Getting things ahead of time:

• Diapers and safety pins
• Baby Sheets-6
• Baby blankets-2
• Adsorbent cotton-1 roll
• Diaper pail
• Baby lotion and baby soap-preferably glycerinated
• Baby clothes-light and easy to wear
• Your necessities-
• loose and front-open cotton clothes etc.

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SOME POST – NATAL EXERCISES

The best post-natal tummy exercise is laughter.
To keep the circulation going in the legs, you need to perform certain exercises.
During first week post delivery, you may perform simple foot paddling movements and pelvic floor exercises.
During second week, do some body movements like curl-up/down and side curl exercises.
After second week, you may perform some exercises given below. But do not forget to consult your doctor before starting.

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CARE OF NEW BORN DURING BIRTH

1. With proper education and muscular training during antenatal period, much of anxiety, fear and pain can be avoided.
2. You can co-operate in every way with the birth process.
3. You can get the joyful sense of achievement by giving birth to a new person, a joy you deserve after nine months of pregnancy.
4. After birth of your baby and proper management by a child specialist, the baby is handed over to you. You must not forget to put your baby to your breast as soon as possible, preferably within one hour of the birth of the baby in case of a normal delivery and within four hours in case of caesarean delivery.
5. Keep the baby in a warm blanket and warm in the winters.
6. Do not give bath to the baby on the first day as this may lead to fall in the body temperature of the baby.
7. Don‘t give honey, milk, or plain water to your baby. The first thing that a baby requires first is breast-milk.
8. Now enjoy your baby, your baby now requires to be played with, talked to, smiled with , but all this with lovingly and gently.
9. Your baby should not be crowded with many people, as he is tired and needs rest.

FEEDING OF YOUR BABY

Breast feeding is the best for your baby, as it is a complete food which is non allergenic, sterile, and safe, at appropriate temperature, protective and it does not need preparation.
So for the first 6 months or so, give only breast milk. Mother’s milk never harmful.

At feeding time, the baby should be hungry, dry, neither too cold nor too hot and held in a comfortable position. You can feed your baby in any comfortable position. In case of caesarean section also, you must feed your baby within 4 hours. You can feed your baby in lying down position but make the head end of bed high. Put the baby to breast in a position so that his face is towards the breast.

Once you are ambulatory, start feeding your baby in sitting position. You must sit on a moderately low chair with an arm rest and preferably a low stool for raising your foot and knee on nursing side. The baby should be held by the same side arm and hand, while other hand supports the breast and directs the nipple towards baby’s lips. Baby should be expected to take most of the areola (dark portion around nipple) and nipple into his mouth. Both the breasts should be used for nursing every time. During feeding babies tend to swallow some amount of air which can trouble you baby. So after suckling. Gently hold the baby against your shoulder and pat on the back till you hear the burp(burping).

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PROBLEMS WHILE FEEDING FROM THE BREAST

1. SUCKING DIFFICULTIES

The method of suckling at the breast and bottle is different. A baby who has been feed with a bottle therefore finds it difficult and confusing to suckle at the breast.
To suckle effectively, the baby should be well attached (latched) to the breast to be able to take the nipple and enough of areola into his mouth for effective suckling.
Most babies suck easily and naturally. But occasional baby seems to have, to learn to suck. You should not give up trying. But at the same time, you should not get exhausted. You should allow yourself and your baby time to rest and regain strength in between suckling exercises.
You may have short and flat nipples. Go to your doctor, he will explain you the method of suckling from a flat nipple.
You may have engorged breasts or full breasts. In this case baby can only chew the nipple tip and cannot get it into his mouth to suck properly. The baby becomes impatient, cries and turns away from the breast. On such occasion, have patience and express little milk before suckling the baby.

