DIABETES IS NOT ASERIOUS PROBLEM

DIABETES MEANS:-
                                 
Diabetes mellitus is a common disease in the United States. It is estimated that over 16 million Americans are already caught with diabetes, and 5.4 million diabetics are not aware of the existing disease. Diabetes prevalence has increased steadily in the last half of this century and will continue rising among U.S. population. It is believed to be one of the main criterions for deaths in United States, every year. This diabetes information hub projects on the necessary steps and precautions to control and eradicate diabetes, completely.

Diabetes is a metabolic disorder where in human body does not produce or properly uses insulin, a hormone that is required to convert sugar, starches, and other food into energy. Diabetes mellitus is characterized by constant high levels of blood glucose (sugar). Human body has to maintain the blood glucose level at a very narrow range, which is done with insulin and glucagon. The function of glucagon is causing the liver to release glucose from its cells into the blood, for the production of energy.

There are three main types of diabetes:

• Type 1 diabetes
• Type 2 diabetes
• Gestational diabetes

Type 1 and Type 2 diabetes impede a person’s carefree life. When breakdown of glucose is stopped completely, body uses fat and protein for producing the energy. Due to this mechanism symptoms like polydipsia, polyuria, polyphegia, and excessive weightloss can be observed in a diabetic. Desired blood sugar of human body should be between 70 mg/dl -110 mg/dl at fasting state. If blood sugar is less than 70 mg/dl, it is termed as hypoglycemia and if more than 110 mg /dl, it’s hyperglycemia.

Diabetes is the primary reason for adult blindness, end-stage renal disease (ESRD), gangrene and amputations. Overweight, lack of exercise, family history and stress increase the likelihood of diabetes. When blood sugar level is constantly high it leads to kidney failure, cardiovascular problems and neuropathy. Patients with diabetes are 4 times more likely to have coronary heart disease and stroke. In addition, Gestational diabetes is more dangerous for pregnant women and their fetus.

Though, Diabetes mellitus is not completely curable but, it is controllable to a great extent. So, you need to have thorough diabetes information to manage this it successfully. The control of diabetes mostly depends on the patient and it is his/her responsibility to take care of their diet, exercise and medication. Advances in diabetes research have led to better ways of controlling diabetes and treating its complications. Hence they include:-

• New improved Insulin and its therapy, (external and implantable insulin pumps) have advanced well to manage elevated blood sugars without any allergic reactions.
• Oral hypoglycemic drug, controls diabetes type 2.
• New improved blood glucose monitor (new device for self blood glucose monitoring), and hemoglobin A1c laboratory test to measure blood glucose control during previous 3 months.
• Effective availability of the treatments for affected body organs due to diabetes.
• Better ways to manage mother and its fetus health during the gestational diabetes phase. 
• PREDIABETES:-
•                          Prediabetes is a stage between normal and diabetes stage. It is an alarming sign for upcoming diabetes or a chance to change your future. Universally, numerous terms are given like, Borderline Diabetes, Chemical Diabetes, Touch of Diabetes etc. The term Prediabetic was given by the US Department of Health And Human Services and ADA on 27th march 2002 with an intention to create awareness and convey seriousness of the condition. Also, they motivated people to opt for appropriate treatment and lifestyle modification. According to the ADA statistics 17 million US citizens are diabetic and 16 millions are prediabetic. ADA defines it as a stage before the development of diabetes, with normal glucose tolerance, but with an increased risk of developing diabetes in near future.
    
       Prediabetes is a condition when your blood sugar level triggers higher than normal, but not so high that we can justify it as type 2 diabetes. According to the Centers for Disease Control and Prevention, 41 million U.S. adults aged 40 to 74 have prediabetes. And the same reports from, The American Academy of Pediatrics show that, one of every 10 males and one of every 25 females have prediabetes aged from 12 to 19 years.  
• WHAT CAUSES DIABETES:-   
•                 
  
  The precise Etiology of most cases of diabetes is uncertain, although certain contributing factors are as follows:
  
  Type 1 diabetes
  
  Type 1 Diabetes is autoimmune disease that affects 0.3% on average. It is result of destruction of beta cells due to aggressive nature of cells present in the body. Researchers believe that some of the Etiology and Risk factors which may trigger type 1 diabetes may be genetic, poor diet (malnutrition) and environment (virus affecting pancreas). Secondly, in most of the cases, diabetes occurs because there is abnormal secretion of some hormones in blood which act as antagonists to insulin. Example- Adrenocortical hormone, Adrenaline hormone and Thyroid hormone.
  
