Premature Labour Pain,Pneumonia in children,Septicemia Infection in Newborns,Congenital Malformations in Newborns,High Risk Pregnancy,Diabetes in Pregnancy,High Blood Pressure in pregnancy Jalandhar Punjab.
Parental Guidelines
The information contained on this site is sourced from standard textbooks on Pediatrics. However, it is neither meant to be complete nor an exhaustive account of the diseases or their treatments. It is only intended to be a patient information resource supplementary to the information given to them by the treating doctor. The hospital shall not bear any responsibility for any adverse outcomes arising out of self treatment or holding back treatment or consultation or any change in treatment from that advised by the treating doctor. Additionally on this website, we clearly refrain from giving any medical advice on intake of medicines for any disease condition whatsoever, which we consider dangerous.
Emergency Services
What to do in case of FALL?
LOOSE STOOLS: diarrhea 
What should be done in case of NOSE BLEEDING 
How can I help my child grow and develop?
Children's Growth 
Suggestions for handling common problems in children 
How should I take care of my newborn baby? 
What are the danger signs in newborns or when should I seek help of a doctor? 
Tips for general care of a newborn baby for a first time mother 

Breast-feeding- Nurse on demand during the day and night. Baby should wet and poop a lot. Feed from only one side at one time and don’t forget to alternate sides. Drink lots of fluids. Eat or drink a balanced diet as per your choice, and if you need to take medicines, take only what your Obstetrician prescribes.
Breast feeding is the most natural way of feeding and is best for both mother & baby.
Strict back or side sleeping: Please, snuggle your baby at necessary to get the baby to accept this position. It is important to lower the risk of sudden infant Death Syndrome (SIDS)
Cord care- Just leave it alone. Keep the diaper folded down to keep urine off the cord as much as possible, but don’t worry about it. Come to hospital if it gets smelly or there is redness or discharge from or around it. Cord usually falls off by end of first week.
Eye Care- A persistently sticky eye with redness indicates conjunctivitis. This may be treated with medicated eye drops prescribed by your Doctor. Persistent watery eye discharge particularly if it is from one eye, is often due to a blocked tear duct. This is treated by massaging the site where the tear duct is located i.e. between the eye and the root of the nose (better to ask your doctor to demonstrate the exact site). This helps to open up the tear duct. Kajal / Surma application is best avoided because of risk of injury or infection to the eye.

Mouth Care- if the mouth is thickly coated, glycerin may be used to clean the mouth. A persistent white curdy coating indicates a fungal infection and requires treatment after consulting your Paediatrician.
Nose Care- A blocked nose or a stuffy nose is common and normal in young infants. Normal saline nasal drops are commercially available and can be used as required to clear up a stuffy nose in your baby.

Ear Care- Routine cleaning of the ears is not required. Use of an ear bud is not recommended and can be harmful. If a lot of wax accumulates in the ears, you can consult your doctor for ear drops to dissolve the wax.

Nappy Care- Use of cotton diapers is preferable. Cotton diapers need to be washed with a simple detergent or soap & dried in sunlight. Huggies or other commercially available diapers are convenient but expensive and in general, their use is best restricted for an outing or an occasional night. While using these, please keep in mind that they need to be changed every 2 to 3 hrs especially during summer & monsoon months. Babies are at higher risk of developing rash in nappy areas. Nappy rash creams are occasionally necessary to prevent/ treat simple nappy rashes. If rashes severe and spreads to the thighs, it may indicate an infection and will require treatment from a Paediatrician. Keep the nappy area clean and dry to avoid rashes.

Skin Care- A baby should be bathed with a mild non-medicated soap. Other skin care products like shampoos, creams and powders are not recommended. Transient skin rashes are common and may be treated with baby lotion. The scalp often has scaly rash resembling dandruff called ‘cradle cap’. Which tends to settle in the first few months, in severe cases, consult your Child Specialist.

Massage- Although not medically necessary, an oil massage is a social custom in many families. It may be done provided a few precautions are followed. Oil should not be put on the face, in the nose and ears, the breast of newborn baby should not be massaged and the foreskin of the penis in a male infant should not be pulled back. If the baby develops any reaction to the oil e.g. peeling rashes or boils, the massage should be discontinued. Any natural oil like coconut oil, olive oil, desi ghee etc are generally well tolerated. 


Genital Care
Girls- During the daily bath and after each stool, the baby needs to be cleaned with plain lukewarm water and sterile cotton wool. The labial folds are to be separated gently for cleaning. The cleaning should always be from ‘Front to back’, so that the stool is not pushed forward to the urinary area, which can lead to urinary infection.

Boys- the penis should be washed from outside during the bath,. Pulling back foreskin during the bath is not required. The foreskin of the penis is usually tight in infancy, and forcibly pilling back the skin is harmful. The foreskin gradually loosens over the first few years of life in 97 % of boys. Some parents may wish to get their baby circumcised for religious reasons. If so, they should discuss with their Paediatrician regarding the correct time and procedure to get it done.
Stool and urine pattern: a newborn baby should pass urine at leas 7-8 times a day or after each feed. Most infants on breast feeds pass 8-10 golden yellow semi-solid stools every day. It is not uncommon for some infants to pass a stool as infrequently as every 4-5 days. This does not need active treatment
Vitamins- Routine supplements of vitamins are not necessary for full-term breast fed infants. Exposing the baby to the morning sun for 10-15 minutes is a good way of giving the baby natural vitamin D.

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My newborn baby looks yellow/ diagnosed as having jaundice, what to do? 

About 60-70 % of newborns develop physiological jaundice on the second or third day of life. The yellow discoloration (icterus) is first detectable on the face and trunk, sparing palms and soles. The jaundice deepens by 4th to 5th day of life. Physiological jaundice does not need any treatment. It does not indicate any infection. If the jaundice presents within the first 24 hours of life & when it is deep and intensely stains the trunk, or also stains palms and soles; or if it persists beyond 2 weeks; you will need to consult your baby’s Paediatrician for appropriate investigation and management.

Why and how should I exclusively breast feed my baby? 

Breast Feeding is “Good for the Mother, Perfect for the Baby!”

