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Dr. Pradeep DubeyDr. Pradeep Dubey
MD (Ped.), DCH.MD (Ped.), DCH.
Dr. Pradeep DubeyDr. Pradeep Dubey
MD (Ped.), DCH.MD (Ped.), DCH.
DIVERSITY IN CHILDREN’S DEVELOPMENTDIVERSITY IN CHILDREN’S DEVELOPMENT
Children are more living beings, more living than grown up peoplewho have built up shells of habit around themselves therefore it is important for their mental development that they should not have mere schools for their lessons but a whole world ,whose guiding spirit is personal love.
Rabindra nath Tagore
Fastest Growth Rate
Brain growing still faster
hence more prone to injury .
Fastest Growth Rate
Brain growing still faster
hence more prone to injury .
EMBRYOEMBRYOEMBRYOEMBRYO
Age at conception >20 yrs. or < 35 Age at conception >20 yrs. or < 35
yrs.yrs.
Wt. > 40 kgs.Wt. > 40 kgs.
Ht. > 145 cms (4’10”)Ht. > 145 cms (4’10”)
Wt. gain in pregnancy – 10kgs in 9 Wt. gain in pregnancy – 10kgs in 9
mths.mths.
Age at conception >20 yrs. or < 35 Age at conception >20 yrs. or < 35
yrs.yrs.
Wt. > 40 kgs.Wt. > 40 kgs.
Ht. > 145 cms (4’10”)Ht. > 145 cms (4’10”)
Wt. gain in pregnancy – 10kgs in 9 Wt. gain in pregnancy – 10kgs in 9
mths.mths.
NUTRITION OF MOTHERNUTRITION OF MOTHERNUTRITION OF MOTHERNUTRITION OF MOTHER
Iron – Jaggery, Date palms & Apples etc.Iron – Jaggery, Date palms & Apples etc.
Protein – Milk, Cheese, Eggs & nuts etc.Protein – Milk, Cheese, Eggs & nuts etc.
Calcium – Milk & Milk products.Calcium – Milk & Milk products.
Smoking & AlcohalSmoking & Alcohal
Food hygiene & Stay away from pets.Food hygiene & Stay away from pets.
Iron – Jaggery, Date palms & Apples etc.Iron – Jaggery, Date palms & Apples etc.
Protein – Milk, Cheese, Eggs & nuts etc.Protein – Milk, Cheese, Eggs & nuts etc.
Calcium – Milk & Milk products.Calcium – Milk & Milk products.
Smoking & AlcohalSmoking & Alcohal
Food hygiene & Stay away from pets.Food hygiene & Stay away from pets.
D I E TD I E TD I E TD I E T
Mother – Rh negativeMother – Rh negative
Precautions for Rh Precautions for Rh
incompatibility incompatibility
Mother – Rh negativeMother – Rh negative
Precautions for Rh Precautions for Rh
incompatibility incompatibility
MATERNAL BLOOD GROUPMATERNAL BLOOD GROUPMATERNAL BLOOD GROUPMATERNAL BLOOD GROUP
Diabetes, Hypertension, Epilepsy, Diabetes, Hypertension, Epilepsy,
Heart Disease.Heart Disease.
Uncontrolled diabetes Uncontrolled diabetes risk of birth risk of birth
defect.defect.
Change drugs like valproateChange drugs like valproate
Diabetes, Hypertension, Epilepsy, Diabetes, Hypertension, Epilepsy,
Heart Disease.Heart Disease.
Uncontrolled diabetes Uncontrolled diabetes risk of birth risk of birth
defect.defect.
Change drugs like valproateChange drugs like valproate
SYSTEMIC DISEASES OF MOTHERSYSTEMIC DISEASES OF MOTHERSYSTEMIC DISEASES OF MOTHERSYSTEMIC DISEASES OF MOTHER
Prolong low grade fever.Prolong low grade fever.
Burning in micturition – rule out UTIBurning in micturition – rule out UTI
Foul smelling genital discharge.Foul smelling genital discharge.
Fever with rashesFever with rashes
R/O G. U. infections of fatherR/O G. U. infections of father
Vaccination Rubella, TT, Hep. B.Vaccination Rubella, TT, Hep. B.
Prolong low grade fever.Prolong low grade fever.
Burning in micturition – rule out UTIBurning in micturition – rule out UTI
Foul smelling genital discharge.Foul smelling genital discharge.
Fever with rashesFever with rashes
R/O G. U. infections of fatherR/O G. U. infections of father
Vaccination Rubella, TT, Hep. B.Vaccination Rubella, TT, Hep. B.
