infancy. Parents should not use elbow splints nor apply bad tasting liquids on the thumb. Thumb sucking does not harm any other parts of the baby.

Eyesight

A baby sometimes cannot open his eyes right away because the normal pressure on his head during birth has caused puffiness. That pressure may have also damaged some tiny blood vessels in his eyes. Both these conditions are absolutely harmless, require no treatment and will correct themselves.

On birth the child can focus his eyes clearly upto a distance of 20-25 cms only. Beyond that on birth, he cannot focus both his eyes at the same time. He may look to be cross eyed. Both of these conditions clear up as his eye muscles develop within a few months and his vision improves rapidly.

The eyes are bathed constantly by a steady flow of tears, not just when the baby is crying. This is why it is unnecessary to put any drops in the eyes while they are healthy. The tear ducts may be blocked and no tears be shed for the first few weeks. Usually blocked duct will clear by itself. You can help by keeping the eye clean.

A mild but chronic infection of the eye lids, most commonly in one eye, may develop. The eye waters and tears excessively. White matter collects in the corner of the eye and along the edges of the eye lids. The discharge may keep the lids stuck together on waking up. This condition is also caused by an obstructed tear duct. It is fairly common, is not serious and does not injure the eye. It may last for a few months but the baby will grow out of it. When the lids are stuck together, soften the crust and open them gently by applying water with your fingers or with a clean wash cloth. A fit of gentle massage could also be given. If the duct does not get cleared even after 4 or 5 months, consult a doctor.

Cases of squints, conjunctivitis and subsisting cross eye should also be shown to a doctor. Baby is born with capacity of eyes to focus upto 20-25 cms only and can manage to focus upto a reasonable distance by eight weeks and by three or four months he can take in more details and build up a three dimensional picture of the world. This enables him to move about without facing danger. His eye for details improves and by 5 or 6 months he can discriminate between different facial expressions and respond accordingly.

Development of normal vision requires plenty of visual stimulation. The parents have to provide this by taking the baby out for sight-seeing. If he is in a stroller, he will be able to look all around him and enjoy the fascination of the unfolding world. This unfolding world will make lasting impressions on his young mind about the beauty of nature and the effect of the environment.

Teething

Generally teething starts at around six months. These primary milk teeth are important as they guide the adult teeth to grow in correct positions. There is no standard time for the baby's teeth to erupt. It would be interesting for you to know that both Julius Caeser and Napolean were born with teeth. If a baby is born with a tooth that should be removed. With the first tooth at six months, the molars are there by 2 ½ years and teething finishes with wisdom teeth coming in at age 20 or thereabout.

Baby would be irritable when a tooth erupts. He will generally have fever, vomiting and even diarrhoea. The gums will be red and swollen. The tooth can be felt through the gum. His cheeks may also be red and he is likely to drool, excessively. Other symptoms of teething are increased thumb sucking, gum rubbing, poor appetite and wakefulness. A small cooled carrot or a piece of hard toast may be given to the baby to chew on. This will make teething less painful. Massage his painful gums with finger tips.

Baby teeth begin to fall out when he is 5 to 6 years of age. The first permanent teeth also start appearing at 6 years of age. Breasts fed generally have healthier teeth because of the nature of mothers milk and the natural rinsing action during breast feeding.

For good dental health, it is important that the child eats right foods in a right manner. By giving sweet foods in between meals increases the exposure of teeth to harmful acids. Give him sweet foods at the end of a meal instead. Do not give him sticky candy. Cheese given at the end of a meal makes saliva alkaline which counteracts the acid that crodes teeth. Eating candy for hours is bad. According to Dr. Hauks in the Dental Survey, apples have a unique mouth cleansing property. They promote the flow of saliva in the mouth. Use of yogurt, because of its helpful bacteria, is specially beneficial for the teeth. Clove oil has been used for centuries to sooth a toothache.

Avoid giving milk or juice in a bottle at bed time. During sleep less saliva is produced and bacteria can develop in the mouth, producing decay acids that erode the protective enamel of the teeth and the mouth can have rotten teeth as early as three years old. Drinking substantial amounts of sweet fruit juice is another cause of early tooth problems.

It has been established that the crowns of all the baby teeth are formed in the gums before birth. These are, therefore, made from what the mother eats during her pregnancy. Milk and cheese, citrus, tomatoes, cabbage and some sunshine taken by the pregnant mother will help in healthy teething. The baby's permanent teeth are being formed within a few months after birth. Then he is getting plenty of vitamins. Let his food then fortified with vitamins C and D.

Fluoride in the water makes stronger teeth. Principal cause of tooth decay is lactic acid manufactured by bacteria that live on sugars and starches. Sugar of the fruits have a brushing action on the teeth.

Once the molars are through, the child could be encouraged and trained to use a soft small tooth brush for care and protection of the teeth.

Sleep

Shakespeare calls sleep the "Chief nourisher in life's feast.'! Sleep, truly, is more than a restorer. It is a nourisher. It is allied to nutrition. Sleep behaviour in children is genetically inseparable from nutrition. The early association between feeding and sleep is extremely close. The baby feeds to sleep and he wakes to feed, which promptly puts him again to sleep. As he grows older, his sleep becomes more defined. He wakes up more decisively. The child has to learn to sleep in the same manner that he learns to creep, stand or walk or to grasp things. He learns to stay awake and to enjoy it. In the same way, he must "learn" to stay soundly asleep in sizeable stretches.

In the beginning the babies feel comfortable sleeping on their stomachs. The pressure on the abdomen relieves the gas pains of colic etc. It is better this way till he learns to change sides. He should be taught to sleep on side with the help of pillows placed to support him. Sleeping on side, should be his position during the latter life.

In the first month or so, wrap your baby in a blanket or a similar cover, covering his feet and upto the neck before you put him down. Before that give the baby a comfort such from the breast, darken the room at night, stroke his back or limbs to soothe him. In the first few weeks 14 to 20 hours sleep per day is quite normal. By 12 weeks the total sleeping hours may get reduced to about normal. By 12 weeks the total sleeping hours may get reduced to about 14 per day, half of it by the way of sleeping through. By the end of the first year the sleeping hours may be about 12 to 13 including two daytime naps. Adults drift to sleep, babies plummet. Babies sleep and are relatively immune to noise. Little children above 2 years of age have to be taught this social skill of going to sleep. As the child grows, this task of putting to sleep becomes more complex. A shift to crib may not be accomplished with ease. Crib may be acceptable for the day time nap but not for the night. By 16 weeks he has passed through his colic syndrome and probably thumb sucking has set in. At age 2 he relates himself to some one else and calls his mother back on some pretext or the other. At age 3 or 3 ½ he is ready for a change from the crib to the bed.

Most sleep difficulties are man-made rather than child made and arise from over rigid methods of management. For example, the folk lore and folk wisdom say that a child will separate from the mother of his own accord in his fourth year. Until then he is too little and helpless to be expected not to want her at night. You may manage to get this age reduced to 3 years by your manipulations, but if at the age of 1 year you want him to sleep in a separate room, his rebellion is natural. A child of that age cannot "learn independence" just by being put in a room by himself. You are thus making him feel unsecure and unwanted throughout his life. This is an important issue. Bring a "lovey" for him. Try to establish that lovey as a substitute for the mother and make that lovey inseparable from him. That may help you.

For avoiding the sleep syndrome take action on some of the following suggestions. To keep him active during the day. Reduce his day nap hours. Do not allow any nap after 3 PM. Mother to go to put him to sleep and have a relaxing routine by the bed-side before actually tucking him in.

He is bound to wake you up at night. You would soon know about the hour of his thus waking you up. Wake him at night before he wakes you. Talk to him, hug him, give him the bottle and kiss him good night again. This will have a far reaching and lasting effect on his psyche.

Never take him out of the bed or rock him. Instead soothe and stroke him with your hand. Occasionally substitute your comforting voice for yourself. Reinforce one particular ?lovey' (doll) always, in every way, so that he carries that lovey to bed with him.

Encourage your child to come into your bed for a cuddle in the morning, no such privilege being granted at night before his getting into his own bed. It is a sensible rule not to take a grown child into the parents' bed to sleep for any reason. One exception, acute illness!

Growth

A child's growth is a development process, beginning at birth and continuing all the through adulthood. Within minutes of birth, the baby, if placed next to several bodies, can recognise his mother by the rhythm of heart-beat with which he had become familiar over a period of nine months. The new-born prefers to hear the voice of the mother to a stranger's. A few days after birth, the baby can identify his mom even by smell. His sense of touch is well developed. He can focus on objects approx 25 cms aways and soon he can imitate facial expressions of the people around him. A child is ever anxious to learn. He is most receptive to learning when (i) his body is still, (ii) he looks eagerly at his surroundings and (iii) his breathing is rapid and irregular. When even an infant fulfills these three conditions, start teaching him as if he were 2 or 3 years more than his real age. The results will be gratifying.

The first five years in the cycle of development are the most fundamental and the most formative. No two children are exactly alike. The way a child behaves is largely determined by the body he inherits. As Dr Gessel has expressed, "environmental factors modulate and influence but not determine behaviour". An infant's or a child's behaviour can be strongly influenced by the way his mother treats him. And each mother finds her own ways as a mother of her own special baby. Speed or tempo of movement of each child is, to a large extent, an inborn characteristic. Otherwise, as stated by Byron, a child is "Mischief-making monkey from his birth". On an average, upto school going age, boys tend to be about six months slower in their development than girls. But after that age, according to an English proverb, "one boy is more trouble than dozen girls".

The human life-cycle is governed by natural laws. These laws of development are comparable to the laws of gravitation. Development takes time. It is a continuous process. It is for you, as parents, to create the right environment for learning to achieve a satisfactory rate of development. You have to create a responsive environment in which the child learns to operate and operates and not you that operates.You have to create a human environment in which the child learns to achieve development not from the toys but more from the people around him, from the neighbours and from other children around him. You have to arrange and create occasions for his intimate inter-action with each of the above mentioned group of persons or with those individuals on one-to-one basis. You must vary the environment to sustain the interest of your child. Rotate activities for different objects and different skills. You have to make the learning enjoyable. Tell the child what you are doing and why. Ecourage his going exploring, raising his curiosity and help him to satisfy that curiosity. And the most important thing in this process of learning for growth is that you must quit while the interest is high. He will, in that case, tend to request you to pick up where it was left. His interest and involvement is then bound to be high.

Physical Health

Physical health is very important. Health is not a condition of matter, but of mind. But it is only if his body is in good health that you will be able to effectively attend to questions of his emotional and mental health and to the questions of upgrading his intelligence. In this behalf, the most important items relate to the breast feeding of the child for as long a period as possible. This item has been dealt with in the chapter on breast-feeding. Next items of importance are the other feeding and nutrition and tackling the problems of health hazards like diarrhoea and other diseases which have also been dealt with in separate chapters. Dr Michacl Hastin Banner, a renowned specialist in child-care, has indicated how to tell if the baby is developing normally. He indicates that the following yardsticks for physical growth must be achieved:-

Weight and Height

Then there are yardsticks of height and weight which are indicative of the growth of the child. There is, however, no need for you to worry about his measurements if he is happy and there are sings of his general well being. The range of "normal" weights and heights at a given age is very wide. A new-born boy may weigh anything from 2.5 to 4.5 kgs without giving cause for concern. Similarly a five-year old child may weigh from 13 to 26 kgs without causing much concern. Do not compare the measurements of your child to others of his age. These are dependent also on whether the child is of narrow or broad frame and even on his genes.

To measure your child's height once he is three or four, get him to stand against a wall with his feet together and his heels and shoulderblades touching the wall and head held up, tilting gently the chin upward. Before 3 years you measure his length lying down. Measurements of a child of normal growth are given in the following table:-

The above measurements are for girls. In case of boys, add 7% to those measurements upto the age of 2 years. For boys at ages above 2 years add 3% to the measurements for girls of that age.

Children should be weighed every month upto the age of 6 months and thereafter every 3 months upto the age of 3 years. In case it is feared that the child is not gaining in weight on a regular basis, more frequent checking of the weight is recommended. Weight gain is the most important sign of the child's overall health and development. If for two months there is no increase in weight, it is certainly indicative of a problem. The child is either unwell, is not getting due nutrition or is emotionally upset and is not getting proper attention. In all such cases breastfeeding should be stopped up. Immunization should also be checked and in case of default, necessary immunization got done immediately. It must be ensured that the child is eating 6 times a day there is enough fat and dark green vegetables in the diet. Hygiene of the child must also be checked. Quality of the bottled milk needs special attention because if the child has not been ailing, the main reason for lack of increase in weight could be the fault in the quality of bottled milk. Breast feeding is the best cure for many defaults.

A child upto the age of three years needs six meals a day with adequate quantity of soild foods and fats as he grows. Any default in this will result in the child not gaining weight. In India 43.8% of children suffer from moderate degree of protein energy malnutrition. This can be controlled by adding fats and solids foods in adequate quantities and by drawing in a substantial way on breast-feeding.

Amongst children deficiency of Vitamin A causes about 40,000 new cases of nutritional blindness each year in India. Adequate care should be taken to ensure that your child does not fall into that trap. Feed him on dark green vegetables, orange and yellow fruits and vegetables such as mangoes, papayas and carrots etc. Supplements of vitamin A may also be necessary if the child suffers from recurring attacks of diarrhoea. Vitamin A comes in adequate quantity in breast milk also.

Illnesses are important factors holding back a child's growth. It is the mother's job to know about all the ailments which could possibly affect her child and to take preventive action in that connection. Most of these ailments have been dealt with in another chapter and need your special attention. When the child is ailing, two things happen. First his appetite goes down, and secondly whatever food is eaten, less of that gets absorbed into his system. If it happens several times, there is a great setback to the growth on all fronts. It is, therefore, very necessary to continue feeding him. Offer the child those foods and drinks which he likes. Soft foods, sweet foods, a little at a time and as often as possible should be offered, Steps should be taken to buoy up his spirits. Getting him into the company of a child of his age may work especially if that child is fed in the presence of yours. The child should not be considered to have recovered from the illness until he is at least at the same weight as when the illness began and has become active and plays about as before. It is not too much to repeat another time that breast feeding is the best missile in your armoury to shoot down most of the illnesses. Use it continuously. It will bring you success all the time if you do not throw that missile away prematurely by discontinuing breastfeeding before 18 or 24 months. Breastfeeding must be continued along with solid foods for a long, long time!

Zinc is as much necessary for the growth of the child as it is for an expectant or nursing mother. Zinc is good for the health of the immune system and its deficiency may result in frequent infections, reduced appetite, skin disorders and horizontal white marks on the nails. WHO recommends an intake of 15 mg of zinc per day. Good sources of zinc are cheddar cheese, peanuts, whole wheat bread, eggs, liver, chicken and milk.

In addition to the need for physical growth, there is great need for emotional and mental development.

Emotional Growth

Emotions give life its colour, richness and completeness. Emotions are a positives force that serve to energize and enrich an experience. Emotions on the other hand can also disrupt, disorient or even alienate. Parents have to find out for themselves as to what does the kid want to accomplish by becoming emotional. Emotions may be used to get special attention or to retaliate or to save oneself from functioning. Perents have to control the negative use of emotions. The child may have fear and anxiety. Never laugh at his fear, instead help him to get over it. He may have the fear of darkness or the fear of the school. Encourage him to express his fear and provide a firm resolve that he has to go to school.

Generate a democratic climate in the house, encourage open expression of feelings whether positive or negative. Accept the child as he is. Do not nag. Encourage and oppreciate every small positive step of the child. Respect the child. Listen and clarify. Encourage independence. Do not pity him. Nobody likes to be pitied. Do not use competition the child for doing household chores. It is his share in making the home operational. Do not spoil the child nor promote rebellion by being too strict.

You can help him substantially in his emotional growth by making him feel secure. Never threaten the child at all, much less that he will be deserted or thrown out. Provide a schedule of his feeding and sleeping. Demonstrate your love by hugging, kissing and by holding him. Teach him new skills and pat him when he displays competence. Spend time together. There are many things which can be done together by the mom and her small child and which make him feel being at the centre of things.

Worldly desires and race for fulfilling those desires, cause most of the emotional upsets amongst adults. For a kid whose world gravitates mainly around his mom, a kindly gesture from you makes all the difference to him. He does not have many such other desires which cannot be fulfilled by his mother's grace and intervention. For his emotional growth, demonstration of love from his parents, brother and sister, are enough. They should show their feelings, touch, hug, kiss, care, share and be outgoing. See and experience the magic of physical touch. Smiles and laughter beget smiles and laughter. Actions such as these will provide a guarantee for an emotionally healthy life. Make him feel that family and friends are his life and blood and that he has to foster them.

A very specific need of young children is continuity in their care givers. He is used to getting his security from the one or two individuals and if any of them disappears suddenly, a vacuum is created which will take long to fill. Change in caretakers should, if necessary, be gradual, one taking over from the other with a good overlap period.

