Monsoon Maladies: Preventive Tips by a Paediatrician

Monsoon gives relief from intense summer heat with welcome rain but with rain come the monsoon blues and maladies. 

  1.   A. Malaria
  2.   B. Dengue
  3.   C. Chikungunya 
  4.   D. Japanese encephalitis
  5.   E. Leptospirosis
  6.   F. Scrub typhus


  1.   A. Viral and bacterial gastroenteritis
  2.   B. Amoebic giardia infection 
  3.   C. Viral hepatitis A & E
  4.   D. Typhoid and Paratyphoid fever 
  5.   E. Cholera 





VACCINES FOR JAPANESE ENCEPHALITIS available for children above the age of 1 year in two doses (one month apart)


Prevention is the mainstay in management of mosquito/vector borne diseases. 


  • – Preventing pooling of stagnant water

    – Desilting of drains

    – Fogging

    – Change water in flower vases,coolers every week .

    – Avoid using saucers underneath flower pots.

    – Cover water containers, overhead tanks tightly

    – Cans, bottles, tyres in covered dustbins

    – Treat water in flood like situations

    – Mesh doors/ windows in homes and use of mosquito nets wherever required


On a personal level

  • – Wear light colored long sleeved shirts and trousers to prevent being bitten by mosquitoes.
  • – Use of insect repellents on exposed areas. 
  • – Mosquito repellents of limited value/ use. They are available as liquid plug ons, roll ons, creams and sprays. 



Humid, sultry weather creates ideal conditions for respiratory viruses to thrive. 

Flu Vaccine needs to be taken every year around this time of the year. 

This is specially important for the very old, the very young, the immune compromised and also the people with asthma, allergies and frequent respiratory infections. 

In fact, it can be taken routinely by everybody. 


On a personal level

  • – Keep nose and face covered during sneezing and coughing. 
  • – Keeping tissues and handkerchiefs separate.
  • – The virus spreads quickly and easily from one person to another so interpersonal hygiene is very important.
  • – Frequent hand washing with soap and water.


Since there is no cure for viral respiratory illnesses supportive treatment includes:

  • – Drink plenty of fluids to stay hydrated. 
  • – STEAM inhalation and saline gargles help. 
  • – Paracetamol in age/ weight appropriate doses every four-six hours if    temperature is 100 deg F or more. 
  • – REST AT HOME !



These are all WATER AND FOOD BORNE DISEASES — SPREAD BY THE OROFECAL ROUTE- wherever and whenever there is a break in public/ personal hygiene. 


The diseases include: 

  1. 1. Gastroenteritis- diarrhoea and vomiting 
  • – Viral 
  • – Bacterial 
  • – Amoebic or Giardia

2. Jaundice or hepatitis A and E
3.Typhoid and Paratyphoid fever


Vaccines preventable diseases include :

  • – Hepatitis A
    The vaccine is given in two doses, six months apart to everybody after the age of one year. 
  • – Typhoid vaccine
    Typhoid conjugate vaccine can be given to all age groups above the age of one year. It needs to be repeated every two-three years once or twice for long lasting immunity. 
  • – Cholera vaccine
    It is to be administered only in epidemic or flood like conditions. 



  1. Good personal hygiene 
  2. Hand and Nail hygiene 
  • – Thorough hand washing with soap and water after using the toilet, or after handling a patient with diarrhoea. 
  • – Hand washing before cooking/ making feed for children. 
  • – Hand-washing after handling animals
  • – Cut hand nails to be the base to prevent the dirt from accumulating under the nail beds. 


Food safety precautions include:

  • – Washing and peeling of all raw food and vegetables before eating. 
  • – Wash hands before handling food. 
  • – Avoid cut fruits, fresh fruit and sugarcane juices from outside/ street vendors.
  • – Avoid street food.
  • – Avoid food with milk products, food with cream and mayonnaise or chutneys from outside. 
  • – Eat at clean eateries.
  • – Drink only properly treated/ bottled water when out in public places.
  • – Do not drink untreated water from street vendors, ponds or streams. 
  • – Do not swallow water while swimming 


Enjoy the monsoon with all these precautions/Dos and Don’ts!

Everything one must know about Breastfeeding

Motherhood is one of the most exalted positions.

Breast feeding is an emotionally fulfilling experience both for the mother and the baby.

It takes motherhood to another plane because to nurture your baby, have the breast milk (called ‘AMRIT’ by me), flowing into the baby’s mouth and system can be a truly exhilarating and overwhelming experience for the first time mother or a mother again and again.

