‘Parents have to discipline the child to eat healthy’

Dr. MD Shah has been Consulting Pediatrician and Pulmonologist at Nanavati Hospital, Mumbai for the last 38 years.

Also running a private practice, Dr Shah is advisor to the Indian Academy of Pediatrics.

This pediatrics expert is skilled at managing respiratory problems in children.

Dr. Shah took time off his busy schedule to answer Sify readers’ questions on child health in an exclusive chat. Read the complete transcript here.

Sir, My son age is 2 years. he is not drinking any milk. He is refusing to drink milk. He was drinking mothers milk properly and still he is asking for mother milk. please suggest any solution for this.
It appears that he is addicted to mother’s milk and so he is refusing the other milk.. stop breast feeding immediately and it should not be re started even if the child refuses to take any milk.. after a few months he shall get de addicted to breast feeding and will start taking other milk.. other milk could be combined by sugar, Bournvita, Horlicks,etc. to make it more palatable..

pl. provide list of immunisation of kids after 10 years of age
Immunisation should be continued after 10 yrs also.. Typhoid vaccines should be given every 3 yrs and the vaccines against Deptheria, Pertussis and Tetanus should be given every 2yrs till the age of 18yrs.. Influenza vaccine should be given every year… Vaccination against Mumps, Measles and Rubella should be repeated at 12 yrs and in women before pregnancy… Chickenpox vaccine should also be repeated at 12yrs if the child has not already suffered from chickenpox..Cholera vaccine and Meningococcl vaccine are indicated only at epidemic of these diseases… Human Papillona Virus vaccine should be given to all women between 9-45yrs to prevent cervical cancer..
The vaccine chart we got from the hospital in PUne is different than what we the doctors follow in Goa. Is there any universal chart for vaccine? Also, I wanted to know the “must give vaccines” and optional ones. Please help doctor.
Indian Academy of Pediatrics has given a chart for the immunisation for children taking into account who can afford them…e prevalence of diseases and the cost and effectiveness of vaccines… some vaccines which are useful but costly are not included in the National programme of Immunisation and are kept optional for the people …Optional vaccines are also desirable provided the parents can afford them..

doctor, my son, 16, has high IGE level. im giving him montec lc for last 3 months. doc has asked to continue for 3 more mnths. will it reduce
Increase of total IGE level indicated sensitigation to allergance..hence a test has to be carried out to what allergance the child is sensitized… .this can be done by skin prick test or by doing specific IGE levels..in our country intestinal parasites are also an important cause of increasing IGE levels and hence the child should be dewormed if intestinal parasites are detected…Skin prick tests are preferable as they are much cheaper and reliable as compared to specific IGE Levels..

Dear Sir, As one our brothers child is suffering from Thalsemmhia since 4 years we need your help to get cure, please advice.
Cure of thalsemmhia is only a bone marrow transplant… but as it is a costly treatment and most parents cannot afford it one can opt for regular blood transfusions and iron chelating agents to prevent the toxicity of iron which is transfused during the blood transfusion…

Is there anything to overcome egg allergy
There is a definite proved egg allergy and the best remedy is to avoid it… any form of food which contains egg like even a cake should be avoided…

I have a boy kid of 6yrs old he is having problem of digestion some times he is vomiting and the vomit is badly smelling as well when he wake up in morning his mouth also haves some bad smell pls. give the proper guidance to recover the same.
First the parent should get the stool examination done to find if there is a chronic infection in the intestine.. for a symptomatic relief you could give Ondem 4mg..one tab 3 times a day before food.. give digestive enzymes such as unizyme or any other after meals…

Asthma since 3. Recently when turned 10, we started giving him Tiova 9ug 2 puffs after which he never had attack. We also give Nedocromil Sodium (Tilade). I tried stopping Tiova, but mild symptoms reappear. Any side-effects? How long should continue ?
These are preventive medicines and should be continued for a long time… Practically there are no side effects but avoid high doses…

Biotin Deficiency treatment is available in India
Yes it is available in India.. And there is Biotin Tablet too….

GM, Dr.Shah My daughter is 2yr.8m old ,whenever she gets cold and fever, she gets breathing problem and caugh though we have controlled breathing problem after consulting Doctro who had suggested budecort and now we are unable to control her caugh.
From the history it is apparent that the child has got asthmatic tendency which is preciptated by respiratory infection..use of budecort has helped in controlling the asthmatic tendency which leads to breathlessness.. However the infections are not prevented by this drug and this can be reduced by improving the child’s nutrition and vaccinations and also by drugs which increase immunity to infections

my daughter 14, having weezing last 4 to 5 years doctor said will reduce or stop medication within 6 months or 1 year but more than 1 year still continuing how long the medication should be continued?
The commonest cause of weezing lasting for such a long period is bronchial asthma ..it appears is that your child is suffering from it and will require long term management which will improve the use of relieving drugs and preventive drugs and preventive measures..the duration for which it should be continued is variable…