  Type 2 diabetes
  
  Type 2 Diabetes is also called non insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. It occurs when the body produces enough insulin but cannot utilize it effectively. This type of diabetes usually develops in middle age. A general observation says that about 90-95 % of people suffering with diabetes are type 2; about 80 percent are overweight. It is more common among people who are older; obese; have a family history of diabetes; have had gestational diabetes. There are number of risk factors found to be responsible for type 2 diabetes like, the more the Etiology and Risk factors carried by an individual, the higher the risk for developing diabetes.

  Following are the Causes of Diabetes

  • Hereditary or Inherited Traits : It is strongly believed that due to some genes which passes from one generation to another, a person can inherit diabetes. It depends upon closeness of blood relationship as mother is diabetic, the risk is 2 to 3%, father is diabetic, the risk is more than the previous case and if both the parents are diabetic, the child has much greater risk for diabetes.
  • Age : Increased age is a factor which gives more possibility than in younger age. This disease may occur at any age, but 80% of cases occur after 50 year, incidences increase with the age factor.
  • Poor Diet (Malnutrition Related Diabetes) : Improper nutrition, low protein and fiber intake, high intake of refined products are the expected reasons for developing diabetes.
  • Obesity and Fat Distribution : Being overweight means increased insulin resistance, that is if body fat is more than 30%, BMI 25+, waist grith 35 inches in women or 40 inches in males.
  • Sedentary Lifestyle : People with sedentary lifestyle are more prone to diabetes, when compared to those who exercise thrice a week, are at low risk of falling prey to diabetes.
  • Stress : Either physical injury or emotional disturbance is frequently blamed as the initial cause of the disease. Any disturbance in Cortiosteroid or ACTH therapy may lead to clinical signs of the disease.
  • Drug Induced: Clozapine (Clozaril), olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel) and ziprasidone (Geodon) are known to induce this lethal disease.
  • Infection : Some of the strephylococci is suppose to be responsible factor for infection in pancreas.
  • Sex : Diabetes is commonly seen in elderly especially males but, strongly in women and those females with multiple pregnancy or suffering from (PCOS) Polycystic Ovarian Syndrome.
  • Hypertension : It had been reported in many studies that there is direct relation between high systolic pressure and diabetes.
  • Serum lipids and lipoproteins : High triglyceride and cholesterol level in the blood is related to high blood sugars, in some cases it has been studied that risk is involved even with low HDL levels in circulating blood.
  DIABETES DIET:-
•         Diet plays a significant role in controlling the diabetes. The diabetic diet may be used alone or else in combination with insulin doses or with oral hypoglycemic drugs. Main objective of diabetic diet is to maintain ideal body weight, by providing adequate nutrition along with normal blood sugar levels in blood. The diet plan for a diabetic is based on height, weight, age, sex, physical activity and nature of diabetes. While planning diet, the dietician has to consider complications such as high blood pressure, high cholesterol levels.
• With respect to the above factors, a dietician will assess calories to be given, like scheming the carbohydrates, proteins, fats, type of carbohydrate, amount of fiber and so on.
• Exchange meal plan is a diet program which balances the amount of carbohydrate that we intake per day. Glucose is a sugar released from carbohydrate so, if we want to control blood sugar we have to limit the consumption of simple carbohydrate. Carbohydrate foods are given as value per portion, known as the exchange. This plan helps us to decide on the type of food to be taken, the amount of food and also the time to eat. You can plan for more flexible meals as you get more knowledge about the diet for a diabetic, may be like the counting carbohydrate meal plan or constant carbohydrate. But there is no common diet that works for everyone. Nor is there any particular diet that works perfectly for any diabetic over a long period. While planning diabetes diet we should adhere to certain important factors, they are as follows:

