Parveen Kumar*

Assistant Professor, Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalya, India

*Corresponding Author: Parveen Kumar, Assistant Professor, Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalya, India.

Received: April 22, 2019; Published: May 14, 2019

Citation: Parveen Kumar. “Steps to Improve Child Health”. Acta Scientific Paediatrics 2.6 (2019):13-14.

Child health had been a subset of adult medicine for a long period. The gradual recognition of child health and illnesses being different from adults led to evolution of Pediatrics as entire new medical specialty in late 19^th and early 20^th century. It was also gradually appreciated that the response to various illnesses, medications, nutrition and external mileu varies with age and development of a child. So, it is very crucial to improve child health to not miss opportunity to gain their full potential as adult.

An estimated 6.3 million children under 15 years of age died in 2017, mostly of preventable causes, according to new mortality estimates released by WHO, UNICEF, the United Nations Population Division and the World Bank Group [1]. It accounts for about 1 child mortality every 5 seconds. The majority of these (5.4 million) occur in the first 5 years of life, with newborns accounting for about 50% of them. Most of the under 5 mortality is due to preventable or treatable causes such as complications during birth, pneumonia, diarrhea, neonatal sepsis, and malaria. By comparison, among children aged between 5 and 14 years, injuries become a more prominent cause of death, especially from drowning and road traffic. Thus, by and large, the care of child health is needed from conception to adolescence.

Antenatal period

The nutritional status of women prior to and during pregnancy plays a key role in fetal growth and development. Poor nutritional status in a woman in the period before she conceives and in early pregnancy (up to 12 weeks gestation), may increase the risk for adverse pregnancy outcomes. Current evidence suggests that folic acid supplementation in the peri-conceptional period can prevent neural tube defects.

WHO recommendations

All women, from the moment they begin trying to conceive until 12 weeks of gestation, should take a folic acid supplement (400μg folic acid daily).

Women who have had a fetus affected by a neural tube defect or have given birth to a baby with a neural tube defect should:

• Receive information on the risk of recurrence;
• Be advised on the protective effect of periconceptional folic acid supplementation;
• Be offered high-dose supplementation (5 mg folic acid daily); and
• Be advised to increase their food intake of folate.

Birth defects, or congenital malformations, are structural or functional abnormalities affecting baby in antenatal period itself and can be well detected by regular ultrasound screening and some invasive tests (amniocentesis, chorionic villus sampling etc) in few. The regular antenatal visits not only help in detection of these malformations, they also help in monitoring the progress or resolution of few entities like antenatal hydronephrosis and also guide for planned delivery at a speciality centre if needed.

Natal and post natal period

The delivery by a trained medical personnel help in initial assessment of the baby and rules out any birth defects. The baby is kept warm beside mother and exclusive breast feeding is encouraged for first 6 months. The success story and importance of breast feeding has already been covered in earlier editorial by Dr Manju Bala Dash [2]. Similarly the importance of baby skin care has been highlighted well by Dr Sandipan Dhar [3].

The colostrum is the first breast milk and is a must first feed for the baby. Its rich in various nutrients and promote health of baby. Like the breast feeding, scheduled immunization is very important for the child as it helps in immunity and reducing mortality from various preventable causes. The vaccination schedules vary in different countries and it may differ in various regions of same country in view of various regional diseases impact. A wide coverage of population for vaccinations has been known to reduce morbidity and mortality.

After 6 months of age, complementary feeds should be started and include coverage of various nutrients. As child grow, food habits have to be monitored. They should be taught the importance of healthy food and environment. Factors likely to have a major effect on promoting health and reducing rates of chronic illnesses/ cancer:

• Reduction of smoking/environment pollutants
• Increased consumption of fruits and vegetables
• Control of infections
• Avoidance of intense sun exposure
• Increased physical activity
• Reduced consumption of alcohol and possibly red meat.

The children are not spared from cancer. There are many cancers which are age specific and particularly seen in children. There are many key symptoms that might be cancer including:

• An unusual lump or swelling anywhere on your body Recent change in the size, shape or color of a mole
• A sore or ulcer that does not heal after several weeks
• Unusual bleeding or discharge
• Cough/croaky voice lasting more than 3 weeks
• Persistent difficulty swallowing, respiration or indigestion
• Blood in urine or stool
• A change to more frequent and loose bowel motions 4-6 weeks
• Unexplained weight loss
• heavy night sweats
• Unexplained pain /ache that lasts longer than 4 weeks

Any new symptom/sign (e.g. 3 weeks or more): see your doctor

• If it turns out not to be serious, you’ve got peace of mind
• If it is serious, by getting treatment early you have the  best chance of making a good recovery
• If it is cancer, best chance of early diagnosis and           

The evolution and scientific advances have come with some costs. Children, especially in developed countries are falling prey to sedentary life styles, physical inability and are getting prone to obesity, early diabetes and early cancer. But most of it is preventable.

Take home message: prevention is the best

• Avoid smoking, overeating, and overdrinking, and keep moving.
• Do not consume food and beverages with artificial sweeteners.
• Children should not use cell phones.
• Buy local seasonal food.
• Don’t microwave anything in plastic.
• Avoid as much plastic as you can.
• Get immunised.
• Be Sun Smart: avoid sun burn by covering up and wearing suncream.
• Self body awareness
• Know early warning signs of cancer
• Spread the news: Cancer diagnosed early is mostly treatable.

Bibliography

1. https://www.unicef.org/publications/index_103264.html
2. Manju Bala Dash. “Success Story of Infant and Young Child Feeding Training Programme”. Acta Scientific Paediatrics1 (2018): 01.
3. Sandipan Dhar. “Baby Skin Care: How to Combine Science and Arts”. Acta Scientific Paediatrics5 (2018): 01-02.

Copyright: © 2019 Parveen Kumar. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.