Pediatric one liners - Dr. Anil Mokashi

Pediatricians, doctors and paramedical health providers need simple short messages. This is an attempt to reach child care service providers. Transfer of child care technology to masses is our aim and objective. That is our mission. You type any topic in search and you will get up to date carry home messages on that topic.

You give me an opportunity, to weigh the child regularly, I will give you a healthy baby.
Growth is a measure of health.
Birthweight, doubles by 6 months, triples by one year.
Road to health card is a birthright of every child.
A good doctor weighs every child at every visit.
Growth curve is more important than a single weight.
Keep him on road to health
Arm circumference up to 5 years Below 14 CMS= malnutrition.
Tonics help. Doctor to gain weight not a child.
Weigh him every month, till he is 3years old.
Something is wrong if weight remains same for two months in first year.
Declare him ‘cured’ only when he regains the weight lost during an illness.
One extra feed till cure, helps to catch up the weight lost during illness.
Small frequent feeding is the best way to overcome anorexia during illness.
For physical, mental and emotional growth talk, play, show love for him.
Weight indicates acute malnutrition; Height indicates chronic malnutrition.
To get more attention of doctors, bring him regularly for weighing.
A Marathi couple should not expect a boy with Punjabi physique.
A child who dies from diarrhea, dies from dehydration.
Thirst is an earliest indicator of dehydration. Look for it.
Sunken eyeballs and fontanelle indicate dehydration.
Replace the amount of water lost in diarrhea.
Continue breast feeding during diarrhea.
A glass of water, A pinch of salt and A spoon of sugar, in small quantity, frequently, is all the treatment of diarrhea.
A right way of advising salt, sugar solution is: “Five teaspoon every ten minutes”.
Too much salt and sugar in rehydration fluid is dangerous.
Use Salt Sugar Solution to prevent dehydration. Use Oral Rehydration solution to cure dehydration.
Let mother make ORS and feed it before she leaves for home.
Diarrhea is cured by giving food.
Use medicines for diarrhea only on doctors’ advice.
Drugs for diarrhea do more harm than good.
The worst treatment for diarrhea, is to stop food and fluids.
Nasogastric drip of ORS helps in vomiting.
Every doctor and health worker should be able to give “a nasogastric drip”.
Wet mopping of floor twice a day, prevents diarrhea.
Everything that goes in his mouth, must be clean.
Animal faces are also infectious.
Like flowers, children also droop without water.
Prevent diarrhea by preventing malnutrition. Prevent malnutrition by preventing diarrhea.
Breastfeed as soon as possible after birth.
Breast milk alone is the best possible food and drink in first four to six months.
Give one extra feed for one week after his diarrhea.
A child with diarrhea, is like a pot with a hole. Fill him up faster than the water flows out.
To prevent diarrhea,
A) Continue breast feeds
B) Give measles vaccine
C) Use latrines
D) Keep food and water clean
E) Wash hands before touching food
F) Control house files
Virtually every mother can breastfeed her baby. Some mothers need a helping hand.
Frequent sucking, frequent emptying, good diet and a peaceful life increases breast milk.
Breast milk secretion is a physiological process. So, it will increase by means that are physiological and not pharmacological.
Breastfeed till 18 months or more.
Lactation failure is in fact a management failure, or a failure of her adviser.
Breastfeed babies are healthier.
Breastfeed any time on demand by the baby.
Adjust the clock, according to your baby. Not the baby, according to the clock.
Excessive crying, is not equal to Inadequate breast milk.
If he is seeking or weak and he cannot suck, express the breast milk, and feed by a spoon.
Inadequate breast milk is a medical diagnosis. Think twice before accepting a grandmother’s diagnosis.
Bad feeding position leads to nipple problems.
Pregnant mothers can breastfeed for four to six months, their milk is not Bad or Sour.
A working mother can keep her child, only on breast milk, IF SHE DESIRES.
A painful lump in breast, in a nursing mother is an emergency. To express and help them empty is the best treatment.
Expressed breast milk can be stored in a cool place for 8 hours, in a refrigerator for 12 hours.