• Fiber should be at least 1.4 oz / day
• Instead of 3 heavy meals, we should go for 4-5 small mid intervals
• Replace bakery products and fast foods by simple whole cooked cereals, and don't eat carbohydrates 2 hours before bedtime
• Consume fresh fruit and vegetables at least 5 exchange/ day

Diabetics always need to take care of their diet and also about the food they eat. Care has to be taken because all foods contain not only carbohydrate, but also some energy value. Protein and fat available in the food are converted to glucose in the body. This glucose has some effect on the blood sugar level, which has to be taken care of. Furthermore, you needn’t have to eat only the bland boring diet. Instead, you can eat more fruits, vegetables and whole grains. All it means is that you need to select foods that are high in nutrition and low in calories.
Fats (Limit to 1 serving per meal) A serving can be:-

• 10 Peanuts.
• 1 Tbsp Salad Dresssing
• 2 Tbsp light salad dressing or saur cream.
• 1 Tsp margarine, Oil or mayonnaise.
• 1/8 Avocado.

Sweets (Substitute for starch or fruit serving occasionally) A serving can be:-

• 2 Small Cookies.
• 1 Small Cupcake or Muffin
• ½ Cup Ice cream.
• 1/3 Cup Frozen Yoghurt.
• ¼ Cup Sherbet.
• 1 tsp Syrup or Honey.

Milk (2-3 Servings per day) A serving can be:

• 1 cup Milk.
• 1 Cup Low Fat.
• 1 Cup Artificially Sweetened yogurt (No sugar)

Meat / Fish/Chicken (2-3 Serving per day) A serving can be:

• 2 oz Cooked Lean Meat/Poultry/Fish.
• ½ - ¾ Cup Tuna or Cottage Cheese.
• 1 Egg or 4 oz Tofu or 1 oz cheese.
• 2 Tbsp peanut Butter.

Vegetables (3-5 Serving Per day) A Serving can be:

• 1 Cup Raw Vegetables.
• ½ Cup Cooked Vegetables.
• ½ Cup Tomato or Vegetable Juice.

Fruits (3 Serving per Day) A Serving Can be:

• 70 gm small fruit.
• ½ Cup canned fruit.
• ¼ cup Dried Fruit.
• ½ Cup Fruit Juice. (No sugar)

Grains, Starchy Vegetables and Beans. (6 plus Servings Per Day) A Serving Can be:-

• 1 Slice of 1 oz bread or ½ (1 oz) Bagel or 5 Crackers or 1 Granola bar.
• ½ Hamburger or Hot dog Bun or a tortilla of 6 inch or 2 tacos.
• ½ Cup Cooked Cereal, Cooked beans, Lentils, Corn, Peas, S. Potato, Potato or Pasta.
• 1 Cup winter Squash, 1 Cup Soup.
• 1/3 Cup Rice or 3 Cup Plain Popcorn (Fat free)

  DIABETES CARE:-

Diabetes can be a tough disease to handle. There are many reasons for it, firstly, causes of the disease are not clearly known, it is difficult to prevent. Secondly, once you get the disease, it is not possible to cure the same and you need to take care of your health for entire life. This task can be quite daunting; here are a few tips to help you.

Diabetic Care Tips

If you have diabetes, you need to take some precautions, in your day to day life as well and not only at those times, when you feel sick. Here are some precautions that you can take in your everyday life:

• You should monitor your blood glucose level regularly. Depending on the severity of your condition, your doctor would tell you about the intervals, in which you should take the test.
• You should take regular doses of medicine or insulin, as have been prescribed.
• Regular exercise proves to be useful in controlling glucose levels. However, you should avoid few exercises, that are known to cause further complications like cardiovascular diseases, hypoglycemia etc.
• In case your glucose level drops suddenly during or after exercise, you should consume a fruit juice or some similar drink that provides you with sugar.
• Weight reduction is a key of success in managing diabetes; hence take all the measures of carb control, what you can.

