Many parents these days are clueless about how to bring up a child
By Dr Gita Mathai
Published 6.11.18, 9:43 PM
Updated 6.11.18, 9:43 PM
2 mins read
AddThis Sharing Buttons
Stuffing food down a child’s unwilling throat is a recipe for disasterImage: Wikimedia Commons
AddThis Sharing Buttons
Many parents these days are clueless about how to bring up a child. There is no support from a rambling family — grandparents, widowed aunt, unmarried uncle — and domestic help is not only hard to get but also unreliable. That is a huge problem for working mothers.
Feeding the child — when and how much — usually becomes an area of conflict. Parents often have unrealistic expectations but stuffing food down a child’s unwilling throat is a recipe for disaster. And starting the day with a glass of milk — especially one fortified with protein powder — is not a good idea. It fills the stomach, suppresses appetite and provides a sense of satiety which often stays the whole day, making the child refuse breakfast.
Instead, start the day with exercise. Let the child run on the terrace or in the garden for 20 minutes and then get him or her ready for school. Keep at least 30 minutes in hand for breakfast. Feeding the child because “there is no time” will lead to retching, vomiting and refusal of food. Meals need to be savoured, this takes time. There should be a fixed place for eating — in front of the television, iPad or mobile phone results in mindless eating, obesity and lifestyle diseases in later life.
Regular exercise is a must. Twenty minutes of aerobic activity morning and evening goes a long way towards improving memory, productivity and helping the child fight fatigue. It is a good idea to put the child into structured sports training or martial arts. Such children are less likely to experiment with smoking, drinking and drugs. They are also less likely to be hooked on to the Internet, suffer acute depression or attempt suicide.
There is a lot of misinformation in the media about immunisations. These injections have been developed to protect children from disease. It is necessary to immunise against diphtheria, pertussis, tetanus, polio, H. influenza, pneumococcus, rotavirus, hepatitis B and A, flu (every year), typhoid (every three years), chicken pox, measles, mumps, German measles and HPV (human papillomavirus). Some of these diseases can be fatal or leave the child with lifelong disability. Polio can cause paralysis of limbs, mumps sterility, chicken pox deafness and blindness, hepatitis B permanent liver damage, H. influenza and pneumococcus brain fever and ear impairment.
Children can be demanding, but they lack the maturity to discern between good and bad. Therefore, parents should not always give in to their requests. The approach to a child should be consistent, firm, affectionate and authoritative, not authoritarian. If something is “no” then it should remain so despite temper tantrums, pleading and “recommendations” from grandparents.
We tend to support our children and give them a sense of entitlement to opportunities they do not deserve by bending rules and paying bribes. If parents do not obey rules, they cannot expect their children to do so. (A typical example is the crash helmet rule.) Pushing them into unsuitable professional areas because of parental pressure and bribes results in failure and frustration.
Children who lead a disciplined, orderly life and are allowed to develop their interests are likely to become successful in their endeavours and realise their potential. Children who are trained to be diligent, methodical and have self-control are more likely to grow into happy adults than their careless or undisciplined peers.
The writer is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India. If you have any questions on health issues please write to yourhealthgm@yahoo.co.in
People - young and old, male and, mostly, female - ask friends, relatives and physicians, "Do I look fat?" Often, the honest answer should be "yes". Visual perception of weight (thin, okay and fat) is usually correct. It needs to be backed up by scientific measurements for accuracy.
At present, 14.4 million Indian children and 30 million adults are obese. This is an unseen, unrecognised and dangerous epidemic. Part of the problem lies in our culture - we equate a potbelly with prosperity, like plump children and curvy women with a BMI around 30.
People sometimes ask, "Am I the correct weight for my age?" While weight does tend to creep up with age, especially in women, your ideal weight depends on your height, not your age. It needs to be measured scientifically.
The BMI (body mass index) is weight divided by height in meter squared. It should ideally be around 23 and, preferably, under 25.
Waist circumference should be 102cm (40inches) in men and less than 88cm (35inches) in women. In the Indian context, this has been brought down to 31inches in women and 37inches in men.
The waist-hip ratio (circumference of the waist divided by that of the hips) should be less than 0.9 for men and 0.85 for women. In children, the value is less than 0.5.