  • Helps a baby’s brain develop optimally.
  • Protects against cold, allergies and other infections.
  • Is the only food a baby needs for the 6 months of life?
  • The preparation and motivation of the expectant mother in order to establish breast feeding successfully needs to begin birth of the baby, during the Antenatal check ups.
  • Inverted and cracked nipples must be managed during pregnancy itself, so that problems are resolved before delivery of the baby.
  • The mother should be guided & encouraged to put the newborn baby to the breast as soon as possible after the birth (preferably within first hour).
  • According to the baby-Friendly Hospital Initiative (BFHI) guidelines, breast-feeding should be started within half an hour of a normal delivery and within 4 hours of caesarean section.

Benefits of breast feeding:

  • Emotional bonding of mother with child and increased sense of well-being.
  • Always available and best nutrition for newborn.
  • Uncontaminated food at the correct temperature for the baby.
  • High level of protective antibodies.
  • Promotes brain growth in the baby.
  • Reduces incidence of diarrhoea, respiratory and ear infections for your baby.

For the mother:

  • Reduces post delivery bleeding.
  • Helps mother in shedding excess weight and fat gained during pregnancy.
  • Reduces incidence of breast abscess, breast engorgement and breast carcinoma.
  • Reduces chances of next pregnancy in the immediate period.

Steps to successful breast feeding:

  • Before delivery, tell your doctor you intend to breast feed your baby.
  • Start breast feeding your baby, as soon as he/she delivered.
  • Know about benefits of breast feeding to both mothers and baby.
  • Learn how to maintain lactation by expressing even when separated from your baby for some periods like sickness.
  • Do not give your newborn any other food drink, other than breast milk, unless indicated by your pediatrician.
  • Practice “Rooming-in”-keep your baby with you the whole day. (this will help bonding and understanding baby’s needs.)
  • Let your baby suckle “on demand” Breast feed him whenever he/she cries.
  • Do not give artificial teats or pacifiers (dummies/ soothers) to breast-feeding infants.
  • Consult your doctor on adequate care of breasts and nipples during pregnancy. Wash breasts during daily bath with clean water. After breast feeding, wipe breasts with clean cloth or allow them to dry naturally before dressing.
  • Maintain your personal and baby’s hygiene for good health.

Misconceptions/ myths in breast feeding
Some mothers may have following misconceptions about breast feeding like:

  • You need to give sugar water (dextrose) or formula to take care of your baby’s nutrition, in the first few days.
  • Baby’s feeding pattern has to be regulated.
  • Mothers should not nurse their baby while lying down.
  • Mother’s milk has no food value after 12 months.
  • Baby can have allergy to mother’s milk.
  • Cow’s milk and formula feeds are also as good as human milk.
  • It is Ok to give formula milk just once a day.
  • Baby should be allowed to cry otherwise he/ she will get spoilt; mother should not pacify him/her.
  • Babies should sleep at night and feed during day time.
  • All babies should pass stools every day.
  • These misconceptions are not correct and may harmful to baby if followed.

Breast Feeding.
How to know mother’s milk is enough for the baby:

  • Baby passes urine more than 4 times in 24 hours for first 3 days, and 7-8 times in 24 hours, subsequently.
  • Baby gains weight adequately- 30g/day for first 3 months,
  • Baby sleeps peacefully after a feed.

Some reasons for inadequate milk:

  • Giving your baby top feeds, dextrose & sugar water, and formula feeds, etc.
  • Changing to other breast mid-feed.
  • Mother’s diet has inadequate fluids, less fresh fruits/not taking a balanced diet.
  • Mother is tired/exhausted/inadequate sleep.
  • Painful breasts.

Managing Problems during breast feeding:
Baby not sucking:

  • Stuffy nose, improper position, too warm or cold surroundings, respiratory infection, earache.
  • Nipple confusion due to bottle feeding or use of soothers/ pacifiers.
  • Mother having painful & engorged breasts, stressed mother-loud talk / arguments, long separation from baby, excessive hunger in baby.

Sore / painful Breasts:

  • Improper position, Improper latching-baby’s lips should cover most of brown areola surrounding the nipple. Baby sucking will then not be painful to the mother. 
  • Improper & forceful expression of breast milk.
  • Tight brassieres.
  • Breast engorgement/ abscess.
  • Cracked nipple or local infection.

Some instructions for Working Mothers:

  • Express milk and store in fridge for baby’s feed in her absence.
  • Increase night time feeds.
  • Wake up 15-20 minutes, using alarm, before time of morning feed.
  • Sit with baby for 20-30 minutes immediately after coming home.
  • At least 4-6 months maternity leave.
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My mom in law says, "Give bottle at least once a day". Is this correct? 

Some mothers give bottle “only ONCE a day”  as the elders feel that it would be easier to switch them over from breast to bottle finally and so that baby gets a sound sleep at night. Both these arguments are highly flawed. Bottle can cause dangerous infections to your baby and it is not something that is indispensable (no animal in nature uses bottle to feed its babies; bottles were invented hardly 100 years back and human race is million years old) . Babies should be exclusively breastfed till 6 months and thereafter semi-solid and solid food should be added to the diet. Top milk even if needed can be given with glass. Secondly, it gives Moms, not babies, a sound sleep! In fact, breast-feeding at night gives baby extra time for sucking. And since more Prolactin is produced at night, it is important to keep up adequacy of flow of breast milk. It also enhances mother-infant bonding

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What should I do when my baby is crying excessively? 

Crying is a baby’s way of communicating with you. A cry that is consolable may be due to hunger, wet nappy, tiredness, boredom or any other reason. An inconsolable and continuous cry usually means pain. It is very difficult to localize pain in babies but there are some tips:

  1. Most of the reasons are concentrated around various orifices (mouth, nose, ears, anus, eyes)
  2. Check all exposed parts for insect bite, swelling, redness
  3. If the baby is not able to feed and there is noisy breathing, nasal blockade may be the cause
  4. Check the nappy area for rashes
  5. Check mouth for any whitish coating or ulcers
  6. Check ears, eyes for discharge
  7. Get Doctor’s help, if not able to console the baby
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My baby never sleeps at night, what to do? 