In case you are suffering from any ailment like flu, cold or any other disease or infection, some extra precautions need to be taken, to avoid further complications by diabetes:

• Check your blood sugar level more frequently, to ensure that no harm is being caused by diabetes.
• The illness may force some changes in your diet; consult your doctor/endocrinologist about the changes you need to make in your diabetes medicine accordingly.
• You should drink lots of water and other clear liquids.
• Remember not to cut yourself completely from food even if you are not experiencing hunger.
• Consult the doctor, if you feel abnormal in any manner. For example you may be feeling excessively sleepy, giddy, may have trouble with urination etc.

Even though diabetes is a chronic condition, the same does not mean, that you will have to avoid every activity you enjoy, once you contract it. You can have the same amount of fun, provided, that you take certain precautions. Remember, if you have diabetes, you cannot ignore the precautions, nor do you need to get bogged down completely by them.

DIABETES CONTROL:-
Whether your treatment consists of diet alone, diet and tablets or diet and insulin, you need regular blood tests to keep a check on your blood sugar. Urine sugar test is not a reliable indicator of diabetes control.

When blood glucose remains higher than 200mg/dl for 8-10 weeks, the concentration of glycosylated hemoglobin (HbA1c) arises. A (HbA1c) measurement therefore reflects the blood glucose control over a preceding 2-3 months period, while the estimates of blood glucose indicate the glucose value at the time of blood test. HbA1c values between 6-7% indicate very good control on diabetes. You should aim at keeping your blood glucose in the normal range i.e. between 90-130 mg/dl while fasting and less than 180 mg/dl after meals and HbA1c around 7%. Frequent tests for blood glucose are necessary when starting treatment with insulin.

If you are doing capillary blood glucose test using a hand held glucometer, do not squeeze the finger to bring out a sample after you have picked. This invariably gives a low glucose value. Ask your diabetes nurse for a demonstration of capillary blood glucose test.

Urine test for sugar is not reliable indicator of diabetes control. Although spillage of sugar in urine occurs when the blood glucose exceeds 180 mg/dl in the majority of healthy persons, this is not always so in a patient with diabetes. Most patients with diabetes of many years acquire an increase in the renal threshold for glucose (capacity to prevent spillage of glucose into urine). Hence urine test for glucose is not helpful for assessing control of diabetes. In the presence of urinary infections, the bacteria eats up the sugar present in urine, thereby making urine test for sugar unreliable. 

DIABETES PREVENTION:-

Prevention is proven to be one of the most effective and powerful methods to fight diabetes. More than 50% of diabetes is caused due to inappropriate lifestyle. Regulating lifestyle can prove to be advantageous in downfall of probability of contracting diabetes in one’s life. Loss of weight not only helps in fitness but also in control of blood sugar levels. Losing 10% of initial body weight and regular exercise can immensely reduce the risk of diabetes. Physical activities play a key role in reducing the body weight and on the other also the extra blood sugar is broken down. It also helps to uphold the blood sugar in the normal range. You are more liable to diabetes if you are overweight (may also lead to obesity), are having genetic or hierarchal means of predisposition along with proper physical activity.

Food choices: Foodstuffs containing low glycemic carbohydrates, proteins or fats can initially help to lose body weight and maintain dancing blood sugar level. Prefer healthy foods which are low in fats and calories such as lean fish, lean chicken, turkey and fruits and vegetables. Go slow on fast and fried foodstuffs for prevention of diabetes. Avoid processed carbohydrates as much as possible. Try to increase high-protein food in your diet. And reduce eating refined flour i.e. white flour, bleached flour, treated flour and other kind of white flour.

The Fundamentals to prevent diabetes: Diabetes can be prevented by good production of the insulin and keeping the body fat percent low. Insulin and fats helps to maintain body weight and control sugar level. Consumption of meals to a small fraction instead of heavy food also helps to control diabetes. Also avoid eating carbohydrates few hours before you go to sleep. Taking in high-protein breakfast and 5 or 6 small meals a day also helps you to maintain the body weight. This will also help to control excess consumption of fats and carbohydrates.