Do not put a lock on mother’s mouth. That may harm breastfed baby. Let her eat normal diet.
The society is in a hurry to start top milk. Inform the danger well in advance.
For a lactating mother, “Rice, Dal, Roti, Subji enough for both.” Is a good diet advice.
No food is banned for a nursing mother.
For nursing mothers, some families say no rice. Some families say: only rice. Both are wrong. She should eat everything – enough.
Adequacy of breast milk is indicated by
1)Let down reflex. 2) Weight gain. 3) Sound sleep. 4) Normal stools. 5) Urine more than 6 times a day.
Say no to pre-lacteal feeds. They hamper milk secretion.
Do not discontinue breast milk for baby’s or mothers’ illness.
Doctor knows more than the both neighbor & the grandmother.
Breast feeding, prevents diarrhea Bottle feeding, causes diarrhea.
Breast feeding delays next period and helps birth spacing.
Breast feeding offers the baby protection against many illnesses.
Mothers milk can never be defective.
Breast feeding creates an emotional bond between child & mother.
Baby bottle is a baby killer.
Love only one at a time, either the bottle or your own baby.
Do not start bottle feeding just because baby cries.
Bottle feeding is not easier, Breast feeding is easier
Bottle-fed babies suffer from serious illness and die.
If you have to allow bottle feeds. Let mothers see how to do it well.
feeding bottle must be cleaned before and after use.
Artificially fed babies need 5 feeds per day.
Dilution of milk means starvation of the child.
Milk powder is risky. Add one measure powder to ounce water.
Do not forget the nipple while sterilizing bottle.
Do not wipe the nipple with your pallu.
Advertisement of bottle feeding? In your clinic? Remove it just now.
Bottle feeding means ‘Top milk’ with bottle. Discourage both.
A baby’s food must be well mashed.
Breast milk is the best and cheapest source of proteins.
A young child needs a plate of his own.
Help a young child to feed himself
Rice, dal, Roti, Sabji four times a day is the crux of all nutrition science.
Mixed food is a good food.
Milk powder is best used by adding it to a child’s Kanji.
Malnourished children loose appetite.
A sick child needs more proteins for repair and growth.
98.a child who gets enough calories gets enough proteins.
Add oil or ghee to the child’s kanji.
Fruits and vegetables have vitamins and minerals They are protective foods.
There are no nutrients in fizzy drinks.
Children have small stomachs. They need 5 feeds a day.
Small frequent feeding is the best way of feeding.
Do not incriminate food for his illness.
Don’t expect a doctor to advice avoid oily, fried and sour That is a neighbor’s advice, not a doctor!
Food cures illness.
Do not keep a child’s shirt without pocket. Do not keep a child’s pocket without dry food.
Breakfast and tiffin is a must for school children.
Keep food approachable and available to the child.
He will never overeat.
Forceful feeding creates problems.
He should get what, when, how much he likes to eat. He should not get what, when, how much mother likes him to eat.
Give him the family food frequently. He will start liking it.
No child eats unless he is used to.
Not eating well is a question of habit and not of appetite.
To lose weight, eat half.
A young child needs foods rich in vitamin A.
God has not made cow’s and buffalo’s milk for human babies.
Cow’s milk is a liquid diet. It has 98% water and 2% solids.
Lot of milk satisfies the hunger and starves the child.
A child consuming lot of animal milk does not grow well.
Six rules of good nutrition.
First rule of good nutrition: Continue breast feeding till 2 years.
Second rule of good nutrition: Start Kanji at 6 months.
Third rule of good nutrition: Add proteins to Kanji.
Fourth rule of good nutrition: Add fruits and vegetables to the Kanji.
Fifth rule of good nutrition: Feed Kanji four times a day.
sixth rule of good nutrition: Continue feeding during illness.
There will be no malnutrition if all the mothers followed all six rules of good nutrition.
‘Milky kid is sick, ‘Eater kid is healthier.
Milk is not a complete food.
Immunization protects children from several dangerous diseases.
immunization is urgent.
133.All immunization must be completed in first year of life.
It is safe to immunizes a sick child.
it is safe to immunize a malnourished child.