Body weight usually increases because of fat deposition. There can be all-over deposition of fat under the skin, which produces a pear shape with big hips and thighs. There can also be accumulation of visceral fat in the abdomen, around the internal organs. This creates a "beer belly" or "muffin top" and unsightly "love handles" hanging down the sides of an apple-shaped body.
Visceral fat is dangerous because it acts as an organ and secretes hormones called adipokines. These contribute to a variety of diseases such as deranged lipid profiles, Cushing's syndrome, polycystic ovary syndrome (PCOS), glucose intolerance, insulin resistance or diabetes, early onset of osteoarthritis (especially the knees) and Alzheimer's. The fat also gets deposited in the liver, causing it to enlarge and get damaged, becoming a "fatty liver".
Getting into shape is not easy. Crash diets, "fat-free" meals, meal-substitute shakes - in other words, severe caloric restriction - can initially cause dramatic weight loss. The body then adapts, goes into "famine" mode and starts to conserve calories. The weight stabilises for a while and then slowly creeps up.
It is better to eat healthy, restricting your intake to 75 per cent of your regular diet, avoiding high-calorie, trans fat and sugar-laden snacks and eating 4-6 helpings of fruits and vegetables a day. This way the weight not only melts off - though slowly - but is likely to stay off.
Visceral fat is more likely to respond to a combination of diet and exercise rather than calorie restriction alone. "Cardio" or aerobic exercise such as running, jogging, walking, cycling, dancing or swimming for 40 minutes to one hour a day is ideal. Dancing has the added benefit of maintaining balance and coordination and delaying the brain changes linked with ageing. If you cannot spare a 40-minute chunk of time everyday, four sessions of stair climbing for 10 continuous minutes or even a two-minute brisk walk every hour during the day is beneficial and will help.
Muscles increase the BMR (basal metabolic rate). The higher the BMR, the more calories a person burns, even at rest. So build more muscles and maintain the ones you have. (You lose muscles with age.) Do a set of muscle-strengthening excercises with light weights every alternate day along with your cardio workouts.
The writer is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India. If you have any questions on health issues please write to yourhealthgm@yahoo.co.in
YOUR HEALTH — ?Dr Gita MathaiAug 15, 2018 00:00 IST
As we age, one or both of our legs can pain. A slip or fall or even an awkward step can sprain the ankle. It bears half the weight of the upright body but is a relatively weak joint. If the ligaments are strained, swelling and pain occur. If the ligaments are torn, there may be bruising as well. The R.I.C.E. treatment (rest, application of ice every 20 minutes, compression with an elastocrepe bandage and elevation ) for 2-3 days will usually work. Medication such as paracetamol and ibuprofen help relieve the pain. If there is no improvement after three days, a fracture may have occurred.
If you have an active lifestyle, you can develop a sudden severe pain on the inside of the leg called "shin splints". It is more likely to occur if you have flat feet or use footwear unsuitable for activity or if muscles around the bone are overused. They can be relieved with ice packs and elevation of the legs. If shin splints are persistent, a stress fracture (hairline fracture) may have occurred.
–– ADVERTISEMENT ––
Varicose veins appear as bluish swellings on the legs, usually on both sides and cause a dull, throbbing pain. They occur if valves in the veins are weak, making it difficult for blood to be pumped back into the heart from the legs. They are usually seen in people whose BMI (weight divided by height in metre squared) is greater than 30, in women during pregnancy or in those who sit or stand long hours for work. Wearing compression stockings, exercise and losing weight help.
Cramps occur as a sharp, unbearable pain, usually in the calf muscle. The muscle becomes tight and forms a hard lump which can be felt under the skin. It can be relieved by stretching and massage. It occurs with dehydration and lack of sodium or calcium. It usually goes away on its own. Recurrent cramps need medical evaluation.
Sciatica is a sharp shooting pain that extends from the lower back down the thigh, usually on one side. It is due to a slipped or herniated vertebral disc impinging on the nerves to the leg. It usually improves with OTC medication and physiotherapy. If it is persistent and incapacitating, surgery may be required.
Peripheral neuropathy may damage nerves in the thighs and feet. They may exhibit pricking or shooting pains that get worse at night. It is usually because of vitamin deficiencies, infections, nerve damage or diabetes. Treatment of the underlying cause is required in addition to specific medication.