Breast feeding is about the wondrous joy of nurturing a new life. Breast feeding is in fact a gift to the mother herself and the baby.

So, happy breastfeeding!

Here are a few tips, do’s and dont’s, benefits to help the mother breast feed her infant with ease.

  1. 1. Put the baby to the breast as soon as possible after birth.

The baby suckles instinctively.

The uterus contracts and helps control uterine bleeding.

The inseparable bonding starts with the first suckle, it’s an experience to cherish!

  1. 2. The first milk secreted is called ‘COLOSTRUM’. This is produced in ‘small quantities’. It is thick and yellow, but is rich in calories, proteins and antibodies.

A baby does not need a large amount of feed soon after the birth and does not go hungry if sucking on colostrum. Besides colostrum initiates regular production of milk.

  1. 3. Sucking frequently at the mother’s breast is of paramount importance.

When a baby sucks at the mother’s breast, a message is sent to the pituitary, which in turn instructs breast to produce more milk.

So more demand more supply, less demand less production of milk/supply- hence, failure of lactation!

  1. 4. Mothers will often have engorged, swollen, painful breasts in the first few days after birth. This is because the demand and supply chain is not regulated in the first few days.

  2. 5. The baby must get a soft, supple breast to suck on. So, in case of engorged, painful, lumpy breasts, it is important to physically express milk out either manually or by a pump in the first few days.

  3. 6. Feed on demand is the dictum, preferably from both breasts, both the fore and hind milk- “fore” is the milk when the baby first suckles and the “hind” the last part of it.
    Both have their own qualities!

  4. 7. Babies don’t always suckle because they are hungry. They often keep the nipple in the mouth and snooze because of the secure feeling and bonding that they feel!

  5. 8. The baby’s stomach size is small so they need to be fed frequently on demand.

  6. 9. The baby must be taught to put the entire areola (the dark tissues surrounding the nipples) into the mouth while sucking to prevent “sore nipples” in the mother.

  7. 10. The mother and the baby must be in comfortable positions with a cushion on the back, under the baby, and under the mother’s thigh and the mother can change sides and positions.

  8. 11. The baby needs to be fed for 15-20-25 minutes each time. So, a comfortable position where the back does not hurt is important.

  9. 12. Feeding while lying down should be avoided to prevent the baby from getting smothered.

  10. 13. Since breast milk is tailor made specific for the baby, this milk is easily digestible and less wind/colic producing.

  11. 14. Breastfed babies often do not need to be burped because the baby digests mother’s milk very easily.

  12. 15. Babies will often pass bright, yellow watery, frothy stools while they are on the breast. This is because of “gastrocolic reflex”. The moment breast milk goes into the stomach, the intestines gurgle out a stool. This is absolutely normal and should not be of any concern.

  13. 16. Babies need to be fed night or day but mostly on demand.

  14. 17. There are no contraindications to breast feeding.

  15. 18. Diet during lactation.
    The mother can eat every food.
    There are no do’s and dont’s with her food/diet but a healthy diet goes a long way and she certainly does not need to eat for two.

  16. 19. Babies exclusively breastfed for the first six months without any formula supplements have fewer ear infections, respiratory aliments, allergies, urinary infections and diarrhoeal episodes.

  17. 20. Breastfeeding reduces the risk of SIDS (sudden infant death syndrome)

  18. 21. It also reduces the incidence of diabetes and obesity! And it helps the child remain well into the adulthood.


  20. 23. The baby gets milk at the right temperature ready at all times, with warmth and comfort from the mother’s breast.

  21. 24. Breast milk, tested for centuries is a complete and perfect food for the baby. There is indeed no substitute for mother’s milk.


Breast Feedinghowever, may not be a very happy experience for some mothers, with the pain and discomfort post delivery, lack of sleep, postpartum depression, swollen painful breasts, intruding interfering “I know it all” mothers in law and mothers and elders! A demanding family and children, sore nipples, back ache to name a few.

So, of course, there “is no pain no gain” adage, but there is also a saying “this too shall pass”.

So, enjoy exclusive breast feeding for six months!

There is no need of water, honey, supplements etc.

Breast milk has more than 80% water, so baby’s need for water is fulfilled by breast milk even in hot dry climates.

Continue to breast feed even after the first six months but add weaning foods to the diet for the babies increased demands!

Breast feed even well after the first year and maybe into the second year as well!

Breast and bottle feed together may cause nipple confusion and the baby may give up the breast for the ease of bottle feed.