Dear Sir, I have my son aged 3 yrs, and the problem is he never want to eat anything, just forcibly we feed him. What should I do, only he loves junk foods, like maggi, soupy noodles, wafers, etc.
This child has a poor appetite then the cause has to found out and the usual cause in our country is Iron Deficiency Enemia and Protein allergy malnutrtion..however if the appetite is good and the test is perverted so that he refuses the normal home food and prefers to eat the junk foods.. here the parents have to discipline the child and also persuade him to accept more healthy and nutritious home food…

my son is 11. he gets stomach upset frequently. he never eats salads. pl help
The usual cause of stomach upset are diet related and chronic or acute intestinal infection.. So the child should be given hygienic food and easily digestible foods and if he has idiosyncrasy to any particular food then that food should be avoided…

doctor, my son has itching in summer all over. he bathe twice. any home remedies for this?
Itching is due to food allergy or skin parasites like scabies.. Scabies can be treated by anti scabies drugs and food allergy can be treated by avoiding the offending food…in few cases itching can also be caused by nylon or synthetic clothes.. the child should be advised to use simple cotton clothes…

how many polio vaccine we have to give
We recommend oral polio vaccines in the 1st year and 3 oral polio vaccines between 1-5 yrs..

it is difficult to manage tantrums in adolescents. pl advice
First find out the cause of the tantrums as this is variable in each case.. First step is to elevate the cause and if this is not possible the adoloscent should be advised to change his mental attitude and face the cause of tantrums of tension in a rational way…

doctor, my niece has type 2 diab. slightly overweight. will this go away. she is on medication
Type 2 Diabetes is caused by genetic factors and involve mental factors like faulty diet and obesity… By correcting the diet and reducing the weight clinical manifestations of Type Diabetes can be prevented in early stages but genetic susceptibility cannot be cured…

my sister’s daughter stammers. pl suggest treatment
If the child is old enough then speech therapy could be given by an expert speech therapist…Drugs are not very useful but drugs like Nootropil may be tried for a period of 2-3 months…

when does a child really begin to walk? my son is 15 mnths old and still crawling
Usually the child starts walking without support between 11-16 months.. the normal age is variable and heavy weight babies walk a little later when compared to light weight babies..

doctor, pl give us your contact in mumbai. my son has allergic bronchitis 2 times every year
You can contact me at 022-26494010 (between 4pm-9pm) and take the appointment

pl suggest what diet to introduce while weaning
Starting weaning should be around 4months with foods fruit juices like orange juice, sweet lime juice etc. Next weaning foods could be soups like tomato soup , carrot soup or even a mix vegetable soup and cereals like rice and wheat and also ragi and nachini followed by bananas, cheeko, papaya, etc. …and for non-veg people yellow of egg, chicken soup or mutton soup may be introduced between 6-9 months..and boiled fish could be introduced between 9-12 months…

is there any way to prevent swine flu. we are in pune and it is very scary
Vaccination against flu is available and this should be given and those who are very close to the effected individual may be given drugs like tamiflu for a short period…

doc, can allergic asthma be controlled by treatment with montec LC for 6 months
Montec LC mainly controls allergic rhinitis (cold) and this is the contributive factor towards asthma the use of Montec LC may help to certain extent but other treatments is necessary…

im having 6 mnth old baby, he has colic pain every evening. on neopeptine., how to prevent this?
The commonest cause for this is flatulence which produces intestinal spasms leading to colic..hence the treatment should be directed towards reducing gas…this cab done by digestive enzymes and by giving more easily digestible foods… Second common cause is intestinal allergy to some foods… And those foods should be avoided…

my son is 16. he has nasal polyp and septal deviation and doc has suggested surgery. is it safe at this age or can we allow him to be without surgery. he has trouble breathing at night
They are caused by chronic sinusitis, aspirin allergy or cystic fibrosis .. first treat the cause and if it still persists it can be removed…

hello doctor, is it compulsory to do tonsil operation to prevent asthma
No.. tonsils are rarely a cause of asthama..they should be removed only if they are septic…

doctor, my son has ingrown toe nails. how to treat this. if he wears shoe he is ok, but when he wears chapal, he gets dirt inside and pain. pl help
Ingrown toe nails could be corrected by a surgeon …

My son is 12 months old. But is weight is 6.75kgs & height is about 68cms.He hardly eats. But he is very active. Is this normal? whether my son will gain weight & height in coming days? Thank you
He is definitely underweight because the expected weight should be 9-10 kgs..he should be thoroughly examined by A Paediatrician to find the cause of his growth retardation and treat him till he achieves his expected height and weight… this may require a treatment for several months…

when will you visit hyderabad.

