Articles on childhood

3 Major Reasons for Childhood Obesity

Ms. Swati Kapoor, Dietitian/Nutritionist
A chubby child might be cute, but did you know that childhood obesity can not only have an impact on the child’s immediate health, but can affect the child’s health adversely for many decades to come. It is estimated that one in five children between the age of 6 to 17 is overweight. Many of these children face a high risk of developing obesity related problems, such as high blood pressure, diabetes, and heart disease. Let us discuss 3 major reasons for childhood obesity. 1. Inadequate sleepIt has been found that in the first year, infants need 14 to 18 hours of sleep in a day. Out of this, 10 hours at night and the remainder during daytime. Toddlers need 13 hours, and up to about 18 or 19 months, they should still be getting two naps a day and 10 hours at night. Lack of sleep can disturb the behavior of the child and they can start behaving stubborn, irritated or frustrated. An overtired child in school may have trouble focusing and paying attention in class. He may become forgetful and make silly mistakes.2. If any of the parent is obeseChildren learn things from their parents. So, if you are obese and if you tend to buy foods that are convenient to eat and tasty, such as cookies and chips, your child will have a higher risk of being obese. To keep yourself and your child fit, encourage your child to take up a sport, walking, running or any other physical activity.3. Parental restriction of a child's eatingParents trying to restrict their children's access to certain foods will only make them want those foods more. For example, if kids have never had a chance to eat potato chips regularly, they may overstuff themselves when the food appears at a friend's party or picnic. Therefore, moderation and control in portion is the key to control your weight. Being parents you need to work on changing the food environment in your home so that a wide variety of healthy choices such as fruits and vegetables are available while unhealthy options are not.To keep your children healthy don’t use unhealthy food to comfort them when they are hurt or disappointed.

High Salt Intake in Childhood Might Be Linked to Obesity

Ms. Swati Kapoor, Dietitian/Nutritionist
High salt intake has been blamed as one of the root causes for obesity in adults. And now research shows that it even applies to children. Research published in the journal Pediatrics shows that the more salt children consume; the more they slurped on sugar-sweetened drinks. And those who drank more than a serving a day were 26% more likely to be overweight or obese, suggesting that salt may be part of the chain of events contributing to the childhood-obesity epidemic.Apart from this study, one of the research studies also showed that adults or children who ate more salt, felt thirstier and consumed more fluid. This has been quoted by Carley Grimes, the study’s lead author, a dietitian and doctoral student at Deakin University in Australia. The amount of salt in your blood rises and to control it, your body gets thirsty. But the problem with adolescents is that, when they feel thirsty, they try to reach out for soda and sugar based drinks instead of water, which ultimately leads to unhealthy weight gain.Salt-rich diets could be the key to why some children battle with obesity, according to a research at the University of London. In a study of data on 1,600 children, they found that children eating a salty diet tend to drink more, including more sugary sodas and drinks.The researchers calculated that for every gram of salt those children consumed, they also drank 17 g of sugary drinks. The kids who did not commonly drink sugar-sweetened beverages wound up eating more than half a gram of salt less than the group of kids who drank sugary drinks. “That’s significant,” says Grimes. “It’s a bag of chips a day”It is very important to educate adolescents about salt intake. Here are some tips which can be inculcated in your lifestyle, to help reduce salt intake.Try to consume home cooked food most of the time.Stick to fruits, salads and vegetables.Consume calcium rich foods like milk and other dairy products.Other than obesity, a high salt diet can trigger other health problems like high blood pressure and cardiovascular ailments. Controlling salt intake might be difficult in India, since salt consumption is high across all regions and foods. Try to refrain from adding extra salt to home food, or when eating out.