2. SOMETIMES YOU MAY THINK THAT YOUR BREAST IS DRY, BUT ACTUALLY IT IS NOT:

1. Before you put your baby to your breast ,you should calm down, rest for sometime, have something nice to drink. this should become ritual, repeated each feeding session.
2. Make sure that you sit in a comfortable position before you feed your baby, so that you remain undisturbed.
3. Make sure that the baby is sucking strongly and in a good position and not causing you pain.
4. Sometime the scheduled feeding is helpful.
5. Whenever you feel ejection reflex coming, even if it is out of schedule, you must put the baby to the breast.
6. If still you feel that it is insufficient, sedation for short period is helpful. (largectil-245)
7. Some lactogogues like perinorm or some herbal capsules like lactare can be taken, if milk is really insufficient…
8. Psychlogical support and practical help from a kind, experienced relative is the basis for success and not starting on to top feed.

3. SORE NIPPLES

This is the most common cause of breast failure. Your nipples can be sore at any time but is most common in early days pf lactation. This can result from:

1. Sudden exposure to unaccustomed actin of suckling.
2. Faulty sucking
3. Engorged breasts.
4. Flat nipples.
5. Prolonged suckling in a bad posture or positon.

The pain is worse when baby starts sucking and it gets less as nursing proceeds. Sore nipples could be prevented by examining them intently and correcting the problem in last trimester of pregnancy.
IF SORE NIPPLES DEVELOP:

1. Short and frequent nursing promotes healing. Let the baby suck on unaffected side firsrt.
2. If both the nipples are equally painful, very careful milking by hand elicits ejection. Baby can be put to breast as milk starts flowing.
3. Nursing the baby in different positions.
4. Apply hind milk, edible oil or some herbal preparation to the nipple after breast-feed.
5. Expose the nipple to the air in between feeds to aid in healing.
6. If the baby has oral thrush(fungal infection) or you have thrush on nipples, treat with some antifungal lotion.
7. If nipple is extremely sore, it may be temporarily necessary to stop breast feed but keep expressing the milk.

4. INVERTED OR FLAT NIPPLES

1. Manually stretch the nipple and roll the nipple between thumb and finger several times a day.
2. Grab the breast tissue so that areola forms a teat and allow the baby to feed.

5. TOO MUCH MILK

When you have too mush milk, and it flows too fast out of the breast, the milk fills the baby’s mouth and chokes him. In this situation you must express some milk before feeding the baby.

6. BREAST ENGORGEMENT

1. Take analgesics to relieve pain
2. Apply warm packs to help milk flow and relieve pain.
3. Put the baby to the breast as often as possible.
4. Gently express milk prior to breast feed to soften the breast and help the baby attach well.

EXPRESSION OF MILK

Espressing milk is helpful in following conditions:

1. For relief of engorgement
2. To continue feeding a sick baby
3. help maintain milk when breast feeding is temporarily stopped.

Methods: Hand expression, syringe expression, hand pump and electric breast pump.

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WEANING

When your little baby grows, he needs more than what your breast can offer. So, when your baby is 6 months of age, introduce supplementary food items (weaning).
Rigid rules in choice of supplements and time of introduction should be avoided.
Introduce small quantity of new food until baby gets used to it.
New food must be tried for several days before it is discarded.
Forced and coaxed feeding should be discouraged.
Put the food preparation on inside of cheek and not in front of the tongue.
Use a small spoon to feed your small baby.

FROM 6 MONTHS

(TOTAL SEMISOLIDS = 1 KATORI A DAY IN ADDITIN TO BREAST MILK)
1. Breast milk   2. Dal water   3. Soup (vegetable and tomato)       4. Fruit juice     5. Banana shaker     6. Suji kheer   7. Rice powder milk    8 soup  9. Boiled egg in milk    10. Idli with curd      11. Boiled and meshed Potato

FROM 7-9 MONTHS

(TOTAL SEMISOLIDS =2 KATORI A DAY IN ADDITON TO BREAST MILK)
1. All items given above    2. Introduce boiled rice with dal   3. Bread with milk or dal  4. Suji halwa  5. Chicken soup ect.