Every woman between 15 to 44 must be fully immunized against tetanus.
Live vaccines die easily.
Like ice-cream, Vaccines must be kept cold. Heat spoils them.
Follow immunization time table.
Don’t freeze D.T.P.
Keep refrigerator door shut.
Your doctor’s opinion is final if some other doctor follows different schedule of immunization.
Typhoid vaccine is a must.
If Government does not provide any vaccine, take it from private. Child is yours not Government’s.
Regular check up in pregnancy reduces the risk of childbirth.
Every birth should be attended by a trained person.
Watch for warning signs to reduce the risk of pregnancy and childbirth.
More food and more rest are a must during pregnancy.
Pregnancy before 18 and after 35 is dangerous.
Birth interval less than 2 years is dangerous.
Healthy girls face less problems of pregnancy when they become adults.
Childbirth fever can be dangerous Don’t neglect it.
Having more than 4 children is risky.
A pill is safer than pregnancy.
Use a drug only when really needed, and when you know how to use it.
There is some danger in use of any medicine.
Medicine is a double-edged weapon.
Most diseases are self limiting Nature cures them. Drugs are rarely required.
Medicines like bullets, can hurt if fired indiscreetly.
A person who eats well does not require extra vitamins.
Injections are not more effective. Most drugs are equally effective when taken orally.
Injected medicines are more dangerous than oral.
Use antibiotics only when really needed.
164.Anitbiotics are useless in viral diseases like common cold diarrhea, measles, infective hepatitis and mumps.
Keep an adrenaline ampule ready for severe drug reaction.
Right duration of treatment is as important as Right dose of a medicine.
Dose depends on weight of child.
One teaspoon is 5 ml.
One ml gives 20 drops.
Shake the bottle before giving medicine.
Give antibiotics for minimum 3 days.
Many drugs at a time are harmful.
First dose of a medicine should be given in the clinic before the mother goes home.
One injection of procaine penicillin is useless by itself.
Sharpen blunt needles.
Boil the syringes and needles for minimum 20 minutes to make them sterile.
Give as few injections as possible.
Don’t touch the end of the needle before injecting.
Don’t wipe the needle even with spirit swab. It is wrong to do so.
Children having sulfonamides must drink plenty of water.
Be cost conscious while using drugs.
Give iron for at least 3 months.
A child who is allergic to penicillin must never have Penicillin or Ampicillin again.
Don’t use chloramphenicol for mildly ill children.
Don’t give ephedrine or adrenalin to children below one year.
Believe in doctor not in injection.
To avoid unnecessary injection offer examination fees to your doctor.
Doctor gives injections because people ask for. People asks for injections because doctor gives.
Encourage the use of disposable syringes and needles.
Do not use placebo injections.
Breastfeed babies rarely needs drugs.
Tell her in how many days the medicine bottle should be over.
Prepare the medicine in clinic by adding water to powder in a medicine bottle.
Encourage the medicine labels in Devanagari Script.
Doctor and mother both should have the same size of spoon in mind.
Medicine available in generic name is cheaper than the brand name.
Show her how to use a dispersible tablet.
Teach her the technique of feeding medicine to a stubborn child.
Prevent mosquito bites to prevent malaria.
Pregnant women should take antimalaria tablets where malaria is common.
A full malaria treatment includes chloroquine and primaquine in right dose and right duration.
Keep a child with fever cool and not cold.
Cold sponging is the best treatment available for fever.
Fever is a friend. It fights diseases.
Paracetamol alone, is enough treatment for fever.
Cold sponging avoids fever fits.
Most children with fever do not need an injection.
A child with fever must be in a well-ventilated room.
Record temperature of all ill children.
Too many cloths increase temperature.
A child with fever needs plenty of fluids.
Measles rash comes on fourth day.
Measles is a viral disease. Antibiotics are useless in measles.
Give chloroquine injection only in cerebral malaria.
Diagnose typhoid only after 1 week of illness.
Give typhoid vaccine to all patients when they get cured.
Redness warmth swelling, pain are local signs of acute infection.
Height of fever does not indicate seriousness.
