Baby’s Health

 My child is 18-months-old and he has been vaccinated with all the government vaccines but I haven’t given him any additional vaccination. Our friends and relatives say that there are lot more vaccines to be given, so could you please suggest and advice how important are those vaccines?
 Good that you have given all the government vaccines but there are many more vaccines available which are as important as the vaccines you have already given. The only problem is lack of public awareness regarding these newer important vaccines. And the other thing is that these vaccines are little costly and are not included in the national immunization programme of Nepal. Hence, we give these vaccines after one-to-one discussion with the parents.
These newer vaccines are very useful to prevent your child from harmful diseases like: Mumps, Rubella, Flu, Pneumonia, Chickenpox, Typhoid, Meningitis, Hepatitis A and B infections, Yellow Fever, Rabies and Diarrhea, some of which are communicable diseases and are more common in school-going children. This is to inform all the parents that these vaccines are available as: MMR, Influenza (Vaxigrip), Injectable polio (IPV), DPT booster, Pneumococcal, Meningococcal, Chickenpox (Okavax), Typhoid, Hepatitis A and B, Yellow fever, Rabies, Rota virus, Japanese Encephalitis, Td booster, Human Papilloma Virus (HPV) vaccine. Thus, by giving these newer vaccines, children are being protected against harmful infections before they come into contact with the infection in the community by using the body’s natural defense mechanism and by triggering an immune response to the disease without actually suffering from the disease. And, stress should be given on booster doses, as with period of time, the effects of the vaccines go on decreasing. Hence, booster doses are required to boost up the immune response to a good level. For other details on vaccination please check out my BLOG at:

 I have a 1-year-old baby girl and she usually suffers from pneumonia. Whenever I land up with doctors, they always comment that I was late for her check-up and so the pneumonia has worsened and she requires admission. So, could you please highlight on some important symptoms by which I can recognize her problem early and take her to the doctor in time?
 Pneumonia is a broad term that is being used for most of the lower respiratory tract infections. It is more common in children less than five years of age.  This being the commonest cause for seeking health facility in developing countries like ours, it is important to know about some common signs and symptoms for its early recognition and treatment in time. A child with pneumonia will usually present with fever, cough, noisy breathing, fast breathing, poor feeding and vomiting at times. This is the time you should meet your pediatrician and get her treated before the disease become severe. But, in case if child presents with fast breathing, restlessness, chest in-drawing (kokha hanne), wheeze, grunting, bluish discoloration of lips and skin, inability to drink/feed, and inability to rest properly, then it indicates severe pneumonia and this is life threatening and requires urgent hospital admission without delay. My advice as a doctor is: since your child is just 1-year-old, vaccinate your kid with pneumococcal and influenza vaccine for prevention.

 My son is 7-years-old and he usually suffers from constipation. He has difficulty in passing stool because of which he has pain and cries at times while passing stool. He also complains of passing blood at times when he has hard stool, which worries me. So, doctor, is there anything to be worried about and how do I help him?
 This is a common problem that we come across in our day-to-day OPD. Most of the time, constipation is just habitual and due to improper dietary habits, but sometimes, it could be because of some disease like hypothyroidism or some local anal problem like fissures or piles. So, the most important thing for your son would be: give him a diet rich in fibers, green leafy vegetables, fruits, milk, and increase liquid diet. Help him to pass his stool comfortably by applying some vaseline or lubricants around the anal area and examine locally for some wound, crack or some mass coming out his anus, which may be the cause of painful defecation. Finally, get a surgical consultation to rule out some local anal problem and in case your child is on the chubbier side, with poor school performance and increased laziness, then get his thyroid hormone tested after consulting with an endocrinologist. n

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