FROM 9 – 12 MONTHS

(TOTAL SEMISOLIDS = 3 KATORI A DAY IN ADDITON TO MILK)
1. All items given above   2. Chapati with vegetable soup or dal    3. Soft parantha ect .

At about 1 year of age meals prepared for adults should be given in quantity approximately half of your daily diet.

VACCINATION OF YOUR BABY

Prevention means taking care.
You must get you baby vaccinated against all possible diseases.
Kids need most of their shots by the age of 2 years.
Be sure to get shots started on time, preferably at birth, so that you can stay on schedule and protect your baby.
It is important to get short s at the right ages. Shorts will work best at these ages.
You don’t usually need to put off a shot because your baby has a old or some other minor illness or is on antibiotics. It is important to go ahead with shots unless your baby has high fever or has had severe reaction to previous shot. Carry shot record card/vaccination card at all times.
Some information about shots:
1.BCG: It protects your baby from tuberculosis. It is given at birth. Redness and swelling appears at 3-4 wks, which heals spontaneously (normal). Do not foment over injection site. Do not apply any medicine over it. Report to your doctor in case swelling appears in 3 or 4 days or a swelling appears in axilla.
2.DPT: It protects your baby from 3 diseases: Diphtheria, whooping cough and tetanus. Redness and swelling may develop at injection site. You can use ice pack or thrombophobe ointment over the swelling. If there is fever and irritability sys crophen can be given.Recomended number of doses 3 primary and 2 booster doses.
Report to doctor, in case baby
Cries excessively inspite of medicines or
Swelling increases over 3 days or
baby gets fits.

3.OPV (Oral Polio Vaccine): This is not a shot but oral drop, which prevents a crippling disease--- POLIO. Breast milk should not be given half an hour before and after OPV.

4.IPV(INJECTABLE POLIO VACCINE):The IPV given today has been enhanced to protect children from polio .

Recommended number of doses
same as DPT

5.MMR: Measles, Mumps and Rubella are serious diseases. They spread form person to person
They cause:-

Measles-rash, cough, fever and can lead to ear infection, pneumonia, diarrhoea, seizures, brain damage and death. Mumps-fever, headache, swollen glands in front of ears and can lead to hearing loss, meningitis, painful testis or ovaries. Rubella-rash, fever, swollen glands, arthritis and can led to abortion, congenital malformation in babies in case of pregnant woman having the infection.

This vaccine is given at the age of 15 months and preferably a second dose at 5 years.

6.TYPHOID: This vaccine is given after 2 and gives precession for 3 years, so has to be repeated every 3 years.

7.HEPATITIS B VACCINE: This vaccine prevents a deadly infection which has no treatment. The disease is transmitted to the baby from mother or syringes, needles, tattoing, ear piercing, scratches and cuts. The vaccine is given at birth (0,1, and 6 month).

8.HIB VACCINE:

The Hib vaccine protects your child from the Haemophilus influenzae type b bacteria, which can cause epiglottitis (severe swelling in the throat that makes it hard to breathe), a serious form of pneumonia, and a disease called bacterial meningitis.

Meningitis is an infection of the membrane covering the brain and spinal cord that can lead to lasting brain damage and deafness in young children, and can sometimes be fatal. Haemophilus influenzae can also cause serious joint and skin infections as well as other less common infections.

Before the Hib vaccine was approved for young children in the late 1980s, Hib was the leading cause of bacterial meningitis in U.S. children under 5. Every year in the United States, roughly 20,000 children under 5 developed severe Hib disease. About 1 in 4 of those children suffered permanent brain damage and 1 in 20 died.

Thanks to the vaccine, the number of cases in kids under 5 had dropped to 259 by 2003 — a decline of more than 98 percent. The cases that still occur are mostly in children who haven't gotten all their shots or are too young to have been immunized.

Recommended number of doses
Four doses.

Recommended ages
• At 6 ,10 and14 weeks

• Between 15 and 18 months

It's especially important for kids to get this vaccine on schedule, because the diseases it protects against tend to strike children between the ages of 2 months and 2 years.