Keep the head uncovered if it has scalp infection.
Severe skin sepsis can kill a child.
Do not squeeze bottle.
scabies is a disease of family. Treat whole family.
Drugs can cause rashes.
Gentian violet is good, cheap and effective. It is not an out-of-date medicine.
Dettol bath cures and prevents skin infection.
Early and full treatment of T.B. prevents it’s spread.
TB and leprosy germs do not recognize Socio-economic status.
If you suspect a child might have TB, start him on isolex and rifampicin.
Below 2 years look for TB in family. Above 2 years look for TB in contacts.
Too many doctors spoil a T B patient. Don’t change doctors unnecessarily.
To stop TB treatment is an important decision. Let your doctor take it, not the family.
Many children are infected with TB But few become ill.
Learn from accidents yourself and others have met with.
Many things in home can be dangerous four your child. Be careful now, later it will be too late.
Malnourished children catch TB easily.
Never give Isonex alone to any TB patient.
Blood-stained sputum in an adult, is usually caused by TB.
T.B. and Leprosy are completely curable.
Wash the wound with soap and water immediately. Costly ointments are unnecessary.
It is better to have no bandage than to have a dirty and wet one.
Do not massage a broken bone.
Keep the burn area clean.
Don’t make him vomit the swallowed kerosene.
Turn him on one side if he gets fits.
Don’t feed water to unconscious patient.
Metal key, chappals cap or onion all are useless to cure fits.
Don’t try to force open the clenched teeth during convulsion. It is not important.
Green leaves and yellow fruits prevent night blindness.
Vitamin A deficiency blindness is sudden.
school failures and low performance can be due to refractive error or deafness.
Do not put anything household in eyes. It is dangerous.
wipe the nose, do not blow. Blowing causes ear and sinus infection.
Do not wait for tooth cavity to hurt. Fill it early.
Saline gargles is a good treatment for pharyngitis.
Wet ear does not heal. Dry ear heals.
Ear drops do not cure discharging ear.
A ‘tonsillectomy camp’ is an antisocial work.
Tonsillectomy never helps weight or Hight gain.
When a child is breathless, cough is serious.
Antibiotics do not cure common cold.
Do not give antibiotics for less than 3 days.
Fast breathing above 40/min, is abnormal, above 60/min. is pneumonia. (If child is quiet.)
A child with cough and cold needs help to eat and drink plenty of fluids.
A child with cough and cold becomes dehydrated. Give O.R.S.
Prevent pneumonia by
1) breast feed for six months.
2) good nutrition later.
3) full immunization.
To prevent hookworms
1) Use latrines
2) Do not go barefoot.
If child vomits worms, treat vomiting first, worms later.
The dose of worm’s medicine does not depend on child’s weight.
worms thrive on child’s food and child starves.
Give iron either of the two, Mother or child who looks paler than the other.
Always give iron for at least 3 months.
Dirty needles cause jaundice.
Deworm anemic children.
Wrap him in a cold season. Remove cloths in hot season and fever.
Diseases can kill newborns in hours. Time is precious.
Newborn not accepting feeds is serious.
Burp a newborn after every feed.
Sunken soft spot=Dehydration. Swollen soft spot= Meningitis.
If a newborn does not breath “in 4 minutes” he may get cerebral palsy.
A healthy newborn gains ½ kg. per month in first six months.
Jaundiced baby needs plenty of fluids.
All babies who vomit blood need vitamin K injection.
Even in warm countries babies die of hypothermia.
Never give newborns medicines to pass faeces.
A dry cord does not get infected.
Infected umbilicus can kill a baby.
If a mother has TB. /Leprosy. The baby must get breast milk.
Aids is an incurable disease.
Aids is passed by
1) Sexual intercourse
2) Infected blood
3)Infected mother to newborn child
Women with aids should avoid becoming pregnant.
Unsterilized needle or syringe can cause aids. Use disposables only.
Home Cures: Try to do no harm.
Home Cures: Be sure of safety.
For very serious illness, Modern medicine is much safer.
Respect old traditions build on them.
No home cure is safe for poisonous bites.