Babies usually have a sleep wake cycle that is opposite of mother. This is because when in womb they go to sleep when mother is moving around due to rocking motion and wake up when mother lies down.  Help your baby understand the difference between night and day. Make sure the room is dark at night and there are no noises. Giving the baby a gentle massage followed by warm bath at night time is a good idea to induce sleep at night

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How and when should I wean my child? 

In an exclusively breast fed infant weaning (addition of other food items in diet) should be started at 6 months but if the baby is being given top milk also, it is better to start weaning at 4 months along with breast feeding rather tan giving top feeds.
Weaning Advice

Age  Type of Feeding 
0-6 months  Exclusive breast feeding. Mother's milk is best for your baby. No water or any other milk required. Please avoid bottle feeding. 
4-6 months  Start weaning your baby with semisolid food & not with bottle & milk. Homemade cereals like rice kheer, dalrice, rava kheer, etc. Start with fresh home made fruit juices. One food and small quantity at a time, then start next item after a week. Commercially available weaning preparations can be used if needed. Please continue breast feeding.  
6-9 months  Mashed fruits (apple, banana). Vegetables in the form of soup. Eggs yellow first & later white can be started. Please continue breast feeding. 
9-12 months  Full diet in the form of dal- rice, khichadi, milk, biscuits, sprouted legumes, fruits & vegetables. Please continue breast feeding. 
After 1 year  Full child diet, try to continue breast feeding 1-2 years as per your convenience. Child should eat more food & drink less milk. 
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My child does not eat anything, what should I do? 

Children are often fussy eaters. Do you feel that your child does not eat anything? Does not open mouth while feeding? Eats at the neighbor place but not the food you lovingly prepared. Is your child dependent on maggi, chips, noodles, candies and fruity? Is he/she drinking milk the whole day? Does not eat any vegetables or dal / sabji except for potato? “Not eating” is not a disease; it does not need medicine or tonics. Actually there is no medicine known as tonic parents and caretakers insist on such type of prescription which is not appreciable.
These are few things we should keep in mind while feeding children:--

  • It takes around 5-20 trials of a food item before a child likes it, so while introducing a new food item we should be patient. We must not assume that the child will like it the very first time, it takes time to develop a new taste.
  • If the child vomits, do not get upset, wipe his / her face and restart feeding. Some children develop this habitual vomiting to avoid eating; mothers should not get anxious about it.


  • Children who are dependent only on milk can also be fed with food mixed with milk like porridge, rice, banana and suzi. The quantity of milk can be gradually reduced and solid food increased..
  • Do not always mix vegetables with potatoes let the child have other green vegetables, fruits and pulses.


  • Parents should not get worried if the child does not eat. If the child is not sick he has enough reserves to remain empty stomach for at least a day.
  • You can feed children in attractive plates and utensils (e.g. with cartoons) which will make eating an enjoyable process for them.


  • Do not put on the TV while eating. Children should be encouraged to eat on the dining table.
  • Bottle feeding should be discouraged else child will not learn to chew the food.


  • Some children eat biscuits, chocolates and chips a lot and so are not hungry when food is served to them. These things should be offered only after children finish the food as a reward.
  • It takes time to get rid of bad eating habits sometimes it may take few days. Initially the child may resist but do not give up on your efforts. Always try to inculcate good eating habits in children for their good health. Your confidence and efforts will make them disciplined too.
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My baby is now above one year, what precautions should I take to prevent any injury or harm to him/her? 
  1. Keep all medicines out of your child’s reach in a closed cupboard
  2. Check all electricity wires fordamage
  3. Fit safety sockets on all electricity points
  4. Lock away all pins, needles, scissors, matches, knives
  5. Never leave a child unattended in kitchen, bathroom or on terrace
  6. Keep aerosol cans, sprays, toilet cleaners, acids etc out of your baby’s reach
  7. Don’t leave plastic bags lying around, they can cause suffocation
  8. Do let him/her play with a toy having small parts, coins, buttons etc as these can be ingested or inhaled
  9. Do not give nuts to the child
How does one contact ANKUR? 
We as a policy do not encourage phone consultation as it can be dangerous because the Doctor has not examined the child. Still a specialist pediatrician is contactable 24 hours on the NICU mobile no: 9501300776 or our EPABX no 01814679999 ext: 915. It is our humble request to use this facility sparingly and to be patient if the doctor concerned is busy in the care of sick babies in NICU or PICU
Phone no : 0181-4679900-99
E-mail :
Address : ANKUR Hospital, 663,
Guru Teg Bahadur Nagar,
Near Guru Ravi Dass Chowk,
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What emergency facilities are available at ANKUR? 

A Consultant Pediatrician, is available 24 hours to look after all Emergencies, should such a need arise. The Emergency Room meets the immediate medical needs of the Patients. Emergency medicine doctors and nurses specialize in treating patients who are suffering from a serious illness or injury that could get worse if not treated quickly. A Pediatric Surgeon is available on call for urgent surgeries. A Fully equipped Ambulance service is available for the transportation of Sick patients round the clock. Trained nursing staff accompanies the ambulance every time.

Neonatal Intensive Care Unit (NICU) is a unit of the hospital specializing in the care of ill or premature newborn infants. When a high risk newborn is delivered anywhere in the vicinity of Jalandhar and we are contacted, a fully equipped neonatal transport team travels to the town to transport the baby from the delivery table to ANKUR's NICU. We are particularly trusted for ventilator care of newborns when babies at other centers need neonatal ventilation.

The Pediatric Intensive Care Unit (PICU) at ANKUR Hospital is a four-bed unit caring for sick children, older than a month. In PICU we have state of the art equipments and technology including advanced ventilators, cardiac monitors, defibrillators etc.

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What to do in case of injury due to FALL

Children are very prone to fall from bed, stairs etc. Most of the times injuries are mild but they can be serious also and it is very important to detect them in time so that early treatment can be started.

An injury to the brain is likely when

  • There is continuous vomiting,
  • Child Loses consciousness,
  • Has seizures,
  • Sleeps excessively, or ,
  • Complains of headache (-a small child may cry excessively),
  • There is bleeding from nose or ear despite no evidence of direct injury
  • Development of black eye

Some types of head injury may even have symptoms appearing later (up to 24 hours).

