Most mothers, particularly if it is their first baby are given varying advice, opinions and suggestions. Even the housemaid contributes her share of advice in baby care. These advices are often conflicting and may not be scientifically correct. There are many “well wishers” who cannot digest their meals unless they have passed some “invaluable guidance” to the mother, particularly regarding rearing of the baby.
If the baby is crying there will be different viewpoints. It is ear ache, put oil in the ear; it is a tummy ache, press the stomach, give gripe water; it is constipation, give a laxative, the baby has fever, cover him with blankets etc. Parents should be able to separate the reality from the well meant but sometimes unscientific suggestions of the “well wishers.”
The scientific facts are given below and also myths exposed, so that the parents can really know what is good for their baby:
1. Mothers cannot breast-feed immediately: The baby should be put to the breast as soon as he and the mother are comfortable. Baby’s born by operation i.e. caesarean section can be put to the breast as soon as the mother comes out of the anaesthesia and is comfortable, approximately 4 hours, even if the mother is on I.V. drip.
2. Initial milk (colostrum) is not good for the baby: The milk produced within 1-2 hours after parturition is less and called “colostrum”. Some mothers think it as “witch milk” and discard it thinking it to be harmful. Nothing is farther from the truth. Colostrum though looks thin, sticky and yellowish is very rich in nutritional factors (richer than even milk) and should in all cases be given to the baby.
3. A breast-fed baby needs water: The breast milk is 99% water. So no supplementation with water is advocated during the first 4 months when the child is exclusively on a milk diet. After that as weaning starts and the baby eats semi-solid food, he requires water in order for the body and the kidneys to handle the solute load. However in very hot conditions, the baby may lose a lot of water through the skin and water supplementation becomes necessary. There is no point in adding glucose to water.
4. A newborn requires multivitamins, gripe water, Bonnisan etc: A baby requires only mother’s milk and nothing else. The only supplementation, which is really required, is iron starting at the age of 4 months. Gripe water contains alcohol, which may be sedating.
5. A mother ruins her figure due to breast-feeding: Breast-feeding helps the mother to reduce weight as some of her energy and calories is “going out” in the form of breast milk.
6. Exposure to cold, breeze, cold drinks, ice cream causes cough/cold in the child: Coughs and colds are usually caused by viruses present in the atmosphere and not by breeze, cold drinks etc. The viruses are present ubiquitously, more so in the cold months. So parents make all types of erroneous conclusions and blame the above-mentioned things for the coughs and colds, which are anyhow more common during the winters due to the increased prevalence of the viruses.
Almost every parent believes that the child gets a cold when he eats cold things like ice creams, cold drinks, curd or fruits like oranges. In fact no dietary restrictions are prescribed in respiratory infections. Children should be encouraged to take a lot of fluids, as this is the best way of liquefying and bringing out the mucus from the lungs.
7. Swathing the baby in woollens from head to toe will prevent colds: It can make the child comfortable. But, it cannot kill the viruses present in the air nor can it prevent the baby from contracting those viruses simply because the baby has to breathe the air. Therefore, coughs and colds cannot be prevented and all children have many episodes during their childhood.
8. Teething causes diarrhoea and fever: Teething causes mild irritability in the child because of the irritation of gums by the erupting teeth. It directly doesn’t cause any illness.
9. A fat baby is a healthy baby: In fact a fat baby is more likely to be an obese adult, because there are more fat cells in the fat baby. A baby whose weight stays within the range of normalcy is absolutely healthy, even if he appears lean.
10. Starvation is good during diarrhea:This is a very erroneous concept, originating because feeding during diarrhea does increase the volume and frequency of diarrhea. Plus the child usually passes stools every time the baby eats something and hence the parents consider that whatever he has eaten is “lost” in the stools. This is incorrect. Even during profuse diarrhea, at least 60% of what is given to the child is absorbed in the blood and thus provides essential nutrition that is very necessary for the baby.
11. Diarrhoea and constipation: A common misconception is that if the baby passes 8-10 stools per day it is diarrhoea and if passes once in 2-3 days, it is constipation. More important is the consistency of the stool. It should not be liquid (semi-soft is O.K.), nor too hard, so as to cause pain to the child during evacuation.
12. Vitamins and tonics increase the appetite and the weight of the child: The weight of the child increases by what food he consumes and not by tonics and vitamins. These also do not increase the appetite. What increases the appetite is the quality of food, the parents removing all types of pressures on the child to “force” eat and the child’s mood and temperament. Vitamins are sought after by the parents as a must for the baby and a panacea for being fit and fine. In fact they do little but burn a hole in the parent’s pockets.
13. Only baby products should be used for the baby care: Any ordinary soap, shampoo, oil or lotion is good enough for the baby. There is no need to go for expensive products, commercially touted as exclusive for the baby and ideal for them.
14. Talcum powder should be applied: It is not necessary. It only makes the baby smell good and thus there is no harm in applying it.
