Brief Answer:
Questions answered one by one

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through your query and understand your concern. Let me assure you that I have the necessary expertise and experience needed to answer your queries. Let me try to answer them one by one:

a) Before going into your question I need to explain some background first. If you look at the environment around your house it might not be exactly the same (or similar0 all over West Bengal and neither would that represent the weather in XXXXXXX (which is more varied). When a blood sample is drawn, it therefore does not represent the microenvironment in and around the heart. In case of some individuals the sensitivity of the trigger mechanism is more than that of others. The trigger mechanism of the heart beats, and also muscle contraction is based on the cyclic flow of ions or electrolytes. Thus the acute shortages in microenvironment may not reflect in the overall bodily environment that is sampled in case of a blood test for electrolyte imbalance which is necessarily a gross average from many microenvironments. So, largely speaking, the reason of such fluctuations is unknown. PSVT is not something concerning and poses no threat to life. It usually stops on its own but it cannot be predicted what may trigger it again.

b) Frequent passage of loose stools can lead to electrolyte imbalance if adequate rehydration with breast milk or ORS is not done. One single episode is however unlikely to cause it.

c) Keeping the child exclusively on breast feeding is the best way to prevent electrolyte imbalance from occurring. However, relating to the prevention of PSVTs, there is no particular preventive measure to suggest. You need not remain concerned about it.

d) Forget electrolyte imbalance. Consider that things in the body are not going properly. The primary thing to consider is the urine output. If the child passes urine more than 6-8 times in 24 hours, things are fine and you need not worry. If the urine output is lesser than that it indicates dehydration which may predispose to electrolyte imbalance. In that case giving increased amount of breast feeding is all that is required. Another warning sign to look for is lethargy.

e) As I mentioned, you need not bother about electrolyte imbalance. The body runs on a balance of numerous metabolic or electrochemical reactions that go on throughout the body. These reactions maintain a balance of electrolytes in the body fluids including blood (which are necessarily a soup of electrolytes or salts in a watery medium). When things go wrong, this balance is no longer maintained and it leads to electrolyte imbalance.

f) There are only three broad things to be done (1) Exclusive breast feeding (2) Maintaining hand hygiene (3) Maintaining a comfortable temperature and air flow.
Nothing else needs to be done.

g) As already explained, pathological testing will not necessarily reflect something occurring in microenvironments unless there is something grossly wrong. I have already mentioned the symptoms that are to be looked out for. In case of lethargy or reduced urine output, it is advisable to visit a pediatrician. He might order a blood count and C-Reactive protein (CRP) level to be tested, but it largely depends on the scenario.

let me know if you have any further queries.

Regards
Dr. Diptanshu Das
+91-0000 XXXXXXX

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Brief Answer:
Questions answered one by one

Detailed Answer:
Thanks for writing back.

1. Babies often get colics especially when on formula feeds. That could be the reason for his crying in spite of being fed. In such a case switching back to breast milk should provide relief. You should burp the baby for at least 15-20 mins after each feed. All you need to do is to hold the baby head end elevated for this duration. The extra air taken causes distention and hence colics. Proper burping will ensure its escape and the milk will not regurgitate back from the stomach to the food pipe, thus providing relief. You can otherwise continue to give Coliaid when needed. You need not give it on regular basis. It is a safe medicine and you need not worry about any disadvantage of giving it.

2. For a baby of this age, it is normal to pass stool several times a day or even after each feed. Alternatively the child may pass stool once in 10 days and that is normal too. Unless the stool is hard and pellet like, you need not grow concerned. It is also normal to pass green stool or a combination of yellow stool. The green colour occurs due to rapid transit through large intestine where the bile pigments do not get adequate time to convert to the yellow colour of stool. It is OK for some mucus to be there in the stool.

3. Vomiting is not normal but can occur due to regurgitation of food. It could be due to overfeeding or due to intolerance to formula feeds.