Children also gain trust in themselves from being respected as human beings by their parents or care givers. Such a self-assurance helps them to be comfortable with themselves and with all kinds of people, for the rest of their lives. Respect from parents is what teaches children to give respect to their parents in turn. Anger and hatred in the child's family damage the child's inner development.

Emotional health is the basis of the child's development of a sense of security, confidence and the ability to cope well with other people and with the world at large. Emotional relations established very early in life set the pattern of relations in later life.

Building Confidence and Self-respect

Nothing is more risky than sending a child into adolescence with no skills, no unique knowledge, no means of compensating for shortfalls in other areas. You may reward, push or even bribe the child and, if necessary, right from age one, make him learn some special skills, which other children of his age do not have. Take out time to introduce the child to learn and then do something special. Arrange some coaching, if necessary and help the child to compete. Everything your child cannot accomplish, inspite of best efforts should be toned down in importance. Simultaneously avoid over protection. Let him do things on his own which he should so do.

Get chores done by your child, which others, one year older, hesitate to undertake. Objective of getting these chores done is to develop responsibility. Competence and confidence. Show him how to do it with him and then let him do it alone. He will know what your aim is.

Do not bride. The best payment for a job well done is a smile or a hug or telling others, within the child's earshot, how proud you are of him. Paying for say, making a bed detracts from his being a proud member of the family and makes him feel he should be so paid for many other things.

Do not put him to too manu chores. Do not overdo it. Work is valuable, drudgery is not. The child is a member of the family, not its slave. Characterise your home by democratic practices and openness.

You should not only love your child but, in addition, make him believe that he is held in esteem by you. You need to guard what you say or do in the presence of your children. Lead them to think positive and consider you as a confidentally. Even when you have to discipline your child, do it with respect and not in front of others.

Your ultimate goal is developing self-esteem in your child. In addition to overseeing the physical health and well being of your child, you must help him to develop attitudes that nourish his self-esteem. Develop, overtly and covertly, his confidence in the world around him. Develop in him a sense of personal power, which he is even able to demonstrate e.g. ability to move a ball. Make him feel lovable-both by giving love and receiving love. Make him feel special. And if you do that honestly, on the basic of achievements which, though small, are real, your child will become special!

Childhood is a time for play and exploration. Observation and experience from the basic for learning. Fantasy is an essential part of childhood. Emotional and social well-being are as important as academic, artistic or athletic performance. Take special care of his emotional concerns.

Once the child expresses a special interest or displays such interest in a particular activity, you should accept the child's priority and move in that direction. Allow him to experiment and explore. Cultivate respect as the child learns to regulate his own body. Encourage communication with him. Balance your child's success and failure rates and send positive message - not necessarily verbal.

Routine followed by parents is seen by the child as a great adventure. Each new thing he learns is a source of great pleasure for him. Bringing out his appetite for learning is one of your most important jobs as a parent. Create a role for yourself According to Plutarch "the wildest colts make the best horses". Encourage his explorations and appetite for learning. Let him become a "wild colt" but keep the remote control in your hand.

Let your child take the lead in finding one the areas of interest and play. Show your child that he is smart and capable. Step back to your own childhood and develop your own zest for learning to be passed on to your child.

In a child appreciation of aesthetic experiences is established well before artistic expression. By the time a child is 18 month old, he has been responding to music, pictures and rhymes for many months but his creative experiences are still very limited. His first artistic attempts are simple and random as he experiments with various media. At 2 years his expeimentation is still manipulative but is becoming more vigorous, more defined and more complicated. He is less individualistic in his artistic expression than he was earlier. He is becoming strongly imitative. At 3 years, order begins to emerge along with more precision and control in the use of artistic media. Gradually imagination enters (about 4 years) and is combined with humour to form products which are a delight to the child.

Singing songs, learning rhymes, drawing pictures and reading stories aloud help the child's mind to grow and prepares the way for learning more and more. A child needs help to develop creativity. Help in these areas will increase his proficiency in these skills. He will soon find himself above others in those areas which are considered fine and artistic. His self-confidence will grow and self-respect increase.

Play is not pointless. It is one of the most essential parts of growing up. This play should be for play's sake. While playing with other children, he is continuously learning many manipulative skills which he cannot learn in the company of adults. Providing useful materials and ideas for plays is to be your contribution to his picking up new ideas and new skills which always add to the growth of his personality. Once he becomes cognizant of his own personality, he is on a track of constant growth. He soon learns that though remaining and active member of the community "he travels fastest who travels alone". His personality grows only in its personal manifestation.

Learning Manners

Manners are the outward sings of your consideration and respect for others. For learning manners the first step and the most important thing is to have the child like people. Manners are morals. Manners are ways of respecting others. If the child likes people he meets, he would fell like even sharing a fascinating experience with them and that is a good unconventional way of giving an expression to his good manners.

Another important step is for children to grow up in a family whose members are considerate of each other. Then they radiate kindliness. In that environment even if some one does not utter the words - thank you, it is fine because perhaps that feeling is conveyed ten times over by that affectionate radiance from your bright eyes.

The children have to be introduced to others in a healthy environment where the visitors get respect from the parents and vice versa. That is a good back-drop against which you teach your child just how to be polite and considerate. If it is done in a friendly spirit he is proud to learn. He observes that every body likes good mannered children and would like to join the rank of likeable children. The appreciation they get makes them more friendly. That is an incentive for improving their manners still further. Children should be coached about manners when you are alone with them and not in the embarrasing company of others. It is the nagging tone, the bossiness that even a young child finds irritating. Let such coaching be done in the privacy of the loving parent-child relationship.

We can teach our children good manners only by example. Manners will become important to children if they are important to parents and if they continue reminding the child in subtle ways. The desire of a 2 or 3 year old to please others makes him more receptive to learning simple courtesies. He will learn from your behaviour - how you treat women or your own daughters, how friendly you treat other men and how you participate and enjoy family life or how rude and violent you are to others. He believes consciously and sub0consciously that your way is the correct way of dealing with others and he will follow your example - whether it is good manners or bad? This overt and covert learning starts from age one.

He has to be taught how to meet people. Shake hands or exchange greetings and even make courtesies. How nice it is to see a 2 or 3 year old with folded hands making a Japanese style courtesy with a bow to a friend of the family. One would like to lift and kiss such a child and if that is done in return, by the visitor, what a boost to his affectionate personality it would be. Such an appreciation is generally easy to come as the visitors know, praise the child, and you please the mother. Table manners and simple answering a telephone by a 3 or 4 year old could add to his personality. Good conversation habits, maintaining eye to eye contact, giving him equal time in his conversation with you and waiting to speak instead of interrupting, are such simple yet so impressive as manners that these manners will add ten fold to the maturity of the child. Franklin says, "teach your child to hold his tongue, He will learn fast enough to speak". When your friends come to visit, include the child in conversation for the first few minutes before suggesting another activity for him. He should be taught to eat with grace, holding a door instead of letting it slam and using language that does not offend. Scores of other examples could be given but any thing which is the outward sign of our consideration and respect for others is good manners and must be encouraged.

Let us now refer passingly to some examples of bad manners too. Tough talk, unkempt style of clothes and hair, untied shoe laces, coming to table with dirty hands, stuffing their mouths with big morsels of food, throwing the clothes on the floor, slamming the door or leaving it open. These are some examples of bad manners and must be avoided. Good manners will help children to be sociable and popular not only with their own age group but also with the elders.

You should always include your baby in social gatherings and teach him the basic pleasantries from as early an age as possible. Introduce him to a number of new faces. Before exposing the child to such social gatherings, the parents could play games with the child, introducing each other, shaking hands, bidding good bye, applauding and other social graces including grown-up courtesies.

Breast Feeding

Breastfeeding is a fundamental requirement. It is not merely a matter of choice. Nature brings milk to the breasts of the mother simultaneously with the birth of the child. Why?

During the first 72 hours after delivery, the breasts produce a thin yellow fluid called colostrum containing antibodies that protect the baby against a range of intestinal and respiratory infection when his own immune system is very weak. Why?

Quantity of milk produced depends to a great extent on the sucking action of the baby at the breasts which sends messages to the hypothalamus which in turn stimulates the pituitary gland in the brain to release two hormones : Prolactin which is responsible for the manufacture of milk in the milk glands, and oxytocin, which causes the milk to be passed from the glands to the reservoir behind the areola. Intensive sucking means more release of prolactin hormone and manufacture of milk in the milk glands and viceversa. Thus the supply of milk is, to a certain extent, dependent on the intensity of the demands of the baby. Why is such a variable capacity designed for the milk machine of the mother?

It is abundantly clear that this food manufactured by this maternal system is meant for the feeding of the infant, for his nutrition protection. Anybody who, for what-so-ever reasons, deprives the child of this breast feeding, commits an offence against the laws of nature and must be punished in one way or the other. If you deprive a person of something manufactured for his exclusive use and which is so important for his protection and for his growth, and especially if that person is your own child, can you ever forgive yourself for such an act of neglect and indifference?

Composition of Human Milk

Breast milk is individualised for each child. Raw materials for the production of this milk are selected from the blood stream of the mother, according to the needs of the child. Breast milk changes in composition from day to day. It is custom designed for your own child. While the colour of ordinary milk is white, the colour human milk in the beginning of feeding is bluish because of low fat content but becomes creamy towards the end of feeding due to fat content going up. Human milk contains more of vitamins A and E, and also of vitamin C if the mother is eating well. Human milk contains twice as much iron as the other milk and it is better absorbed. All iron requirements are met for the first six months from first breast feeding. Zinc which is extremely important for growth is available more in breast milk. Outside milk contains more of calcium, phosphorus and sulphur but most of these minor minerals are excreted and so is extra protein. Human milk contains more sugar and has higher cholesterol level but that helps fight high levels of cholesterol in later life. Human fat globules are smaller and absorbed easily. Fat of outside milk is high in saturated fatty acids. Human milk contains enzyme Lipase which helps digestion. It also has growth modulator amino acid. Taurine which is very important for development of brain and the nervous system. It is because of the superiority of the human milk that a few banks/stores of human milk are reported to have come up in USA inspite of its low shelf life.

Advantage of Breast-feeding

Breast feeding benefits the nursing mother in many ways. It is good for your figure. Fat stores developed during pregnancy are laid down specifically for lactation. In the absence of breast feeding, that fat will look unseemly in various parts of your body. With breast feeding you burn almost 1000 calories each day. With a little care and management your beauty can blossom forth. Nursing does not ruin the breast. Instead you become a fuller blossomed woman and with proper care of the breasts light massage etc. during breast feeding, you may yourself be surprised to see how shapely your breast look after a year of delivery. It is an established fact that breast feeding, causes the uterus to shrink more quickly to pre pre-gnancy size. It also decreases the post delivery bleeding. There is no menstruation generally for the entire period of active breast feeding. It is good for health because you get many spells of relaxation every day when you are feeding and making love with your child. Hormone prolactin also enhances this feeling of relaxation. Breast feeding is nature's contraceptive. Hormonal balance in your body will prevent ovulation. But, please note that breastfeeding, on its own, is not a very reliable method of family planning.

Breast feeding is convenient for the nursing mother, no bottle have breasts with are not limited by the size of the breasts. You can breast-feed a premature baby. You can breast-feed even if you have started mensurating and even if unluckily you have become pregnant again, in which case quantity of breastfeeding will have to be reduced. In case of breastfeeding your child continues to smell good. Even his bowel and milk spit do not have the strong odour of a bottle-fed.

After a couple of weeks, breast feeding becomes pleasurable for the mother. Many nursing mothers say that the pleasure sensation they feel in their breasts and in their genital region while they are nursing are very similar to the sensations they experience during sexual excitement.

Breast milk alone is the best feed for a baby upto 4-6 months of age. Breast milk is nutritionally and chemically balanced. It is at the right temperature. It is sterile and contains immune substances. And it is available to the baby always. It is always ready to drink, sanitary and uncontaminated. Its protein is nutritious and digestable than cow's milk protein. Mother's milk has higher level of zinc which is important for growth and for a strong immune system of the child. It prevents constipation and lowers the incidence of food allergies. Breast-fed infants use their calories more economically.

Dr.A.S. Goldman of the University of Texas Branch at Galveston says, "it is already widely accepted that human milk is rich in factors that protect directly against infection, but we found evidence that it contains at least one factor that activates the baby'' own immune system"" Mother'' milk transmits antibodies and protective substances Scientists have found that 75% of the cells in breast milk are macrophages that kill bacteria, fungi and virus. Those cells also help to stop the growth of cancer cells. Scientists have also recently discovered that a solution containing 5% content of human milk killed half a culture of parasites in a test tube within 30 minutes. Cow's or goat's milk was unable to produce a similar result.

Breast feeding causes less diarrhoea, no respiratory illness and less of other infections. It promotes better digestion by forming softer curds in his in his stomach. There are no allergic reactions, no eczema, asthama or running nose. Suckling at the breasts is good for baby's teeth and jaw development as these muscles are exercised in suckling.

The main case against breast feeding is that it is a solitary pursuit and becomes boring for the mother. Of course this activity cannot be shared by others. But imagine how much opportunity it provides for forming bonds between the mother and the child and thus laying a foundation for a happy family relationship. It does require an effort and a commitment. But if such a commitment is not there, why go in for a child at all. Another objection raised is that there is no easy way of knowing as to how much milk has been consumed by the child in case of breastfeeding. The wet diaper, regular bowel movement, sleep following nursing, the bright eyes, alert look, the glow and the smile on the face of the child all show his contentment. Mother also feels the flow and a periodic weight gain will by itself show how much is the intake. The only problem faced in case of breast feeding is that the medicines taken by the mother get transferred to the milk. But only a few commonly used drugs are contra indicated for the child. Most vitamin supplements are contra indicated for the child. Most vitamin supplements are safe. The mother as also her physician have to be careful in this behalf.

Regulating Milk Supply

Milk supply for the baby is influenced by the parents management. Worry, tension and fatigue rob you of the milk output. Rest and relaxation add to it. The more often you nurse your baby and the more vigorously he nurses, the more milk you are likely to have. The release and working of the two hormones-prolactin and oxytocin, manufacturing and supply of milk due to the sucking action of the baby has already been explained . Frequent sucking is needed to produce enough breast milk for the baby's needs. If the mother is a reluctant feeder, the production of milk in her system is bound to go down. Incases where the breast milk is supplemented with cow or goat milk, powder solutions or other breast milk production. This reduced production may not be sufficient to meet the needs of the baby and may have to be further supplemented. Once supplementation with bottled milk starts, it means entry into the vicious circle of ever reducing milk production. The use of a bottle to give other drinks to the baby can cause some to stop breastfeeding completely. The sucking action of bottle feeding is different from that of sucking the breasts and the baby will usually prefer the bottle because less sucking is required. After 4 weeks, it may not only effect the milk production but may ultimately even ease the weening process. If contraceptive pills are used during lactation, the hormones of the pill may inhibit milk production.

Expressing milk manually for five minutes gives extra stimulation and results in greater production. In the first few days there will generally be drought of milk. Such a situation is controlled by expressing manually for stimulating production. Expressing manually may also be necessary in case of working women. The milk thus expressed could be stored for upto eight hours and fed to the child.

Food taken by a nursing mother directly effects milk production. Following foods may be tried for increasing her milk flow:

1. Fennugreek seeds (H.Methi) : A gruel of these seeds will help considerably.
2. Alfalfa : It could be taken as sprouts, tea made from seeds or juice of fresh alfalfa leaves. This juice could be taken with carrot juice or some other organic drink.
3. Musk melon : With its combination of calcium, potassium and sodium, it stimulates milk production in nursing mothers.
4. Raw papaya is eaten as a curry by women to stimulate secretion of breast milk.
5. Whole potatoes : When baked or roasted in their skins.
6. Black gram dhal (H.Urad dhal) as also parsley and amaranth increase production of breast milk. Dhal should generally be taken in the mornings.
7. The leaves or seeds of fennel (H. Kala Zeera) boiled in barley water and drunk are good for increasing the breast milk.
8. An admixture made with aniseed (H. Sonf) taken on empty stomach increases both the quality and the quantity of breast milk.
9. Milk of peanuts extracted by wet crushing of these nuts which have been soaked in water for 24 hours. This peanut milk should be diluted before being given to the mother.
10. Diluted grass juice. Nothing else should be consumed for at least two hours thereafter to help assimilation.
11. Garlic, tamarind and cotton seeds also help in increasing milk supply.
12. Soups and red gram also stimulate milk production.

Do not forget that adequate rest, less work, well-balanced diet, iron and vitamin supplements, lots of fluid and manually expressing the milk if the baby does not empty the breasts, are the basic formulae for getting adequate milk supply.

Feeding Postures

A good nursing position is such that you can hold the position for some time without feeling cramped or stiff. Bring the baby to the breast, not the breast to the baby. Baby's body should be face to face with yours. His mouth should directly face the nipple and he should be close enough to take all of the areola or much of into his mouth.

In the beginning and for night feedings it would be more restful to lie down to nurse. Lie on your side with a pillow under your head and one or two behind your back. Use folded cloth or towel under the baby's head as he lies facing you with his mouth at breast level. Your bottom arm can be up and out of the way or under the baby's head. Nurse the baby first on the bottom breast then tuck that breast under your bottom arm and lean over the baby and nurse with the top breast. Switch sides next time.