A fall with an injury to the head is an emergency where the child has to be examined by a pediatrician. In some cases CT scan head may be needed. Do not administer any pain killers or sedatives to the child without consulting the doctor  

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What is Fever?
Body temperature higher than normal is called fever. Upper limit of normal temperature in children is same as adults i.e 98.6 F. Everyone's temperature tends to be lower early in the morning and higher between late afternoon and early evening.  
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) What is the significance of fever? 

Fever is not the disease by itself; it is only one of the symptoms. Generally infections caused by viruses or bacteria are the cause in children.  

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What's the best way to take a child's temperature? 

It is very important to record the exact temperature of your child when you suspect fever and convey the information to the pediatrician. There are many ways to measure temperature

  1. Rectal: a special rectal thermometer is used. This is the actual core temp. of the body and you do not need to subtract or add anything to the value obtained. This is the best method to measure baby’s temperature
  2. Oral: in children above 3 years of age, oral temperature can be measured just like an adult.
  3. Axillary: In babies above 3 months of age, axillary temperature can be checked. In children above 1 year, one needs to add 1 F to the measured value to get the exact temperature.
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What should I do if my child has high grade fever? 
Though fever is just a symptom and not actually a disease, it the commonest cause of panic in parents. When a child has high grade fever (>102*F), first thing to do is to remove excess clothing and sponge the whole body of the child with a cotton cloth dipped in tepid water. One can safely administer paracetamol drops (Crocin or Calpol) in dose of 2 drops/kg body wt of the child, repeated every 6 hrly.
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What are the causes of COUGH in children? 

Children get cough due to an irritation in the airway. The focus of irritation can be anywhere from the nose, ears, throat, the trachea (windpipe), bronchi, or the lungs themselves. Most coughs accompany the common cold, which is a viral infection of the ear, throat and nose. Once cough starts, the irritation usually persists over a week. Cough can be caused by bacteria, viruses, allergies, foreign body or drugs. Cough occurring again and again, usually suggests an allergy of the airway.

Long standing coughs (more than 15 – 20 days) are rare and usually suggest a long standing disease like Tuberculosis.

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What are the Danger signs in a coughing baby? 
A child with cold and cough needs urgent evaluation by a doctor if
  • There are chest retractions (in drawing of chest wall during inspiration)
  • There is head bobbing (movement of head with each breath) & nasal flaring
  • Excessive & inconsolable cry
  • Lethargy & drowsiness
  • Not feeding
  • Bluish lips, tongue & nails
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What is diarrhea? 

When a baby passes stools more frequently that his usual routine, or when the stools are more fluid than his usual stools, he is said to be suffering from diarrhea.

Diarrhea in children younger than 5 years is usually caused by viruses. Such a diarrhea is self limiting. It is usually watery, and there is no blood or mucus in the stools. Irrespective of the cause loose stools result in loss of fluid and salts from the body-known as dehydration, which can cause considerable harm. It is important to consult your doctor when your child has diarrhea.

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What is the best way to treat diarrhea? 
Best way is through oral rehydration fluids and Zinc supplementation. Most children with mild diarrhea can continue to eat a normal diet including formula or milk. Breastfeeding can continue. If your baby seems bloated or gassy after drinking cow's milk or formula, call your pediatrician to discuss a temporary change in diet.
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What special fluids can be given for moderate illness? 

Children with moderate diarrhea may need special fluids. These fluids, called electrolyte solutions ORS, have been designed to replace water and salts lost during diarrhea. They are extremely helpful for the home management of mild to moderately severe illness. Do not try to prepare these special fluids yourself. Use only commercially available fluids—brand-name and generic brands are equally effective. Your pediatrician or pharmacist can tell you what products are available.

If your child is not vomiting, these fluids can be used in very generous amounts until the child starts making normal amounts of urine again.

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What are the Dos and Don'ts in diarrhea 
  • Watch for signs of dehydration which occur when a child loses too much fluid and becomes dried out. Symptoms of dehydration include a decrease in urination, no tears when baby cries, high fever, dry mouth, weight loss, extreme thirst, listlessness, and sunken eyes.
  • Keep your pediatrician informed if there is any significant change in how your child is behaving.
  • Report if your child has blood in his stool.
  • Report if your child develops a high fever (more than 102F or 39C).
  • Continue to feed your child if she is not vomiting. You may have to give your child smaller amounts of food than normal or give your child foods that do not further upset his or her stomach.
  • Use diarrhea replacement fluids that are specifically made for diarrhea if your child is thirsty.
  • Try to make special salt and fluid combinations at home unless your pediatrician instructs you and you have the proper instruments.
  • Prevent the child from eating if she is hungry.
  • Use boiled milk or other salty broth and soups.
  • use "anti-diarrhea" medicines unless prescribed by your pediatrician.
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What are the Danger signs in a baby with diarrhea 

A child with loose stools needs urgent evaluation by a doctor if

  • Not passing urine even after 4 hrs (2 hrs in newborns)
  • Not taking feeds or oral liquids
  • Lethargic or excessive cry
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What's the best way to treat vomiting?  

For the first twenty-four hours or so of any illness that causes vomiting, keep your child off solid foods, and encourage her to suck or drink clear fluids, such as water, sugar water (1.2 teaspoon [2.5 ml] sugar in 4 ounces [120 ml] of water), Popsicles, gelatin water (1 teaspoon [5 ml] of flavored gelatin in 4 ounces of water), or preferably an electrolyte solution (ask your pediatrician which one), instead of eating. Liquids not only help to prevent dehydration, but also are less likely than solid foods to stimulate further vomiting.

Here are some guidelines to follow for giving your child fluids after she has vomited.

  • Wait for two to three hours after the last vomiting episode, and then give 1 to 2 ounces (30-60 ml) of cool water every half hour to one hour for four feedings.
  • If she retains this, give 2 ounces (60 ml) of electrolyte solution alternated with 2 ounces of clear liquids every half hour.
  • If this is retained for two feedings, add half-strength formula or milk (depending on age), and continue increasing the quantity slowly to 3 to 4 ounces (90-120 ml) every three or four hours.
  • After twelve to twenty-four hours with no additional vomiting, gradually return your child to her normal diet, but continue to give her plenty of clear fluids.