Children of Obese Mothers Have Higher Heart Risk

Ms. Swati Kapoor, Dietitian/Nutritionist
Weight loss is a lot more than just about looking good. Its about good health. People associate obesity with personal health but recent studies have suggested that mothers who are overweight can have an effect on the heart health of their child at birth. Other issues such as fetal distress and increased risk of obesity, hypertension and metabolic disorders later in life were also identified. According to this study children of obese and overweight women have a higher risk of premature death from heart attacks and other cardiovascular related diseases.A Scottish research showed a 35% higher risk of dying before the age of 55 for adults whose mothers were obese during pregnancy. It also stated that maternal obesity increases the risk of premature death and hospital admission for cardiovascular events such as heart attack, stroke and angina.Obese people are at a higher risk of heart disease, because of their lifestyle and eating habits. According to another study, being overweight in pregnancy may cause permanent changes in appetite control and energy metabolism in the unborn child, leading to a greater risk of heart problems in later life. The study highlighted the importance of maintaining a healthy weight, sensible eating habits and sufficient activity during pregnancy.To avoid obesity during pregnancy it is important to follow a balanced and nutritious diet, along with some exercise or activity. During this phase the body needs extra nutrition for the developing foetus. Not just for the pregnant woman, but even for the lactation period that will follow. But, it is important to note that being pregnant doesn't indicate that the mother has to consume food for two individuals, as she is supporting a life within her. The key to a healthy pregnancy is to consume a balanced diet with light and frequent meals, and to regularly take the supplements or medicines prescribed by the doctor. One should also try to be active, for e.g. go for walks or do pregnancy specific yoga, but under supervision.

Retinopathy of Prematurity - Childhood Blindness

Dr. Atheeshwar Das, Ophthalmologist
The World Health Organization says that India and other middle-income countries are facing the third epidemic of ROP. Extrapolating the government data (primarily from northern India) every two hours in India, three babies have reached the threshold for ROP treatment. Up to 24% of childhood blindness in India is due to retinal pathology and ROP is one of the most important cause. Prevention was never so better than cure when it comes to treating ROP. There are multifactorial reasons for terming ROP as a pending epidemic. With the advent of improved facilities in Neonatal Intensive Care Units (NICU), preterm low/very low birth weight neonates now survive and are exposed to the risk of developing ROP. These babies who would not have survived otherwise in the past two decades, in small towns, are now surviving in greater numbers and many develop ROP.The awareness of ROP among the medical fraternity is very low as a result of which the babies are referred to a retina specialist only late in the course of ROP. There are many myths among the paediatricians regarding ROP. One among them is that, babies who have never received supplemental oxygen therapy do not develop ROP. This myth has been busted now and it has been proved that supplemental oxygen therapy is not the only causative factor for ROP, though it plays some role. 20% of babies who never received oxygen in postnatal period still develop ROP.As per the Western data, ROP occurs in babies who weigh less then 1500 gms. However in India, we tend to see ROP in babies who weigh more than 1500 grams. If we had applied the western criteria for screening babies, we would have missed 20% of the ROP cases. Western developed countries guidelines do not apply to Indian context as the neonatal and postnatal care vastly vary. There is a tendency to see a large number of ROP cases in the rural areas in India,probably due to neonatal care practices prevalent there. Gestational age or post conceptional age as a screening tool is ineffective in rural area as it is almost impossible to date the pregnancy. ROP once diagnosed early is graded according to the set guidelines and treatment initiated as per protocol. Early treatment of ROP can go a long way in preventing blindness. ROP can be effectively managed with laser photocoagulation. The immature retina in a pre-term neonate when exposed to very high concentration of ambient oxygen is susceptible to develop new blood vessels, which have a tendency to bleed. If the treatment is initiated early, these new blood vessels regress and the retina attains maturity subsequently. On an average for every 10 preterm neonates I screen, 4 would have ROP and among them 2 or 3 require treatment.All this, calls for a clarion call among pediatricians; neonatologists and ophthalmologists who need to counsel the parents, screen for ROP more aggressively and to frame guidelines for screening Indian babies.  Already there has been initiative in this context in the form of tele-ROP screening with help of Ret-cams, which can be transported to remote rural areas in Karnataka.We need more such initiatives targeting the rural areas in particular, as ROP blindness is definitely preventive.