For sitting position, sit straight up in bed or in a comfortable chair. Position the baby so that his head, chest, genitals and knees all face you. His buttocks should be in one hand of yours and his head should be in the bend of that elbow. Slip your other hand under your breast with all the four fingers supporting the breast without any of the fingers being on the areola. Gently touch the lower lip of the baby with the nipple to get his mouth wide open. Quickly pull his body in so that the mouth fixes on the areola. The nipple should be deep in baby's throat. This way there will be no movement of the nipple when the baby sucks.

If there is pain, insert your finger in the side of his mouth to break the suction and reposition the baby. Do not pull him off the breast. His mouth should cover the nipple fully. If he drifts, wake him, burp him and switch sides.

Only two postures have been described above by way of illustration. There could be many more in keeping with the basic requirements given above. The ultimate position will have to be determined only by you and your baby, one which is convenient to both of you. Positioning of the baby and the breast is of great importance. A faulty sucking position can cause sore or cracked nipples, inadequate flow of milk or even refusal of the baby to feed. If the positioning of the mother and the child is good, the baby's whole body will be turned towards the mother. The sucks will be long and deep. The baby will be relaxed and happy and the nipples will not pain. Be gentle to the baby. Do not hold the head to direct the mouth to the breast. Do not squeeze across the cheeks to get the mouth open.

Frequency

It is strongly recommended that the breast feeding should start within the first hour after delivery. Breast feeding should be continued well into the second year of the life of the child. Breast milk provides energy and protein to the baby and protects him against disease. Such a protection is needed more in the second year when he learns to walk and play and gets ill frequently. Longer period of breastfeeding will lay a solid foundation for a healthy life in years to come. It is a sin to terminate breastfeeding earlier as a matter of choice. Decision to terminate breastfeeding should be a joint decision of both the mother and the child. It should be continued so long as the child wants it and asks for it. If he wants to terminate it earlier than nine months, you and your husband should jointly look into the possible causes of such a termination and try to remedy the situation. Do not be discouraged; Do not quit easily. Try and continue trying. If, on the other hand, the mother asks for it and cannot be convinced to continue, it seems nothing can be done. Milk will not come to the breasts of such a mother in adequate quantity. First thing is convince such an unwilling mother. Then there are cases where the child does not agree to the termination of breastfeeding and must have one or two feeds even after 2 years of age. Advice is to continue with it so long as the mother can manage it. Longer the better. In Indian villages many mothers breastfeed their children for over two years. That is what the tradition has taught them.

Mother produces the most milk in the morning when she is rested. First two feeds should consequently finish by the mid morning. Please remember that breast fed babies, on an average, feed more often because breastmilk is digested more easily and quickly. In the first two weeks feeding may be needed 10-12 times a day. The feeding should not be by the hour. It should be on demand. Do not draw up a programme as to at which hours the feed will be given. Baby feeds to go to sleep again and wakes up to take the feed. On the first day nurse the baby for 5 minutes on each breast at a time till the baby is satisfied. On the second day feed him for 10 minutes at a time on each breast and on subsequent days for 10 to 15 minutes at a time on each breast and feeding must be done at both the breasts on every occasion. After sucking at one breast, burp him, diaper him, if necessary, and then put him to the other breast and then let him drift off. General observations indicate that from 10-12 feeds per day in the first two weeks, he may demand only 5-6 feeds at the end of 8 weeks and 4-5 feeds per day thereafter. The frequency of breastfeeding will be reduced considerably if he is bottle-fed in between.

Milk ducts can clog as a result of tight clothes, fatigue, prolonged periods without nursing or even because of body curves of the mother. It may even result in infection. In such an eventuality besides applying warmth and massaging, allow the baby to nurse on that side more frequently. Baby's suckling will help clear out the duct faster than everthing else. If you develop breast infection on any other count also, do not stop feeding. Instead nurse more frequently. You thus give anti-bodies to the child.

If cow's milk or any other formula is used in the first few days, chances of continuing breast feeding and its frequency are reduced.

Breast Care

A well fitting brassiere is the first requirement for the last few weeks of pregnancy and for the entire period of breast feeding. A good nursing bra should be of pure cotton, with wide opening for nursing, with comfortable straps and not tight across the chest. It should be easy to open and close the bra with one hand. It would be better to have a bra that lets you uncover one breast at a time.

The breasts and nipples need regular and systematic attention three months prior to delivery. The annointing and massage of the nipples prevents their cracking that so often interferes with successful breast feeding. During this predelivery period do not use soap on the nipples. The glands around the nipples will be secreting substances to keep them Clean. Soap will dry them out. Breast massage will prevent clogging of the milk ducts. Nearer child-birth manually express colostrum a couple of times to open the milk ducts and prevent engorgement. The nipples should be toughened. For this rub your nipples briskly but gently with a towel after daily bath. After rubbing take the nipple between your thumb and forefinger and pull it out firmly. Twist or role the nipple between your fingers for a minute or the privacy of your house with your breasts uncovered to expose your nipples to the air. Occasionally allow your nipples to rub against your clothing by going without a bra. Sometimes encourage your husband to stimulate your breasts both manually and orally, as part of love making and enjoy the same. In case of inverted nipples, pre-natal preparation is very necessary. These can often be drawn out during pregnancy. These preparations will greatly help in healthy nursing. If you leak milk, press the nipple into the chest using cotton handkerchief to press it in.

Within 2 to 4 days of the child birth, because of the increased blood supply to the breasts and because of the pressure of the newly produced milk, the breast tissues get swollen. In such cases give frequent feeding. Apply mild moist heat to the breasts for about 20 minutes before feeding. In mid-feeding have a mild massage of the breasts towards the nipples to get milk flowing.

In case of sore or hard breasts or where the breasts get swollen or caked, see that the child does not suck one breast for more than 12 minutes because ordinarily the child should be able to empty one breast in about 7 minutes. Over-sucking will make it more sore. Nurse on the less sore side first. After feeding, prepare pancakes of wheat flour, baking soda and sour milk and supply hot pancakes to cover the affected part fully. Change them and reheat them to complete 15 minutes of fomentation. Alternatively, bake large potatoes, crush them and put the soft potato pulp in a woolen cloth and apply to the breasts as hot as can be tolerated. Continue for 15-20 minutes. Supplement of bone meal and dolomite tables consisting of calcium and magnesium may also relieve painful breasts.

For relieving engorgement, before starting feeding, express a little milk manually. This will soften the breast. Massage the breast once or twice from the outer edge towards the nipple. Apply hot or cold packs before starting feeding.

For treating sore nipples, ensure that during feeding mouth of the baby Covers minimum portion of the areola and some milk is expressed manually before breast feeding. Nurse more frequently. In such cases less sore side may be taken up first. Limit sucking to five minutes on the sore side. To ease pain, apply ice to your nipple just before a feeding. Use vitamin E, pierce a capsule, squeeze out a drop and rub in into the nipple after finishing nursing. Do not wipe away any milk left on your breast after a nursing. Let it dry there. That milk at the end of the feed is high in lubricants and contains an antibiotic. Do not use soap, alcohol or tincture of benzons on your nipple. After bath expose your nipples to the light of a 60 watt bulb for 10-15 minutes. The most important thing in this behalf is to keep the nipples dry by exposing them to open air, Change nursing position so as to change the pressure of the child's mouth on different sides of the nipple.

For treating a clogged duct, feed more often and longer so that the baby empties the breast. Change position from lying to sitting. Express manually the affected breast after each feeding. Offer the sore breast first. Apply moist heat. Do not sleep on your stomach as that will put pressure on your breasts. Continue to nurse. Do not stop.

For cracked and sore nipples, after nursing, apply molasses on the nipple. This treatment will never fail you. The other cure is to apply gelly made with the seed and white substance at the centre of quince (H.Behi). Soak the seeds in a little hot water, Strain off seeds before it becomes too thick. Apply that gelly. You may avoid cracks if you apply a little olive or peanut oil as often as you remember and certainly after feeding.

Miscellaneous

American Folk Medicine by Clarence Meyer says "Sage (herbal) tea given in cold infusion will, within a few days, cause the milk to leave the breasts". This is, then, the way to stop producing milk, when so considered necessary and urgently. Otherwise, if the breastfeeding is stopped, your body will stop creating those hormones and milk production will taper off. For this reason, if you need to stop breastfeeding temporarily, you should keep expressing milk manually so that the production continues in the body. Working women should expel some milk at place of work when they cannot hold it any more. On reaching home, expel little more milk, wash the breasts and then feed the baby.

If your breasts sag or are small, develop the pectoral muscles. That will make the breasts seem larger and firmer. To accomplish this, Maggie's "Woman's Book", prescribes the following exercise:

"Lie on your bed. Rest the upper arm on the bed and bend the elbow so that the hand is straight in the air. Put up your elbow and swing your arms in and down towards your thighs, circle them back up. Start making small circles, working slowly towards your thighs, and back up, then circle in the other direction. Repeat this exercise in each direction a few times. Now find the position where you feel the muscle is working most and work there. To trim down or to keep in shape do just a few circles each day with light weights in hands" besides firming the breasts, this exercise may increase milk cells as well.

Pay close attention to your nutritional needs. You expend about 1000 calories a day in breast-feeding during the first five months of nursing. These calories have to be met mainly by increasing the protein foods by 50% and dairy foods by 100%, fat intake remaining the same. Take lots of fruits and vegetables as also whole-wheat bread besides foods which increase foods which increase the milk production. Special attention must be paid to the intake of adequate quantities of calcium and vitamin D. Non-fat dry milk and, for non-vegetarian mothers, white of egg are goof foods for the period of nursing. Fluids, that is, water, milk, soups and juices should be taken in abundance, Great care should be taken to see that you do not put on extra weight. Also please see that you peel or thoroughly wash vegetables to get rid of pesticide residues and avoid fat rich dairy products. Avoid caffeine. Avoid cabbage family vegetables because these produce gas. Please remember that it takes about 4 to 6 hours before the food eaten by the mother effects the milk of the breasts. Avoid dieting. If you are not already much overweight, do not lose more than one kilogram a month while you are nursing. Moderate exercise is necessary during this period. It could be generally taken after nursing. You could go for walks, and your child, on many occasions, could, in a pram, be your exercise "buddy".

There is no single optional time for weaning. Wean when your baby loses interest, after a minimum period of six months at least. Weaning should be a mother-child decision when there remain no nutritional or emotional reasons to continue brestfeeding. Then do not offer breast, nor refuse it. If mother wants to withdraw, then bottle milk is better than nursing at a grudging breast. For easing the weaning process, make nursing sessions shorter. Use distractions before and while nursing. Give attractive and favourite other foods before starting breast feeding. Invite his playmates just before nursing hour. Give him lot of affection during those activities. In the process of reducing nursing, first discontinue those sessions which are inconvenient. Continue talking to the child about a deadline for weaning because he was now a "big boy". Give examples of others. Do not use traumatic techniques. Nurse occasionally when the child implores. These suggestions for weaning have been given when weaning becomes necessary for medical reasons or because of certain conditions of the mother. Otherwise continue nursing, especially when the child wants it. His emotional sucking and proper food for the mother are likely to continue enough milk for him.

More important than all the benefits of breast feeding given above are the physical and emotional bonds of the most intimate nature created between the mother and the child by that skin to skin and eye to eye contacts between the two. It provides the most gratifying experience for both of them. Nursing does not provide food alone. It also provides the warmth, the love and the motherly unspoken reassurances that he can always fall back upon her for comfort, when-ever needed. It makes him the child of the mother for whom she can sacrifice anything. Mothers who have not nursed for a full term do not know what they have missed!

Feeding and Nutrition

Good eating habits start young. Food provides the raw material for growth. Nutrients provide for a healthly immune system. There are a number of important ways in which a child's food requirements differ from those of an adult. Children grow at a tremendous rate and need much more energy in proportion to their body size. High fiber and low fat diet is not suitable for children under two. Toddler's small stomachs full up quickly and fiber rich foods may fill them without providing enough calories. For them more important are energy rich foods such as fats and dairy products. Janet Coleman of the British Dietetic Association believes "One of the most important are energy. Restricting fat reduces their caloric intake. After the age of two, if the child has a good diet and adequate caloric intake, you can reduce the amount of saturated fat they eat". Dairy products are a good source of protein and calcium and they provide calories. Encourage them to have milk, yogurt and cheese with meals and between meals.

Breast milk is the best for the child. He must be fed on that as much and as frequently as possible. The more the child draws on this source of food, the more milk will be produced by the mother's breasts. If and when the child reduces his draw on this source, the supply gets reduced in geometric progression. It is therefore, extremely desireable that the demand of the child on his mother's milk is not reduced. Utmost effort must be made not to bring in cow's milk goat's milk or some formula milk to supplement the mother's milk in the first four to six months of the child's life. Concentrate efforts on the various steps mentioned in the chapter on breast feeding to increase breast milk. If all efforts in that direction fail to give results then perforce milk will have to be fed from the bottle.

Bottle Feeding

Most popular form of milk for the bottle is the cow's milk delivered to your door step by your friendly and reliable milkman. It should be boiled, sterilised and diluted with water. It may be sweetened with very little sugar. Use a clean funnel to fill the bottles if necessary. Warm the feed to about 38 degree C (100 degree F) by placing the bottle in warm water for a few minutes. The bottle may not be heated otherwise. Bottle-feeding is simple but make sure that the baby can swallow properly and that he does not take in air with the milk. It is diffcult for the baby to swallow when he is lying flat. In that position he may even vomit. Do not try to force the baby to finish the bottle after he has stopped sucking. The baby knows when he has had enough. Hold the bottle at such an angle that the nipple is always full of milk. That will ensure that least amount of air is swallowed. It is better if the baby is in an upright or propped up position while being fed from a bottle. Babies feel happier when burped. Burping makes you relax, slow down, hold your baby gently, and stroke or pat him, and this is good for both of you. Do not give your baby a bottle full of milk in bed. His teeth will get discoloured and full of cavities. If he needs a bottle as a 'lovey' to go to bed with him, give him a bottle with water. Fortify the milk of the bottle with vitamins and iron.

Wash the bottle soon after use. Rinse every thing. Use brush for the inside of the bottle. Nipples should always be washed by hand. Needle or tooth pick should be twished in each nipple hole. Boil the nipples and caps for five minutes. In selecting the nipple ensure that it is the standard one which releases the milk at two drops a second when the bottle is held upside down.

Solid Foods

More children are being fed solid foods at an earlier age while nutritionists encourage a delay in introducing solid foods at least into the second half of the first year of life.

There is a temptation to feed solids as early as sixteen weeks. Such a premature attempt to introduce solids during the first four months invites enough to handle solids competently. His tongue protection and lip constriction patterns are so dominant that they interfere with normal swallowing mechanisms. Solids, if given early, upset the mother's milk balance also. It may result in marked reduction or over production of the mother's milk.

Not until 20 to 24 weeks is the baby likely to mature and interested enough to handle solids. At this period the mother is capable of maintaining an adequate milk supply over a full 12 hour interval without the stimulus of the infant's sucking. There is a special advantage if the child persists in demanding an early morning feed.

For giving the first solids begin with the mid-day meal. Start by feeding him from one breast. Then give him one or two teaspoons of food. After that give him to other breast. Then give him one or two teaspoons of food. After that give him the rest of the milk. As soon as the baby starts having any quantity of solid food, start with 20 millilitres of water at a time. You may feed him upto 100 millilitres of water during a whole day.

Start with home prepared cereals. It is best to start with rice as a cereal, well cooked and mushed. Wheat should come after a few months of the first rice feeding because wheat causes allergy more often than other cereals. Fruit is often the second solid added to the diet after cereals. Babies take to fruits enthusiatically. Banana should be very ripe. Mash it and add a little milk to it, if necessary. Stew the other fruits for the first few months of solids. You could add apples, pears and apricots etc. Postpone grapes till he is 2 years old. You could include fruits even twice a day.

Strained cooked vegetables should be the next to be added to his diet. Start with carrots and sweet potatoes. Squashed turnips and onions should be started late and spinach should be taken up even later. If a vegetable causes looseness or mucus, postpone taking that vegetable on board by a month or so.

Introduce solid foods gradually-one food at a time. Introduce a second food after a week and another one every week. This will provide a clue if he is allergic to some foods. Consistency of food is very important. The food should be in a thin and creamy form. Babies hate lumpy foods.

Learning to chew comes later. Foods should not be bulky. These foods should be energy rich with fats in the form of butter, cheese etc. You must ensure that he gets the fuel for growth. Dried fruits are also concentrated caloric source- could be wetted and mashed. Do not add any salt or sugar to any of these foods. Let the tastes formed be in favour of low salt and low sugar content, Egg yolks are out unit six months and egg whites until one year due to allergy risks. Do not start including refined foods. Start with complex carbohydrates. Serve fruits, not puddings. Put cooked vegetable through a blender or a sieve. Always prefers home prepared foods. Do no feed him on food from jars. Never forget that baby tastes are being formulated every day and that baby tastes are different from the adult tastes. Cater to the taste of your baby.