In most cases, your child will just need to stay at home and receive a liquid diet for twelve to twenty-four hours. If your child also has diarrhea, ask your pediatrician for instructions on giving liquids and restoring solids to her diet.

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When to see the doctor? 
If she can't retain any clear liquids or if the symptoms become more severe, notify your pediatrician. She will examine your child and may order blood and urine tests or X rays to make a diagnosis. Occasionally hospital care may be necessary. 
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How to differentiate regurgitation (which is normal in infants) from vomiting? 

Infants (<1 yr old babies) may regurgitate immediately or some time after feed. This can be very alarming for the parents or caretakers but is usually harmless for the baby. The regurgitant may be digested feed (curdy material), feed as such or watery gastric juices depending upon the time interval between feeding & regurgitation. The points to differentiate are as follows:

  • Generally babies cry before & after vomiting but they become relaxed after regurgitation
  • Regurgitant is never Yellowish or greenish in colour
  • Regurgitation never leads to dehydration or wt loss even over prolonged durations whereas vomiting usually causes these
  • Baby usually asks for more feed or fluid & becomes hungry after vomiting but goes to sleep after regurgitation
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What should be done in case of NOSE BLEEDING 

When a child hurts his nose and he begins to bleed, or in hot summer months when bleeding starts spontaneously, the child has to be put in a sitting position, bending forward, enough to allow blood to drip out of his nose. The nose has to be pinched with two fingers, long enough to stop the bleeding.

Once the bleeding stops, the child needs to be brought to hospital for examination, and necessary treatment. Some bleeds require medical treatment; some need intervention by an ENT surgeon, while still others may need a neurosurgeon, when the blood is mixed with watery liquid from the brain.


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How can I help my child grow and develop? 

You can help baby learn to explore the world around him in variety of ways. As you play with him, watch for his responses, encourage him to imitate you nad to initiate play on his own.
Birth to 3 months                                                                                                

  • Handle and rock your baby often.
  • Talk, sing, and read to him.
  • Place him on his stomach with colorful toys or pictures within his sight.
  • Give him rattle to hold.

3 to 6 Months

  • Let your baby see her reflection in a mirror.
  • Play peek -a-boo. Count and kiss her fingers and toes.
  • Introduce a floating toy or cup to her bath. Encourage her to reach for the toy and to splash in the water.
  • Help her to roll from stomach to her back, trucking her arm under her chest and supporting her head.

6 to 9 Months

  • With your pediatrician’s approval, teach your baby to eat finger foods like cheese cubes, dry cereal, or pieces of banana in a higher chair.
  • Encourage him to pick up objects from one hand to another hand, to knock down a stack of objects, to roll and catch a ball. Find a variety of toys he can push or slide.
  • Show him pictures in a book while you describe the picture.
  • Recite nursery rhymes to him.

9 to 12 Months

  • Play pat-a- cake with your baby. Encourage her when he / she initiate play.
  • Provider him / her with stacking toys, blocks in a container, kitchen objects like plastics pots and pans and plastics bowls with lids.
  • Imitate sounds and show her how to repeat speech sounds.
  • Encourage her to walk by helping her to learn how to pull herself up and to move along the furniture.

12 to 15 months

  • Teach your baby to hand a spoon and to drink from a cup. Using a plastic cup with two handles- and a bib.
  • Encourage him/her to take first steps by going between two people or by moving towards a favorite toy held a step or two away from him.
  • Play listening games to help identify sounds (the clock, cars, dog, & televisison).
  • Ask him to point to familiar objects as you name them.
  • Provide a riding toy that he/she can use to scoot himself forwards or background.

15 to 18 Months

  • Your baby can help to remove her clothing – Socks, hat, coat.
  • Teach him/her to follow your direction to sit down or stand up.
  • Show him/her how to brush his /her- and yours.
  • Provide him/her with finger paints, puzzles and scooping toys in a sandbox.
  • Teach him/her to point o and name body parts on you, herself, or pictures.

18 to 24 Months

  • Identify shapes for your baby, cake pans and drawing teach him to zip and button.
  • Help him to organize his world. Show him how to separate and sort his socks from Daddy’s boxes from cans, paper cups from prepare plates.
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Children's Growth 
Growth Charts 
Premature Labour Pain,Pneumonia in children,Septicemia Infection in Newborns,Congenital Malformations in Newborns,High Risk Pregnancy,Diabetes in Pregnancy,High Blood Pressure in pregnancy Jalandhar Punjab.
Premature Labour Pain,Pneumonia in children,Septicemia Infection in Newborns,Congenital Malformations in Newborns,High Risk Pregnancy,Diabetes in Pregnancy,High Blood Pressure in pregnancy Jalandhar Punjab.
Premature Labour Pain,Pneumonia in children,Septicemia Infection in Newborns,Congenital Malformations in Newborns,High Risk Pregnancy,Diabetes in Pregnancy,High Blood Pressure in pregnancy Jalandhar Punjab.
Reading growth Charts 
Note that boys and girls grow at different rates, and hence there are different growth charts for them. In the appropriate graph above, look at your child's' age in the x-axis. Follow the line vertically upwards to meet the weight of the child as you have recorded. (In the green band showing the weights). The nearer a child is to the centre of the band, his weight is at par with the largest majority of children in this age group. Above and below are children who are proportionately advanced or lagging in weight.  
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What are some of the developmental milestones my child should reach by three months of age? 

By the time your baby is three months of age, she will have made a dramatic transformation from a totally dependent newborn to an active and responsive infant. She'll lose many of her newborn reflexes while acquiring more voluntary control of her body. You'll find her spending hours inspecting her hands and watching their movements.

Here are some other milestones to look for.