BABIES THE PRECIOUS GIFT OF GOD---CARE THEM

The journey of childhood—commencing from the birth of your ‘baby’ who has just begun cooing to an independent ‘preschooler’ who digs in his plate without your help to a less fussy ‘school going kid’ who hops in his school bus happily bidding adieu—is full of responsibilities and fun for you. You might want to be armed with knowledge and, as a parent, prepare yourself for the responsibilities ahead. In this endeavor of yours, please don’t find yourself alone. We are there to help you along your journey as a parent with any concern or question you may have.

Under this section, you will find helpful information on many aspects involved in the proper upbringing of your child. So read on to explore articles and tips reviewed by experts on the following: developmental aspects by age (Baby of different ages, Preschooler and School going child); health issues, such as neonatal jaundice, how to take care of premature and preterm babies; nutritional information such as when and how to introduce your baby to complementary feeding, what are the nutritional needs of a preschooler and a school-going kid, healthy food preparations. We also feature here information on the recommended routine Immunization schedule for Indian children.

My Baby's Development

After having happily treaded the challenges experienced during those 9 months, your happiness is doubled when you hold your newborn in your arms. But you seem to be pondering over these lines that goes in to say– “Every day would be a new challenge”. Isn’t it? With different changes taking place in your baby’s physical, emotional & cognitive development, you would be confronted with these very often:-

What to expect from your baby at every stage? Whether it is normal? What facts you need to be commonly aware of as a new parent? When you need to be a little cautious or its time now to head to the paediatrician?

Monthly Development of The Baby (4 to 6mths)

With every new dawn, the stage sets up newer and amazing challenges for the baby to explore and parent to dwell in delight. As the baby grows older, she becomes more responsive towards her surrounding and to what all is happening around. A wide array of developmental changes can be observed in her physical, social, emotional and intellectual growth. Variations exist in their normal patterns of development. Albeit, some babies acquire the skills much earlier as compared to others but most of them escalate at a normal rate achieving the milestones meant for their age. As a parent, all you need to do is observe, interpret, guard and embrace as you see your baby stepping in every month trying to ape newer changes that becomes part of her overall growth.

Baby's Development (7-12 Months)
Prepared to track down the journey of your little adventurer? If still, stifling with the urge to say ‘’yes’’! Then ain’t be! For, as your baby becomes more mobile, his emerging abilities will keep you guessing for more.