Finger foods may be introduced at age 7-8 months. A small portion of a carrot stick and crust of a whole-wheat bread are good. These provide good training.

Shift to chopped foods gradually. All babies choke a little as they get used to eating lumpy foods just as the babies fall while learning to walk. No problem. Add eggs to diet only after 9-10 months. Never give a raw egg. Egg can be given with any meal if the baby likes it. Egg could be given along with cereals. Do no give more than three or four eggs a week.

In fever do not feed solids to the baby. Must curb the quantity of sucrose and fizzy drinks that the child is likely to demand. For sweetening foods use honey, or dates, etc. If the babies do not begin to bite and chew food around 6 to 8 months age, they are likely to resist longer. Parents should aim to have a baby weaned off sloppy foods and start eating family meals by the end of 18 months. Learn to say No to junk food. If parents give in to the children into bad eating habits. Wean them from biscuits sweets and crispies and try them to get attached to cheese cubes, grated cheese, raisins, slices of apples and pears, bananas home-made pop corn without salt or sugar rice cakes carrot sticks and grapes etc.

Feeding Battles!

At about one year and with walking ability and with a negative attitude towards almost everything, starts the struggle between the child and the parents. Endangered relationship starts to go beyond food. It goes to dropping food and even smearing messy foods. When the child gets on the war path, you should try to get out of the struggle. You cannot win and you really should not win. Do not take the baby's resistance personally. You should allow the child necessary freedom to explode, to refuse and to test limits. After the very first bout remove the food. Soon he will begin to eat again.

Fix limits on how long feeding will continue and stick to those limits. Getting him to eat more is not important enough to justify the toddlers walking around while eating. Total development of the child is more important. The baby will survive nutritionally a few missed meals. Feeding should not develop into battle ground. Evolve a system and a routine. After a particular age, adopt regular feeding times if you want to avoid battles. Give up the idea of feeding on demand in the early months. Have no snacks in between. After a maximum feeding time of, say, 20 minutes, put the toddle down and put away the food. Give small amounts of food at a time. When the child finishes that, give more. As soon as he get attention by his food, end the meal. The child wants to get attention by his provocative behaviour. He is not after more food. You should deny him such an excitement. Instead of feeding battles, feeding should be a pleasant communicative area.

Faulty management may be the cause in some cases. Parents should not be disturbed by periods of stationary weight. The subtlety of body chemistry and child behaviour are one. The poor eater may manifest himself as early as 12-16 weeks. He may be a vomiter. He insists on being fed the same food, the same way, at the same place by the same person. He is a poor eater. It is this very person who generally likes to enter the feeding battles. By about 4 or 5 years of age, such a child also outgrows much of his indifference and propensity to fight.

After two years the energy needs of the children reduce dramatically and they start asking for funny foods. They would much rather play than eat. On this new battle front your strategy has also to change. If the child refuses food, do not press. One missed meal will not hurt. Make food look attractive. Offer small portions at a time. Do not rush the child. Put a small amount of every thing on the plate, even if some food items have been rejected before. Say no to food that are a waste of stomach space. Offer raw vegetables and attractive salads before the regular meal. This could be the start of eating healthy foods - no fried stuff, no white refined wheat products, no sucrose rich or salty foods. Give children under two, full cream milk of cow or goat. From age two introduce low fat milk.

Nutrition Tips

Fruits and vegetable are most nutritious when fresh. Peel tough skinned fruits and vegetables. Cook soft skinned fruits and vegetables in their skins so as to retain their vitamins and fiber. Cook fruit and vegetables in steam or in a tightly covered pan with as little water as possible. This helps to retain the vitamins which are otherwise lost in cooking. If you want to give meal to the baby, cook and puree it and thin the puree with vegetable water or soup. Use poly - or uni-unsaturated fats. Limit the use of butter and saturated fats after 2 years of age. Enrich mashed vegetables with little fat.

Do not buy burised or wrinkled fruit and vegetables. Do not soak them in water. Just wash them. Do not overcook foods. Cook food just before eating. Let the food go directly from the fire to the table. As it is usually not possible to cook fresh food for a child five or six times a day, cook three times a day. Fill the remaining three slots with breast feeding, dried foods, fruits, bread, nuts and other clean home-made snacks which can be stored for long periods.

The child needs energy for basic metabolism of the body at rest, for baby activities, for processes of digestion and excretion and for growth. The figures given below are meant to indicate to you the requirements of an average metabolism and average activity. These figures do not limit you because your child may have a metabolism wherein he burns more calories or may be hyper-active and thus need more energy:-

Over nutrition could be as harmful as under nutrition. Just to give you an Idea, one gram of fat yields 9 calories, one gram of protein 4 calories and one gram of carbohydrates 4 calories.

When consulting tables of representative values of foods for nutrients, do not forget that those values are based on averages and in fact would depend on the amount of nutrients in the soil on which those foods were grown. Another variable factor is the physical capacity of the child as to how much energy, fat, protein etc he can extract or draw from the food he eats. Those tables are just for you general guidance.

Prefer foods on which no insecticides have been sprayed and which have ripened on the trees and not ripened by use of chemicals.

Shakespeare, in Hamlet, provides a tip in this behalf when he says, "Fruit unripe, sticks on the tree; But fall, unshaken, when they mellow be".

In childhood, adequate intake of vitamins A, B and C is necessary Natural sources of these vitamins are: vitamin A-yellow and green fruits and vegetables, milk and milk products, egg yolk and liver. Carrots are very rick in vitamin A; Vitamin B (generally B2, B6 and B12)-whole grains, milk, legumes, liver, brain, banana, peanuts, raisins, eggs, fresh fish, meat and yellow and green vegetable. Vitamin C - citrus, papaya, mango, tomatoes, potatoes and other fruits and vegetables.

Immunization

Child population in India in 1996 was 307 million. The infant mortality rate in 1971 was 129 deaths per 1000 live births. This got reduced to 79 per 1000 live births in 1992. In that year, under 5, mortality rate was 124 per 1000 live births. 103 countries have a lower infant mortality rate of under 5 than India. In India Kerala's IMR was the lowest. In India six killer diseases of measles, whooping cough, tetanus, polio, diptheria and T.B. account for almost half of the mortality vaccines. If your child is not so protected he has 6 to 8% risk of falling a victim to one of these diseases by vaccines. If you child is not so protected he has 6 to 8% risk of falling a victim to one of these disease, and that is a substantial risk! It is, therefore, essential that all parents know what are these diseases about and when can these vaccines be administered to their child. Let us talk briefly about these diseases.

Tuberculosis

It is high bacterial infection that most commonly affects the lungs. It can also affect joints, bones, kidneys etc. In childhood tuberculosis takes other forms. It causes symptoms such as fever, irritability, poor appetite, fatigue etc. In later childhood it is less likely to cause serious trouble. If, however, left untreated, can cause death. Treatment is with antibiotics. Immunization is with BCG vaccine which can be administered at birth or soon thereafter. A sore or a pimple develops at the BCG site after about a month. This dries up in 2-4 weeks and needs no treatment.

T.B. is among the ten top killers in India. Overcrowding and poor environmental hygiene are some of the causes of T.B. It spreads amongst children when its germs spread with the coughing of the T.B. patient. Children who are listless and malnourished without an obvious cause should be investigated for TB. Good nutrition is important in resisting TB infection. Improve the nutrition of the borderline children.

T.B. can be cured. Preventing T.B. is better than treating its serious consequence. It is important that the treatment is continued as long as it is advised. In cases where it is discontinued due to neglect, the person becomes resistant to those medicines and in many such cases he cannot be helped. It is very important that the infected persons cover their mouths and noses while coughing and do not spit out the sputum except in a receptacle contents of which are either burnt or buried.

Polio

The disease begins with a general sick feeling, fever, headache, diarrhea and vomiting. A few cases on to paralysis. If there is any paralysis remaining after the acute stage of the infection is over, it must be brought to expert medical attention.

An unimmdnized child will almost certainly be infected with the polio virus. And for every 200 children who are infected, one will be crippled for life. One-third of all cases of polio occur before the age of one year. At birth or, as soon as possible thereafter, when the baby is immunized against T.B. with B.C.G, a first dose of polio vaccine should also be given at that time. This is taken by mouth. There are three types of virus that can cause polio. A person has to take all three types of vaccine to be completely protected. Each time a trivalent (three type) vaccine is given by being directly dropped onto the tongue. Three other dozes of polio vaccine should be given at the ages of 6,10 and 14 weeks. Polio vaccine should also be given at 1 ½ years of age. If there is delay between the dozes, the risk is only during the period of delay. The protection will eventually be as high if all the dozes are given. This vaccine can be given at the same time as shots against DPT. In some cases a booster dose is given at age give. Effect of that lasts for five years.

Diphtheria

Diphtheria is a serious and highly contagious bacterial infection but it is a completely preventable diseases. Enlarged tonsils are generally covered by a gray membrane which look like dirty white patches. Some times it begins in the larynx with hoarseness and barking cough. The child may have mild fever, breathing difficulty, sore throat and cough DPT (Diphtheria, purtussis i.e. whooping cough and tetanus) vaccine has, in the West, made it a rare disease. If attended by breathing difficulties, hospitalisation would be recommended. Without treatment this disease can cause pneumonia and even heart failure. DPT, the vaccines against the above mentioned three diseases are combined and given in a series of three shots, 4 weeks apart, starting at age 6 weeks. The protection from these three shots gradually tapers off and a booster shot given at age 1 ½ years and another shot of diphtheria and tetanus given at age 5 years and at intervals of 10 years thereafter. A small lump or ?knot' may form in certain cases at the place where the child received the shot. It may remain for several months but nothing to worry about. Some doctors recommended giving acetaminophen at the time of the shot to reduce significantly the soreness and fever associated some times with these vaccines.

Whooping Cough (Purtussis)

This is a cough with a distinctive "whoop" sound as the child tries to breathe. It is a bacterial infection which clogs the airways with mucus. It may be accompanied with common cold symptoms and vomiting. The child may cough eight or ten times on one breath. Whooping cough could last from 4 to even 8 weeks at a time. The main dangers at this young age are exhaustion and pneumonia. Whooping cough takes from 5 to 14 days to develop after exposure to infection. Fatality from this disease is very high. DPT vaccine generally proves effective in the prevention of this disease. Details about DPT vaccine given in the para on diphtheria apply. Due to the success of immunization programme, it is east to forget how prevalent diseases like whooping cough and polio once were.

Tetanus

Deep cuts or punctured wounds may be contaminated by the street dirt or soil that contains cattle manure. They may some times carry the germs of tetanus (lock jaw). Tetanus germs grow in dirty cuts and generally kill most of the people who become infected, if they are not immunized. Doctors, in case of such wounds, recommend a booster tetanus shot immediately. Delay in getting the shot may prove fatal in some cases. DPT vaccine proves effective, if taken in earlier stages. Details about the use and effect of this vaccine are given in the para on diphtheria.

When mothers give birth in unhygienic conditions, both the mother and the child are at risk from tetanus, if the umbilical cord is cut with an unclean knife or if any unclean article is put on the stump of the cord, tetanus can grow. If the tetanus germs enter the mother's body, and if she is not immunized against tetanus, then her life will also be at risk. All women should get immunized against tetanus before or during pregnancy. As a matter of fact all women of child-bearing age should get immunized against tetanus. A first dose of the vaccine should be given as soon as pregnancy is known. The second dose can be given 4 weeks after the first. No dose should be given in the last 2 weeks of the pregnancy. A third dose should be given 6 to 12 months after the second dose. These 3 tetanus vaccinations protect the mothers and their new born babies for 5 years.

All infants should be immunized against tetanus (which is included in DTP) during the first year of life. He should be given a booster dose at 11/2 and 5 years of age. Tetanus is a major killer of the new born. If the mother is not already immunized, then one baby in every hundred will die of this disease.

Measles

It is a highly infectious and potentially serious viral illness. Measles for the first 3 or 4 days has no rash but the eyes are red and watery. Brownish red spots appear behind the ears and then spread to the rest of the body. White spots appear in the mouth. After 3 days of the rash things should start improving and patches begin to fade. They take about a week to go away entirely. If the fever stays or returns, doctor must be consulted. Bed rest and plenty of fluids are recommended. Complications could be ear and chest infections, vomiting, diarrhea and possibly pneumonia. 3-4 times a day rinsing of the mouth is also recommended. Keep the room warm. Light poses no danger.

An unimmunized child is likely to get measles. It can kill. Children who survive this disease are weakened and may later die from malnutrition or other illness. Measles is also an important cause of malnutrition and blindness. A quarter of all deaths from measles occur before the age of one year. Measles is one of the most dangerous of all childhood diseases. For the first few month of life, the child has some natural protection against measles, inherited from the mother. This interferes with the measles vaccine. But after nine months, natural protection comes to an end. The child is now at risk from measles and can and should be immunized. So it is vital to take a child for measles vaccination as soon as possible after the age of nine months. Measles vaccine has made a great impact and many countries are without cases of this disease.

The first symptoms of measles begin to appear from 1 to 16 days after exposure to the infection. It is contagious for others from the very beginning of the cold symptoms. One attack of measles confers immunity for life.

General

Immunization protects against several dangerous diseases. A child who is not immunized is more likely to become undernourished, disabled, and open to greater mortality risk.

• The vaccines work by building up the child's defences.
• Breast feeding is a kind of natural immunization against several disease. Some of the mother's resistance to disease is passed on to the child in her breast milk, and especially in the thick yellow milk (called colostrum) which is produced during the first few days after the birth.
• All primary immunizations should be completed in the first year of the child's life.
• If, for any reason, a child has not had all the vaccine doses in the first year of life, it is vital to have the child immunized as soon as possible thereafter.
• It is safe to immunize a child who is suffering from fever, cough, cold, diarrhea or some other illness or malnutrition. Any advice against giving the injection is wrong.
• After an injection, the child may cry, develop a fever, a rash or a swelling at the site of injection. No worry. As with any illness, a child should be given plenty of food and liquids. Breast feeding is especially helpful.
• Every woman between the ages of 15 and 44 should be fully immunized against tetanus.
• Parents, please note that a child should be taken for immunization five times in the first year of the child's life.

Immunization Schedule for Children As recommended by Unicef, WHO and Unesco

Parent Child Relationship

Attachment is the connection between two persons who are attuned to each other's presence, wants, needs and feelings. Attachment provides the emotional foundation of your baby's personality. The way you play together, the sounds and gestures you make to each other, the way you look at each other, all contribute to those feelings. Strong attachments are formed in the first six months. Little babies are remarkably responsive at birth. With their gurgles and seductive use of their eyes, they can win over anybody. Their eyes tell you more than any amount of words. Body language is big in babies. The period just after birth is an important one. There are those who believe that it is a critical period for human bonding. Bonding then is reciprocal. Between 4 and 6 months the baby starts recognizing and wants mom and mom alone and no one else will do. He is so seductive that it makes love ooze from every pore of the mom's body. These are the beginnings. Lasting relations come with time, closeness and commitment.

Warmth

Warm loving parents create warm loving children. Touch, hold, carry your baby. Be close. Be just there, Talk. Chat and talk some more. Even the tiniest tot needs words, words which he interprets on the basis of the body language that accompanies those spoken words. These spoken words are so powerful that they help wire his brain cells and contribute to his intelligence quotient. If in jest the dad roughs up the baby, his reaction is -how wonderful! He wants it repeated. Education is not just 3 R's which will start later. Education also means and includes social competence, communication and, more than anything, love, pure love. Loving is the best lesson which is learnt in those early days. With loving parents, the baby in coming days learns honesty, decency and good manners. Play is a great way to learn also. Confident parents produce more confident children. Parents with a goal and purpose in life produce excellent children. With parenting it is the quality that counts. Thus come into existence the parent child connections.

Harvard Pre-school Project of 1960's revealed the following common denominators amongst the mothers of the best children. These mothers had a positive outlook on life; these mothers were energetic, patient and tolerant of their children. They did not prevent their children. They did not prevent their children from taking minor risks in play. They did not devote all their time to their children. They did not pamper their children. They designed interesting games and play environment full of stimulating objects and learning challenges. Those children were in C group if their mothers spent either very little or all their time with their children. What is important is not only the quantity of time but also the quality of how it is spent. Children often mirror their mothers behaviour. Children of depressed mothers are generally depressed and the mothers with a positive outlook definitely imbue their children with a positive and optimistic view of life.

John Hopkins researchers Silvia Bell and Mary Ainsworth came to a conclusion that the most effective way to soothe a crying baby is to pick him up and hold him. If that does not work, feeding him may. The team found that when mothers responded promptly and consistently to their babies' cries, the babies generally stopped crying and became increasingly independent.