HEPATITIS A, B, C, D & E: Preventions and Treatments

HEPATITIS A, B, C, D & E: Preventions and Treatments

‘Hepa’ – means liver & ‘itis’ means inflammation/infection.

Hepatitis is infection / inflammation of the liver. Hepatitis can be caused by various viruses and the liver may also be affected in various bacterial infections as well.

Viral Hepatitis is commonly caused by:

1.Hepatitis A
2.Hepatitis B
3.Hepatitis C
4.Hepatits D and E

Clinical features/ symptoms of all types of Viral Hepatitis include:

1.Yellow discoloration of eyes.
2.Dark, yellow colored urine.
3.Loss of appetite.
4.General symptoms like fever,weakness, lethargy, nausea, vomiting.
5.Enlargement of liver.

Hepatitis A,D & E: These are water and food borne diseases caused by orofecal transmission -of these, Hepatitis A is the commonest. This is most often seen when there is break in hygiene, viz food ,water or hand and nail hygiene.

This is commonly seen during summer and monsoon months.
1-Intake of contaminated water, food.
2-Food/ cut fruits/ fruit juices from street vendors, where hygiene is 100% suspect.
3-Break in nail and hand hygiene.
4-Not washing hands after using toilet.

1-Prevention is by:
Vaccination against Hepatitis A.This is given in two doses, 6 months apart, anytime after the age of 1 year.

2- Prevention is also by:
1. Drinking clean, potable water
2. Avoiding open street food
3. Keeping food and water covered to prevent contamination by flies.
4. Storing milk and milk products like, yogurt, cream, mayonnaise etc. in a cool and covered environment.
5. Washing hands with soap and water after using the toilet.
6. Keeping nails cut.
7. Avoid eating stale food, kept in the open, in hot and humid conditions- creating ideal conditions for viruses to thrive.


1. This is a short term self limiting disease, with no known cure.
2. Rest and consumption of clean food and water, helps contain the disease.
3. No role of sugarcane juice or yellow food etc.

Hepatitis A and C

Transmission can be Horizontal or Vertical.

Horizontal Transmission is by transmission from one person to another by :
-Blood and body fluids contamination.
-Contaminated blood transfusion.
-Use of infected syringes or needles.
-Use of contaminated razors, blades etc like during a hair cut etc.
-Sexual transmission, vaginal and semen secretions contaminated with Hepatitis B virus.

Vertical Transmission is from mother to the baby during child birth.

There is no vaccine against Hepatitis C
Hepatitis B can be prevented by giving three doses of the vaccine at zero, one month and six months.
Zero dose is/ can be given at birth. Second and third doses can be given at one month and six months. People not vaccinated in the first six months, can be given at any age at zero, one and six months interval. There is no need of booster dose.

Prevention of Hepatitis B and C

Lifestyle modifications

-All blood and blood products must be Hepatitis B and Hepatitis C free.
-Adequate sterilization of medical and surgical equipment including dental instruments/ equipment.
-Prevent needle stick injuries.
-Do not share equipment for injecting drugs.
-Do not share straws/ notes etc. for snorting drugs.
-Prevention/ protection during delivery of a Hepatitis B affected mother.
-Injection of immuno globulin and Hepatitis B Vaccine to the baby- immediately after birth.
-Tattooing and body piercing to be done with sterilized equipment.
-Do not have unprotected sex with an affected person.

Hepatitis C treatment:
There is no vaccine available for Hepatitis C. The last few years have seen the use of new drugs for the treatment of Hepatitis C. RIBAVARIN and INTERFERON , some of which work by boosting the immune system and the other by attacking the virus itself.

Treatment of Hepatitis B
There is no known treatment for acute Hepatitis B. The condition generally clears up on its own- but a fair number of patients develop chronic Hepatitis and Cirrhosis of liver. Drugs like TENOFOVIR and ENTECAVIR can be used to treat chronic Hepatitis. Treatment in the acute stage is mainly supportive.

Clinical features/ symptoms include:

6.Yellow discoloration of eyes.
7.Dark, yellow colored urine.
8.Loss of appetite.
9.General symptoms like fever,weakness, lethargy, nausea, vomiting.
10.Enlargement of liver.