My Baby's Health

MY BABY’S HEALTH

An expecting mother would strictly keep up to the routine visits to her obstetrician and adhere to the best nutritional advice, to ensure that she sails through her pregnancy smoothly with a healthy baby. No sooner the baby is born she would be confronted with these:- What is the importance of breast milk? How can I build up my baby’s immunity? Is that dose of vaccine really essential for my baby’s health? What if my baby is born with a medical problem? Should the baby be rushed to her doctor now? Stay well informed and well learned about the different aspects that play a pivotal role in your baby’s health. This will aid you to get acquainted with the facts in a better way. Infant Immunity Babies do possess some innate immunity, as their mothers’ infection preventing antibodies are passed on to them through their Umbilical Cord. But this immunity needs to be further strengthened so that it can shield the baby from various infections and illnesses in later life. Importance of mother’s milk:- Breast milk has all the essential nutrients required by the baby during the first four to six months of life as compared to commercial infant formulae. It contains immunoglobulin, lysozymes and bifidus factor which help fight infections. Thus, breast-fed babies as opposed to artificially fed infants have fewer incidences of diarrhoea and respiratory tract infections. So newborn babies should be exclusively breastfed for at least six months and refrained from being fed on any kind of infant formula and complementary feeds. Immunization:- It also becomes important to ensure a timely shot of vaccinations to your baby as per the recommended Immunization schedule. In sync with the baby’s healthcare personnel, make sure that she receives the necessary immunizations before her second birthday thereby guarding her against all the major childhood illnesses. Baby with a Medical Problem It is imperative to understand that the possibility of your baby being born with a medical problem cannot be completely overlooked. A first examination of the baby at the hospital would certainly involve the following:- Assessing the growth parameters like length, head circumference and weight since birth. Physical examination of the baby to check for any abnormalities of the organ function. Checking for the normal functioning of the baby’s reflexes, hearing and vision. A close discussion getting in to knowing of how your baby is taken to breastfeeding, her sleep patterns and bowel movements. The doctor would also recommend the necessary screening tests to detect the presence of any major inborn illnesses or medical problem, if he suspects through the observed symptoms. If the screening tests reveal that your baby is suffering from a medical problem, she would be required to be transferred to a neonatal unit for additional care and detailed investigation. By talking to the nurse or your doctor, you could find out ways to store the breast milk. A breast pump would be ideally suitable for this purpose. The breast milk would then be defreezed and given to the baby when her condition improves. By speaking to the baby’s health care provider, take a closer insight in to knowing more about the birth defects and accompanying medical problems. Comprehend them, as this would ease in dealing and taking care of such babies with lesser anxiety. Visit to your Baby’s Doctor Babies cry to communicate their needs. It could be that a soiled diaper is adding to her discomfort or she has not been fed since a long time. However a peculiar distinct cry that usually lasts for an unusual period of time indicates a medical problem, necessitating immediate help from the baby’s doctor. A major amount of an infant time is spent in sleeping through the day. You would normally find them to be awake, while being nursed. But noticing them to be excessively drowsy and disinterested during their feeds should not be ignored. An infection of the Umbilical Cord where in the stump becomes red or gets filled with pus could also lengthen the incessant spells of your baby’s cry. Report to your baby’s doctor immediately. It is usually observed that the tear ducts of an infant’s eye open on their own, but in some cases they remain clogged shedding the mucous membrane surrounding the eyes. With the white discharge crusting up on the baby’s eyes, keeping the eyelids open can also become a difficult task for them. Since there is a danger of the baby contracting a severe eye infection, a detailed examination by the doctor is needed.