Movement milestones

    • Raises head and chest when lying on stomach
    • Supports upper body with arms when lying on stomach
    • Stretches legs out and kicks when lying on stomach or back
    • Opens and shuts hands
    • Pushes down on legs when feet are placed on a firm surface
    • Brings hand to mouth
    • Takes swipes at dangling objects with hands
    • Grasps and shakes hand toys

Visual and hearing milestones

    • Watches faces intently
    • Follows moving objects
    • Recognizes familiar objects and people at a distance
    • Starts using hands and eyes in coordination
    • Smiles at the sound of your voice
    • Begins to babble
    • Begins to imitate some sounds
    • Turns head toward direction of sound

Social and emotional milestones

    • Begins to develop a social smile
    • Enjoys playing with other people and may cry when playing stops
    • Becomes more communicative and expressive with face and body
    • Imitates some movements and facial expressions
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What are some of the developmental milestones my child should reach by seven months of age? 

From age four to seven months, the most important changes take place within your child. This is the period when he'll learn to coordinate his emerging perceptive abilities (the use of senses like vision, touch, and hearing) and his increasing motor abilities to develop skills like grasping, rolling over, sitting up.

Here are some other milestones to look for.
Movement milestones

  • Rolls both ways (front to back, back to front)
  • Sits with, and then without, support of her hands
  • Supports her whole weight on her legs
  • Reaches with one hand
  • Transfers object from hand to hand
  • Uses raking grasp (not pincer)

Visual milestones

  • Develops full color vision
  • Distance vision matures
  • Ability to track moving objects improves

Language milestones

  • Responds to own name
  • Begins to respond to "no"
  • Distinguishes emotions by tone of voice
  • Responds to sound by making sounds
  • Uses voice to express joy and displeasure
  • Babbles chains of consonants

    Cognitive milestones

  • Finds partially hidden object
  • Explores with hands and mouth
  • Struggles to get objects that are out of reach

    Social and emotional milestones

  • Enjoys social play
  • Interested in mirror images
  • Responds to other people's expressions of emotion and appears joyful
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Although each baby develops in her own individual way and at her own rate, failure to reach certain milestones may signal medical or developmental problems requiring special attention. If you notice any of the following warning signs in your infant at this age, discuss them with your pediatrician.

  • Doesn't seem to respond to loud sounds
  • Doesn't notice her hands by two months
  • Doesn't smile at the sound of your voice by two months
  • Doesn't follow moving objects with her eyes by two to three months
  • Doesn't grasp and hold objects by three months
  • Doesn't smile at people by three months
  • Cannot support her head well at three months
  • Doesn't reach for and grasp toys by four months
  • Doesn't babble by four months
  • Doesn't bring objects to her mouth by four months
  • Begins babbling, but doesn't try to imitate any of your sounds by four months
  • Doesn't push down with her legs when her feet are placed on a firm surface by four months
  • Has trouble moving one or both eyes in all directions
  • Crosses her eyes most of the time (Occasional crossing of the eyes is normal in these first months.)
  • Doesn't pay attention to new faces, or seems very frightened by new faces or surroundings
  • Still has the tonic neck reflex at four to five months

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Because each baby develops in his own particular manner, it's impossible to tell exactly when or how your child will perfect a given skill. The developmental milestones listed in this book will give you a general idea of the changes you can expect, but don't be alarmed if your own baby's development takes a slightly different course. Alert your pediatrician, however, if your baby displays any of the following signs of possible developmental delay for this age range
  • Seems very stiff, with tight muscles
  • Seems very floppy, like a rag doll
  • Head still flops back when body is pulled up to a sitting position
  • Reaches with one hand only
  • Refuses to cuddle
  • Shows no affection for the person who cares for him
  • Doesn't seem to enjoy being around people
  • One or both eyes consistently turn in or out
  • Persistent tearing, eye drainage, or sensitivity to light
  • Does not respond to sounds around him
  • Has difficulty getting objects to his mouth
  • Does not turn his head to locate sounds by four months
  • Doesn't roll over in either direction (front to back or back to front) by six months
  • Seems inconsolable at night after five months
  • Doesn't smile spontaneously by five months
  • Cannot sit with help by six months
  • Does not laugh or make squealing sounds by six months
  • Does not actively reach for objects by six to seven months
  • Doesn't follow objects with both eyes at near (1 foot) [30 cm] and far (6 feet) [180 cm] ranges by seven months
  • Does not bear some weight on legs by seven months
  • Does not try to attract attention through actions by seven months
  • Does not babble by eight months
  • Shows no interest in games of peek a boo by eight months
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Why does my child need to be immunized? 
Immunizations have helped children remain healthy for more than 50 years. But many parents still have many questions about them, including the following:  
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Major vaccines and their side effects

BCG:  A Vaccine against tuberculosis given by one month of age administered over the left shoulder rnnnegion. A swelling       with scab formation occurs by 6 weeks to 2 months after.
 DPT: Diphtheria, Pertussis (whooping cough) and Tetanus are serious but preventable diseases. This vaccine should be given at 6 weeks, 10 weeks and 14 weeks and then against 18 months and 4 to 5 years of age.
Side effects: tenderness at injection site, fever, irritability, excessive crying.
 Polio: Polio is a dangerous disease, which leads to paralysis of different muscles.IPV (Inactivated Polio vaccine) and OPV (oral Polio vaccine) is recommended at birth, 6 weeks, 10 weeks, 14 weeks and then again at 18 months and 4 to 5 years.
Side effects: May have mild diarrhoea.
 Hepatitis A & B: Hepatitis A is a serious contagious disease.  It is water borne and spreads through contaminated water supply. It is given in two doses 6 mo apart at 1yr and 18 months.  Hepatitis B virus is found in blood and other body fluids. Vaccine is recommended in 3 doses: 1st dose at birth, 2nd dose at 4 to 6 weeks, and 3rd dose at 14 weeks of age.
Side Effects: pain redness, swelling and warmth at injection site: flu like symptoms. Serious reactions are rare, but may occur.
 Measles Vaccine: Measles, a viral illness that can cause serious disease in infants. Vaccine is the best protection against this disease. It is recommended at 9 months of age, but can be given as early as 6 months, during at epidemics.
Side Effects: Soreness. Swelling, Warmth with in 48 hours and mild fever, rash may occur at about at 5 days to 1 week after immunization.
 MMR: Measles, mumps and rubella (German measles) are serious virus diseases. Vaccination is the best protection against these diseases. It is recommended at 15 months and 4 to 6 years of age. Contraindication: Egg allergy, immunocompromised, long term steroid therapy, neomycin allergy.
Side Effects: Soreness, swelling and warmth at side with in 48 hours. Rash, fever upto 103 degree. Swelling of glands, seizures usuallly secondary to fever, at 1 to 2 weeks after immunization.
 HIB: Haemophilus influenza type B causes serious bacterial infection, which can cause serious disease especially in children less than 5 years. This vaccine protects against infection caused by this bacteria like meningitis (brain fever), Pneumonia, epiglotitis, infection of the other body system such as blood, joints, bone, soft tissue and covering of the heart. It is indicated at 6 weeks, 10 weeks, 14 weeks and 15 to 18 months of age.
Side Effects: Fever, redness, swelling and warmth at the injection site.
 Varicella vaccine; Varicella or chicken pox is a highly communicable disease. It is caused by Varicella zoster virus. This Vaccine is indicated for individual 12 months and older. 2 doses may be given if more than 13 years at first vaccination.
Side Effects: Soreness, swelling, redness at injection sites, fever, varicella like rash, upper respiratory infection, abdominal pain, fatigue, disturbed sleep, vomiting may occur 0 to 42 days post vaccination.