9.HEPATITIS A VACCINE:

This vaccine protects your child against the hepatitis A virus, which causes a liver disease. The long-term physical consequences of hepatitis A are far less serious than those of hepatitis B or C. Still, a bout of hepatitis A is no fun, and the worst cases can cause liver damage and even death.

Hepatitis A is the most common type of hepatitis in the United States, with the highest rates among children ages 5 to 14. Disease rates vary from year to year, and many of those infected show no symptoms — so it's hard to know how many people are infected each year. Before the vaccine came along, the number of reported cases was up to 35,000 per year, but experts believe that after adjusting for underreported and asymptomatic cases, the number could be closer to 180,000.

The hepatitis A virus is carried in feces and may be transmitted by unwashed hands, so it can easily spread in daycare centers and other places where children play together. For example, a caregiver may help an infected child use the bathroom, forget to wash her hands, and then transmit the virus by touching her own mouth or another child's mouth.

Hepatitis A also is transmitted through contaminated food and water. The virus is very hardy and can survive for a long time on exposed surfaces, in raw foods, and in sewage.

The virus may cause symptoms such as fever, fatigue, nausea, vomiting, abdominal pain, dark urine, and sometimes jaundice, but it doesn't always cause symptoms, particularly in children. There's no treatment for the illness, but most children recover on their own within two months. About 15 percent of those infected have ongoing or relapsing symptoms for six to nine months. Three to five in a thousand cases of hepatitis A are fatal.

Recommended number of doses
Two shots, at least six months apart.

Recommended ages
Between the first and second birthday (ages 12 to 23 months).

If your child is 2 or older, ask your doctor whether a vaccination is in order. Young children who aren't fully vaccinated by 23 months can still be vaccinated. And vaccinations are recommended for older kids in certain high-risk groups, too.

10.CHICKENPOX:.

Most experts now recommend the chicken pox vaccine, and many schools and day care centers require it. Here's why:

1. Chicken pox is no party. If your child gets it, he's likely to develop a rash of itchy, painful blisters accompanied by fever and fatigue. If the blisters get infected, he may need antibiotics. They may also leave permanent scars, possibly on his face. If he's going to daycare or school when he gets chicken pox, he'll have to stay home for eight or nine days.
2. Chicken pox can be serious and even deadly. Before the vaccine came along, an average of 10,600 hospitalizations and 100 to 150 deaths caused by chicken pox occurred annually in the United States. Most of the severe complications and deaths occurred in previously healthy people.
3. The vaccine will protect your child from the worst of this illness. While the vaccine isn't 100 percent effective (about 2 percent of vaccinated children still get chicken pox), vaccinated children who come down with it will have only very mild symptoms. That usually means fewer than 50 blisters, no fever, and less sick time.
4. The vaccine can help protect your child against a related disease called shingles. About 10 percent of adults who have chicken pox earlier in life get this rash of extremely painful and disfiguring blisters that can be inches across.

Shingles appears when the chicken pox virus, which lives forever in the central nervous system, "reawakens" and becomes active again. People who have been vaccinated against chicken pox may still get shingles but will have a much less severe case than those who had the disease itself.

For all these reasons, the indian Academy of Pediatrics have put the chicken pox vaccine on the schedule of recommended immunizations.

11.PNEMOCOCCAL VACCINE:This vaccine, also called Prevnar, protects against pneumococcal (pronounced new-m'COCKL) infections, which mostly strike children under age 5 and can lead to some of the worst childhood diseases. Kids under 2 years old are most at risk.

Before the vaccine was available, pneumococcal infection caused more than 700 cases of meningitis, 13,000 blood infections, and 5 million ear infections in children under 5 every year, according to the U.S. Centers for Disease Control and Prevention (CDC). The infection is caused by pneumococcus bacteria, also known as Streptococcus pneumoniae. These bugs live in the mucous lining of the nose and in the back of the throat, and when plentiful enough can cause an infection in the respiratory tract, middle ear, or sinus cavities.

