My daughter often complains of headaches. But she does not exhibit any accompanying symptoms such as cold or fever. Nor are they caused by hunger or playing under the hot sun. She is seven years of age and is an active child. Should I consult a doctor? — Tamara R, Chennai

Yes, you need to consult a doctor. A recurrent headache needs to be investigated, especially if there is no obvious cause. The doctor will run some tests to ascertain the cause of her frequent headaches. Children can also suffer migraine. If so, it helps to begin early treatment to prevent persistent symptoms. 

My firstborn began to experience gassiness after I started him on solid foods at six months. I don’t use packaged baby foods but serve natural staples such as ragi, wheat and rice. I am now expecting my second child. Should I switch to organic baby foods available in the market for my second child? — Deena Thomas, Kochi

‘Gas’ or flatulence is intimately connected with diet. Avoiding certain foods may be the answer to your problem. Organic food is beneficial but not essential. Home-cooked food — whether organic or not — is the best solution to ease infants into eating adult food. Remember, infants need to be exclusively breastfed until six months old.

Subsequently, the purpose of introducing solid foods is to get them to gradually eat from the ‘family pot’ when they are a year old. This is known as weaning. In the first few months of weaning, it’s important to introduce new foods gradually with around two-three weeks’ gap between new foods. 

Weaning can start with rice kanji or gruel. The purpose is to introduce her to new tastes — a few spoons per day will suffice. Gradually, other foods such as ragi, rice and dal combinations, vegetables, and fruits may be added at intervals so she becomes accustomed to a varied diet in the toddler years. The consistency of food also matters — from six-eight months, stick with puree/smooth gruels. After nine months, semi-solid foods can be introduced. Infants should not be offered hard food and snacks such as peanuts. They could choke on them.

I am due to deliver my first child in the next few months and want to be prepared. Before I begin breastfeeding, are there any medications, foods or beverages I should avoid? Also, are there any food supplements to improve my breast milk? — Sanskriti Saxena, Mumbai

The World Health Organisation(WHO) recommends exclusive breastfeeding for the first six months, followed by partial breastfeeding for two years. Paediatricians are unanimously supportive of breastfeeding because the evidence regarding its positive effects is mountainous. It benefits children’s immunity, nutrition, brain development and long-term health and well-being. Infants are born with natural reflexes which help them suckle.

Thus, in the first few days, it is mostly about mothers getting ‘positioning’ of the baby right. Breastfeeding is a dynamic process — as the baby feeds, the mother lactates. All that the mother requires is a healthy diet, lots of fluids and plenty of sleep. 

A baby who feeds and sleeps for at least an hour, urinating more than four-five times per day and gains weight after the tenth day, is healthy. Some infants feed vigorously from day one, others take a day or two. Drugs are best avoided or used cautiously during the breastfeeding period. Even caffeine passes into breast milk.

Therefore, it is advisable to restrict your coffee intake for the first few months after delivery.

(Dr. Nisha Miriam George is a paediatric consultant at Sundaram Medical Foundation and Dr. Rangarajan Memorial Hospital, Chennai)

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