Tips for Baby Care-2


Bathing the baby 

1. Bathing should be a happy experience for the baby.
2. Bathe once a day or may be twice a day depending on the weather.
– When it’s really hot with temperatures in the 40℃, a dunk in the water twice a day is a good idea.
– Do warm up the room/ bathroom half an hour before bathing in cold weather.
3. Time of the day for a bath
– In winter it is good to bathe in the forenoon i.e. between 11 a.m. to 12 noon, when the day gets warm.
– One can also bathe at night, before putting the baby to bed. But bathe in a warm environment to prevent a chill/ hypotherma.
4. Temperature of water to be used should be neither too hot nor too cold, just comfortable for the baby.

Talcum Powder 

Bad idea !!

– No talcum powder of any make.
– It blocks the pores and may cause allergies.

Kajal/ Surma

Bad idea!!

– No kajal or surma to be used in a child.
– It doesn’t improve vision. Known to cause eye infections and conjunctivitis!!

Black threads, Bangles 

– No black threads around wrists, neck or groin please!
– Have them around the ankles if you so desire.
– No bangles etc. as the sharp edges can injure/ hurt the baby.

Oil massage 

Good idea !!

1. Use any oil of your choice- coconut, olive, desi ghee, mustard, til oil- provided it suits the baby’s skin- or an oil used in your state/ region.
2. A gentle massage in whichever direction by the mother/ grandmother/ father etc. with gentle loving care.
3. Don’t express milk from the babies breast or press or squeeze.
4. Baby oils don’t strengthen bones.
5. They relax the baby, cause a loving bond with the baby.
6. It doesn’t matter whether you gently massage before a bath, after a bath or without having to give a bath.
7. Massage with lighter oils in summers.

Blocked nose in a Baby 

1. Babies often have blocked nose even without a cold.
2. Use saline nose drops- one to two drops in each nostril 5-10 minutes before a feed or in case of a blocked nose.
3. One can also use nasal mucous extractors if required.
4. Make the baby sleep a little propped up.

Clipping the nails

Do clip the nails with a small scissor or nail clipper, because dirty nails may lead to infection and long nails can cause scratches on the face!

Better Approach towards Parenting

Every parent wants their child to live a happy and healthy life and for that, they take every possible measure to ensure their safety and wellness. But sometimes, good parenting with too many restrictions can become distressful for your child. Children cannot grow until they come out of their comfort zone and hence, it is required that they are given their space to develop and nurture into a strong individual mentally. Thus, it has become important to give your child some privacy and space that motivates them to experience life on their own.

Here are some of the approaches which you might follow to respect your child’s privacy-

1. Allow solo time for your child: As children start to reach adolescent age, they start to separate from their parents as it is a natural part of growing up. Parents do feel uncomfortable to leave their child alone, but solo time provides your child with a variety of learning opportunities as he/she can explore his/her surroundings at his own pace, become self-reliant, and learn from his mistakes. This will boost a sense of confidence in your child.

2. Encourage your child to be socially active: It is difficult to let your child slide away from your vision for a long time but restricting your child to not make friends just to ensure his safety would affect his communication skills. He would find really hard to interact once he grows up with age as a child left alone in his childhood have a drastic impact on his mental health.

3. Do not ask too many questions: Being cautious and aware of your children’s activities is fine but asking them too many questions would create more distance between you and your child. The naturalness of the conversation ends with a bombard of questions towards your child.

4. Give them their personal space: When your child starts to develop form adolescent to teens, provide him/her a separate space. Do not overlook your child’s journal or dig into their friendly conversation if they invite over their friends.

For detailed counseling of parents about children rearing and parenting, visit leading consulting pediatrician in Delhi. She is a well-experienced Pediatrician who has been working in the field of child care since the year 1971.

Dr. Promilla Butani, a leading pediatrician specialist doctor in Delhi. Child Care specialist Doctor is essential to ensure that your child is healthy & disease-free.

Call us to book an appointment at 9811051270 or visit Dr. Promilla Butani’s Clinic.

Why Vaccinations are important for your Baby?

All parents are very protective towards their children and vaccination is one such way to safeguard your little ones from health dangers. Giving a baby all the recommended vaccines by the age of two ensures protection from many serious childhood diseases. Immunisation is a proven safe and effective way to ensure your child’s health.
Here are some of the reasons why you can’t afford to miss your child’s vaccination on time-

1. Act as a shield from serious diseases
Vaccination is the main reason for the ‘extinction’ of some serious diseases. Vaccines have made this health achievement possible and guarded parents, children and the community from the devastating effects of some serious illnesses. Once the child is properly vaccinated against a disease, their bodies are conditioned to withstand it off in a better way.