Tv in the Bedroom Might Be Linked to Childhood Obesity

Ms. Swati Kapoor, Dietitian/Nutritionist
Obesity is amongst the most common health problems among the youth today. There can be many reasons that lead to obesity such as overeating, medical condition, no physical activity, etc. In a recent national study, researchers from the Geisel School of Medicine at Dartmouth and the Dartmouth-Hitchcock Norris Cotton Cancer Center found that having a television in th bedroom was a significant predictor of adolescent weight gain. The researchers have observed that children who have televisions in their bedroom put on much more weight and show high BMI parameters than those who don’t.The researchers said they don't know the exact reasons for the weight gain but they offered two possibilities: greater exposure to food advertising and disrupted sleep patterns, including later bedtimes and poorer sleep quality.Sleep deprivation is one of the adverse effects of having a television in the bedroom. Sleep is very necessary for our health. At least 7-8 hours of sleep a day is required. It is seen that children with televisions in their bedroom, have sleep problems and ultimately gain weight. According to experts "When kids have TV in the bedroom, they isolate themselves from the family," he added. "They tend to go to bed later. They tend to be less active. They tend to snack on junk food. All of this will increase weight."It’s not so much that if you sleep, you will lose weight, but if you are sleep-deprived, meaning that you are not getting enough hours of good quality sleep, your metabolism will not function properly.Also, when you are sleep deprived, you will automatically feel low on energy and will grab something unhealthy to eat, which will gradually give you unwanted fat.Bedroom televisions linked to increase in BMIResults of one of the study revealed that having a television in the bedroom was linked to an excess BMI of 0.57 at 2 years after study baseline and an excess BMI of 0.75 at 4 years after study baseline. Furthermore, they say a bedroom television may increase exposure to child-targeted food advertising.It becomes important to conduct parental education regarding this issue which can affect the child’s health. It is important to keep the youngsters in discipline in their daily routine. Removing the television from the bedroom could tackle the problem of obesity to some extent.

10 Healthy Reasons to Promote Breastfeeding

Dr. Yogesh Kumar, Ayurveda
We all know that mother's milk is the beat nutrition for a baby and it also gives mental and emotional satisfaction.In the first year of life the baby grows fast.Doctors advice to breastfeed the baby at least up-to six months.After six month period the baby's weight increases by double, as compared to birth weight.To provide this fast growth baby needs essential calories ,proteins and other nutrients which is supplied by mother's milk and that is why we need to promote breastfeeding in babies.In today's world breastfeeding the babies have gone out of the fashion.The "modern moms" are finding it uncool to breastfeed their child.The soul purpose of this article is to promote more  mothers to breastfeed their children and clear the doubts in their mind related to breast feeding.The following are some benefits of breastfeeding.Benefits of BreastfeedingIt created a sense of  mental and emotional bond between mother and her baby. The baby feels more secure close to the mother.It is natural and  ready to consume, no need to prepare like artificial milk nutrition products.This best Natural Nutrition is free and no money can buy this precious gift.It protects the Baby from various communicable diseases as it has natural defense mechanism(antibodies).The mother's milk is sterilized hence it do not cause any digestive problem in the babies.Babies know the difference between the mother's nipple and artificial nipples.The babies who grows on mother's breast feed milk  have less tendencies to develop thumb sucking habits.The temperature of the breast milk is perfect for the baby.It is believed that babies fed on breast milk have better bones and muscle development as compared to non breast fed babies.Breastfeeding has been linked to developing protection against Childhood Cancers.Note: Mothers should always clean the nipples before and after the breast feed.