GENITOURINARY INFECTIONSGENITOURINARY INFECTIONSGENITOURINARY INFECTIONSGENITOURINARY INFECTIONS
400 mcg. Start before conception400 mcg. Start before conception
Birth defects Birth defects by 30% by 30%
Mandatory food fortification in US & Mandatory food fortification in US &
ChileChile
400 mcg. Start before conception400 mcg. Start before conception
Birth defects Birth defects by 30% by 30%
Mandatory food fortification in US & Mandatory food fortification in US &
ChileChile
FOLIC ACIDFOLIC ACIDFOLIC ACIDFOLIC ACID
Early breast feeding – Early breast feeding –
Colostrum helpsColostrum helps
Avoid bottle feeding Avoid bottle feeding
Weaning by 5 - 6 months.Weaning by 5 - 6 months.
Early breast feeding – Early breast feeding –
Colostrum helpsColostrum helps
Avoid bottle feeding Avoid bottle feeding
Weaning by 5 - 6 months.Weaning by 5 - 6 months.
F E E D I N GF E E D I N G F E E D I N GF E E D I N G
Psychosocial support.Psychosocial support.
Good Nutrition – Milk, Ghee, Good Nutrition – Milk, Ghee,
Dry fruits & Jaggery etc.Dry fruits & Jaggery etc.
Isolation and temp. control Isolation and temp. control
Hygiene Hygiene
Psychosocial support.Psychosocial support.
Good Nutrition – Milk, Ghee, Good Nutrition – Milk, Ghee,
Dry fruits & Jaggery etc.Dry fruits & Jaggery etc.
Isolation and temp. control Isolation and temp. control
Hygiene Hygiene
HEALTHY TRADITIONAL PRACTICES HEALTHY TRADITIONAL PRACTICES HEALTHY TRADITIONAL PRACTICES HEALTHY TRADITIONAL PRACTICES
Responsiveness / AlertnessResponsiveness / Alertness
Spontaneous motilitySpontaneous motility
Persistant hyper excitability Persistant hyper excitability
Feeding difficultyFeeding difficulty
Constant fisting after 2 monthsConstant fisting after 2 months
Abnormal movements / convulsions.Abnormal movements / convulsions.
Abnormal posturesAbnormal postures
Abnormal Head circumerence.Abnormal Head circumerence.
Responsiveness / AlertnessResponsiveness / Alertness
Spontaneous motilitySpontaneous motility
Persistant hyper excitability Persistant hyper excitability
Feeding difficultyFeeding difficulty
Constant fisting after 2 monthsConstant fisting after 2 months
Abnormal movements / convulsions.Abnormal movements / convulsions.
Abnormal posturesAbnormal postures
Abnormal Head circumerence.Abnormal Head circumerence.
TWILIGHT SIGNS/CONSTELLATIONSTWILIGHT SIGNS/CONSTELLATIONSTWILIGHT SIGNS/CONSTELLATIONSTWILIGHT SIGNS/CONSTELLATIONS
26
Abnormalities of toneAbnormalities of tone
Primitive reflexes weak / persistent Primitive reflexes weak / persistent
(>6 mths)(>6 mths)
Delayed appearance of postural Delayed appearance of postural
reflexesreflexes
Delayed mile stonesDelayed mile stones
Ocular abnormalitiesOcular abnormalities
Lake of response to sound.Lake of response to sound.
Abnormalities of toneAbnormalities of tone
Primitive reflexes weak / persistent Primitive reflexes weak / persistent
(>6 mths)(>6 mths)
Delayed appearance of postural Delayed appearance of postural
reflexesreflexes
Delayed mile stonesDelayed mile stones
Ocular abnormalitiesOcular abnormalities
Lake of response to sound.Lake of response to sound.