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"Do vaccines even work? Most of the people who get these diseases have been vaccinated." 

Yes. Vaccines work extremely well. Millions of children have been protected from serious illnesses such as polio, whooping cough, measles, tetanus, and diphtheria because parents have had their children immunized. Most childhood vaccines are 90% to 99% effective in preventing disease. They are even more effective in reducing disease severity. Occasionally a few children may not develop the desired protection after receiving a vaccine.

But to not vaccinate your child gives them no protection from the possibility of getting one of these deadly diseases.  

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"I've heard that some children have serious side effects from vaccines. Are vaccines safe for my child?" 

Vaccines are safe, and severe reactions to vaccines are very rare. Mild reactions to vaccines do occur, but they do not last long. There may be some swelling, redness, and discomfort where the shot was given. Your child may have a low-grade fever and be fussy afterward. Symptoms of more serious reactions are much less common. Call your child's pediatrician right away if your child has a

  • Very high fever (>103F)
  • Generalized rash (including hives)
  • Large amount of swelling around the shot or in the limb used for the shot

Your child's pediatrician can decide whether your child should receive future doses of the same vaccine.

Children with certain health problems may need to avoid some vaccines or get them later. For example, children with cancer, those taking steroids for lung or kidney conditions, or those who have problems with their immune systems in most cases should not receive vaccines like the measles, mumps, and rubella (MMR) or chickenpox vaccine. These are not safe for children with these health problems because the vaccine is made with weakened live viruses. For children with seizures, the pertussis part of the diphtheria, tetanus, and pertussis (DTaP) vaccine may need to be delayed.

Ask your child's pediatrician when the vaccine can be given.

Remember, immunizations are an important part of your child's total health care. Immunize your child on time, and keep your child's immunization record up to date. Make sure you take your child to the pediatrician's office or a health clinic on a regular basis.  

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Adverse events following immunization 

Most children complain of some pain, redness and mild swelling at the site of injection, this is common. Though nothing needs to be done in most cases, it is usually helped by, application of ice. Hot fomentation etc is not recommended.

Some vaccines particularly DPT, cause a fever that may last more than a few hours, and they need some medicines for fever.  

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Things to remember about vaccination 


  • Prior to immunization, inform your doctor if the child has had any significant reaction to the last dose.
  • Immunization can be done in the presence of a minor illness.
  • The suggested schedule may be modified by your doctor as per the need.

BCG : A nodule appears usually 3 to 4 weeks after BCG vaccination. It may soften or ulcerate in 2-4 weeks. No application or fomentation is necessary. It heals leaving a scar, indicating effective vaccination.

DTwP : There may be mild fever, pain, redness and swelling at the site of the injection. A small painless lump may remain for a few weeks. For fever and pain, paracetamol syrup or drops may be given, the dose may be repeated every 4-6 hrs if required. Please consult your doctor for any other reaction.  

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Vaccination schedule 
To ensure a healthy life for your child you should follow your baby's health from intrauterine life till he discharged from hospital, not only for manifest problems, but various rare conditions. These tests are the norm in most developed countries.
  • Antenatal Anomaly screen
  • Postnatal Dysmorphology Screen
  • Metabolic screen
  • Hearing screen
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Antenatal Anomaly screen 
Level II ultrasound scan done at 5 months for all mothers to-be screens any defects in formation of various organs. It always helps us to prepare for the new arrival keeping his special needs, should an anomaly be detected. 
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Postnatal Dysmorphology Screen 
A specialist screens all newborns after birth with a critical eye to search for any abnormality, malformation, or any major or minor defects in most internal organs. If you have a baby discharged from ANKUR, rest assured, we have taken great pains to ensure that your baby is well, or that you have been informed about any future problems likely to arise from any findings of this examination. 
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Metabolic screen 

The human body is made up of a vast number of complex chemical molecules. Sometimes some defects creep in, in the structure of these molecules. This results in defects that have wide ranging impact over the whole body system. These limit the body's ability to handle some items in milk, like some amino acids, which are converted to damaging molecules. If the defect is known at birth, avoidance of offending items makes the difference between health and irreversible disease.

Some hormones like the thyroid hormone support brain growth. Defects in this hormone, causes a major impact on the brain development of the child. If known at birth it is eminently treated.

When we look at defects in chemical structure of the body, we call it metabolic screening. We routinely screen all newborn, delivered in our hospital for three major defects-hypothyroidism, G-6-PD deficiency and, 17-OHP.  

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Why do newborns need hearing screening?

Although most babies can hear normally, 2 to 3 of every 1,000 babies are born with some degree of hearing loss. Without newborn hearing screening, it can be difficult to detect hearing loss in the important first months and years of your baby's life. About half of the children with hearing loss have no risk factors for it.

Newborn hearing screening can detect possible hearing loss in the first days of a baby's life. If a possible hearing loss is found, further tests will be done to confirm the results. If a hearing loss is confirmed, treatment and early intervention can start promptly. Early intervention helps babies with hearing loss and their families learn important communication skills.