Symptoms of Learning Disabilities in Children

Dr. Vykunta Raju K. N, Neurologist
DefinitionDisorder of one of the basic psychological processes involved in understanding or in using language, spoken or written, which may manifest itself in an impaired ability to listen, speak, spell, read, write, think (e.g. planning) or to do mathematical calculations (not due to mental retardation [MR] or sensory deficits [e.g impairment in hearing, vision etc].Common Elements in the Definitionsü  Brain dysfunctionü  Uneven growth pattern/psychological processing deficitsü  Discrepancy between potential and achievementExclusion of other causesTypes of Learning Disordersü  Dyslexia– Difficulty in reading ü  Dysgraphia– Difficulty in writingDyscalculia– Difficulty in mathematical abilitiesEtiology - Often genes + disorderTobaccoAlcoholHead InjuryOtherMales predominateFamilialUp to 5-10% of "seemingly normal" schoolchildren have this hidden disability. Dyslexia affects 80% of all those identified as learning-disabled. SpecificLD is now believed to be a result of functional problem with brain"wiring" rather than an anatomic problem and is genetically inherited.Preschool children Language delayPronunciation problems Slow in acquiring vocabulary Difficulty in rhyming words Trouble with learning numbers, alphabets, days of the week, colors and shapesSchool-going children             Presenting problems-more commonly with school performance-difficulty is in one particular subject Slow to learn the connection between letters and sounds Confuses basic words (run, eat, want) Makes consistent reading and spelling errorsTransposes number sequences &confuses arithmetic signs Poor spelling, slow reading Has difficulty in left right coordinationHas difficulty in tying shoe laces, organizing pencil box. Comprehension of these children is often superior to isolated decoding skills Reading Disorder(Dyslexia)  There is generally a combination of difficulties in the ability to compose written texts as evidenced by grammatical or punctuation errors within sentences, poor paragraph organization, multiple spelling errors, and excessively poor handwriting. This diagnosis is generally not given if there are only spelling errors or poor handwriting in the absence of other impairments in written expression.SlowComprehension defectsVocabulary limitationsLimited experienceFigure notations – complex and denseDirecting– dense, readability very high, in high distraction  positionSlowVocabulary limitationSpellingPunctuationOrganizationExperienceHandwriting– poor readabilityNote takingReading is very difficult ( + x )MultiplestepsPoor tool useSelf confidenceAnxietyWrittenOralEtiologyCourseFamilialCourseIQReadingrateStandardscoresComprehensionSpellingStandardscoreCan person read what they have writtenImpaired vision and hearing Attention Deficit Hyperactivity Disorder(ADHD) Mental Retardation Pervasive Developmental Disorders Communication Disorder Lack of opportunity, poor teaching Normal variations in academic achievement Anxiety Poor studying skillsConsensus ClinicalCriteria (CCC) for Diagnosis of Learning Disorders -adapted from DSM IV-TRIQ85 or more No vision impairment No hearing impairment Presence of adequate opportunity for learning with proper motivation GLAD score below 40%, at two levels below the child’s current class level Difficulty in reading / writing / mathematics that significantly interferes with academic functioning.Along with GLAD, Bender Visuo-motor Gestalt Test will be used to assess motor coordinationOnset during infancy or childhoodMost show a delay or impairment in developing functions and most undergo a steady course. Outcome depends on the severity of the disability, the age or grade when remedial education is started, the length and continuity of treatment, presence or absence of associated emotional problems, and parental and school supports. With appropriate remedial education and provisions,most children with LD can be expected to achieve academic competence and complete their education in a regular mainstream school. However, some children may still be unable to cope up and need to continue their education in special schools.1. Management of Primary Problem Remediation and AccommodationBehavioural & Psychological treatmentAllowing extra time A separate quiet room for taking tests   Alternatives to multiple choice questions Providing access to syllabi and lecture notes Tutors ‘talk through’ and review the ‘content’ of reading material Tape recorders and recorded books Allowing use of computers with spell checkersCalculatorRead problemWordprocessingSpell checker (right-click)NotesPhotocopiesInstructor OutlinesNote takerFolder for each subjectWhere are the classesLibrary– contact personScheduleSupportServiceCourse load – start slowDisability certificate. Extra time to write examinations, grace marks, supplemental writer during their examinations and also the facility of integrated as well as inclusive education. TheNational Trust for the Welfare of Persons with Autism, Mental Retardation andMultiple Disability, 1999, recommends promotion of inclusive education. The Sarva Shiksha Abhiyan (SSA, 2000), pledges to “ensure that every child with special needs, irrespective of the kind, category and degree of disability, is provided education in an appropriate environment".

