Milestones

First Seven Years

When a child is born, we are so excited that they are here. But do we realize how important the first seven years truly are? During these years, the brain develops its mapping system very fast. The first 7 years provide the most crucial milestones in a child’s development. Imagine, as a parent, armed with the knowledge that the cognitive and psychological development truly depends on the first 2,555 days of a child’s existence, would you parent your child differently? It is important to be aware and make the best of the early years.

Under the age of 7, a lot of the milestones are common for boys and girls. Below we have listed some of the milestones a child achieves by this age. If the progress is not as listed below, we suggest that you consult your paediatrician.

• Speaks clearly & understands better long series of commands. e.g - Please go to the bathroom, brush your teeth and change into your nightclothes.
• Understands jokes & puns better
• Can tell time & directions – north south-east, west, right, left, up and down
• Able to do homework on their own and read independently.

• Baby teeth falling out (some children develop this at 4-5 years also which is normal) and permanent teeth coming
• Height growth approx. 2-2.5inches a years & 4 to 7 pounds/year weight gain
• Participate in sports/outdoor activities regimental routine.
• Maintain a growth chart
• Avoid digital addiction.

Calories for a child - 1200 to 1800 calories

• Protein - 3-5 ounces
• Fruits - 1 cup (mix cut)
• Grains - 4-6 ounces
• Dairy - 2 cups

A wonderful and easy way to ensure that we get the above, are the following 3 suggestions, daily.

• 2 eggs, cooked, in any style that the child enjoys
• 1 cup cooked green peas & broccoli or green peas & any other veg - low in calories, high in protein and minerals like vitamin C.
• Yoghurt mixed with fresh fruits and topped with a teaspoon/tablespoon of honey.

Must consider after consulting the pediatrician- the following vaccines

1. Hep A
2. Immunoglobulin (IG ) for Hep A
3. Hep B
4. Influenza
5. MMR
6. Meningococcal vaccine
7. Japanese encephalitis
8. Yellow fever

11. Band-aids and bandages
12. Thermometer
13. Otrivin nasal drops (pediatric)
14. Tobarex eye/ear drops
15. Z and D drops suspension
16. ORS sachets
17. Enterogermina
18. 10 cc syringes
19. Small scissors
20. Any special need medicine for your child as prescribed by your doctor.

Please consult your family doctor before giving the medicines

Puberty In Girls (Age 8 - 16)

Let us understand the word ‘Puberty” – 

Puberty is derived from the word “puber” which, in Latin, means ‘adult’. Adolescence is the final stage of growth from childhood to adulthood. In medicine, these are well described as Tanner stages of puberty and are reflective of the physical changes in a girls body. Is your daughter’s development on track? Here are the stages and important changes at they occur:

1. Breasts begin to bud & areola (pigmented area around the nipple) enlarges
2. Light genital hair appear
3. Height increases by 2- 2.5 inches / year.

1. Breasts start budding
2. Pubic & underarm hair begin to grow & darken
3. Growth spurt & 3 inches/year may happen
4. Acne develops

1. Breasts grow further with nipples protruding
2. Body / pubic / hair reach adult levels.
3. Menarche i.e. time when periods begin

Some interesting facts and customs:

1. Interesting history about menarche i.e. start of female menstrual cycles: A tribe of people in Canada called the Nookas, celebrate by having a big party after girls first menstrual cycle. Then she is taken far out to the sea and left to make her way back to home by swimming back to land. On reaching the shore successfully, she is greeted by the village for her perseverance and patience.

2. Some African tribes have a long period of mentoring for all the girls who have started to menstruate in the preceding year.

What is happening in our bodies?

From infancy to about 7 years of age, the FSH and LH (follicle stimulating and luteinizing hormones) which stimulate the ovaries are low in the body. By about 11 years of age, these hormones start rising and cause the ovaries, to produce estrogen and testosterone. Estrogen is responsible for breast growth, bone growth and female body fat distribution. Testosterone is responsible for acne and sex drive.

However these hormones take a while to stabilize in our bodies. In this interim period, after menarche, a girls menstrual cycle can be irregular or heavy. Don’t panic. Its absolutely normal. If the cycles are too painful or too heavy and the child is losing excessive blood, then you need to get the blood tests and ultrasound of the pelvis to rule out any problem.