TWILIGHT SIGNS/CONSTELLATIONSTWILIGHT SIGNS/CONSTELLATIONSTWILIGHT SIGNS/CONSTELLATIONSTWILIGHT SIGNS/CONSTELLATIONS
26
A L A R M I N G S I G NA L A R M I N G S I G N A L A R M I N G S I G NA L A R M I N G S I G N
Grossly delayed MSDGrossly delayed MSD
Constant fistingConstant fisting
Abnormal head sizeAbnormal head size
Gross hypotonia or HypertoniaGross hypotonia or Hypertonia
Reduced response to sound Reduced response to sound
Paucity of movementsPaucity of movements
Asymmetrical limb movementAsymmetrical limb movement
Persistance of neonatal reflexesPersistance of neonatal reflexes
Abnormal postureAbnormal posture
Grossly delayed MSDGrossly delayed MSD
Constant fistingConstant fisting
Abnormal head sizeAbnormal head size
Gross hypotonia or HypertoniaGross hypotonia or Hypertonia
Reduced response to sound Reduced response to sound
Paucity of movementsPaucity of movements
Asymmetrical limb movementAsymmetrical limb movement
Persistance of neonatal reflexesPersistance of neonatal reflexes
Abnormal postureAbnormal posture
ALARMING SIGNSALARMING SIGNSALARMING SIGNSALARMING SIGNS
6
Follow up of high risk babiesFollow up of high risk babies
High index of suspicionHigh index of suspicion
Brief account of developmental history Brief account of developmental history
& examination& examination
Detailed neuro developmental Detailed neuro developmental
assessment by child development group.assessment by child development group.
Investigations – metabolic screening, Investigations – metabolic screening,
EEg, CT scan & Chromosomal studies etc.EEg, CT scan & Chromosomal studies etc.
Early & appropriate intervention.Early & appropriate intervention.
Follow up of high risk babiesFollow up of high risk babies
High index of suspicionHigh index of suspicion
Brief account of developmental history Brief account of developmental history
& examination& examination
Detailed neuro developmental Detailed neuro developmental
assessment by child development group.assessment by child development group.
Investigations – metabolic screening, Investigations – metabolic screening,
EEg, CT scan & Chromosomal studies etc.EEg, CT scan & Chromosomal studies etc.
Early & appropriate intervention.Early & appropriate intervention.
EARLY IDENTIFICATION OF DEV. DISORDERS - ?EARLY IDENTIFICATION OF DEV. DISORDERS - ?EARLY IDENTIFICATION OF DEV. DISORDERS - ?EARLY IDENTIFICATION OF DEV. DISORDERS - ?
12
1.1. Early identification of neuro Early identification of neuro
developmental disorders.developmental disorders.
2.2. Minimisation of persistence Minimisation of persistence
abnormalities & detection of transient abnormalities & detection of transient
neurological abnormalitiesneurological abnormalities
3.3. Prevention of asymmetries & Prevention of asymmetries &
abnormalities of development.abnormalities of development.
4.4. Stimulation along channel of normal Stimulation along channel of normal
developmentdevelopment
1.1. Early identification of neuro Early identification of neuro
developmental disorders.developmental disorders.
2.2. Minimisation of persistence Minimisation of persistence
abnormalities & detection of transient abnormalities & detection of transient
neurological abnormalitiesneurological abnormalities
3.3. Prevention of asymmetries & Prevention of asymmetries &
abnormalities of development.abnormalities of development.
4.4. Stimulation along channel of normal Stimulation along channel of normal
developmentdevelopment
EARLY INTERVENTION - AIMSEARLY INTERVENTION - AIMSEARLY INTERVENTION - AIMSEARLY INTERVENTION - AIMS
xi
WE ARE GUILTY OF MANY ERRORS AND FAULTS, BUT OUR WORST CRIME ISWE ARE GUILTY OF MANY ERRORS AND FAULTS, BUT OUR WORST CRIME IS
ABANDONING OUR CHILDREN, NEGLECTING FOUNTAIN OF LIFE.ABANDONING OUR CHILDREN, NEGLECTING FOUNTAIN OF LIFE.
MANY THINGS WE NEED IN LIFE CAN WAIT, THE CHILD CAN NOT. MANY THINGS WE NEED IN LIFE CAN WAIT, THE CHILD CAN NOT.
RIGHT NOW IS THE TIME – HIS BRAIN IS GROWING ,RIGHT NOW IS THE TIME – HIS BRAIN IS GROWING ,
HIS BLOOD IS BEING MADE. HIS SENSES ARE BEING DEVELOPED.HIS BLOOD IS BEING MADE. HIS SENSES ARE BEING DEVELOPED.
TO HIM WE CAN NOT ANSWER TOMORROWTO HIM WE CAN NOT ANSWER TOMORROW
HIS NAME IS “TODAYHIS NAME IS “TODAY””
GABRIELA MISTRAL (NOBEL LAURIET FROM CHILE)GABRIELA MISTRAL (NOBEL LAURIET FROM CHILE)
FOR FURTHER DETAILS :
www.healthychildindia.comwww.healthychildindia.comPLEASE VISITPLEASE VISIT
““DEVCHHAYA” DEVCHHAYA” Early Intervention Centre
Prem Mandir Chowk, Wright Town - Jabalpur