Arthritis of Hands: It Must Be Rheumatoid Arthritis

Dr. Tanoy Bose, Internal Medicine
Vital notes:RA is a chronic debilitating joint disease that affects small joints of hands and foot.More common in females aged 20 to 50 years.It is not synonymous with Rheumatic Fever which occurs in children aged less than 15 years.It has got nothing to do with monthly Penicillin injections and checking ASO titre. Somebody on Penicillin injections or being checked for ASO titre should change the doctor immediately.Untreated disease may cause deformity of hands and foot causing deterioration of quality of life.Erosion of small joints along with loss of entire joint architecture is the basic disease process.Early morning stiffness of joints along with swelling of one or more small joints of hands is very characteristic.Treatment is done with Methotrexate, Hydroxychloroquine Sulfate, Sulfasalazine, Leflunomide and short courses of steroids.Difficult diseases are treated with costly injections called biologics.The motto of treatment is “ catch early, hit hard and achieve and maintain treatment goal “Lung and cardiac complications are common in long term disease.Rheumatologists but not the Orthopedicians nor neurologist are the best person to treat the disease.Introduction:Rheumatoid Arthritis is an autoimmune disease of mankind where the cells and molecules who are responsible for security of our body, misidentify the joint tissue as foreign substance and start destroying them similar to the way they usually do when a bacteria or virus enters the body. This misdirected attack towards our own body is called autoimmune phenomenon.The worst affected parts of the body are the joints of hands and foot. These small joints that are responsible for performance of day to day activities like eating, holding, writing, typing, washing etc become painful and swollen causing stiffness and deformity. This results in poor quality of life and subsequent depression. Early diagnosis and continuous treatment with specific medicines is cornerstone of treatment.What are the symptoms?Symptoms vary from person to person and also from early stage to late stage of the disease. In early stage there may be mild pain and stiffness involving 1 to 4 small joints of the hands and feet with a typical pattern of stiffness of those joints after rising from bed. During this phase it is very difficult to diagnose the disease. But it is very important to catch the disease in this stage. Researchers have proved that joint damage and bony erosion start even before the symptoms have manifested and hence earlier the treatments better the results.In a full blown case of Rheumatoid arthritis the picture is very classical of a middle aged female presenting with pain and swelling of hand and foot joints along with early morning stiffness that responds to steroids brilliantly. Wrists and the knuckles are predominantly involved. Patients are unable to hold a pen or open the door or do cooking etc. Gripping the wrist firmly causes pain and the hand joints are warm.In a advanced case of the disease we often find elderly people presenting with crooked hands with areas of permanent swelling and skin changes due to chronic friction. The skin fold may contract chronic fungal infections and the joints are swollen and painful.A few other organs are damaged in silence and they create serious problem at the advanced stage of the disease. Lungs, Heart and Blood Vessels are frequently affected. There is accelerated cholesterol deposition in arteries of heart causing increased risk of heart attack and brain stroke. These patients frequently contract infections which are difficult to treat.Involvement of spine or low back is uncommon. However, cervical spine or the neck region is the only part of the spine that may be affected in this disease. What is the difference between Rheumatic Fever & Rheumatoid Arthritis?There is a heaven & hell difference between these two entities. Rheumatic Fever is a disease of childhood. It usually occurs in children aged less than 15 years and is characterised by excruciating pain, swelling and redness of one or more big joints of arms and legs that responds excellently to Aspirin. This disorder may cause cardiac problems and is the leading cause of Valvular Herat disease in India. It is often characterised by some skin rashes and rarely neurologic