The parent has first to understand the purpose of the child's behaviour, and then have a relationship of mutual respect. Be firm but kind and occasionally talk about the child's good points. Parents should take a note of their own inadequacies. You should talk less and act more, looking at the world from the children's point of view. Treat kids as persons. Respect kids and require respect in return. Parents have to teach by example, especially in the fields of work ethics, devotion to family, generosity to others and voluntary selfless service. Teaching by example does not ride over teaching by telling. Kids always need our word also as to why we do what we do. One of the important tasks of the parents is to put the kids on the road to thinking what should be done and why. This thinking process could be initiated at an early age - starting with loud thinking by the parent describing in simple words thinking that is involved. This could be followed, in later years, by placing a simple problem facing the child and enumerating two or more possible lines of action and then leading him to come to an acceptable solution. This has to be followed by helping kids take on real responsibilities. This has to be a slow process but must be started before the rebel in the child comes out at the age of two. The child must be given independence but he must simultaneously be controlled when he starts destroying hedges. Control and independence have to be properly balanced.

The time for a child to join the human community is the very first year of his life. Moral development begins in love. Loving babies means a lot more than holding them or comforting them. It means with what feelings and involvement you feed the child and in what manner you introduce a new food. By loving children when they are babies, we help them not only develop positive relations with their parents but also with human beings in general. Love leads to learning. When a baby is picked up and put to a shoulder, he just does not stop crying but also looks around. He explores the world from that shoulder of love with eyes which are misty with love. Love is always needed. It is never too late to start love. Love lights the lamp of human development. Research has shown that the most obedient babies were of loving mothers who were sensitive to baby's signals, could see things from the baby's point of view and cared for the baby's moods, wishes and activities. Parent child relationship is very important in building self-confidence and self-respect amongst children. It is also crucial to their emotional growth, in their learning manners in the growth of intelligence amongst children as also in enforcing discipline when they go wrong. The role of the parents in those areas has been taken up in the sub-chapters dealing with those subjects and is not proposed to be repeated here. Hostility under the surface of children of 2 years age lessens after three. Children around three have reached a stage in their emotional development when they feel that their parents are wonderful people. At the other end, whatever good the mothers and fathers instinctively feel like doing for their children is usually the best for them. With these attitudes, the parents keep lines of communication open with their children. The parents listen to what the children have to say and the parents get children to listen to them. There is no tone of hostility and the talk is restricted to friendly conversation. Love and affection again come to the surface after having suffered and eclipse for a couple of years in between. The parents are eager to make the child happy, the happiest baby, because they hear Dr. Wilde proclaim: "The best way to make children good is to make them happy"!

Discipline

A child below three cannot respond to reason and he cannot grasp the connection between cause and effect. He understands when he has gone worng. He also understands that you are angry. Do not forget that the child's memory is very short and if you postpone action on his wrong, he will later on not be able to appreciate the cause for the cause for the punishment. Children thrive equally well on both strict and permissive discipline. What they cannot take is inconsistency and the parental conflict. The job of discipline a small child is the most difficult but is also necessary. Discipline is needed for 2 or 4 year olds when they are getting into all sorts of unsavoury situations, but it is different in case of a 10-month old. You cannot treat him like an adult. Punishment is not for such babies.

Discipline should first be applied with the tone of your voice, later with the word "No". Thereafter distraction should be applied. A very mild punishment could be meted out as the last resort. Threats, withdrawal of pleasure and spanking have no place for young children below 2.

Spanking is not good. No doubt it is an assertion of the parental authority which can deliver a jolt that sometimes brings the child out of the defiant behaviour. Spanking may help where nagging and yelling have failed. Spanking may control a particular behaviour but try some other possible actions before spanking. Only one or two spanks are enough. Never hit with any thing harder than the open hand. Never spank children younger than 2 or older than 4.

Even in disciplining, a current of love should continue to flow in all that you do. This could also be mentioned occasionally. Do not lose your sense of humour. It is bad to be overly punitive or being too strict. Do not confuse harshness as firmness.

Start to introduce routines and good habits from an early age. From the end of first year start to mould the behaviour. Praise and reward good behaviour. In matters of sleep, be as firm as is needed to keep peace. You should on a proper occasion discuss in details the limits upto which the child could go. Tantrums, not eating, not going to bed are all bids for getting some recognition or concession from you. But if the ground rules have been laid with mutual consent, the child has just to be reminded and required to honour the earlier concessions. In all this disciplining do not forget the basic role of the mother to feed the hungry, comfort the crier and lift the grumbler. Even in the midst of a conflict with your child, do not abandon your privilege as a mother to forgive and forget, ignore minor misbehavriour. Do not remove a privilege for too long.

Get your own act together, try to remain calm, and then teach and discipline through love and example. Your baby will be very receptive to justice and fairplay. Parents who have to punish a child frequently, themselves need help.

Body Ailments

Illnesses are important factors holding back a child's growth. Some ailments are very common and some account for a greater portion of the under 5 mortality rate. For raising of a healthy child the mothers must know basic facts and know how to give First Aid before the physician comes into the pricture in case of some of these ailments and problems. Some of these body ailments are dealt with hereunder:

Diarrhoea

"Acute diarrhoea is one of your body's best defence mechanisms. It's your body's way of getting some thing nasty out of your system!" Lyun McFarland
University of Washington
Medicinal Chemistry

Purge is consnidered beneficial and helps speedy recovery. At the same time diarrhoea can kill a child by draining too much liquid from his body, if you are not vigilant.

Intestines of the infant are sensitive for one or two years and can be upset by milder germs even. A new food or too much of fruit juice can cause such an upset. But this kind of upset is usually mild. There could be a couple of extra loose stools greenish in colour and different in appetite. In such cases the symptoms are gone in a couple of days without any special treatment.

Chronic diarrhoea may begin spontaneously or with a stomach flu. These are soft, runny and smelly bowel movements, four or five in number. These may have mucus or undigested food also therein. These are the signs of the irritation of the intestines resulting in the refusal of food by the baby and repeated watery, green and smelly stools, sometimes even with pus and blood therein. The baby has a temperature of 100 degree F (38 degree C) or more, is listless and has dark ringed eyes. If the fontanels on the head are depressed, this is a sure sign of dehydration. Possible dehydration must be treated immediately.

It is essential to give him plenty of liquids. Avoid milk products other than yoghurt. Avoid carbonated drinks, jelly, too sugary drinks, apple and other juices. The best drink for such a situation is the mother's milk, 'daal' water, water from 'khichri', butter milk or lemon water and water with both salt and sugar.

An effective drink for diarrhoea can also be made by using eight level tea-spoons of sugar and one of salt dissolvd in one litre of clean water. This is the simplest to make. Do not alter the proportions.

A special drink can be made by using a packet of ORS-oral rehydration salts available from pharmacies and Health Centres. Dissolve the contents in the amount of water indicated on the packet. If you use too little water, the drink could make the diarrhoea worse. If you use too much water the drink will be less effective. Give this to the child to drink from a cup or a spoon. Do not add O R S to other liquids such as milk, soup or soft drinks. Other alternatives are weak tea and green coconut water. If nothing else is available, give water from the cleanest possible source. Though plain water is difficult to retain but it is better than giving no liquid whatsoever.

Give these liquids every time a watery stool is passed or a vomit is made. Dose-between a quarter and a half of a large cup for older children. If the child vomits, wait for ten minutes and then begin again, giving the drink slowly in small sips at a time.

Continues these extra liquids until the diarrhoea has stopped. This will usually take between three and five days. Continue to nurse the baby if you are breastfeeding. If you are bottle feeding the child add equal quantity of water to the usual bottle content. This extra dilution should be stopped as soon as diarrhoea stops.

Discontinuting of soild foods during diarrhoea is wrong. The child's appetite is low so he will have to be tempted to his favourite foods. These should be well meshed, softened pulses or vegetables, mashed potatoes, strained cooked carrots or ripened bananas or other fruits like mangoes. Food should be freshly prepared and given five or six times a day in smaller quantities.

In many countries yogurt is used as a treatment for diarrhoea. The friendly bacteria in yogurt called acidophilus tends to help normalise bowel functions. Yogurt has an antibiotic effect, especially against E. coli, the main cause of traveller's diarrhoea. Bran also helps normalise the bowel function. Bran helps relieve both constipation and diarrhoea. Bran thickens the loose stool of diarrhoea and softens the hard dry stools in constipation. Bran may help in diarrhoea though not recommended as a part of the normal diet for infants.

Most medicines for diarrhoea are either unseless or harmful. Do not give any medicines unless prescribed by a trained health worker.

After recovery from diarrhoea, the child would need extra food for the nourishment lost. Feed and food may be increased for about a weak.

Diarrhoea can be prevented by keeping food and water clean and by washing hands before touching food. Use latrines or bury the faeces. Bury or burn all refuse to stop flies spreading disease. Cover food and drinking water as a protection from germs. If cooking was done more than 11/2 hours before consumption, heat the cooked food to 75 degree C before eating.

In case of young babies the greatest danger from diarrhoea is dehydration. Some signs of dehydration are sunken eyes, extreme thirst, no tears when the child cries, depressed fontanels on the head, not eating normally and vomitting frequently, passing several watery stools in one or two hours and sometimes passing mucus or even blood in stools. In such cases seek qualified medical help.

Infantile Colic

In colic a baby cries inconsolably for several hours on end, often putting his legs up to his chest as though in response to intermittent periods of abdominal pain for which no organic reasons can be established. These are period of estreme fussiness associated with clenching of first and flexing of legs, belching, passing of gas and stomach rumbling. No one knows for certain what causes colic. There is no pathological explanation. It cannot be measured by blood tests or medical machines. It amounts to a pattern of unsettled behaviour. Inspite of all this colic is a very real condition which leaves the parents at their wits end. Ceaseless inconsolable crying transforms the confident, optimistic happy parents into demoralised defeatists. In colic the crying is generally of a high pitched screams. It is not known why it happens but it usually starts after the first three weeks of the baby's life. These spells last for about 12 weeks and then colic disappears as mysteriously as it begins. All babies always get better in the end.

In the matter of treatment of colic it is important for the parents to recognise that the condition is fairly common, does not do the baby any permanent harm and will go away in 3 months time. If the parents can, therefore, accept the condition in a fairly calm and resigned way the battle is half won.

In this behalf the good news is that babies with colic are generally healthy children. They eat and sleep well, gain weight normally and show no ill effects from the colic.

For treatment no drugs are needed. The baby may be soothed by any rhythmic activity such as rocking, swaying, being taken in the car for ride, in a swing, a rocking cradle or a rocking chair or putting him in a sling. Vibration, thus, some times, soothes a colicky baby.

Ann Price of National Academy of Denver Colorado suggests "Extend your forearm with your palm up. Then place the baby on your own arm chest down, with his head in your hand and his legs on either side of your elbow. Support the baby with your other hand and walk around the house with the baby in this position. It definitely helps".

Wrapping the baby snugly in a blanket has a calming effect. It is used extensively in some countries. Warm bath and heating pad applied to the abdomen could also help.

Some people slice an onion and dip it in hot water. Give the baby a tea spoonful of the onion water a few times a day. Burp the baby frequently while feeding.

Maternal diet should, during the colic days, be free of cow's milk. In colic it reportedly went when intake of cow's milk was given up both by the mother and the child. This is worth a trial. Some contend that the caffeine and spiced foods in the mother's diet could be the culprits.

Colicky babies are usually more comfortable on their stomachs. They get relief so laid across the parent's knees or on a hot water bottle and massaged at the back.

The fact that the trouble is commonest in the evenings suggests that fatigue plays a part in bringing about this condition. The remedy may, in that case lie in having the child rested for the crucial period.

One guess is that this condition is due to a periodic tension in the baby's immature nervous system and, therefore, nothing will calm a colicky baby.

Each child has on "Achilles heal" i.e. an organ which responds to stress and creates symptoms. If that organ is the stomach and if the symptom is the colic pain, then all that has to be done is to reduce the stress factor in the child to get rid of colic pain.

Respiratory Problems

A child generally gets sick with colds ten times more than with all other illnesses combined. Most colds are started by a virus which lowers the resistence and some regular bacteria get their chance to multiply and spread, causing pneumonia, ear infections, and sinusites. The best thing to avoid a cold is to avoid close phycial contact with any one who has one. Colds are not serious till a complication sets in.

There is no cure for the common cold. Only symptoms can be treated. In the absence of complications. Home remedies suffice. Symptoms generally are stuffy running nose, cough, fever & listlessness. The nasal discharge is first clear and then thick and yellow. Cold cannot be treated with antibiotics. Ordinary nose drops may cause "rebound" congestion. Saline nose drops, prepared at home by dissolving half tea spoon of table salt in about a quarter litre of water, help in loosening up tick mucus. So it could be below out more easily. Nasal obstruction could also be lossened by the child sleeping on his side opposite to the stuffed nasal passage. Use of vasallne or an oil with a little finger on the inside of the nostril upto 1 cm depth, could help stop a running nose. Use of vitamin 'C' supplement meant for children can also provide some relief. Extra moisture in the room prevents stuffiness of the nose. Keep the child indoors. Humidify the nose secretions by giving the child lot of liquids. Dilute the baby's milk with water.

Sinusitis occurs when drainage of mucus from the sinuses into the nose is impaired during a bout of cold or flu. Symptoms of sinusitis, besides those for cold, include a feeling of fullness and discomfort around the top of the nose. Humidifying the room would help considerably.

Bronchitis or laryngitis usually show up as coughs, wheezes and breathing difficulties and, may be, fever also. Coughing, unless persistent and severe, is not necessarily a bad sign. It is nature's way of getting rid of mucus and foreign matter in the respiratory tract. Cough medication generally does not help. In these cases also keeping the child properly hyderated with warm soothing beverages like tea with honey helps. For bronchitis, humidification of the surroundings will help. In case of laryngitis with hoarseness and coughing, a doctor must be consulted.

Pneumonia is an inflammation of the lungs caused by a virus. The affected lung may get out of action. Pneumonia may be caused by cold or by conditions like asthma, whooping cough and measles etc. Fever, chills and pale damp skin are some of the symptoms. These may be supplemented by difficulty in breathing and even indrawing of the chest. In all cases of pneumonia medical advice should be taken without delay, more so, if the child is breathing more rapidly or if the lower part of the child's chest goes in as the child breathes in.

Pneumonia kills about 6,00,000 (Six lakh) children each year in India. Breastmilk protects against many infections. Breastfed babies have half the number of pneumonia bouts as compared to the bottlefed- more so, if the breast milk alone has been given to the child during the first four months. Well fed babies are less likely to catch this disease. Vitamin A helps greatly Oranges, carrots, dark green leafy vegetables and yellow fruits should be taken in abundance. Vitamin A supplements also help. Primary immunization also affords some protection against pneumonia.

During cough and cold amongst young children, they must be fed both to fight the infection and protect the rate of growth. With a blocked nose, it may be difficult for the child to suck the breasts. It may become necessary to squeeze out the breast milk and feed the child from a cup or spoon. Other foods should be fed in small amounts more frequently. After termination of the illness give the child an extra feed till he comes back to the pre-illness weight.

A child with cough or cold should be kept warm and covered if he is running temperature also, give some temperature lowering medicines meant for children which through experience you find suit him best.

Smoking surroundings increase the risk of pneumonia. Keep the child away from tobacco smoke. Other children who are sneezing and spitting also increase that risk.

Air in the child's room should be kept fresh by opening a door or a window but ensure that he is kept away from draughts. Clean the nose frequently. A moist atmosphere will help easing the breathing. Inhaling water vapours from a bottle of hot water will be extremely helpful.

Fever

When the child is unwell his body temperature and breathing rate go up and his appetite goes down. Normal temperature for a child is 37 degree C (98.6 degree F) When on rectal reading the temperature goes above 39 degree C or below 35 degree C medical help may be sought if the temperature so persists. Child's temperature varies considerably at different times of the day. It is lower in the morning than during the day and is higher in the evening. A rapid pulse also indicates that the child is unwell. The average pulse rate for a very young baby is 100-150 beats per minute. This slows to 100-120 for a one year old and 80-90 for a five year old Both the temperature and pulse rate increase with exertion also.

A raised temperature is usually the result of a bacterial or viral infection. When the bacteria overcome the defence system of the child and invade the bloodstream, then a general fever develops. Small children upto the age of 5 years become feverish very easily. A minor digestive upset may be enough to raise the temperature for a few hours. Only if the fever persists that it becomes a cause of concern. High fever may be brought down by sponging the child's body with tepid water. Always encourage a child with a fever to drink as much fluid as possible to maintain a proper hydration level. Removal of warm clothing and bed clothes to expose as much of his body surface also helps. Ensure that he is not exposed to a draught. Lowering room temperature is useful. Parents are advised to give nothing except extra liquids and observe. No aspirin or a similar tablet may be given because it may mask how high the fever is going to go. Generally, in most children temperatures upto 39 degree C (102 degree F) are not dangerous but if there are some complicating factors, medical advice may be sought early. Please do not forget that the fever is one of the methods the body uses to help overcome the infection.

Nappy Rash

In infants the epidermis layer is thin and susceptible to irritation and infection. Sweating is scanty. Skin is more prone to blistering from trauma or infection. Diaper rash is caused by the baby's skin being in prolonged contact with the warm acidic urine. Recent research has shown that it is the urine itself, not the ammonia produced therefrom that causes rash. Itching is, perhaps the most common and least tolerated of symptoms. Skin rashes may be mainfestation of so many different conditions.