Night feeding Night Time Feeding As a dutiful mother, you constantly find yourself spending more time with nursing, burping, changing nappy. Managing domestic chores takes a backseat for a while and at certain times it’s even drifting away from catching up your wonder sleep. Well, this is how your daily schedule would look like initially. But you would soon seek solace in switching back to your normal routine after you have successfully weathered the many challenges of parenthood. Needs of a Newborn It’s true like adults, babies too need their share of good sleep but they also need to curb their frequent hunger pangs at regular intervals. So initially, you would observe your baby waking up quite often for several feeds i.e. around 6-8 times every 24 hours. This is also well supported by the fact that frequent feeding your newborn would also help stimulate an adequate milk supply. She might wake up two to three times during the night but this would gradually reduce as she starts feeding more during the daytime.This could then be indicative that your baby is storing up enough reserves of energy so that she can sleep well in the night. General feeding patterns of a baby:- By around four months, most babies would sleep comfortably through the night. But this would be possible only if they have had been sufficiently breastfed during the day. Demand feeding begins when your baby grows a little older by few more weeks. You now need not be strict in following the 2-3 hour gap for every feed, the way you did in the initial days of your baby’s birth. You could let your baby set the pace for feedings, once you observe that your baby is gaining weight well and has normal urine and stool output. Babies of around three to six months usually require a feeding during the night. So make sure, you nurse her well apart from showering the much needed attention during the same. This is equally important as it would help you interpret your baby’s anxiety, to know if she is crying or uncomfortable for any reason other than hunger. Encourage nursing in a Sleepy Baby Babies usually tend to be in an active sleep state. You can easily sense that they have yet not entered a deep sleep stage by checking for the following:- Your baby’s eyelids would be partially closed along with some rapid eye movements. You could also observe involuntary movements of arms, legs and notice a sucking reflex. Gently massage his hands and feet using your thumb. Support her back while you hold her in the feeding position. Communicate to your baby that she now needs to be fed, maintaining an eye contact while you initiate the process. You could also make use of a small amount of expressed milk. With the help of a dropper, just dribble some amount into her mouth to help swallowing while feeding. Weaning from Night Feeding Weaning your baby from night feeds should be gradually followed after six months of exclusive breastfeeding. Discuss your baby’s sleep patterns with her paediatrician and then opt for reducing the number of feeds during the night. You could let your baby nurse only one breast to slowly reduce the amount of milk she would take during nighttime feeds. If your baby is on a bottle feed during nightime then consider giving her some ajwain water instead of formula milk. This is because during continuous suckling if your baby dozes off while feeding, prolonged contact with milk would result in tooth decay. However also keep observing that she doesn’t sleep with the milk bottle in her mouth as it can be dangerous. Some babies may take up easily to the process and sleep peacefully when they are about five to six months old. But for some toddlers, it won’t work in the similar way. They woke up during the night because they were used to having night feeds. So an abrupt change in their schedule would make them more anxious resulting in heightened crying spells. Be patient. See how it works for your baby and then try to let her adapt to this change smoothly. Before taking your baby to sleep, always ensure to have a desired atmosphere favourable for good sleep. Have dim lights in your baby’s room. Sing a calming lullaby, affectionately cuddle her before you place your baby in her crib. The one she may be used to hearing before sleep would actually make her sense that it’s time to sleep.  COMMON COMPLAINTS :- Bedwetting Wetting the bed at night (nocturnal enuresis) is commonly observed in many three to eight year old children. With respect to the gender, 60% of all the bed-wetters are males and a major percentage of them wet the bed almost every night. There can be many underlying reasons behind the problem of Bed wetting. Some of them are described as follows: Heredity can play an integral role in some cases. It’s been observed that if one parent or both parents seem to have been faced with this problem in their childhood, then there are around 50% chances that their child will also be a bed wetter. However, in these cases, the child may usually get over with the problem at the same age as did his parents. Children with a small bladder than normal are more likely to suffer from this problem. Besides this, problems in the valve that controls the flow of urine from the Bladder could also be contributing factors. Urinary tract infections, problems of Constipation that may cause a full bowel to exert pressure on the Bladder may be few other reasons. Due to poor and delayed functioning of the brain in some children, voluntary control over certain bodily functions such as being able to exercise control over the Bladder may yet not be achieved. Bedwetting may also result due to insufficient production of anti-diuretic Hormone (ADH) that plays an important role in preventing water loss from the body. This Hormone is usually produced in large amounts during night time but since its production is deficient in some children, it could result in bedwetting. Inadequate production of ADH also influences sleep, making it difficult for the person to wake up. Thus, it’s been observed that children who have this problem are usually the ones who also have deep sleep. Stressful events in a child’s life such as moving to a new school, sudden shift in the residential place, quarrelling parents, arrival of a sibling, abuse of any kind and so on can also be amongst some of the triggering factors. In these cases, a child, who did not wet the bed at night, may have started doing so due to stress. Helping Your Child Overcome the Problem As a parent you need to be considerate and understand that your