Pneumococcal bacteria are spread by close contact and through coughing and sneezing. Diseases such as meningitis and pneumonia can crop up within days of infection. Symptoms of pneumococcal pneumonia usually include fever and chills with shaking or trembling, as well as chest pain, coughing, shortness of breath, rapid breathing, rapid heart rate, fatigue, and weakness. Nausea, vomiting, and headaches are also associated with pneumococcal pneumonia, but are less common.

Though antibiotics such as penicillin can kill the offending bacteria, up to 40 percent of the strains may be resistant to antibiotics. So experts highly recommend the vaccine, which is effective in up to 90 percent of people who get it. The vaccine can even prevent some of the most serious ear infections among children.

Recommended number of doses
same as DPT

Recommended ages
• At  6  ,10 and 14Weeks

• Between 15  and 18 months

12.MENINGOCOCCAL VACCINE:

This vaccine prevents your baby from fatal disease of brain coverings called meningitis.This is available in india as polysaccharide vaccine against ACW and Y strains and is effective in children above 18 months age.

13.ROTAVIRUS VACCINE:  BEING LAUNCHED SHORTLY

Consult your doctor before immunization if:
Child has fever or sever cold and cough.
Child has loose stools.
Child has history of fits.
Child is on some kind of steroids.
Child has some chronic illness.

DAILY CARE OF YOUR BABIES

THE BATH
It is not necessary more than twice a week in winters to give a complete bath, as long as the baby is kept clean in diaper area and around the mouth.
Use soft glycerinated soap like pears.
Usually it is good to give oil massage before bathing (use bland and non allergenic oil)
A. Sponge bath : You can give a sponge bath in your lap. Keep a water proof material under the baby. Wash the face and scalp with wash cloth and clear warm water. Lightly soap the rest of the body with wash cloth or your hand. Then wipe the soap off by going over whole body twice with rinsed wash cloth, paying attention to creases.
B. The tub bath : Before starting, be sure you have every thing you need close at hand.