For treatment, take the baby's nappy off and lay him chest down, with the face turned to one side, on a towel underlaid with a waterproof sheet. Rinse the bottom with water to remove excess urine and bacteria and then dry well. Do not wash the affected area with soap while there is rash. Use plain water instead of diaper wipes from the market. Then expose the whole diaper area to the air for several hours.

Discontinue use of water proof and plastic pants. Avoid woolen clothing. Avoid disposable diapers so long as the rash problem subsists. Avoid cleaning with baby wipes that contain alcohol. May use a skin protective lotion. When preparing the baby for bed, take extra care. Wash and dry the bottom before applying a coat of protective cream.

Change wet and soiled diapers as soon as possible. Traditional cloth diaper is the most comfortable for your baby. Do not forget that in case of one baby there are as many as 7000 changes before you are finished. Give cloth nappies a vinegar rinse sometimes - 25 ml. vinegar to one litre of water during the final rinse. Breast fed babies have less nappy rash!

Sore Throat

An uncomfortable and painful throat is usually due to bacterial infection or a virus. The child may say that he has difficulty in swallowing or has pain in the throat if he is asked about it specifically. Swollen glands in the neck may indicate a bacterial infection. If the tonsils appear enlarged with yellow and white patches and the breath smells foul with swollen glands, it may be a case of tonsillitis. This happens rarely in children under one year but common amongst children who are exposed to a new range of bacteria on starting school. For treatment liquify his diet. The doctor, after taking a throat swab and examination of neck glands, may prescribe an antibiotic.

In such cases you may find that on one side of the forearm in alignment of thumb, there are knots. Slightly rub those knots for a couple of minutes each time for 2 or 3 days. As those knots disappear, the soreness of the throat also disappears.

Heat a few drops of oil and at night apply that oil on his throat all around but gently and then tie a cloth around the neck to save it from exposure. Repeat for 2 or 3 nights and the difference will become obvious.

Take a few drops of squeezed ginger in half a teaspoon of honey and let the child lick that. This should not be given to infants below six months of age.

Warm liquids will be more acceptable to the children and these will do good. Be on the watchout for possible complications. Avoid dry winter air. Humidification helps.

Ear Infection

Ear infections are common amongst children below 5 years because at that age tubes that connect the middle ear to the throat are short and straight and, therefore, all throat infections can travel to the middle ear more quickly and easily. In such cases the drainage is frequently blocked. Frequent lying down also diminishes drainage from the middle ear. This infection requires early treatment, otherwise, could cause permanent hearing loss. Fever, ear ache, loss of appetite and discharge from the ear are some of the symptoms.

The ears are self cleaning and the ear wax produced by his glands protects the ear from dust, foreign bodies and infection. This infection is not contagious. Keep the child cool and comfortable. Give him lots of drinks. Nasal decongestant is recommended. Warm glycerine may be used as ear drops. Application of heat from the hot water bottle may provide relief. Garlic oil and olive oil drops are also likely to help. You may wash only the outer ear and the entrance to the canal, not inside. Use a cotton swab or a wash cloth for this purpose. Sipping water and swallowing foods also helps. Researchers in Finland have established that breast feeding invokes response and reduces pain.

Lying down aggravates ear pain. Keep the child's head propped up. When the child is busy playing during the day, the tubes which connect the throat to the middle ear are draining in the throat and no pain is experienced. Use of antibiotics in such cases must be left to the decision of the doctor.

Malaria

Eradication of malaria a concerted action at the Government level, by the local community and the families. Places where water collects or stagnates should either be filled or drained or spread over with an oil surface. Regular clean up of the neighberhood is also important.

Young children should be protected from mosquito bites by putting screens on windows and doors, by use of mosquito nets and by using fumigants.

Pregnant women face the danger of malaria doubly. It may cause miscarriage & premature births. The children of malarial mothers may be small, weak and vulnerable to infections. The pregnant mothers could be effectively protected by taking anti-malaria tablets regularly. These tablets are available free from Government health centres. Children should also take similar medication but not daily because that may prevent the child from building up a natural resistence to Malaria.

A child with malaria should be kept cool. Do not put too many clothes or blankets on the child. A child recovering form malaria needs plenty of liquids and food.

Use of black Tulsi (the holy basil) is highly recommended as a curative as also for preventive purpose. Imperial Malaria Conference of 1907 came to the conslusion that "use of black Tulsi reduces considerably the havoc caused by malaria". A couple of washed Tulsi leaves or a few seeds of the plant could do the trick.

Chinckenpox

Chickenpox is a common viral disease which is highly infectious, but rarely serious. It usually appars in winter and spring and rarely affects infants below six months. One attack virtually ensures permanent protection against future infections. Possible symptoms are red, itchy spots that become fluid-filled blisters and then scabs. It could be accompanied by headache and mild fever.

Chickenpox is passed by close contact with a patient in the first week of the rash. The incubation period of 14 to 21 days is followed by a short period when the child feels generally unwell with a mild fever and headache. Crops of spots appear during the next 5 days. As a rule, it is self limiting and resolves completely with no adverse effects. The blister like elevations on the skin usually persist for about a week.

Keep the child at home and discourage scratching. May use an antiseptic cream. Never give aspirin. Aspirin can cause another serious illness. Do not rub the scrabs off. The only complication is boils which come from infecting the pox by scratching. Wash the child's hands with soap several times a day. A small tub may be prepared with one cup full of the baking soda or corn starch.

A vaccine to protect children against chickenpox has been developed by U.S.A. but has not yet been made available for general use.

Childhood Leukaemia

According to February 1993 issue of "Here's Health" De Shmuel Ben Sasson of Hubert Humphrey Centre for Experimental Medicine and Cancer Research in Jerusalem first suspected there might be a direct link between childhood Leukaemia and fluorescent lighting. In examined cases this disease was fully developed at the age of four. It was seen that the white children were more susceptible than the black children. It indicated that the pigmentation in black skin served as a protection screen against flouresent light which emit blue light (400 nm wavelength).This light penetrates the skin and is suspected to produce free radicals which in turn, damage the child's DNA. This causes the leukaemia to develop. It could be prevented by cheap plastic filters being fitted to flouresent lights in maternity wards and in those rooms in the house where infants pass their time. These doctors found supporting evidence from the Netherlands that those born in hospitals were more likely to get leukaemia than those born at home. A unique nationwide investigation into this cancer in children started in U.K. The National Radiological Protection Board of U.K. is also looking into this question. It could take a few more years to decide whether or not to do further research on this subject.

Asthma

Asthma is an allergy in which when an irritating substance reaches the bronchial tubes in the lung (the sensitive organ) the tubes swell, thick mucus is secreted and the passageways for air are so narrowed that breathing becomes diffucult, laboured and wheezing. A child who has asthma suffers consurrents attacks of breathlessness when the tries to exhale. Even a mild attack can be frightening in a child. Typical symptom pattern of asthma in a child would be cold with attacks of coughing and wheezing with many restless nights on that account. Causes could be passive smoke, cold air & family history of allergies etc. Even in developed countries 2 % of persons under 18 suffer from asthma. Figures of asthmatic children under 5 are not available for India or even some developed countries. Following precautions be taken in case of children.

If there is a family history of allergies you should reduce the child's exposure to potential allergins e.g. if either parent had a milk allergy in childhood, do not use milk in bottles till he is six months old. Breastfeeding is the safest. After 6 months experiment and decide.

Solid foods should not be started till 5 months. Each new food should then be started separately a week apart and study the sensitivity to each. Common allergins e.g. dust, grasses, pollens, animal hair, feather pillows should be eliminated from the baby's bed.

Asthmatic wheezing should be treated vigorously and the child told about it. Keep the child occupied so that his anxiety about the disease does not make things worse. Over 30% of children affected by asthma grow out of that condition by adulthood. Get it diagnosed and treated vigorously. Reverse this condition at an early stage.

                      
Today major section of the population has started doing some form of exercise such as walking, running etc. Many of them prefer listing to music while doing their work out. People prefer to play loud music on their headphones as it motivates them to do their regular workout, but listening to loud music during the workout can result in permanent hearing loss.

Hearing damage is more likely to occur if a person uses headphones during the workout. Human body tends to release hormone adrenalin in the body during the workout; this hormone creates fight-flight response in the body, directing blood towards the limb. The blood flow to the ears as well as other organs of the body is limited and this causes hearing loss if they are exposed to loud music during exercise. Hearing loss can also occur if a person is exposed to loud noises over a period of time the noise tends to destroy the hair cells. There are a set of hair cells which capture different frequencies of sound. If a person is exposed to a higher frequency sound for a long time it might destroy the hair cells that capture that particular frequency. And when that happens a person might experience a loud buzzing noise when he/she hears the sound of that particular frequency.

There various signs which might indicate hearing loss such as ringing in ears, unable to hear what a person might be saying on phone, difficulty in hearing low sounds and difficulty in understanding a conversation in a noisy place.  If the hair cells that hear a particular frequency are damaged can be corrected using hearing aids.  

The risk of this damage can be reduced if a person limits his usages of headphones. A person should limit the volume to 50% of the music player’s capacity during the workout, although it would be better to quit the habit of listening to loud during the workout, it is also necessary to limit daily usage of headphones. Since noise can also cause hearing loss it is necessary to protect ones ears while in noisy environment such as construction sites. One should take care not to expose themselves to loud noises for a long period of. Usage of loud speakers might reduce the risk of hearing loss.
 

Honey was known to be beneficial for health in many different ways. Honey acts as antioxidant to the body and it is good for skin, when mixed with lime water and taken known to reduce weight. Now new findings reveal that, studies also show that taking a spoon or two of honey before going to bed can be helpful in reducing accumulated fat in the body.

Honey is known to have a composition which makes it the perfect fuel for the brain, which is the most energy consuming organ. Studies show that liver is the only organ that can provide brain with immediate calories, and consuming honey can help liver provide these calories for the brain.
 
The metabolic rate of the body at night is low, and according to experts, the amount of fat calories that body burns increases during the night as compared to the day. When awake a person’s metabolic activity tends to use glucose calorie more than the fat calorie. Liver is known to provide the brain with the calories it needs while a person is asleep. If the liver is depleted, the brain tends to produce more stress hormones and tends to consume more glucose, leaving one hungry and tried once the person awakens, this process may cause accumulation of body fat.

Honey with cinnamon can also help reduce weight. This combination will reduce toxins in the body and also improve digestion process. It also lowers the pH of the body and helps one feel more energetic throughout the day.   

Despite its benefits honey has some adverse effects it too much of it consumed through the day. Eating too much honey can lower the body’s capacity to absorb nutrients; it can also cause stomach cramps, consuming too much honey over time might cause gastric problems, it can also cause erosion of teeth enamel as it is slightly acidic in nature. It is essential to consume right amount of honey as like any other food items it has its side effects. 

It is necessary to follow a proper diet along with right amount of exercise to maintain good health, but there are few who might feel less energetic or have some food cravings throughout the day even thought they might be following a balanced organic diet. This is because they might be having wrong diet for their body type. The metabolic typing is based on the idea that metabolic activity of the body of each person is different and one’s health would improve if one would follow diet that would be right for their metabolism.  Metabolism is the amount of calories one’s body needs to maintain it, metabolism effects body’s configuration, lower the metabolism rate, more the accumulated fat in the body; hence it important to increase the metabolic rate of the body, following diet based on one’s metabolic type is a way to do so.

Each person is different; some may feel energetic while having diet full of protein while others may not, with knowing one right metabolic typing, one can choose to eat certain foods that might be right for their body type and help lead a healthier life. Metabolic type of a person is determined using a questionnaire or by hair tissue mineral analysis (HTMA). There are three types- carbohydrates, protein and mixed. The carbohydrate types would feel more energetic when majority of their diet consists of carbohydrates, the protein type would feel more energetic when majority of their diet is protein based diet, and the mixed types need both protein and carbohydrates in equal proportions in their diet. One needs take appropriate proportions of carbohydrates, protein, fat, vitamins and minerals according to their type, as body needs a balanced amount of nutrients to perform its metabolic activities.

It is also important to note the order of consuming the meal, for example, a person with carb typing should consume carbohydrates first than consume rest of the meal, as this would improve digestion and also metabolism of the person. Following the metabolic diet will help a person reduce some extra amount of fat in the body.  This type of diet will help maintain right body pH and thus boosting the metabolic activity of the body, thus reducing food cravings. This type of diet might also improve a person’s health reducing the future risks of cardiac diseases, obesity and help boost energy levels of a person. 
 

Insomnia is classified under sleep disorders. It occurs when a person’s system is overly active to fall asleep. This disorder is different from sleep deprivation; sleep deprivation is a condition where a person is unable to have a good night’s sleep due to his/her preoccupation on other avocations which are considered to be important to  that of  a good night’s sleep.  Insomnia is a condition where an overly active system causes problems in staying asleep or falling asleep.

Insomnia can be classified into primary and secondary insomnia, primary insomnia is a condition where a person experiences sleepless nights without developing any health issues due to insomnia and secondary insomnia is a condition where a person experiences sleepless nights as he/she is been suffering from a chronic health condition like cancer. Insomnia can also be classified into acute and chronic insomnia. A person suffering from this condition is prone to more accidents than a normal person due to lack of sleep. Symptoms would include difficulty in falling asleep, difficulty in going back to sleep after waking up in the middle of the night, constantly feeling tired throughout the day. Physical discomfort, going through a difficult life situation (like death of a loved one), taking too much caffeine etc, can be few causes of insomnia.

Insomnia can also be psychological, in this condition a person may experience difficulty in falling asleep as they are unable to relax their minds, and their minds are often preoccupied with racing thoughts making it difficult for the system to fall asleep.

Fatal insomnia is a rare, genetic disorder; it often starts in the middle age and over time turns into serious insomnia. This condition can be divided into four stages ranging from serious sleep deprivation to coma and eventual lead to death. Insomnia when untreated can cause anxiety, depression and heart failure and may also lead to health problems such as diabetes .Insomnia is highly treatable. It can be treated using medication, cognitive-behavioral therapy, group therapy etc. insomnia when untreated, in severe cases may also lead to death; hence it is necessary to seek proper treatment if one is suffering from this condition.
 

                                                             
To avoid the accidents that might occur in the darkness of the night many countries have established street lights. These lights are switched on at a particular time at night, reducing the darkness of the night making people feel more secure and safe. But this artificial light that illuminates the streets is known to cause light pollution.

Light pollution can be identified when brightness of these lights causes an obstruction to view the night sky, due the glare produced by these lights at night the brightness of the stars and planets reduces. Astronomers are especially concerned with this condition; the glare produced by artificial light obstructs the study of stars, planets and galaxies. Light pollution also effects the environment; light pollution also contributes to global warming. Light pollution effects can also be seen in the areas far off from the well illuminated city as this glare is known to reflect back to the earth. Many species depend on light for their life processes, depending upon the light they hunt, sleep, reproduce, etc. And light pollution affects these processes.  This glare has also delayed the migratory period of many species leading them towards extinction. Many species of birds tend to sing at an untimely hour as artificial lighting seem to have altered the time period of day and night, day seem to have prolonged.

Light pollution has also shown its effects on humans. Due to the artificial lighting many have an altered biological clock; it has also reduced melatonin production in the body there by increasing the risk of cancer, it has altered the cardiac rhythm, and also suppressed the immune system. It can also lead many psychological issues. It is one of the reasons why many suffer from mental disorders and this may also lead to sleep deprivation, Children who switch on light and sleep at night may develop vision problems, women who have been working night shifts have a greater risk of developing breast cancer due to light pollution.

 Light pollution is caused when the artificial light tends to direct more light towards the sky. To protect oneself from the effects of light pollution, one should try and reduce the usage of electrical lamps and bulbs; one should make sure to switch off the lights when not in use, one should make sure he/she switches off the lights before going to sleep as this will reduce the escaping artificial light and also benefits a person’s health.
 

                                   
Sleep-disordered breathing is a condition where a person might wake up breathless from a deep sleep. This occurs when the air ways are blocked resulting in less blood oxygen levels. It is a nervous disorder that obstructers air flow through the trachea during sleep.  These obstructions in the wind pipe may occur due to various reasons like excess tissue around the air way, enlarged tonsils, extremely relaxed tongue and throat that might collapse in the air way reducing the air flow through the lungs. A person tend to wake up when blood oxygen drop to an extreme level. This condition is also known as sleep apnea. It more commonly occurs in men than in women.

There are two types of sleep disordered breathing, obstructive sleep apnea and central sleep apnea. Obstructive sleep apnea is a condition where the air passage is blocked, limiting the air flow causing snoring and central sleep apnea is a condition in which the entire air ways collapse as brain is unable to send proper signals to the muscles that control the air flow during the night and when this occurs a person tends to wake up for a gasp of air.