problems. The disease process, the causative agent and the clinical symptoms are completely different from that of Rheumatoid arthritis.Why Penicillin injections are given on a monthly basis?Patients of Rheumatic fever often suffer a damage to the valves of the heart during the attack of Rheumatic fever. This damaged valves are potential sites of infections that may develop in the later part of the life. This infection is called Infective Endocarditis and may cause serious complications if not addressed properly. Penicillin injections are given as a form of prevention of development of this infection and have got no relationship with the wellness or cure of the disease. People who are aged above 15 years and are being treated with penicillin for the first time for joint pain occurring in small joints of hands should immediately change their doctor and consult a rheumatologist.How is Rheumatoid Arthritis diagnosed?Rheumatoid Arthritis is diagnosed by its classical symptoms and some laboratory investigations. To identify early rheumatoid cases we usually follow a scoring system which includes counting of number of joints involved, the duration of the symptoms, checking ESR and CRP in blood and looking for the positivity of Rheumatoid Factor and Anti CCP Antibody. Patients with high values of Anti CCP Antibody are very much likely to suffering from rheumatoid arthritis and also they are very much likely to suffer a aggressive disease courseDoes each and every patient of rheumatoid arthritis develop crooked hands and foot?No. Not all patients suffer from such a devastating complications. There are important characteristics which if present predict severe destructive disease. Females, Smokers, High values of Anti CCP or Rheumatoid Arthritis, Family History of Rheumatoid Arthritis, Early evidence of Joint destruction on X Ray are a few important features who will go forward to develop destructive disease. How Rheumatoid Arthritis is treated?Continuous Physical activity of the involved joints is the corner stone of treatment. More the joints are active, less the damage.Cessation of smoking is mandatory. Smokers tend to develop early joint destruction. Medicines that used in treating rheumatoid arthritis are together called Disease Modifying Anti Rheumatoid Drugs or DMARDs.Methotrexate, Hydroxychloroquine Sulfate, Sulfasalazine, Leflunomide are the principal DMARDs. Of these, methotrexate is the backbone of therapy. Methotrexate is used on a once a weekly basis starting from a dose of 5 mg to 50mg/week and a weekly 5mg of Folic Acid supplement is given to neutralise the adverse effects of Methotrexate. The detail of the drugs is mentioned below.Why I am being given Steroids?Steroids are given for a short period of increased disease activity. In rheumatoid arthritis we do not prescribe steroids in a regular basis. It is often prescribed when the patient is put on the DMARDs for the first time and when there is break through pain or active disease during the treatment. Steroids are used in low dose in a decreasing dosage pattern over weeks and usually are not continued more than a month.What are Biologic agents? Why they are so costly?Biologic agents are highly specific molecules who directly block the action of the culprit chemicals in our body that cause the joint destruction. They are highly researched molecule an d is manufactured abroad. They are usually available in injection formats and have their own side effect profile which includes reactivation of Tuberculosis and other opportunistic infections. Usually patients are checked for latent Tuberculosis Infections, HIV, Hepatitis B and C before the treatment is started. Biologics cause excellent response to the disease causing alleviation of pain and swelling and sense of well being but unfortunately they do not provide any cure. Hence, if biologics are stopped then there are chances that the disease activity may worsen requiring more biologics or aggressive treatment with DMARDs.Conclusion:There are Rheumatologists in every city or town of the country. In case of any kind of aches and pains of joints with or without swelling that is not caused due to any trauma, one must consult a Rheumatologist. We keep on posting and distributing such articles to each and every patient so that a perfect transparency is maintained between the treatment and the patient.