Take off your wrist watch. Wear an apron.
Have at hand-wash cloth, towel, adsorbant cotton, baby lotion, soap, baby sheet, baby blanket, shirt, diaper (made of light cotton cloth), safety pins with covered head ect.
Best place for giving bath is kitchen sink.
Take a high stool to sit.
The water should be about body temperature-test it on your wrist or elbow.
Room should be comfortably warm.
Use only a small amount of water at first, an inch or two deep.
Remember! do not leave your baby alone in the bath tub, whatever may be the urgency, as it can be fatal.
Hold the baby, so that his head is supported on your left wrist and fingers hold him securily in the armpit. First wash the face, with wash cloth, without soap, then scalp with soap. Wipe the soap off the scalp with damp wash cloth going over it twice. Then soap rest of the body with wash cloth or hand.
Use soft bath towel for drying.
Clean the ears and nose with cotton swab.
Apply lotion or powder-lotion if skin is dry and powder if it chafes easily.
Apply some barrier cream in anal and groin areas.
CLOTHING
Body clothes must be light, made of cotton or woolen, simple to wear have no hooks or buttons. Baby should neither by over or underdressed.
Babies are usually over dressed by mothers. This is not good for them. If a baby is always overdressed, it becomes difficult to adjust to changes and is more likely to get chilled.
When putting on shirts and sweaters with small opening, gather than into a loop, slip it first over the back of head and then forwards as you bring it down.
Diaper of your baby should be of light cotton material and not synthetic one. Be careful while you put in a pin-first slip your fingers of other hand between baby and the diaper. Diaper should be washed properly with detergent and more important is to rinse it thoroughly, otherwise it can cause detergent rash on tender skin of your baby.
SLEEP
Baby cot should be of good quality, having no sharp rods or projections.
Your baby's bed should be made of firm and smooth mattress and without a pillow.
Room temperature should be around 20-25 deg C.
Your baby's nose and mouth should be clear while putting him to sleep.
Babies usually vary in sleep patterns. One baby sleeps a lot-20-22hr and another surprisingly little-8-10hrs. As long as baby is satisfied with feeds, comfortable, there is plenty of fresh air in room, you can leave it to them. There are few babies who are unusually wakeful right from the begining and not because anything is wrong. Nothing need to be done-do not get frustrated-jut wait for few moths.
EYE CARE
No surma or kajal should be used. These do no good, but only can cause injury or infection to your baby's eye.
EAR DROPS OR OIL
No ear drop or oil should be used in the ear.
NOSE CARE
None should be cleaned after bath with wet swab. If crusts are hard, use warm saline or saline or salted water.
Put few drops in one nostril, wait for sometime, then clean with wet cloth or cotton swab.
Repeat the same on the other side.
TOYS
Take some time out of your busy schedule to play with you baby.
Simple toys are best. Babies love to play with them.
Till two years, rattles of attractive colors, soft dolls and its dress or furniture, cars and building blocks etc.
Let the baby play at their own level.
Toys should be of non-toxic good material, should have fast colors and should not have small pieces (which could be swallowed).
Toys should not have sharp or pointed ends or edges which can cause injury to your baby.
Toys should be washed frequently to prevent infections.
PETS
If you have pet at home, certain precautions have to be taken to protect your baby.
The pet should be properly immunised.
The pet should not be allowed to come near the baby if he is having some kind of sickness or infestation(ticks etc).
In case of animal bite do not panic, wash the wound immediately with soap and plenty of free flowing water, then consult your pediatrician for anti rabies vaccine and care of the wound.
INSECTS
You must protect your baby from bites of insects especially mosquitoes because they can transmit number of diseases to the baby like malaria, dangue fever and brain fever etc.
The most safe method is use of net. But if you cannot prevent bite by net only, repellant like ALL-OUT etc. can be used.You must also keep the breeding places of mosquitoes like water in the pots etc, dry as far as possible.

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COMMON PROBLEMS OF YOUR BABY

NEW BORN BABY
BODY RASHES :
These are some innocent rashes during newborn period which need no treatment.
Pathologic rash need doctor's advise.
Some of the rashes are-

1. Bluish mottling (innocent)-Babies with pale skin show when chilled.
2. Pearls(innocent) Mild facial rash in newborn like tiny pearls.
3. Blotchy red patches(inncoent)-These rashes appear on second or third day and are temporary.
4. Mangolian spot(innocent)-Big bluish patches especially over the back in dark skinned baby.
5. Seborrhic rash-It is due to dandruff. It should be treated by shampooing the scalp and applying mild steroid cream.
6. Diaper rash-This rash appears in the diaper area. Diapers should be properly rinsed and boiled in vinegar. Apply bland petrolium jelly in the rash area. If it persists consult your doctor.
7. Cradle cap-Over the scalp. It should be treated by shampooing the scalp and careful removal of the pachs with oil.
8. Salmon patch-Pinkish patches are not innocent(hemangiomas) but usually disappear.

BUT THE ONLY CERTAIN AND ABSOLUTE CURE IS TIME.
SPOILED BABY
A kind of spoiling occurs when parents or grandparents are so delighted with the new baby, they are regularly playing with
him most of the time. If he is awake, carrying him around or dancing with him. Gradually baby forgets to amuse himself.
He feels board, deserted and miserable when left alone and cries for attention(even as early as one week of age). What
started as a fun for parents becomes an endless chore.
A mother who cannot hear her baby fret for a minute and carries him most of the time he is awake. Now as you lay him
down, he starts over again. How to un spoil : Earlier you detect, the easier it is to cure. But it needs lot of will power.
Un reasonable demanding ness and excessive dependence are to be discouraged altogether.
SWOLLEN BREASTS
Many babies, both boys and girls, have swollen breasts for sometime after the birth. The swelling certainly disappears in
time. But the breast should not be squeezed or massaged, since it is likely to cause irritation of the breast and infect them.
VAGINAL DISCHARGE
Girl babies may have a mucoid or even bloody discharge form vagina a few day after birth. This is normal and does not
require any treatment.
VOMITING
Many babies regurgitate, especially when they bring up wind and if they have taken a large feed. Although it looks like
whole feed, it is usually a small part of it. If a baby is feeding well and gaining weight and have no other symptoms, what
seems vomiting is regurgitation.
But if baby is un willing to feed or is failing to gain weight or feels un-well, it may be true vomiting. You must consult baby's doctor, because it could be some kind of obstruction in the intestines or infection of the stomach.