child does not deliberately wet the bed. It’s just that his body is unequipped to control the flow of urine while he is asleep due to some or the other reason. Majority of children get over this problem by the age of ten or twelve because their bodies learn to gain control over their bladders. Follow these steps to reduce the chances of your child’s bedwetting problem: Refrain from rebuking your child for wetting the bed as it may affect his self-esteem to a great extent. A child already going through mental distress due to this problem should be rather comforted and reassured from your end that he is perfectly normal and that you both jointly will find a better way to deal with it. Make sure you limit your child’s fluid intake two to three hours before bedtime. Get him to religiously follow a routine of visiting the washroom just before he gets ready to bid you good night. Your child’s frequency of bedwetting may also increase with a sudden drop in temperature. So make sure your child is properly dressed and warm. Cover him with a blanket, if required. Protect the bed with plastic cover placed between the sheets and mattress. You can make your child wear diapers to help him prevent a messy situation, if needed. You may even try practicing an awakening schedule with the help of an alarm clock. Prod your child gently to wake up amidst his sleep two to three hours after he goes to bed and help him visit the washroom. Although some of the above mentioned guidelines may prove effective in managing the condition, in severe cases of bedwetting, it is wise to seek medical help. If there is any underlying medical problem, your doctor will be able to detect it and suggest suitable treatment. A hormonal supplement may be prescribed to compensate for the low levels of anti-diuretic Hormone (ADH). Bladder strengthening exercises may also be recommended. You must remember that the problem of bed-wetting is just a temporary one and it is not a disease. The problem will resolve on its own, though that may take some time; you only need to be patient. Give your child lots of love and treat him/her with respect; remember, they are not doing so intentionally. Whooping Cough What is whooping cough? Pertussis is an infection of the respiratory system caused by the bacterium Bordetella Pertussis. It is commonly known as whooping cough. A child with whooping cough would have severe coughing spells that may often end up in a “whooping” sound, experienced while breathing. These coughing spells in young children, especially infants, can progress to dangerous symptoms like vomiting, choking and even unconsciousness. What are the signs and symptoms of whooping cough? Whooping cough may present itself in a characteristic manner, with the first symptoms being similar to those of common cold. This would include sneezing, runny nose, mild cough, low grade fever (102 degrees celsius or below) and diarrhea. Your child may exhibit the common cold symptoms for about 1 to 2 weeks, with episodes of severe coughing for about two to four weeks. At times, these coughing spells may last for long durations. Recovery from this infection may vary in children, with gradual resolution in a few weeks of the symptoms in some; while in others, the symptoms may wane completely after months. Seek medical help if you suspect your child has whooping cough even if your child has received all his scheduled vaccines. If your child experiences prolonged spells of coughing followed by vomiting, turns red or blue, has difficulty in breathing or showing signs of dehydration, immediately inform his doctor and seek medical care. How does Pertussis or whooping cough spread? An infected person transmits the germs containing droplets in to the surrounding air while coughing or sneezing. These germs gain entry into the lungs of the person nearby during breathing. Thereby, the bacteria multiplies in the airways, interferes with respiratory tract’s ability to ward off the germs producing thick mucus that leads to bouts of uncontrollable coughing. The bacteria may also be responsible for the inflammation and narrowing of the breathing tubes in the lungs. This may result in difficulty in breathing (gasping for air) accompanied with a high-pitched whoop after a spell of coughing. Whooping cough, a highly contagious respiratory infection is considered to be a common cause of childhood illnesses. Infants aged 6 months and younger are more vulnerable to the infection because there Immune System is underdeveloped and because they may not have received all the doses of Pertussis vaccine by this age. What are the complications of whooping cough? Infants aged less than 6 months of age present severe and serious complications from whooping cough and are more likely to receive treatment at hospitals. At times, these complications may even prove fatal. Pneumonia, dehydration, ear infections, seizures, delayed or stopped breathing and brain damage can occur in very young infants and toddlers. How is whooping cough treated? A child suffering from whooping cough will be treated with antibiotics for a period of about two weeks. It is believed that a course of antibiotics started prior to the coughing spells may actually help in lessening the duration of the infection. Even when introduced later, these medications may be of help in further averting the infection from spreading to others. As a result of coughing, your child may be reluctant to eat or drink and may even vomit while being prodded to do so. From your end, make sure you encourage him/ her have few morsels of food at frequent intervals than being forced a big chunk. Also, prod your child to drink lots of fluids (water), preferably sipping more frequently to help prevent signs of dehydration. Be watchful of the following signs of dehydration in young children: thirst, irritability, sunken eyes, dry mouth and tongue, crying without tears, lethargy, less frequent peeing and in infants – fewer wet nappies. While receiving treatment at hospital, the doctor may decide for whether your child may need suctioning of the thick respiratory secretions (mucus). In such cases, his breathing will be monitored and oxygen would be provided, if needed. Intravenous fluids might be introduced if your child has been showing signs of dehydration or experiencing difficulties in eating. Disclaimer: The information included in this section should not be treated as a substitute for medical treatment. Please see your doctor if you have serious medical conditions and need treatment.