People suffering from this disorder tend to feel drowsy throughout the day. This disorder increases the risk of high blood pressure, stroke, obesity and heart failure as the brain stress hormones due to decrease in the blood oxygen levels in the body.  A family history of this disorder increases the risk of developing it. Physical exam and sleep studies are used to diagnose this disorder. Snoring, chocking and gasping are few symptoms to diagnose this disorder and symptoms while a person is awake might include headaches, mood swings, feeling drowsy during the day and a dry throat as soon as the person suffering from this disorder wakes up.

Usually changing lifestyle or behavior can be used to treat sleep disordered breathing and reducing some weight may also help in treating this disorder as most people who are being affected with this disorder are over weight. Breathing aids and oral machines and surgery are also used to treat this disorder. If sleep apnea goes untreated the risk of cardiac arrest might increase.
 

Myopia or near sightedness is commonly seen in all age groups today. Myopia occurs when eye lens muscles are unable to focus on a far off object. Usually glasses or contact lenses are used to treat myopia. Intensity of myopia is known to increase with age. Myopia can also be cured trough laser surgery, but it is a risky procedure. Myopia is also known to cause retinal detachment in rare cases.

Human eyes were once required to focus on far off objects, but the present day requires people to focus on nearer objects such as books, computers, etc. A theory has been developed saying that human body has developed myopia in order to relieve eye muscles from the tension caused due to constant focus on closer objects. Myopia causes blurred vision when a person tries to focus on a far off object.  This condition can help eye muscles relax while focusing on the near object and reduce the tension caused among them. Myopia is known to increase with age. As this condition increases it may lead a rare condition called retinal detachment.

Retinal detachment occurs when the retina of an eye separates itself from the tissue that lies underneath the retina. It occurs when eyeball liquids pass behind the retina through a hole or a tear in the retina and detach it. A surgery or some damage to the eye might cause these holes and tears in the retina and Myopia can in rare cases causes the same.

 Different symptoms to identify retinal detachment include: light flashes, blur vision, blind spot in the field of vision etc. This occurs in myopic patients as their eyeballs are larger than the regular size, causing retina to stretch and due to this the chances of a tear or a hole appearing in the retina increases. Retinal detachment is often treated through surgery, after the surgery one may experience swelling in the eye, blurred vision, discomfort, and watery eyes and in extreme cases bleeding. When a person experiences this condition the chances of it reappearing increases.  One should consult a doctor if one experiences symptoms of retinal detachment. When this condition goes untreated it may also cause permanent blindness of the effected eye.  Myopic patients should get regular eye check up done as this condition may increase the risk of retinal detachment.
   
 

Calcium is one of the important minerals that help in bone development. Deficiency of calcium might result in fractures. In adults deficiency of calcium might cause osteoporosis. Osteoporosis is a condition where bone mass decrease with age and results in weak bones that might be easily broken. Women tend to have a greater risk of this disease than men, as the calcium need of women is much greater than that of men and negligence of calcium intake during their developing years may result in this condition later in life.

The risk of developing osteoporosis increases with age, a family history with this condition, thin skeleton structure, smoking, eating disorders like anorexia nervosa, post menopausal might be few risk factors of developing this disease. Rheumatoid Arthritis is also a major factor that might be the cause of this disease. Rheumatoid arthritis is a condition where body attacks tissues near joints causing inflammation. Due to the medication used to treat arthritis and loss of joint function may increase the risk of osteoporosis.

 Osteoporosis occurs when body is unable to replace new bone cells with the ones that are lost making them weaker and more prone to facture. The factures are likely to occur in hip bone and vertebral Column. Symptoms might appear much later after the damage is done. Symptoms include joint pains, difficulty in standing up, difficulty in sitting straight, sharp pains when weight is put on a particular area and fractures.

Osteoporosis can be treated using medication and different therapies. Vitamin D supplements can be used both to treat and prevent osteoporosis. It is necessary to take a diet that includes calcium and phosphorous, older women need to get their bone density examined on periodical bases to prevent this condition from occurring, especially if one has a family history of this disease. It is also necessary to do aerobic and non-aerobic exercises at least three times a week. Vitamin D and calcium supplements can be taken and one should include calcium rich foods in their diet such as yogurt, milk, spinach etc to prevent osteoporosis from occurring later in life. Vitamin K, magnesium and phosphorus should also be included in the diet to prevent osteoporosis.  Since bone damage can start occurring at a young age without showing any symptoms it is necessary to take precautions against bone disease such osteoporosis for a better living.
 

                                         
Salt is added to food to help preserve it for a longer period of time, salt also helps in regulating the bacterial growth in the food, but it is said that too much of salt in the diet is known to cause various health problems. With increase in the amount of salt in the daily diet, the risk of high blood pressure, stroke, obesity etc increases as a person grows older. It was often told that too much salt is bad for health, but smaller amounts of salts in the diet are not good for health either.

 Salt contains mineral sodium; this mineral is very helpful in regulating the body’s metabolism. This element helps the cells retain water, it also helps in regulating the electrical impulses that are cause in the nervous system of the body, sodium also regulates the digestive juices produced in the digestive system, this helps the body from eating up itself, and it also helps the body absorbing nutrients that the body requires for performing its metabolic activities.  Sodium is a vital element that keeps the muscles from cramping up, and it also helps protect the body from seizures. Low sodium levels in the body can cause water intoxication, this condition is also known as hypothermia, symptoms include nausea, weakness and muscle cramps. Sodium deficiency causes low blood pressure which may cause seizure and also may lead to coma and in extreme cases death. Thus it’s important to check the amount of salt one is consuming in their diet. An optimum amount of daily salt intake would be one table spoon per day.

Since seasoning food with salt can lead to risk of consuming excess salt, it’s recommended to consume food products that contain natural salt. Since the human body doesn’t recognize artificial salt, food items that are rich in natural salts should be included in the diet. These food items reduce the risk of health problems caused due sodium deficiency.

                                                                          
Apart from the salts that contain sodium it is also necessary to include salts that contain elements such as iodine, phosphorus, chlorine, calcium and sulphur in the diet, to help body perform its metabolic activities, these elements also help in reducing future risks of stroke, obesity, hypothermia etc.  Fruits, vegetables and whole grains should be included in the daily diet as they contain these minerals and can help regulate body salt level in a natural way. It is also necessary to use natural salts such as sea salt, rock salt, black salt etc, to help regulate salt levels in body for healthy living. Thus salt is also a necessary element that helps an individual lead a healthy life. Too much or too little salt content in the body may lead to various health issues, thus it important to identify right amount of salt requirements for the body and it should not be eliminated from daily diet.
 

Social networking site such as facebook, twitter, etc have become extremely popular.  With origin of these sites social interaction has become easier, one can easily interact with a friend or a relative who might be living in a different country, these sites provide children with wider range of social circles and one can meet a person with similar interest on these sites. Some of these sites also provide with the facility of advertising and these sites have been helpful to the manufactures in advertising their product or a social worker spread awareness of a particular cause.

Although these sites have their benefits, there are disadvantages associated with these sites. Most adolescents these days are obsessed with these sites. One can constantly find these children updating their status, uploading photos, counting the number of “likes” they get for a particular status or photo. It’s important for them to get as equal or more “likes” than their friends if not they will be left with the feeling of insecurity. It’s also important to aware of type of information one can share on these sites, most often these children tend to share private information on these sites which was not meant to be shared in the first place, it is also important to personalize the settings, sites such as facebook enables the user to block certain information from people who are not on the “friend list”. There were cases where a student is suspended from school because of information shared on the site, hence it important to have knowledge on what type of information to be shared. It is also necessary that one should not provide complete personal details on these sites, so as to avoid unnecessary attention towards oneself.

Social networking sites can be very helpful if used properly. They help in developing certain social skill, they also help in long distance communication, thereby improving the relationship between distant family and friends, and they also help in adverting. Innovation of these sites have brought a change in way people interact with each other, long distance communication is now available at a cheaper price due to these sites. When usage and information on these sites is limited, they can be of a great help in developing ones social skills.   
 

Women have attained success in different fields, today women are also the earning members of the family, they have reached to a certain position, which was unimaginable for them to attain at a certain period of time, now it’s hard to find a career meant only for men. Even though women have attained success in different careers, crime against women still prevails.

There have been numerous case reports against this harassment, in recent years incidents such as rape, acid attacks etc, have increased, a man has more chances of getting promoted compared to a woman, even though they might have sharing similar work, in the same organization, it is also likely that between a man and a woman who share similar work, that the male employee is given higher salary compared to the female employee, thus an organization might be showing differences in treatment  of  their male and female employees. Despite these harassments at the work place, women may also have to go through abuse at her household, making the only place where she can relax unsafe. Working late is not safe for women either, there have been many incidents such as abduction, rape etc making it unsuitable for women to take night shifts, organization might provide traveling facilities for women, but in most cases the cab driver is the one who assaults her. 

It was also commented by a police officer recently, that due to their modern dressing, women are going through sexual harassments, but women living village, who mostly dress in traditional clothing, are also going through similar kind of sexual harassment, thus making this statement untrue. All these incidents take place, not because women are less empowered, but it depends on the way the society treats them.
Indian society traditionally being a male dominant society, believes that women are subordinates and earning is done by men of the family, may be the root cause of all the harassment a woman has to go through, it was believed that a woman should perform her traditional house hold duties and a recent change in this structure has caused this instability, leading to this injustice against women. Even at an young age parents do not let a girl child equal freedom as they might provide her brother with, she has more restrictions over do’s and don’ts, this type treatment by the parents may result in her being more reserved and make it difficult  for her communicate if she’s being harassed at her work place or at her in-laws .

In order to stop this injustice towards women, the society should change its point of view towards this change, until the society changes its views, crime against women may prevail.
 

Binge eating disorder also known as compulsive overeating disorder is a disorder which makes its sufferer overeat, a person with this disorder tends to eat even when he/she is not hungry. Most of people suffering from this disorder tend to be overweight and may prefer to eat alone as they are ashamed of their eating habits. It is hard for people suffering from this disorder to resist the sight of food. Foods rich in salts, sugar and fat tend to create a pleasure sensation in the brain and this disorder becomes more severe, the content of fats, sugars and salts also increases. People with this disorder often tend to have body image issues and this may also lead to depression. After a period of over eating they feel embarrassed and may starve or do vigorous exercise to try and cut down the calories they have gained from over eating. They might also wear lose fitting clothes to cover up their body weight.

 This over eating may also lead to other lead to other health conditions like obesity, heart disease, high cholesterol levels, high blood pressure etc. Depression can be one of the causes of this disorder and this disorder can also lead to depression. This disorder is also caused due to mood swings, when angry or sad people tend to eat to minimize these feeling. Even change in brain chemicals may result in over eating. If the brain does not send the signals that control hunger levels and eating properly then one may not know when to stop and over eat.

This disorder is often treated through counseling; it helps the sufferer control their eating habits. Anti-depressants can be used to treat one who is suffering from both compulsive overeating and depression as treating depression may control one’s eating habits. In some cases even group therapy which involves friends and family of the sufferer can be of great help. Compulsive eaters tend to hide food from their family members; they feel comfortable in having solitary meals as no one would come to know of their eating habits. Informing family members about this disorder might help the person regulate this disorder.  It is necessary to control compulsive eating disorder as it not only affects sufferer’s physical health but also mental health.

                             
Irritable bowel syndrome is a disorder that affects the bowel movements of a person. It is a physiological disorder and not a disease. A person with this syndrome usually experiences pain or discomfort in the intestinal track while passing stool. Women are more likely to develop IBS than men.

Irritable bowel syndrome is caused when colon absorbs too much or too little water from the digested food passing through the colon from small intestines causing diarrhea or constipation. Symptoms to identify irritable bowel syndrome include bloating or cramping pain in the abdomen, constipation and diarrhea. The pain or discomfort tends to get worse during menstrual cycle in women. There might be a change in the consistency of stool from time to time in people suffering from this syndrome. A person suffering from this syndrome experiences discomfort when there is some change in the regular diet or when he/she has taken large meals during the day.

IBS is diagnosed when symptoms last for about six months. Irritable bowel syndrome is believed to be caused when the brain is unable to send proper signals to the colon resulting in irregular movements of the colon, but the actual cause is unknown. To diagnose this syndrome stool and blood test are done usually to rule out the probability of a person suffering from other gastro intestinal diseases that may show the same symptoms.  Mental conditions such as depression, anxiety and stress are also known to trigger the symptoms of IBS.

Irritable bowel syndrome can be treated with some changes in diet, like eating more fiber rich foods like whole grain, vegetables and fruits. Fibers should be added in the small quantities at a time in the diet, as eating too much fiber may trigger the symptoms of irritable bowel syndrome. People with this syndrome should avoid foods that contain high fat, caffeine and alcohol and they should also avoid eating foods such as cabbage and beans which may worsen the symptoms.

People with this syndrome should also avoid intake of too much milk but should increase the intake of yogurt as it contains probiotics – a bacteria which helps improving the digestion. Medications such as anti-depressants are used to treat IBS caused by mental conditions such as depression and anxiety.

Since stress also worsen the symptoms of IBS it is necessary to manage stress, especially for those who are already suffering from this condition. Meditation, exercise, adequate sleep etc, are few methods followed by many to manage stress and these methods also help in reducing the symptoms of IBS.     
 

Exercising is said to be important to maintain a healthy lifestyle and to minimize the risk of diseases that might occur due increase in fat cells. A healthy person requires about thirty minutes of exercise few days of a week.  Most often people tend to exercise without taking breaks from exercising this can lead to over training of the body as sufficient time has not been provided for the body to recover itself.  Over training physically and psychologically damage the body.

People working out vigorously through the week may experience symptoms of over training which includes insomnia, fatigue, inability to carry out complete work out properly and pain in joints and muscles. It is important to plan work out routines according to one’s physical fitness. When a person pushes himself with daily exercise even though he/she is feeling physically exhausted then probably because he/she suffers from activity disorder.  People with this disorder are obsessed with how they plan their work out program. They usually get upset or feel guilty when they miss their exercise on a particular day. People with this disorder would normally miss a social event or get little sleep in order to just get few extra minutes to do some exercise. This disorder is occurs in individuals who have an unrealistic expectations regarding weight loss and some over exercise trying to speed up the weight loss process.

Eating disorders can also be a cause for over training of the body as people with eating disorder tend over exercise to burn off the extra calories they have taken. People with disorder also exhibit depression and anxiety usually when they miss their routine work out. Over exercising can harm the body. Over exercising can damage immune system, it exhausts the body it does not provide enough time for the body to heal and repair itself, over exercising can also lead binge eating as body losses out essential salts and water while working out in from of sweat. It is necessary for these individuals to get adequate sleep as body heals itself in sleep and it is also necessary to take a break from exercising when one’s feeling unmotivated. Counseling can also help a person who is obsessed with exercise.
 
     
 

Drugs are used to relieve from the symptoms of muscular pains, fever and various diseases. Often paracetamol is used to reduce the symptoms of fever, slight aches, flu etc, but if over dosed it can lead to various health problems. When taken more than prescribed doses it may lead to paracetomol poisoning and goes untreated it may even lead to death due to liver or kidney failure. Crocin is commonly known paracetamol in India.

When paracetamol is taken in high doses it may lead to various side effects like organ damage mainly liver and kidney, stomach bleeding, reducing the ability of the pain receptors to detect pain in the body etc.  Alcoholics have a higher risk of liver damage when they take paracetamol. It is necessary to consult a doctor if one experiences symptoms of overdose of paracetamol; initial symptoms include nausea, vomiting, dizziness etc. Symptoms occur within 24 hours of consumption of the drug. Over dose of paracetamol also reduces immunity. In children side effects of taking this drug include rash on arms and legs, liver damage and some children may develop allergic responses against the drug.

Some people can be allergic to paracetamol, when they take paracetamol they may develop rashes such as urticaria. It is very rare condition but anyone can develop allergic responses if paracetamol is taken with other drugs and when this happens it is important to consult a doctor. Alcoholics should avoid taking paracetamol as combination of two may cause severe liver damage. These people should take drugs which have similar effect as paracetamol like ibuprofen.  To prevent side effects from occurring drugs should be taken only in prescribed doses.    

                   
Milk and its products are good sources of calcium and other vital nutrients; it also helps in growth processes in children. Milk contains a sugar called lactose. In few cases when a person consumes he/she is unable to digest lactose resulting in gastric problems in such case he/she might be suffering from lactose intolerance.

 Lactose intolerance may cause due to deficiency of lactase from birth. Primary lactase deficiency is genetic; it is present from birth and secondary lactase deficiency occurs when small intestines suffer from an injury such as severe gastric problems it usually occurs in infancy. People suffering from lactose intolerance suffer from gastric problems if they consume milk or its products. The severity of the symptoms may differ from the amount of lactose consumed; the symptoms include diarrhea, abdominal pain, nausea etc.

 Lactose intolerance is be diagnosed using various tests for example stool test, a person suffering from this condition should avoid eating food products that contain lactose which includes milk and its products. Since all ages groups require certain amount of calcium in their diet it is necessary for people who suffer from lactose intolerance to substitute milk with other food source which are equally rich in calcium such as soy milk.