2. Child growth and well-being
Injections and syringes might prick the child for few seconds but save them from serious health concerns. Getting timely vaccines means ensuring his/her overall health, and boosting the growth. Getting vaccinated against diseases can be considered as a profitable investment as it saves a lot of time, money and denies proneness to health-damaging effects.

3. Vaccinations are safe and effective
Another benefit of vaccinations is that it also saves future generations. Vaccines have been reported to reduce and even eliminate many health-threatening diseases that have caused death or critically disabled people a few generations ago.

Raising a child means you will do all that it takes to help them grow into a healthy being physically, mentally and even spiritually. Vaccinations are a step towards a better immunity and resistance to fight off anything that attacks them. It is important to get them vaccinated today and have a safer tomorrow.

To know more about childcare, get in touch with us at

Teenage Counselling: Channelising the volcanoes within

Children, adolescents, and teens, develop various social skills to ensure their survival and gain emotional intelligence as they grow older.
A stable development leads to a healthy and happy life. Any kind of imbalance in the development process might lead to disequilibrium and result in distorted behaviour pattern in kids. In order to connect with the teens, one must understand their mindset and learn more about their mental health to find out how to help and talk to them. One must interact carefully with the child and deal with their problems delicately. If needed, parents should not hesitate in consulting a therapist as he/she is trained to help you deal with critical issues in a well-constructed manner.

Why Counselling?
Therapy is a safe and constructive space for kids to process their thoughts and emotions which they have inhibited. Teenagers are irresistibly fascinated to explore the unknown, are over energetic and want total control over their life. Teen years are the foundation of a child’s future self (adulthood). The teens are usually aggressive in their approach and are quite impulsive in nature. This might derail them from a righteous path. Counselling and therapy sessions under the supervision of the experts might help restore equilibrium in their lives.

Parents of teenagers are usually worried about the constant mood swings and changes in the behavioural pattern of their child. Unusual and unjustified emotional turmoil and confusion are common in teen years. Peer pressure, academic stress, hormonal changes, and other situations might leave them overwhelmed. This results in confusion, thus, stress and then it becomes a pattern if left unattended.

The Right Approach
Teenage counselling can take many forms. All teenagers with issues desire to be heard without any kind of pressure and judgment. They want others to relate to them but not over-match. Parents and guardians must relate to their experiences but never should over-identify. Some issues might be the result of deeply embedded emotions that are not visible on the surface level. Counselling for them can happen in a very structured form and can involve the use of verified tests in order to find the root cause of the problem.

Teenagers are high in spirit, have their creative juices flowing and are energetic enough to move mountains. Teen years are very critical years of one’s life and must be staged in a productive manner. Counselling is one act to ensure a child’s capability and build a better foundation. Nonetheless, parents must master the art of flipping roles between being a guide and being a friend to their children. You don’t always have to be harsh to them. They must confide in you and that can only happen when you as parents cultivate a friendly relationship with your children.

Along with teenage counselling, Dr. Promilla Butani also provides counselling to the parents who are facing difficulties with their children. If you wish to get a counselling session or know more about it, please feel free to write to us at

Role of Pediatricians in the Physical and Mental Development of Children

Developing a child with good habits and new learnings every day is one of the toughest jobs for the parents. Child development entails the physical, mental, emotional and other development changes that begin at birth & end at the age of adolescence. Parents often seek help from a child specialist doctor to learn about the tips and tricks for the right upbringing. Physical & mental development of children is important for their growth in the society and among their peers. Although every child is unique, development occurs in a predictable sequence. Continue reading “Role of Pediatricians in the Physical and Mental Development of Children”

Last Month of Pregnancy – Tips for Moms to be

From the very first day when you get to know that you are pregnant to the time of delivering of the baby can be both tough and exciting. Motherhood is the most beautiful moment for every woman and it comes with a bag full of responsibilities. The new mothers may feel overwhelmed and holding the baby becomes nearly irresistible. You believe it or not pregnancy is a special experience which grills you in a good manner and helps you to prepare yourself for the new phase of your life. Continue reading “Last Month of Pregnancy – Tips for Moms to be”

Ensure a Healthy & Playful Monsoon for your Kids

Monsoon season has arrived!
Though the rain is finally ending the scorching heat along with it the risk of getting sick arises for the kids as well as the adults. Especially in the case of kids, special attention is required. a lot needs to be taken care of while ensuring that your child does not fall sick. Humidity, flooded roads, mosquitoes, diseases, dirty and unhygienic environments can be the reasons for bad health. Continue reading “Ensure a Healthy & Playful Monsoon for your Kids”