Not in the near future…

please tell us how to cure tonsils, any home remedies to prevent infection?
Tonsils are normal lymphatic tissues which help in fighting infections… they are sentry guarding against infections…..they are required to be removed only if they are septic and non-functional.

how can we find out if a child has got diabetes
By doing fasting and post prandial ( 2 hrs after lunch) blood sugar…

what are the ways to prevent diabetes in children
In children the diabetes is caused by genetic and viral infections such as mumps entrovirus infections which trigger an auto immune process which lead Islet cell destruction which secrete insulin ……In areas like Kerala some toxic dietetic factors lead to destruction of Islet cells

my daughter is feeling hot and sweaty all the time and needs ac even in winter. pl suggest how to change this
The usual causes for excessive sweating are obesity, familiar tendency for over sweating and environmental factors.. I would advice to treat obesity and wear cotton clothes which are not likely to produce perspiration and also please improve the ventilation of your rooms…

my niece is 12. she has blocked nose at night full year
If the block is in both the nostrils the usual causes are allergic rhinitis or rhino sinusitis..this has to be treated and if it is a unilateral blocking of nose it can be due to foreign body in the nose or a polyp…

is there ny way to find out if children have worms. for my 16 yr old, suddenly he gets stomach upset or does nt want to eat food
Simple way is to do the stool examination 2-3 times….Once it might not detect but should detect the second time…

doctor, we are having a 6 yr old girl. she fell dwn from first floor, underwent skull surgery at age 2. will she have any future problems
She may have future problems if the underlying brain is damaged..however if there is only an external injury she may not have any problem…

pl suggest ways to improve concentration in children
Concentration is a key to success in any field..it can be improved and developed by proper training of the mind… One important factor is having an intense interest in the subject in which you want to excel.. this itself helps in concentrating the mind ..the other factors which help are moral discipline of the mind and practice of meditation as taught in Rajyog by Swami Vivekananada

sir, with regards to my 14 yr old, he is having lot of distraction. how to check for ADHD?
If he has ADHD then you should consult an expert Paediatrician to find out the cause for it.. one of the important cause is subtle brain damage during perinatal period or thereafter…..ADHD can be treated by treating the cause as well as symptomatically by drugs like Methyl phenidate, etc.

doctor, my daughter has rashes on her neck, becomes red and itchy in summer. Please suggest medication
The most common cause of rashes with itching on the neck is fungus infection in the neck folds and around. It becomes worse in summer because the excessive perspiration in summer favours fungus infection. Clean the area with wet cotton, then wipe with dry cotton and then apply antifungal cream such as Candid-B Cream 4 times a day.

what is the surest way to know if a child has got swine flu
The surest way of Diagnosis swine flu is to send Nasopharyngeal culture for Swine Flu Virus (H1N1 Virus)

my son is 25 days old. i dont understand if he is crying for hunger or he has some pain.pl help
If your baby is crying because of hunger, he should stop crying on Feeding. If crying persists despite feeding then oher cause like intestinal Colic due to Gas, acute middle ear infection causing ear ache, or simply due to difficulty in passing a hard stool.

my daughter is abt 3yrs, whenever she gets cold, she will be having breathing problem and caugh, though we have used budecort after consulting a doctor. for caugh we have used ambrodyl S and sudinkid but there is no relief from caugh.
Your daughter gets recurrent cold, cough and breathlessness. These symptoms are suggestive of Bronchial Asthama triggered by a respiratory infection. Put the child on long term management of Bronchial Asthama plus give antibiotics when infection is precipitating factor, budecort inhalation should be continued as a long term preventive medicine and Ambrodil-S should be continued till symptoms are relieved.

My son is 2.5 yrs old, and he is getting cough and cold regulary, what are the ways to avoid? Please tell us sir
There are many causes for a child getting cold & cough frequestly. Common causes are under nutrition leading to recurrent respiratory infections, chronic tonsillitis, chronic rhino sinusitis, bronchial asthama and cystic fibrosis. You should consult an expert Pediatrition to determine the cause and remedy.

Dear Sir My son is 2 and half years old. He does not talk at all but his other developmental milestones are normal.Can you suggest any pediatrician at KOLKATA for speech.
It seems your child has selective delay in speech development, so the first step is to get the check-up done to find out whether his hearing is normal or not. If his hearing is normal and if other developmental milestones are normal, then your child should be referred to an expert speech therapist.

hi ihave a one year old son he has gas problem in 11 month many treatment we did but no effect he cant sleep very well day and night .in sleeping he turn his body up and down right and left and crying plz give me some advice he sleep better..
Excessive gas formation can be due to chronic intestinal infection, indigestion, lactose intolerance, intestinal allergy or simply due to excessive air swallowing caused by crying while been given bath, massage or some other causes. Please treat the cause  and give  anti Spasmodics like Colicaid or Cyclopam for symptomatic relief.