DIARRHOEA
Usually a new born baby passes black stool(meconium) for first 2 days or so. On 3 rd to 5th day stools become yellowish
and loose(transitional stool) frequency can vary from 2-12 motions per day.Loose stools in a newly born baby could be
normal if he is active, sucking well and is passing normal quantity of urine. Whenever possible, a baby who has loose
stools, continue to breast feed.
The main danger of diarrhoea is dehydration, so it may need to give salt-sugar solution
as well as breast milk. If baby is un willing to such or is vomiting also, then it may be necessary to stop feeds for sometime
and give ORS. You must report to your baby's doctor in such a situation.
CONSTIPATION
Mothers want their babies to behave like adults and pass one solid motion a day. But young infant's intestines are not
mature enough to tolerate the type and quantity of milk he takes. Exclusively breast fed baby may pass only one stool
on 3rd day or 4th True constipation is common in formula fed baby. Usually adding sugar or fruit juice solves the problem.
SNEEZING
It is usually caused by amniotic fluid or crusts in the nostril and not be infection. It does not require any treatment.
NOISY BREATHING
It occurs in certain babies and is usually caused by the fact that they have not yet learnt to control their palate(soft), They
usually overgrow it.
Other type of noisy breathing is caused by voice box(laryngomalacia). It goes away when baby is asleep.
It may be better if baby lies on his abdomen. This condition should be discussed with the doctor.
NOSE OBSTRUCTION
Put warmsaline or salted water in the nostril and suck with a nasal baloon or clean with a swab.
EYE DISCHARGE
Many babies develop discharge from their eyes since birth. This is due to immaturity or blocked tear duct. Lacrimal
massage as advised by the doctor, should be done till the discharge is there.
BLOOD SHOT EYES
If white part of your baby's eye is red, you do not have to worry as it disappears by itself over a week or so.
CROSSED EYES
In most cases it may become steady and straight as the baby grows. If they are still wandering at 3 months, consult your baby's doctor.

COMMON PROBLEMS OF OLDER BABY

YOUR BABY DOES NOT EAT AT ALL
This may be a problem when your baby is less revenous for food, more interested in all kinds of new activities like
climbing, dropping things on the floor, tipping the cup upside down or playing with the feeder. Fooling at meals is only
a sign that your child is growing up and you are keen about him eating than your baby is. And it is inconvenient and
irritating to the baby and is apt to lead to feeding problems. So whenever your baby looses interest, assume that
he has had enough. It is right to be firm but do not go mad. So must always stop the meals when he looses interest.
Let him feed himself early. Do not worry about table manners. Many babies get fed up with milk sometime in second year.
Do not try to push it into your baby.
THUMB SUCKING
At about 6 months of age, babies usually begin to realise that they are separate persons. They start using sucking, stroking
or rocking habbits at tired or unhappy moments, to bring back security which their parents used to provide. You can
interrupt thumb sucking by comforting your baby or providing pacifier if required. Thumb sucking is also common at 10
months of age or so, because at this age they take less time to finish the bottle. This happens when they get stronger
and the nipple gets weaker.
You can manage thumb sucking as follows:

1. Remember that thumb sucking goes away all by itself. Do not keep worrying. Ignore the symptom if possible, while
   giving attention to more positive aspects of the baby's behavior.
2. Do not use elbow splint or bad tasting stuff on the thumb.
3. Do not scold or pull out the thumb out of his mouth.
4. You can offer a toy, if you see your baby sucking the thumb.
5. Offer plenty of interesting things to play with, so that he does not get bored at any time.
6. Give reward for not sucking the thumb.