Lactose free milk can also be consumed and also intake of foods rich in calcium such as spinach, soya beans, yogurt etc should be increased, often people with a mild lactase deficiency can tolerate low amounts of lactose hence they can consume few milk products. There is no known cure for this condition but a person can lead a healthy life following low lactose or lactose free diet depending on the severity of the condition.
      
   

                                       
Corns formed on foot usually cause discomfort when frictions occurs while walking. Corns are formed near toes, are in a cone shaped projections of dead cells accumulated in a particular area of the foot. When the projection is pressed they usually cause pain and discomfort.

They are two types of corns, soft corns and hard corns. Soft corns develop in between toes. They develop if the bone is too wide near the toes and can also develop if one is wearing tight fitting shoes. They also develop in women who usually wear high heels. Hard corns are formed due to pressure on the feet that results in thickening of the skin. This happens when a person is wearing tight fitting shoes. Hard corns develop in such cases to protect the tissue that lies underneath the skin. A corn can be identified when a person experiences a hard raised cone shaped bump underneath the feet which causes pain or discomfort while walking or when tight shoes are put on. Corns are also caused if one puts on tight fitting socks or stoking.    

There are various ways to treat corns; shoes with more room near the toe area should be used if one is suffering from corns as it reduces discomfort. To treat corns in chemical method solution that contains mild acids such as salicylic acid is applied on the affected area; the acid dissolves the dead skin. To treat it naturally one can us a mixture of Borax Barn and Iodine mixed with warm water and soak there in feet in the solution for about twenty minutes. There are also surgical methods to treat corns but are only used when the corn is infected. To prevent corns from occurring one should make sure that shoes fit their feet properly and also wear socks or stocking that fit correctly.  

                                          
Hypothyroidism occurs when thyroid gland produces fewer hormones. Production of less thyroid hormone may affect growth and cellular activities as this hormone controls these activities of the body. There are many disorders that might lead to this problem.

Thyroid hormone controls the metabolic activity of the body. The amount of this hormone released by thyroid glands is controlled by pituitary gland. In a person suffering from hypothyroidism there is less circulation of thyroid hormones in the body. Hypothyroidism is a common in women than in men and the severity of this condition might increase with age. Iodine deficiency, diseases in pituitary glands or in hypothalamus, thyroid destruction after a surgery etc might be few causes of a person developing this disorder.

The symptoms of this condition might vary from person to person; the common symptoms include dry skin, constipation, fatigue, excessive sleepiness, weight gain etc.  If one suffers from a sever hypothyroidism one may experience puffy eyes, decrease in heart rate, drop in body temperature and heart failure, severe hypothyroidism might induce a person into coma if not treated. After reviewing symptoms physician might recommend blood test to diagnose this condition. If this condition occurs due a diseases or infection of the pituitary gland the blood thyroid levels are extremely low.

Hypothyroidism is treated through medication that consists of synthesized thyroid hormones. The dosage of the medication differs from adults to children. Often children require larger dose of this medication. In few cases people suffering from this condition do not exhibit symptoms until their blood activity levels are increased this may happen if the pituitary gland works harder to maintain normal levels of this hormone, medication can also be used to treat these patients to regulate the thyroid levels in the blood stream. 

Hemophilia is a rare blood disorder which causes excessive bleeding. A person suffering with this disorder has low clotting factor a protein that helps in clotting blood. A person suffering from this bleeding disorder takes a longer time to clot a wound or injury than a normal person. Hemophilia is an inherited disorder; it commonly affects males than females.

 People with this disorder have low number of or no clotting factors in their blood stream. Clotting factors are proteins that help the platelets stick together so as to stop the bleeding. There are two types of hemophilia- hemophilia A and hemophilia B; those suffering from this disorder mostly develop hemophilia A.  The severity of this disorder depends on the amount of clotting factor in the blood; less the count of this protein in the blood stream the more sever is the bleeding. 

Hemophilia can also be developed later in life this type is known as acquired hemophilia. In rare cases women can develop this disorder, this happens right after birth of a child or later in life in middle or old age. Women may also develop this disorder if suffering from heavy bleeding during their menstrual cycle. The risk of developing acquire hemophilia may develop if a woman is going through pregnancy. 

Depending on how many clotting factors are present in the blood of those suffering from hemophilia symptoms may range from mild to severe. Excessive bleeding, frequent injuries, bleeding gums, painful and swollen joints, painful muscles and heavy bleeding during a tooth procedure or a surgery can be few symptoms of hemophilia. A series of test will be done if a person is suspected to suffer from hemophilia, if his/her test results are positive then his relatives also need to undergo these test as in most cases this disorder is inherited. 

Hemophilia is treated using replacement therapy in which clotting factors are injected into the blood stream regularly or when bleeding occurs depending on the severity of the disorder, although there might be few complications like immune system starting to attack the clotting factors or developing an infection if the clotting factors are not treated properly before reaching the blood stream. The joints and muscles can be damaged due to this treatment. But, the treatment can help reduce the symptoms of hemophilia.
 

Psoriasis is a skin disease that causes red, dry thickening layers on the skin and this condition is noncontiguous. It is a chronic skin condition. The symptoms vary from patient to patient and from mild to severe. The symptoms may simultaneously worsen or get better. In some cases the symptoms cannot be seen as the affected area will have very light red patches over it. Psoriasis affects male and female population equally and even though it is present from infancy; it is usually identified later in life.

Psoriasis is an inherited condition; people belonging to the same family might be affected with this condition, but, the exact causes of this condition are unknown. Immune system function and also environmental factors play a role in occurrence of this condition. The affected part of the skin is often red in color and is raised. Elbow, scalp and knee area skin is usually affected with psoriasis. Yellow separations on nails can also be a symptom of this condition.

  There are different types of psoriasis and they affect different areas of the skin. This skin condition can also affect joints, pain in joints with perfectly clear skin can be a sign of this disorder and when this condition is associated with joint problems it is known as psoriasis arthritics. A person suffering from this condition might suffer from joint inflammation in hands, knees and ankles.

This condition is very serious and a person suffering from this should seek treatment. Physical examination is done to diagnose psoriasis, lab test are done rule out other conditions that might cause similar symptoms.

Treatment is provided to stop the symptoms from worsening. The treatment varies from person to person depending on the severity and the type of psoriasis. Mild form of this disease is treated using lotions and creams and advance treatments are used such as ultra-violet treatments or pills and injections are used to treat severe form of this disease. There are also ayurvedic treatments available to treat this disease.
 

It is important to pay attention to oral hygiene to avoid tooth infections. Bacteria or microbes tend to affect the surrounding tissues or the jaw bone causing tooth infections if oral hygiene is not maintained properly. A tooth is easily infected when there is broken enamel; this happens if one has a broken tooth. Body’s defense mechanism cannot stop the tooth from decaying; if the infected tooth goes untreated the infection might spread to the adjoining teeth and the jaws.

There are different causes for tooth infection, mostly occurs when the bacterial activity in the tooth tissues increases. Tooth decay is one of the causes, this occurs when bacteria attacks the tissues within the tooth through the oral cavities if any present. Tooth abscess occurs when the jaw bone supporting the tooth gets infected when this happens puss gets accumulated inside the tooth.

This condition may not result in pain and may not be discovered for a long period of time after the infection has spread.  If the infection is severe then it can also cause fever, nausea, vomiting etc. signs of the infection may include swelled gums, cavities, gum inflammation, pus drain etc. 
One may experience bad breath, bad taste in the mouth if suffering from an infection.

Loss of appetite, tooth discoloration, swelling of jaws and face, ear ache etc is few symptoms experienced by the sufferer. Anti biotic and pain killers are used to treat the inflammation later followed by root canal procedures are used to treat the infection, one may also rinse mouth with salt water to reduce the pain caused due to the infection.

Oral examine and x-rays are done to check for the severity of the infection. Root canal procedure removes the infected the tissue in the tooth, later a dentist may fill it up with metal rods. In cases of very severe infection one might have to get their infected tooth extracted. In order to avoid the spreading of the infection or tooth extraction one may have to seek medical assistance if experiencing symptoms of any dental infections.
 

                                                             
Alopecia or alopecia areata is a condition where the immune system starts attacking hair follicles causing patches of hair fall. It affects are seen equally in both the genders. This condition is acquired and it affects hair follicles on the skin causing bald spots. This condition cannot be prevented.

Alopecia is the result due to abnormal functioning of the immune system, where in the immune system attacks the one’s own body, and in this condition the immune system tends to attack the hair baring cells. In some cases this condition might be hereditary. There are forms of alopecia, thinning of hair on the scalp known as diffused alopecia areata, loss of all scalp hair also known as alopecia totalis and alopecia universalis in this condition a person experience hair loss on the entire body. This condition tends to affect older individuals and is not contagious.

Alopecia can occur in an individual suffering from health conditions such as diabetics, arthritics, thyroid disease etc but, this condition can also occur in a perfectly healthy individual. Reduction in stress levels might decrease the severity of this condition. The treatment depends on the severity of the disease; the treatment includes steroid injections, creams and shampoo that reduce the severity of the condition. Ayurvedic treatments are also available to treat this condition.

Fairness creams help lighten one’s skin tone. The demand of these skin products has grown exponentially in women as well as in men. These products tend to block the melanin production in the body; some products also use bleach to help reduce the skin tone. When these products are discontinued the original color of the skin appears back again forcing one to continue the using the product.

People are usually unaware of the potential damage caused by these creams. Due to the prolonged usage of these creams the skin layers tend to become thinner making it sensitive towards the sun rays causing burning and itching sensations and also making it more prone to acne.  As these creams reduce the melanin production in the skin to reduce the skin tone this increases the risk of developing skin cancer and may also increase the risk of sun burns. These creams may also contain steroids, the effects of these creams may last longer than the regular creams but, these products cause side effects such as acne, skin darkening, skin allergies etc. The bleach used in these creams might cause white patches on the skin and increases the sensitivity of the skin. The vitamin content in the fairness creams added to nourish the facial skin might contaminate the skin and also leading to sensitive skin. Some of these products may contain mercury which is very harmful substance.
Instead of using these fairness creams to reduce the skin tone which causes skin damage over a period of time one should to adapt natural ways to obtain fair skin. One should drink more water, water increase the glow in the skin, one can also use homemade face packs and scrubs. Quality sleep is also important to improve the fairness of the skin, it also important that one should have healthy foods such as fruits and vegetables regularly to maintain healthy skin.

Influenza is a contagious flu that affects the respiratory system. It usually starts with fever, weakness, cold sweat and cough and these symptoms lasts up to three days. Once the fever reduces the sufferer might experience severe weakness and suffer from low body temperature for some time and other complications might arise due to this condition. Complications such as bronchitis, pneumonia, inflamed eyes, etc, might arise due to this condition and in extreme cases this might also lead to death of a person.

Influenza is a viral infection and there are three kinds of viruses that cause influenza classified as virus A, virus B and virus C.  Vaccine is developed against the type A and B viruses.  This vaccine helps anti bodies develop in the body that fight against this virus. Doctors might prescribe drugs for complications caused by this condition also. It not necessary that this condition might affect a person only once, a person who already had suffered from this condition in the past is likely to develop it again.

Influenza usually occurs in colder seasons of the year and this condition affects people equally all around the world. This disease is highly contagious during this part of the year, is more likely to spread by people sneezing and coughing. Getting vaccinated against this condition reduces the possibility of reoccurrence of this disease. 

Anorexia nervosa is an eating disorder that affects the eating habits of an individual. An individual suffering from this disorder tends to avoid taking in food as they think that eating would increase their body weight. They also tend to over exercise in order to maintain their weight as they have a negative body image. 

Anorexia nervosa is a serious disorder that might affect the sufferer’s health. The fear of gaining weight, refusal to maintain healthy body weight and a negative body image are few signs that show that an individual might be suffering from this eating disorder. The sufferer’s priority might be his body, food and dieting, these individuals tend to think about reducing body weight during the day. Extreme weight loss, insomnia, dizziness, reduction in volume of the scalp hair, low blood pressure, etc are few physical symptoms that imply that a person might be suffering from this disorder. 

There are two types of anorexia, the resisting type and the purging type. A person suffering from the refusal type refuses to eat, thus attaining their goal which is weight loss and the purging type achieve weight loss by forcefully vomiting out food they have taken. Refusing to eat, denying hunger, afraid of gaining weight, etc are some of the emotional behavior exhibited by these individuals.

Several complications also arise in those suffering from this disorder. In individuals suffering from this disorder abnormal heart rates are quite common. These individuals also tend to suffer from gastric disorders such as constipation and also tend have a change in enzymes function and liver damage.

This disorder also effects kidneys and bone density and also causes other physical complications.
Treatment that is provided for this condition focuses on weight gain, either a patient is fed through feeding tubes or the sufferer is prescribed a well balanced diet; this is done to treat malnutrition. Psychological treatments and counseling help prevent an individual from relapsing into this condition.    
 
   

When veins in the legs fail to return blood properly to the heart, then one might be suffering from a condition called varicose veins. In this condition, veins tend to return the deoxygenated blood to the heart; the valves in the veins help the blood flow upwards towards the heart, when these valves do not function properly or if a person has weak valves in the veins, he/she might develop this condition. This condition also occurs if too much pressure is applied on legs like standing for a long period of time.

Varicose veins develop mostly in legs but, can occur in any part of the body. If the circulation of the blood is improper, veins tend to swell causing severe pain in the area affected. Larger veins are usually visible causing red or purple patches on the affected area and smaller veins affected can appear on the surface of skin and are known as spider veins as they tend to appear in the shape of a spider web. Ageing, hormonal changes, pregnancy, obesity, etc, increase the risk of developing this condition. Family history of this condition is also a risk factor of developing this condition. Sitting with legs crossed for long or standing for a long period of time may also cause this condition. 

The symptoms of this condition are: aching, itching, cramping, and swelling of the veins. In some cases person suffering from this varicose veins may experience blood clots and skin ulcers. This is not a serious health condition but, a person may also suffer from bleeding, skin sores or skin ulcers as this condition might weaken the skin around the affected area.  Once varicose veins are diagnosed, a doctor may recommend treatments such as laser treatments, using compression stockings, etc.  Surgical treatments are also provided to reduce the symptoms of this condition.

Varicose veins can be prevented in case which involve pressure on the legs such as sitting or standing for long. One should take frequent walks if he/she requires spending majority of their sitting and if work involves standing majority of the work hours then shifting weight from one leg to another might help. One should also avoid crossing their legs while sitting and also avoid high heels. Avoiding tight clothing around legs also helps preventing this condition. 

Chocolate was once proven good for health as it contains many useful anti-oxidants and is also shown to be good for cardiac functioning. In the latest study conducted regarding health benefits of chocolate, it is proven that it can also help in maintaining lower body mass index (BMI).

People were once advised to compensate calorie intake as they had habit of consuming chocolate regularly. Now it’s proven that chocolate can in fact improve the metabolic rates of the body and help maintain a low BMI and consuming more calories had no effect on weight gain, an anti oxidant in chocolate which contributes towards improving metabolism of the body and it also increases cellular activity in the body contributing towards a lower BMI.

Eating some amount of chocolate regularly contributes towards various health benefits. Consuming chocolate regularly also reduces the risk of cardiac disease, lowers blood pressure, improves insulin levels and also reduce the risk of obesity while improving metabolic activities of the body.

Eating dark chocolate is said to beneficial to health but, according to the recent studies any type of chocolate that contains coca, can provide same results. Eating even little amounts of chocolate per day can reduce the risk of stroke, and also helps making blood vessels more elastic which helps in reducing the blood pressure. Around 6 grams of dark chocolate consumed daily can provide with these health benefits.
 

Appendicitis is a result of inflammation in the appendix; appendix is a small closed ended tube which is attached to the first part of colon. Appendicitis usually occurs when the opening of the appendix into the colon is blocked. The blockage occurs when the opening is filled with mucus or when stool passing into rectum enters appendix and becomes rock hard causing inflammation. It may occur when the tissue in the appendix swells and blocks the opening of the appendix. Appendicitis occurs mostly occurs in the older population.

Severe appendicitis left untreated may result in rupture of the appendix, which leads to the leakage of infected material into the abdomen leading to serious inflammation of the abdominal cavity. This condition can be fatal unless treated with strong anti-biotic.the symptoms of appendicitis include: sharp lower right abdominal pain, loss of appetite, nausea, fever, cramps, constipation etc, it is recommended to get medical assistance if one is experiencing the symptoms of appendicitis.

Often to diagnose this condition physical examination and tests to rule out other gastric conditions are done. Blood test if done to check if the body has been fighting any infection so as to accurately diagnose this condition. Appendicitis is usually treated through surgery. The infected appendix is surgically removed in order to stop the appendix rupture as this may leak the infected material into the abdomen. 

Antibiotics are also used to treat this condition and sometimes are helpful in treatment when rupture occurs in the appendix. In case leakage of infected material in the appendix, the doctor may surgically drain out the infected material in order to prevent further complications.  There is no way to prevent this condition from occurring, but, this condition is less common in those who have regular intake of foods rich in fiber such as fruits and vegetables.