4. Giving him A to Z Drops (or any other multivitamin drop) 0.5 ml once daily should provide relief.

Regards

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Brief Answer:
Questions answered one by one

Detailed Answer:
Thanks for writing back. Let me try to answer your queries one by one:

a) Most often such symptoms are due to viral infections (known as bronchiolitis) and antibiotics are ineffective in such cases. Although your doctor has prescribed antibiotics, I doubt if they would not help and irrespective of treatment it usually spontaneously resolves in 5-7 days. I do not think it is asthma (it does not start so early). Levolin Inhaler can be given as required but I am a bit skeptical about the use of omnacortil. I would not be able to clinically examine your child. Probably a second opinion would be useful.

b) I have checked the video. It seems to be due to candidiasis, a fungal infection that occurs when the immunity is depressed. Candid mouth paint is the right treatment for your child.

c) Farting could be due to bacterial degradation of undigested food matter in the intestines. You need not worry about that. Exclusive breast feeding is all that is needed.

d) I do not think it to be needed. Medical benefits in babies of this age is not established.

e) Let me emphasize on the fact that breast milk is the best possible milk for a baby and there can be no alternatives for the same. Most formula milks are cow milk based and hence difficult to digest. Moreover they make the child more prone to complications and infections. Mother's breast milk is produced on the demand of the baby. Hungrier the baby, more vigorous is the suck. More is the suck, more is the amount of breast milk produced. Giving formula automatically reduces the demand of the baby and thereby the production of breast milk. All you need to do is to switch back to exclusive breast feeding and the production will increase automatically. All you need to do is to monitor the urine output. If the frequency is more than 6 times in 24 hours, you would know that the amount of feeding is adequate. If the amount of passage of urine is less or if the child is lethargic you would need to take the child to a doctor without delay.

For a baby of this age, it is normal to pass stool several times a day or even after each feed. Alternatively the child may pass stool once in 10 days and that is normal too. Unless the stool is hard and pellet like, you need not grow concerned. It is also normal to pass green stool or a combination of yellow stool. The green colour occurs due to rapid transit through large intestine where the bile pigments do not get adequate time to convert to the yellow colour of stool. It is OK for some mucus to be there in the stool.

Breast milk also takes care of immunity against common ailments like cough and cold, and diarrhea. So, automatically your worries would be reduced. For a baby of this age, it is normal to pass stool several times a day or even after each feed. Alternatively the child may pass stool once in 10 days and that is normal too. Unless the stool is hard and pellet like, you need not grow concerned. You need not use suppositories but in case you use, it would not be harmful.

If the child seems to have nasal blockage, applying saline drops (like Nasoclear) in each nostril should take care of it. So long as the baby is active and playful, you need not worry.

Babies often get colics especially when on formula feeds. In such a case switching back to breast milk should provide relief. You should burp the baby for at least 15-20 mins after each feed. All you need to do is to hold the baby head end elevated for this duration. The extra air taken causes distention and hence colics. Proper burping will ensure its escape and the milk will not regurgitate back from the stomach to the food pipe, thus providing relief. You can otherwise continue to give Coliaid when needed. You need not give it on regular basis. It is a safe medicine and you need not worry about any disadvantage of giving it.


That is all I have to say as of now. Let me know if you have further queries.

Regards
Dr. Diptanshu Das
+91-0000 XXXXXXX

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Brief Answer:
Questions answered one by one

Detailed Answer:
Coming to your queries:

a) No, I cannot confirm without a clinical evaluation. In any case, stem inhalation should help.

b) If I had a patient like him I would have advised stopping both. But you would need to discuss your choice with your treating physician.

c) Ambrodil S should be continued.

d) No problems with bathing.

e) Oral thrush is due to low immunity. This low immunity is associated with the dry cough that your child has.

f) Bronchiolitis is a viral infection. Asthma is not. The diagnosis of asthma cannot be established just like that in a child of this age.

g) Probably it would be unnecessary to rush so far just for such an ailment. You can give me a call on my XXXXXXX +91-0000.

h) I would still suggest exclusive breast feeding. Formula feeds would inevitably bring down the secretion of breast milk. The production of breast milk is based on the demand of the baby. The flow will adjust itself. If the child is passing urine for more than 6-8 times in 24 hours, consider breast milk production to be adequate. While feeding the baby, use one breast at a time, using alternate breasts for alternate feeding. Do not feed for more than 20-30 mins at a time. Feed at 2-3 hourly intervals. Things would be fine.

Regards

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