If along with the pain in the legs there is swelling, change of colour in the overlying skin, fever, or no improvement after three days, a physician should be consulted.
The liquid of life Your health Dr Gita Mathai Jun 27, 2018 00:00 IST
Illustration: Suman Choudhury Water makes up 75 per cent of the body weight of an infant and 55 per cent of an adult. Our body is composed of multiple complex cells which contain enzymes, electrolytes and electrical charges. All these function only in the presence of water. "Fasting unto death" (for political or religious reasons) will take two months if only food is avoided. It will take seven days or less if water is also withheld.
The exact amount of water required for healthy existence has not been accurately studied. Roughly, the amount required varies with age from around 700ml (1 cup=250ml) a day for infants to 3.8 litres (16 cups) for lactating women. Not all this fluid has to come from water.
Infants get much of their fluid requirement from milk. The electrolyte composition of breast milk is ideal for babies. Any tinned formula has to be reconstituted precisely as advised (usually one flat scoop for 30ml of water) Adding more or less powder will cause variations in the electrolyte composition. The sodium content can go up and down (hypo or hypernatremia, respectively), as the infants immature kidneys cannot regulate this effectively. After weaning, water comes from food, juices and, later in life, from tea and coffee.
–– ADVERTISEMENT ––
The amount of water an adult needs depends on body composition (muscle:fat) outside temperature, humidity and level of activity. A labourer or marathon runner requires more fluids than a sedentary office worker. Before a workout, drink two cups of water to hydrate yourself. An active workout requires one cup of water every 20-30 minutes.
Older people may not be able to regulate their fluid intake relying on thirst alone. They may need to consciously drink water. School and college going youngsters (particularly girls) may suppress their thirst as they do not wish to use the restroom.
High coloured urine does not necessarily mean dehydration. The colour may be due to natural colours or additives in the food.
You can overhydrate by drinking too much water. This results in low sodium or hyponatremia. Headache and fatigue can be followed by muscle spasms or convulsions. Sportspersons can prevent this by adding a pinch of salt to their water or consuming isotonic sports drinks.
Dehydration is more dangerous. Concentration becomes poor, reaction time is increased, learning, memory, and retention are poor, and there may be mood swings. As dehydration progresses, organs can shut down, resulting in death.
Women should be conscious of their fluid intake during pregnancy as dehydration, especially in the last trimester, can precipitate urinary tract infections and premature labour. After delivery, good hydration means there is adequate breast milk for the baby.
The writer is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India. If you have any questions on health issues please write to yourhealthgm@yahoo.co.in
YOUR HEALTH - DR GITA MATHAIApr 18, 2018 00:00 IST
Forgetfulness is a terrible thing. In children, it leads to poor grades. In older people, it leads to mislaid keys and forgotten appointments.
Now, scientists have found the basis of memory, using fancy contrast scans. As new information was processed, they could observe new synapses being formed between the neurons. Repetition made these connections stronger.
These days, both adults and children watch a great deal of television. The objects on TV appear to move because of the unrealistically rapid pace at which they are projected. "Reading" these images overworks the synapses and depletes brain chemicals. As little as an hour of TV a day negatively impacts the processing and retention of information. In young children, it raises the chances of developing attention deficit disorder by 10 per cent.
These neurochemicals are reformed during sleep. Adults and children do not sleep the required 7 and 10 hours respectively at night. A gradual deficit builds up, making remembering difficult.
Just like the body needs physical exercise to stay fit, the brain needs intellectual stimulation. It also requires healthy food, such as fruits and vegetables. Smoking has a negative effect while alcohol, in quantities greater than 30ml a day for women and 60ml for men, can permanently shrink brain cells.
Stress depletes brain chemicals and prevents them from reforming. Music, yoga, prayer, meditation or even just taking 20 deep breathes at a time, three or four times a day, are effective for destressing.
Recall and retention become more efficient if things are written down and then repeated loudly. This is because the brain is then stimulated in all three directions - graphics, audio and visual. Also, break down complicated tasks into simple steps which can be focussed on one at a time. Written notes are a great aid to memory.
The writer is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India. If you have any questions on health issues please write to yourhealthgm@yahoo.co.in
-(2).jpg)
.jpg)
.jpg)