If you would like to know more about the ultrasound scans and other related blood tests, please click here to request a callback. For Ultrasound Pelvis, there are no restrictions. Please come prepared with full urinary bladder. You do not have to be fasting.

Click here to book an appointment. For blood tests at home please request a call back from our clinic, or use the WhatsApp icon at the bottom of the page to book an appointment.

Fertility & Conception

Getting Pregnant

This can be an intense phase in anyones’s life. You want to conceive and may not know how to go about it doing, successfully. Getting pregnant can be summarized into simple steps:

Ovulation is a phase in the monthly menstrual cycle where the egg (ovum) gets released from a woman’s ovary.

Each month between day 5th to 14th /15th of the cycle, the FSH (Follicle-stimulating hormone) causes follicles in one of the two ovaries to mature. At about day 14 (depending on your menstrual cycle), a sudden surge in the second hormone called Luteinizing Hormone (LH) causes the ovary to release its egg.

Now the egg starts its 4-5 days travel through the fallopian tube to reach the uterine cavity. During this travel, progesterone hormone increases and prepares the endometrial lining (the soil for our egg to implant).

Conception occurs when the sperm fertilizes the egg forming a blastocyst (future embryo).

When the fertilized egg /future embryo, also called blastocyst, attaches to the endometrium is called implantation. Sometimes it can cause slight vaginal spotting of blood. The two hormones Estrogen and progesterone -help the endometrium and blastocyst - to thicken and grow.

There are various methods to check:

• During ovulation, cervical mucus becomes stretchy and clear like an uncooked egg white. However this can be misleading due to many reasons like infections, past surgery etc.
• Temperature: take your basal body temperature, that is first thing in the morning before 2 -3 days of your expected ovulation and check it again on the day of ovulation. It is usually one degree above the normal basal body temperature. However, this is also not a sure method as the temperature recordings can also vary.
• Ovulation kits are available to check the dates of your fertility. These are accurate in terms of calculation by dates of your cycle. However sometimes, the mature follicle in your ovary fails to ovulate and forms a cyst.
• Ultrasound follicle monitoring: This is the ideal method of confirming the ovulation due to its direct visualization and accuracy. Along with this, it also tells us about the quality of the endometrial lining and the blood supply for successful implantation.

Benefits of Ultrasound-guided follicle monitoring:-

1. Safe/No radiation
2. 100% reliable for ovulation confirmation.
3. Check the additional problems (if any) – uterus cavity shape, size, cyst in ovary
4. Color Doppler checks the vascularity for successful implantation.

Limitations of ovulation kits:
1. If you are taking any fertility medicines, inaccurate results can happen.
2. Urine which is very light (diluted urine) may not have proper results due to dilution of the luteinizing hormone (LH)
3. It can not tell about the other things that are needed for successful conception(such as endometrial lining, uterus blood supply etc).

Pregnancy is the successful result of a process that has many steps. To get pregnant:

• A woman’s body must release an egg from one of her  ovaries (ovulation).
• The egg must go through a fallopian tube toward the uterus (womb).
• A man’s sperm must join with ( and fertilize) the egg along the way.
• The fertilized egg must attach to the inside of the uterus (implantation).

Pregnancy & Child Birth

“The miracle of birth is a moment where a child is born, a mother is born, a father is born. They never existed before” –  OSHO

A beautiful journey on 9 months to prepare yourself and your partner for the next phase of your life. This requires a lot of growing up when you are on it. Every girl is born with the instinct of motherly love. However, some let it come into existence while others don’t.

Lets start with the most common questions asked by women

1. My haemoglobin has fallen and my blood pressure keeps low in pregnancy. Is it normal?

Women are often concerned with these two vitals. It is normal for the haemoglobin to fall in pregnancy due to hemodilution. It’s our body’s normal response as it has to pump extra blood for the baby so the plasma (the fluid part of the blood)increases more than the cells, causing the haemoglobin count to fall. However, if it falls below 9 gm %, consult your physician and get detailed blood tests recommended. The blood pressure often falls during pregnancy especially in the second trimester due to blood vessels getting dilated in preparation of extra blood flows to the baby.