15. A newborn must be massaged to strengthen his bones and muscles:Massaging in no way strengthens the bones of the baby. It only increases the skin circulation and may make the baby look temporarily “ruddy.”
16. Circumcision is necessary if there is tight fore skin: The foreskin over the penis in a newborn is tight and may not be retracted backwards over the glands up to the age of 5-6 years. This is normal and called “physiologic phimosis.” No attempts should be made by the parents to forcibly retract it, neither is circumcision required for it. Usually it doesn’t cause anv problems in urination. However if there is a swelling at the tip of the penis during urination or the urinary stream is weak (i.e. urine comes in dribble) consult your doctor, as it may be a true phimosis, which requires surgical correction.
17. Kajal is necessary for the eyes: Kajal is powdered carbon. It also contains lead. Both of these are harmful to the eyes. Kajal can be applied anywhere on the face like the forehead, cheeks etc. but not inside the eyes.
18. If the baby has cough, cold, diarrhoea or fever, vaccines should be postponed: Vaccines can be given in minor illnesses without any side effects.
19. A coin should be tied to an umbilical hernia to push it in and “cure” it:An umbilical hernia disappears by its own by the age of 3-4 years in the vast majority of cases. Application of a coin can lead to unnecessary complications for a benign problem.
20. Eating sweets give rise to boils and worm infestation in the child: Boils are an external skin infection caused by bacteria and has nothing to do with eating sweets. Similarly worms don’t thrive on sweets.
21. Measles rash portends God’s blessings: Measles is caused by a viral infection and is no blessing of the god towards the child, nor it purges the body of bad omens.
22. If the baby sleeps on one side, its head gets deformed: It does temporarily, but not permanently. When the baby starts sitting, the head is moulded back to its natural shape.
23. In case of earache pour oil in the ear:It is not advisable. Advice of a doctor should be sought to diagnose the cause of earache and treat it accordingly.
24. Antibiotics are a must for treating coughs, fevers, diarrhoeas etc.: Antibiotics are no panacea for illnesses. Most of the infections are viral and antibiotics are of no use in them. In fact they can cause resistant strains of the bacteria to emerge. So antibiotics should be used judiciously and only when clearly indicated.
25. Rickets: Parents suppose that any bone problem is due to “rickets” (a disease caused by deficiency of Vitamin-D). Thus it is blamed for knock-knees, bow legs, big head, delayed eruption of teeth, short stature, slender arms and legs etc. While rickets can cause them, to attribute all bone problems to it is not correct. For e.g. delayed eruption of teeth may be normal. Symmetrical defects at and below the knee joint like knock-knee, bowing of the legs, out-toeing or in toeing in children is normal and tend to correct itself by the age of 6 years. Prescription of calcium and vitamin-D for reasons mentioned above are not justifiable.
26. Chapping of lips: The corners of the mouth of a child are chapped or cracked. Similarly the tongue may have some soreness or ulcers over it. It is attributed to Vitamin-B deficiency, while actually it is seldom the cause. Chapping of the lips and the corners of the mouth are frequently due to dryness and hence application of an emollient will cure it.
Another common cause is drooling of the saliva or constant licking by the tongue whence it manifests as an irritant dermatitis and requires application of steroid based ointments to cure it. Tongue ulcers are called “aphthous ulcers” and are usually due to obscure reasons. It can cause a lot of pain and the treatment lies in taking soft, bland diet and analgesics. There is no cure for this and it becomes alright on its own. However chances are there that it may recur.
27. Pitryseas Alba: These are whitish spots encountered on the face of a lot of children and are chronic, though with time they subside of their own. Parents wrongly attribute them to calcium or vitamin deficiency or worm infestations, while actually it is a chronic allergic disorder of the skin. Moisturising lotions over it may be useful to reduce the scaling. They disappear permanently at the time of puberty.
28. Whitish lines on the nails: Parents attribute it to deficiency of calcium or some vitamin deficiency, while actually they are normal and seldom reflect a deficiency in the diet. Similarly, the skin at the corners of the nail beds is frequently peeled a bit, which again is attributed to a dietary deficiency. Actually it is due to a recurrent, unrecognised trauma in the day to day work and is not a sign of a nutritional deficiency.
29. Honey: It is a popular food item for the babies and used frequently by the parents both for its nutritional value and also in cases of constipation. Honey should not be given to a child below 1 year of age, firstly because it is not essential and secondly because rarely it can cause a serious and life threatening disease called “botulism.”
30. Treatment of constipation is a must for cure: Many parents believe that unless the child passes normal stools, his illness will not be cured, as if the illness is “excreted” out in stools. During many illnesses, particularly associated with fever, normally there is a transient constipation that is self-limiting and doesn’t require treatment. All that should be done is to increase the fluid intake of the baby, particularly in the form of soups and fruit juices.
31. Straining and crying before urination/ passing stools is abnormal: Both are often observed in normal infants and usually requires no remedial measures.
