• Birth – 1 week after discharge from hospital
• 6 weeks, 10 weeks, 14 weeks of age
• 6 months of age
• 9 months of age
• 12 months of age
• 15 months of age
• 18 months of age
• 5 – 3years – yearly twice
• 4 – 8 years – yearly twice
• 9 – 18 years – yearly once

Many validated growth charts are employed to assess the growth of children which help to give an accurate idea about growth deviation at an early stage. To use these charts, we will measure :

• Length/ height and it’s s variants
• Weight
• Head, chest and mid-arm circumference
• Age dependent and independent indices, etc.

It is importantly to identify and thoroughly evaluate growth problems. Most common reasons are family history and poor nutrition. But it is important to rule out other syndromic causes which are rare. The common growth problems that include :

• Short height
• Abnormal shape of limbs, spine, etc.
• Malnutrition – failure to thrive, underweight, overweight, obesity

There are many validated development tools employed to assess the development and to identify developmental delay at an early age. Some early markers for development delay include :

• Delayed development of head control, rolling over, sitting, standing and walking
• Abnormal behaviour
• Hyperactivity and aggression
• Delayed/ slurred speech
• Abnormal movements or abnormal positioning of limbs
• Clumsiness
• Short attention span/ poor school performance
• Feeding difficulties
• Abnormal biting/ mouthing objects after 1 year of age

Parents facing doubts regarding this can bring their child in for routine check-up and assessment. This helps drastically to reduce the late detection of development delay and initiate early remediation.

• Breastfeeding exclusively at least 12-14 times a day
• Baby is passing clear urine adequately
• Adequate weight gain
• Adequate sleep after each feeds
• Will pass several stools per day

Bring baby to paediatrician immediately if :

• No weight gain
• Crying soon after feeding despite proper burping
• “Cluster” feeding – meaning breastfeeding within 1/2 hour of previous breastfeeds
• Baby has constipation
• Baby falling sick very often
• Baby is turning blue while feeding / sweating excessively on feeding/ not able to suck and swallow milk efficiently

Bring mother to doctor if she is experiencing :

• Feeding difficulties
• Breast pain
• Nipple cracks
• Sore nipples
• Breast swelling with fever
• Flat/ inverted nipple

Such as other sources of milk like cow/ buffalo/ donkey milk, honey, sugar water, sweet flag (VASAMBU), camphor, ghee, water, etc. The side effects are detrimental resulting in infections, lactation failure and organ damage.

Vaccines play a crucial role in preventing, attenuating, eliminating and eradicating all vaccine preventable diseases. Once a vaccine is administered, depending on the type of vaccine, it stimulates and activates the immune system in our body to produce protective antibodies against that particular disease. This is like a “practice run” for the immune system, so that when the vaccinated child is exposed or infected by the actual disease, their immune system is ready to fight the infection.

All vaccine preventable disease in India are life-saving and prevents the dreaded complications of the disease. They include polio, extra-pulmonary TB, measles, mumps, rubella, diphtheria, pertussis, tetanus, haemophilia influenza B, hepatitis B, hepatitis A, varicella, typhoid, influenza virus, rotavirus, yellow fever, meningococcus, pneumococcal, HPV.

Vaccines missed by a few days to weeks from the stipulated date can be given on the day of visit to paediatrician, keeping a track of the previous vaccination dates. Certain vaccines can only be given within a certain age, after which the vaccine efficacy is reduced. But, the child will be at the risk of exposure to that disease in that age period.

So, if any vaccines are missed from birth or after a certain age, due to various reasons like disease or migration of places etc., it can be given as catch-up vaccines by the paediatrician.

No, not all vaccines cause fever. Every vaccine has it’s own set of common and rare adverse effects, which will be predicted and managed efficiently by the paediatrician. So, after every vaccine, an observation for about 30-60 mins is done to note for any immediate effects. It’s best to keep in mind that,

“THE SIDE EFFECTS OF VACCINES ARE MANAGEABLE THAN THE ACTUAL DANGEROUS EFFECTS OF THE DISEASE ITSELF”