That is why the American Academy of Pediatrics recommends that all babies receive newborn hearing screening before they go home from the hospital.

Importance of good hearing

Babies learn from the time they are born. One of the ways they learn is through hearing. If they have problems with hearing and do not receive the right treatment and early intervention services, babies will have trouble with language development. For some babies early intervention services may include the use of sign language and/or hearing aids. Studies show that children with hearing loss who receive appropriate early intervention services by age 6 months usually develop good language and learning skills.

Screening tests

There are 2 screening tests that may be used.

  • Auditory brainstem response (ABR)-This test measures how the brain responds to sound. Clicks or tones are played through soft earphones into the baby's ears. Three electrodes placed on the baby's head measure the brain's response.
  • Otoacoustic emissions (OAE)-This test measures sound waves produced in the inner ear. A tiny probe is placed just inside the baby's ear canal. It measures the response (echo) when clicks or tones are played into the baby's ears.

Both tests are quick (about 5 to 10 minutes), painless, and may be done while your baby is sleeping or lying still. Either or both tests may be used.

If hearing loss is found

This depends on the type of hearing loss that your baby has. Every baby with hearing loss should be seen by a hearing specialist (audiologist) experienced in testing babies and a pediatric ear/nose/throat doctor (otolaryngologist).

Special hearing tests can be performed by the audiologist who, together with the otolaryngologist, can tell you the degree of hearing loss and what can be done to help.

If the hearing loss is permanent, hearing aids and speech and language services may be recommended for your baby. The Individuals with Disabilities Education Act (IDEA) requires that free early intervention programs be offered to children with hearing loss, beginning at the time the child's hearing loss is identified.

The outlook is good for children with hearing loss who begin an early intervention program before the age of 6 months. Research shows these children usually develop language skills at par with those of their peers.

Timing is everything Some parents think they would be able to tell if their baby could not hear. This is not always the case. Babies may respond to noise by startling or turning their heads toward the sound. This does not mean they have normal hearing. Most babies with hearing loss can hear some sounds but still not hear enough to develop full speaking ability.

Your baby will have the best chance for normal language development if any hearing loss is discovered and treated by the age of 6 months-and the earlier, the better.  

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Visual screening 

1. How do I know if my baby needs vision screening?

Your baby needs screening for vision in case he/she:

  • Does not make eye contact at 2 months of age
  • No social smile even at 3 months of age
  • Keeps eyes crossed most of the time
  • Has persistent upward or downward gaze
  • Has continuously oscillating eyes (nystagmus)
  • Has squint
  • Was sick during neonatal (newborn) period and had problems like delayed cry, low blood sugar levels, severe infection
  • Was a premature baby (ROP screening)
  • Needed oxygen for long time in newborn period

2. How is vision sceening done?

  • VEP (visual evoked potential). This is a painless test done just like an EEG. This test measures how the brain responds to light. Light signals are provided through special goggles and electrodes placed on the baby's head measure the brain's response. This is done at 3 months of age or whenever problem is suspected
  • ROP screening: this is needed only in preterm babies. Their retina is examined by indirect opthalmoscope to see if there is any abnormality. Abnormalities if detected in time can be cured by laser in most of the cases. This test is done at corrected gestation age of 32 weeks or 4 weeks of age whichever is earlier
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Neurodevelopmental screening 
All Nicu graduates should undergo Neurodevelopmental screening at 3, 6, 9 and 12 months of age. Other babies also may need this if the doctor or parents feel that they are having delayed milestones (as mentioned in development heading). Early detection of problems is very important as in these cases early intervention can make a lot of positive impact. We at ANKUR hold neurodevelopment clinic on every Thursday. The clinic is headed by Dr Gurpreet S Kochar, DM (Ped Neurology).  
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Suggestions for handling common problems in children 

In young babies, most of the distress caused by cold is due to a blocked nose that hampers breathing while sleeping or feeding. Instill normal saline nasal drops or give steam inhalation to relieve this problem.
Breast fed infants can pass upto 10-12 semisolid yellow non-foul smelling stools/day, especially immediately after a feed, If baby is otherwise normal, active alert, is feeding well and is passing urine after each feed, these should not be treated as diarrhea
It  is very common for babies to throw out curdled milk, feed as such or watery gastric juices immediately or sometime after feed. If baby becomes relaxed or goes to sleep after throwing out and thr baby is gaining weight normally, don’t bother about it. It usually resolves once child is more than 6-10 months of age. Burping the baby  for some time after feed and proper positioning can help decrease this problem
If the baby feels warm. Check temperature in the armpit with a thermometer. If the recorded temperature is more than 100 f, give paracetamol drops and take the baby to doctor’s clinic. If fever is very high, sponge the whole body of the child with a cotton cloth soaked in lukewarm water before going to doctor. Small babies may get fever(hyperthermia), if they are over clothed or kept in very warm room.

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Tips in care of normal newborn baby 
  • Wash your hands before handling, feeding and after each nappy change
  • Only breast milk is required for your baby for the first 6 months. Don’t give any other milk, water, honey or “janam Ghutti”. Give breast feeds on demand or at least 3 hourly. Burp the baby after each feed.
  • Keep the baby warm by using an extra layer of clothes. The hands and feet should be pink and warm to touch.
  • Do not apply anything on the umbilical stump. Keep it dry and clean
  • Keep the number of visitors to the house to the minimum and do not allow anybody to touch or kiss the baby
  • Child can be given gentle massage with any natural oil and bathed daily with luke warm water &  gentle soap
  • Child should be made to sleep on back
  • Keeping the baby in skin to skin contact like a Kangaroo helps in faster weight gain

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Danger signs for newborn babies 
For new Born Babies
  • Baby looks yellow or urine color is yellow
  • Baby looks unwell or refuses to feed
  • Difficult and fast breathing or blue lips
  • Pale in colour or bleeding from any site
  • Too hot or cold to touch
  • Abnormal limb movements
  • Pus discharge from umbilicus
  • Multiple watery stools after a single feed or blood / mucus in stool

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