32. Liver is the centre of control for many diseases: Parents and some doctors, too, have the erroneous notion that a liver problem is responsible for all sorts of indigestion, failure to gain weight, poor appetite, thinness, chronic and recurrent pain abdomen etc. A liver problem (hepatitis) will usually manifest as jaundice, deep yellow urine and nausea/vomiting with a marked decrease in appetite. Thus to blame the liver for each and every problem is injustice being meted out to a versatile and “innocent” organ of the body.
33. Treatment of Jaundice and Hepatitis: It is believed that some sort of liver tonic is a must for treating jaundice e.g. Liv-52, Stimuliv etc. These liver tonics are of questionable benefit. The fact is that the liver is a very versatile organ capable of regeneration of the dead liver cells by its own and doesn’t require liver tonics to keep itself fit and fine. Similarly, there is a misconception that fried and fatty food is contraindicated in liver disorder and should not be given to the child. So often parents just feed the child high carbohydrate diet (most popular being Glucon-D) and even if the child asks for it, avoid oily and fried food.
It is true that in some cases fatty food can cause more nausea, but in that case the child will not ask for it. Even the sight of fatty food will repulse him. So if he asks for it, it means that he will be able to tolerate it. So it can be given. Finally many parents, even educated ones, go to “jaundice specialists” (quacks), who dip the hands of the child in water. The water as if by magic takes on a yellow colour and the “specialist” smugly tells the parent that the jaundice of the body is “removed” into the water. In fact it is nothing else but a hoax and a trick of the hand and parents should be aware of such magic.
34. Intolerance to food & milk is responsible for diarrheas and allergies:Whenever there is a change in the diet of a child, e.g. introduction of a new food substance or cow’s milk, the stooling pattern of the child changes from what parents have been normally used to. Thus there may be an increased frequency, change in odour, flatulence etc. Parents blame the new food as the culprit for G.I. upsets and avoid it or change the milk. In fact change of food is seldom responsible for diarrheas and allergies and to curtail a food without any definite proof of its “harm” is unjustifiable.
35. Child requires more nutrition during illness: It is true, but the fact is that a child’s appetite (or for that matter adults also) is suppressed during an acute illness. Since there is no appetite, there is less intake of food, generating considerable anxiety in the parents who believe that good and wholesome nutrition during illness is a must for the child to fight the disease and get well sooner. The fact is that the immunity and defence mechanisms of the child do not become weak if he doesn’t eat properly for 3-4 days. No attempt should be made to force feed him. As the illness subsides, the appetite of the child comes back and he starts eating ravenously and makes up for any caloric deficiency that he underwent during the acute episode of illness.
36. For diarrheas, half diluted milk should be given: In diarrhea, there is no rational in diluting the milk. Anyhow, how will you give breast milk half-diluted? Another common misconception or advice is to stop milk diet during diarrhea, as if milk is the culprit responsible for causing diarrhea. I once again reiterate that no dietary restrictions are required during diarrhea.
37. For anaemia, iron is a must: It is a common notion even amongst doctors, that iron should be prescribed as a cure for all anaemias without trying to find out the cause of anaemia. So I have seen iron being prescribed for anaemia even in an 8-year-old child. The fact is that iron deficiency is most common till 2-3 years of age. The correct approach is to search for the cause of anaemia and treat accordingly. Finally iron therapy is harmful and in fact contraindicated in a type of anaemias called “Haemolytic anaemias”, the classical example of which is Thalessemia.
38. Illness in a breast-fed baby: If diarrhoea or other illness occurs in a breast-fed baby, the mother may believe that there is something “going out” in her milk to the baby, which he is not able to tolerate or that there is something wrong with her breast milk. Hence she goes for all sorts of self-imposed dietary restrictions. In fact, maternal food intake or breast milk has little to do with diarrhoea/illness in a breast-fed baby.
39. Intravenous drip: Parents believe that intravenous drip is the life-line of the child and that if it doesn’t run properly, it will cause grave harm to the child. Actually a meticulous i.v. drip is required only in cases of dehydration or shock. Otherwise most of the i.v. lines are for securing a vein for the purpose of giving injections periodically. In these cases it doesn’t matter if it is not running steadily. Parents also have the erroneous belief that in a child who is not eating well (as is common in illness), it is a means of nutrition for the child as it contains glucose and therefore if it is not run properly, the child will become weak. On an average, a 5% glucose drip provides 20 calories/kg/day of calories, which is very less if you compare it with the normal caloric requirement of a child and that is 100 calories /kg / day.
40. Deviation of nasal septum, enlarged tonsils and adenoids: These are held culprits for all types of respiratory majority of cases, these are not responsible for the respiratory problems. The parents are often advised operations i.e. removal of the tonsils or correction of the “deviation” of the nasal septum surgically. One should desist from such operations for a child unless there is an absolute indication. The postoperative results as regards the disappearance of the chronic respiratory symptoms are frequently disappointing and parents feel duped as well as frustrated.