It is good to room in mother and baby.
Encourage useful customs,
Discourage harmful customs,
Do nothing about the rest.
Delivery at mother’s place is a good custom. It offers best diet, rest and attention.
Give honey and warm water for neonatal constipation.
Biscuits soaked in milk is a good weaning food. It is ready to feed, acceptable, available, hygienic and affordable.
Warm milk with tamarind is a good treatment for sore throat.
Home cures like tulas, honey, ginger and lemon for cold are much safer than medicines.
To feed honey, ghee, groundnuts when he has measles is a good custom.
Washing feet before entering house and washing hands before touching food are good habits.
First food ceremony at 6 months.
Oil application before bath: good Vigorous massage: harmful.
Fuming herbs and burning coal below the bed is dangerous.
Don’t squeeze swollen breast of a newborn baby.
Don’t cut cord with dirty things. Don’t cover the stump with dirty things.
Hospital delivery is safer.
Oh! He is not a machine to be lubricated with oil through openings.
No eyes become beautiful by using kajal. It harms.
Don’t throw colostrum. It is useful
Why at all give milk? Give only water, if you are friend of “indigestion”.
The ghost called gas in tummy haunts only the frightened mothers.
317 Blind faith on injections, is the worst faith to have.
What happened? He is crying. Give him Gripe water. Our three generations have slept well by consuming alcohol in gripe water.
So what if he doesn’t eat, you must offer him frequently. Don’t get frustrated.
If used to, one year old will eat all. If not, a five-year-old will have only milk.
The custom of “Removing Mududus” is amongst illiterates. You should not believe it.
Don’t blame mother diet for all neonatal illnesses. Don’t blame teething for all infantile illnesses.
Don’t isolate the baby and her mother in dark ill ventilated room.
324 The belief of ‘Dental troubles ‘is troubling the doctors.
Drugs can harm. Test them on rats, not on your own child.
One day fever due to D.P.T. is acceptable than disease, disability and death due to preventable diseases.
Society wants doctors to advice food fads.
‘Branding’ as a treatment, is cruel and harmful.
Oil and betelnut leaf, on sunken fontanelle, diverts attention from oral rehydration.
No medicine can bring out or suppress measles.
God won’t make him sick. He will cure him.
Wound gets sepsis, when not washed with soap and water.
Removing foreign body in eye using your tongue is a bad.
Hot oil as ear drop may cause deafness.
Hair pin or match stick is dangerous for eardrums.
Leeches suck blood, not diseases.
Don’t incriminate seasonal fruits for his illness.
It is wrong to bury the ‘polio ‘affected child up to waist in the waste – refuge.
339.Waste basket is the right place for a feeding bottle.
To grow, he needs freedom. Don’t wrap him in a neat ‘bundle’.
Why for some time? Opium will make him sleep forever! No opium.
Don’t massage his abdomen to cure imaginary colic.
Don’t ever try to remove his neck sprain just because you feel his neck has a sprain!
So what if they are ‘primary ‘the carious teeth stay in your child’s mouth.
Even milk teeth need cleaning. Use a handkerchief.
The quest for a ‘son’ may offer ‘seventh daughter’.
Don’t discriminate between son and daughter.
Strict discipline and over indulgence both are bad. Both spoil the child.
He behaves well in anticipation of appreciation, not fear of punishment.
Over protection and pampering retard his development.
Severe punishment for minor mistakes is bad.
Don’t allow ‘temper tantrums’ to have him his own way!
Create pleasant environment after a good thing he has done. Create unpleasant environment after a bad thing he has done.
Teach him right and wrong in clear terms.
Don’t wait for destructive behavior to diminish with age.
You must follow Doctor’s diet advice.
Go to a doctor for advice, not for injections and medicine.
A good mother asks too many questions.
Childhood with carious teeth is ‘miserable’.
Old is not always gold.
Giving and learning health education is a continuous process.
To make him 9 kg on first birthday, is the only way to make him a P.S.I.

– Dr. Anil Mokashi (Pediatrician)
MBBS, MD, DCH, FIAP, PhD
(Child Growth and Development)