My Mom Is My Best Friend: Communicating With Your Teen

Dr. Hvovi Bhagwagar, Psychologist
“Can I go for a party tonight?” asked 17-year-old Tarun. “Where is the party? How long will you be out? Who’s coming with you?” shot back Madhu.“MOM! Stop asking so many questions. You, like, just don’t trust me!”“Trust. A difficult word in today’s day” thought Madhu, her eyes riveting to the newspaper in her hand. The daily tabloid had featured one more article on the recent rave party in Mumbai. “So many kids were caught there, Tarun. All taking drugs. I don’t want that to happen to you!”“There you go again. Just don’t believe your own son.”Whatever you put it down to – stress, media exposure or the internet – parents and kids are today talking two different languages. The generation gap has become wider by far. The result of this is parents have much less control over their children’s lives.Unfortunately most parents mistake communication to mean ‘telling their kids what to do’ or questioning their kids all the time. But good Communication starts with relationship building. A parent-child relationship is like a bank account and needs constant deposits of listening, trust and an honest attitude. Withdrawing from that account by raising suspicions, screaming, being sarcastic without putting in any deposits doesn’t work in the long run. Here are 5 strategies to start communicating better with your child.Build the bridge: How does your teen respond to you? Does he/she hide stuff from you? When you are talking, do they rudely leave the room? Do they refuse to talk to you for days after a fight? All of these are signs of poor communication patterns set from childhood.  Fortunately, nature has provided a natural bond between parents and children which can be forged at any point. Start now. Respect your child. Let them have privacy. Leave them to explore their interests and career choices without pressure. And allow them to state their opinions.LISTEN! Most parents talk 50% more than they should. No wonder the usual complaint is“My child just won’t’ listen to me!” when actually they are never given a chance to talk! Parents get taken aback at how open their kids can be with simple empathic statements such as “How do you feel?” or “What’s troubling you”No lecturing: In the teen years, avoiding family is the norm. Friends are much more important. Parents have to steel themselves against this, be patient and yet let their child know good from bad in as diplomatic a way as possible.Teens and pre-teens need information on issues like AIDS and abortion but don't lecture while doing this. Have a conversation instead.4Be comfortable with sensitive issues: Why would a teen experiment with drugs? What makes the 16-year-old give into her boyfriend’s demand for sex without protection? Curiosity of course.  Parents who are early birds in informing their children on issues such as sexuality,bodily changes of adolescence, attraction to the opposite sex and drugs,usually have stable and secure kids.Balanced parenting: At no time does parenting get tested more than when the child is between the ages of 12 and 18. Here a parent has to draw a fine line between freedom and authority. Freedom in limits is acceptable, such as if the teen wants to withdraw into a room with a shut door, or stay overnight at a close friend’s place.  But authority needs to come in on issues such as keeping tabs on friends, questioning on whereabouts and insisting on keeping cell-phones always on.Improving the lines of communication between parent and teen goes beyond buying them the latest cellphone and laptop. It is straightforward and honest talking which actually does the trick. Although deceptively simple in theory, communication is tough to practice. Yet, it could make the difference between a child on drugs and one who passes each exam with flying colours!

A Healthy Mouth Is A Few Simple Steps Away!

Dr. Sameera Ali, Dentist
Teeth help us to chew and digest food. They help us to talk, and to pronounce different sounds clearly. Finally, teeth help to give our face its shape. A healthy smile can be a great asset; and because this is so important, it makes sense to give your teeth the best care possible.The good news is maintaining a healthy mouth only requires a few minutes of your time daily. Brushing for 2 minutes effectively, twice daily is mandatory. Ideally brushing after dinner , can be followed by brushing after breakfast the next morning. A great way to improve gum health, is to massage them with a clean finger , this improves blood circulation.Flossing is meant to be done prior to regular brushing , although if you have large gaps between your teeth, then using an inter-dental cleaning brush would be recommended. Water and air flosses are now available and can be effectively used as an alternative to traditional thread floss.While a mouthwash is not necessary, rinsing your mouth vigorously with water after all meals, snacks and even beverages , helps minimize food accumulation and staining. While oil pulling is good for you, it can only be an adjunct to the brush - floss -massage protocol and not replace them. Balanced diet with less sticky and more fibrous foods especially rich in Vitamin C also aids the overall health of your mouth. Too many fizzy drinks can erode your enamel, so daily consumption is a bad idea. If you like deserts, avoid the chewy , sticky variety. A piece of dark chocolate after dinner can be your treat. Smoking is bad for you and for your teeth, as are other tobacco products. Visiting the dentist once a year should be part of your routine, and your doctor can help further educate and encourage you, on how to maintain your teeth for life.