Child Specialist

  Q.   My 3 month old infant takes out milk after every feed. What should I Do???? A. If the infant takes out milk after every feed, it is probably due to reflux. This is because the sphincter between the stomach and oesphagus is a bit loose and the milk regurgitates back. This is known as gastro oesophageal reflux. The management is to keep the baby at an angle of 45 degrees with the head in the up position. This should be done for 24 hours. There is a special milk known as AR (Anti Reflux) milk. This helps to prevent reflux. This milk should be started and continued for a few months. With time by 10 months to 1 year of age the reflux resolves by itself. You can then switch to regular milk.   Website Link: http://www.drmubinaagboatwalla.com/

 Q. My 1 year old son has developed hacking cough specially at night. A. The change in weather resulting in dryness and cold results in allergic episodic cough. This occurs chiefly in children prone to allergies. This causes a bit of bronchospasm, and secretion of mucus. The obstruction to breathing results in coughing. The cough is episodic and occurs in intervals. This occurs specially at night. Giving steam with salt in the hot water helps in clearing the air passages. IN addition, using a humidifier at night is very beneficial. Use of anti allergics is very important. If need be nebulizers should be used. Consult a doctor on what nebulizing solution to use. Nasal sprays are also helpful. Website - http://www.drmubinaagboatwalla.com/

  Q 1. What are the signs and symptoms of constipation in children ??? Constipation is very common in children. It is more of a dietary and life style issue than a medical problem. Children eating fast food are more prone to it. Less fibre in the diet, less vegetables and fruits and more potatoes, white flour, cakes, pasta, noodles promotes it. Rice also leads to constipation. Children also do not indulge in healthy activities and don’t do exercises. They are either on iPad, phone or watching television. This unhealthy lifestyle promotes constipation. Extreme constipation leads to hard stools which produces fissures in the lower anus. The child gets scared to pass stools and the stools are very hard. Sometimes there   is a streak of blood along the stools. If not treated, the constipation becomes even more severe.

Pyrexia of unknown Origin means fever more than 100 F in a child for more than 14 days for which no cause can be found. It can occur in any child whose fever is not settling down with the usual medicines and no focus of infection is found on physical examination. According to Dr Mubina Agboatwalla – child specialist in Karachi , the common causes of fever include respiratory viral and bacterial infections, typhoid, malaria, dengue, viral and bacterial gastrointestinal infections. Meningitis and encephalitis as well as urinary tract infections. In addition, osteomyelitis and rheumatoid arthritis and septic arthritis need to be considered. Further investigations need to include auto immune disorders, rare viral infections, other SARS infections. Blood culture plays a very important role in diagnosis often overlooked due to common use of antibiotics.

High grade fever due to unknown cause is known as Pyrexia of Unknown Origin (PUO). These days high grade fever in children is very common.  According to Dr Mubina Agboatwalla-child specialist in Karachi , every high grade fever is not dengue. It can be a bacterial throat infection, chest infection, due to diarrhea, urinary tract infection, Malaria, Typhoid. However, do not self treat and diagnose yourself. Go to a doctor. Based on history and investigations diagnosis will be made. Self treatment is not advisible.  Common investigations include blood CBC, ICT Malaria, Blood Culture, Urine D/R and Culture. ESR, Dengue NS1 among others. Ultrasound may be ordered if necessary.  People generally tend to use broad spectrum antibiotics like Cefixime. Do not use antibiotics without consultation.

  Q 1. What are febrile fits ?? Ans 1. Febrile fits happen in some children when the fever becomes very high. They generally start when the temperature starts to rise and occurs in children under 5 years of age. The fits occur for a few seconds. The child does not lose consciousness and generally there no frothing from the mouth. The febrile fits can reoccur in some children if the temperature rises again. Q 2. What is the treatment and prevention of febrile fits ?? Ans 2. Febrile fits are generally harmless and do not affect the neurological status of the child. They generally do not require any treatment and anti convulsants need not be given. Prevention is the best cure. In such children, every effort should be made to prevent the fever from rising. AS soon as the child develops fever anti pyretics should be given together with tepid sponging. Febrile fits do not occur after 5 years of age. Website Link - http://www.drmubinaagboatwalla.com/

 It is very common for children to ingest different foreign bodies. The most common is ingestion of small coins. The child or toddler while playing tends to put the coin in the mouth.  The coin can either go in the digestive tract or in the trachea or wind pipe. If it goes in the windpipe or trachea it can result in a medical emergency. It can obstruct the trachea and result in gagging. Severe respiratory obstruction and breathlessness can occur. The coin may get stuck in the trachea or go in the bronchi.  Immediate bronchoscopy needs to be done. And the coin removed. If the coin is in the upper segment or pharynx, thumping on the back can result in the child coughing out the coin. Dr. Mubina Agboatwalla - A Child Specialist in Karachi, another alternative is that the coin enters the oesophagus. It does not generally produce any symptoms and the coin enters initially the stomach, then the intestines and finally the rectum. The coin can be seen on the X- Ray and the pro...