2. Are there any medicines or supplements I should take before I plan to have a baby ex - 6 months from now?

Get your routine annual health check up including blood and urine tests. Ultrasound whole abdomen with transvaginal scan. If all reports are within normal range, then simply start folate supplement.

3. What is the right age of conception?

Harvard Health Review says women aged 35 with partners of the same age were 29% likely to have a baby on their fertile days while women age 35 with partners 5 years older were only 18% likely to become pregnant.

Our recommendation – conceive before you turn 30 if you desire a single child. Planning a 2 kid family, plan first one by 27 years.

4. What are the Dos and Dont’s of first-trimester (first 3 months of pregnancy)?

Dont’s

• consume raw/uncooked food
• wear high heels
• travel on jerky roads
• consume any iron or calcium supplements unless given by your healthcare specialist

Dos

• Be happy
• Be active
• Go for a routine check-up, once a fortnight, with your doctor
• All routine blood and urine tests as suggested by your doctor
• A dating ultrasound scan before 10 weeks of pregnancy (interesting fact— did you know that the most reliable delivery date of the pregnancy comes from this ultrasound scan….. your answer to the question – which zodiac sign is my baby gonna be doc!!!)
• NT/NB – first-trimester anomaly scan between 11- 13 weeks of gestation along with integrated blood tests to assess the baby’s well being in terms of its genetics and chromosomes
• Report any pain/spotting/any discharge per vaginum

5. What are the Dos and Dont’s of the second trimester (next 3 months of pregnancy)?

Dont’s

• consume raw/uncooked food
• wear high heels
• lose weight
• drive due to possible seat belt injury and jerks to the lower abdomen

Dos

• Be happy
• Be active
• Go for a routine check up, once a fortnight, with your doctor
• All routine blood and urine tests as suggested by your doctor
• Start your iron and calcium supplements
• Consume short frequent meals
• Check your weight gain which should be approx 1kg every 2 weeks.
• A detailed/ Targeted fetal anomaly scan between 18 to 20 weeks of pregnancy along with the second trimester blood and urine tests.
• A fetal echocardiography with beautiful 3D/4D ultrasound pictures of your baby around 22-24 weeks gestation
• Get your second part of the integrated blood test, which usually happens at around 16 weeks. Ask your doctor for details.
• Report any pain/spotting/any discharge per vaginum
• Travel if you desire during this time after consulting your doctor. Certain patients have a high risk history so it is always better to check with your doctor who knows your previous clinical records.
• During the end of the second trimester usually, you start feeling fine flutters called ‘Quickening’ in your lower abdomen with proper movements of the baby being felt at around 24 weeks gestation.
• Keep your skin moist and apply virgin coconut oil and buttercreams to avoid stretch marks. However, there are no definitive medicines to avoid stretch marks.
• Start your antenatal exercises.

6. What are the Dos and Dont’s of the third trimester (last 3 months of pregnancy)?

Dont’s

• consume raw/uncooked food
• wear high heels
• lose weight
• drive due to possible seat belt injury and jerks to the lower abdomen
• Travelling

Dos

• Be happy
• Be active
• Go for a routine check up, once a fortnight, with your doctor
• All routine blood and urine tests as suggested by your doctor
• Start your iron and calcium supplements
• Consume short frequent meals
• Check your weight gain which should be approx 1kg every 2 weeks.
• An ultrasound pregnancy to check for the baby’s weight gain and Doppler study for complete evaluation along with amniotic fluid assessment.
• Routine third trimester blood and urine tests.
• Report any pain/spotting/any discharge per vaginum
• Check the hospital,book where you wish to deliver and prepare your suitcase as per the baby list given below - click to open the pdf
• Count the baby movements and check the count of 10 per day, these are also called Cardiff’s count of 10. Healthy babies complete 10 movements in 3-4
  hours in the womb.
• Avoid wearing rings/bangles in hands, ankles or wrists- one can have fluid retention and swelling and these can get stuck!!
• Keep your skin moist and apply virgin coconut oil and buttercreams to avoid stretch marks. However, there are no definitive medicines to avoid stretch marks.
• Continue your antenatal exercises.