1. It is useful to reward the baby for being dry at night.
2. Older babies can be asked to wash their soiled clothes.
3. Should be given no liquids after dinner.
4. Should void before retiring.
5. Wake him repeatedly to take him to bathroom.
6. Some exercises to increase the bladder control as suggested by baby's doctor are helpful.
7. Medical therapy if above measures do not help.

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COMMON CHILDHOOD EMERGENCIES

Babies grow up fast! Before you know it, your baby will be old enough to crawl around the house, exploring everything he can reach! Right from this stage in his life till he starts going to school, your baby will run the risk of house hold accidents which could be traumatic for you. To prevent such accidents form happening, anticipate the pace of your baby's growth and take all precautions that could make your home a safe place for your baby. Keep your baby away from: Medicines, electric wires, plugs(safetycovers), pins, needles, matches, scissors, lighter, knives, aerosol cans, sprays and plastic bags. Following are some of the common accidents/emergencies and their first aid:
CUTS AND SCRATCHES
Wash with soap and water and cover with a clean bandage.
If it is a large cut or wound, consult your baby's doctor for stitching and getting tetanus injection.
ANIMAL BITE
Wash the child sit up with head bent forward. If it is bleeding, apply some guage pieces and exert firm pressure to stop bleeding. Get in touch with your doctor promptly.
NOSE BLEED
Make the child sit up with head bent forward. Do not allow him to blow his nose. Hold the handkerchief gently against the nostrils. Pinch the lower part of the nose for 10 minutes. Place something cold against back of neck, for head or upper lip. BURNS Put cold running water on the burns as quickly as possible. Apply some antiseptic cream and inform your baby's doctor.
BLEEDING
If some wound is bleeding, elevate the part. Press on the would with a guage piece until bleeding stops. Bandage it with firm pressure.
SPRAIN
Put an ice pack over the sprained part. Elevate the part, give some analgesic and call your baby's doctor.
ELECTRIC SHOCK
Cut off the current.
Separate him from the source with a wooden object.
If there is no breathing, give artificial respiration form your mouth immediately.
Keep him warm with a blanket.
Call your baby's doctor.
CHOKING
Let the child cough up the object if he can. If he cannot do it try to pop the object out of wind pipe. Hold the baby upside down and slap him vigrously on the back. If this is not successful, press the baby's stomach upwards and backwards with your fist. Call your baby doctor immediately.
SWALLOWING OF OBJECT
If your baby has swallowed a smooth object, do not worry.
Watch the stool for few days, incase of vomiting or pain in the stomach, consult your baby's doctor.
If he has swallowed a sharp object like pin of screw call your baby's doctor.
POISONING
Give plenty of water to drink.
Cause vomiting by giving salted water and stimulating in the throat.
Do not cause vomiting if he has swallowed kerosene oil or is unconscious.
CONVULSIONS
Prevent child from hurting himself.
Remove excess clothes, reduce fever by sponging if he has.
Insert a steal spoon between teeth to prevent tongue bite.
Take him to doctor.
DROWNING OR NEAR DROWNING
Keep the baby warm.
Put him over stomach and press out water as much as possible.
If he has stopped breathing, give artificial breathing and if there is no pulse, start thumping the heart. Call for immediate medical assistance.
ARTIFICIAL RESPIRATION
Place the child in face up position. Clear the mouth.
Tilt his head back, so that him chin points upwards. Pinch the child's nostrils shut and place your mouth over his mouth.
Blow into the child's lunges. Remover your mouth and listen to the air rush out. Reapply your mouth and release.
Repeat the same procedure 12-20 times in a minute.

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