February 2024

FROM
GOLDEN
MINUTE
TO THE FIRST
4 YEARS
Changing Weather +
Children’s Allergies

Why Breastfeeding Is
Important
 February 2024

From the Editor’s Desk

We had a fantastic February as we dedicated it to newborns and children.
We celebrated the ‘Miracle Milestone’ event as a graduation ceremony
for kids and babies who managed to fight out long-term NICU and PICU
stay and came out all healthy and fit!! We understand what parents go
through and hence our parenting community is also there to support
parents to understand how to manage their babies in difficult situations

Dr. Mahima Bakshi with our expert advice. We are excited to dedicate this issue to all
Momstory babies and kids!!
Maternal Child Wellness
Consultant and Brand Consultant,
Momstory by Sahyadri Hospitals

As a momentous occasion, the Miracle Milestones - Graduation Ceremony marked the resilience and triumph of
our little miracles who have journeyed through the NICU/PICU and emerged stronger than ever against all odds
and medical conditions they faced. The journey of bravery and perseverance of these precious ones who have
overcome hurdles with unwavering strength is a remarkable one and we salute them for it. Their remarkable
journey from the earliest days to the thriving children they are today is a testament to the care and medical
services being offered to them at Momstory with best clinical talent and state-of-the-art infrastructure.

MIRACLE
MASTER CLASS
MILESTONES
EVENT
EVENT
 February 2024

LITTLE
MILLENNIUM
KIDS MARATHON
EVENT
Momstory by Sahyadri Hospitals partnered with the Little Millennium
Schools Pune to be the health & awareness partners for all the toddlers
and children enrolled at the schools across Pune. The event held on
2nd Feb 2024 was the annual sports meet for the group and was attended
by more than 1500+ children accompanied by their parents. The theme of this
year’s event was stated as SAY NO TO CHILD ABUSE.
 February 2024

Rising allergies & infections in

children: Impact of a devolving
climate and environment
Dr. Preeti Lad
Consultant Paediatrics & Neonatology
Sahyadri Hospitals Momstory, Nagar Road

Global warming and climate change are not only affecting flora and fauna but have a major
impact on human life more so in children. While genetics and lifestyle factors play a significant
role in a child’s health, environmental changes and air pollution too are pivotal for the impact
on a child’s health.

Let’s see the environmental factors affecting paediatric health.

Rapid urbanisation has led to a tremendous increase in vehicles on the road. Constructions in and around the city, road
development projects, industrial activities, biomass, and burning, have led to pollutants like particulate matter and
harmful gases such as nitrogen dioxide, carbon monoxide, and carbon dioxide. Volatile organic compounds infiltrate the
delicate airways predisposing children to respiratory ailments. There has been an increase in cases of HRAD
(hyperreactive airway disease), asthma (inflammatory disease of airways), allergic rhinitis (characterised by watery
nasal discharge and sneezing), allergic bronchitis and allergic skin conditions like eczema. Long-term exposure to air
pollutants impairs lung function development.
 February 2024

2. Climate change
Shifts in the temperature and precipitation have caused
temperature variation which is observed after the
winter. The days are very hot, and the nights are chilly
showing the difference in the temperature of almost 20
3. Indoor allergens
to 25°C. This has led to dryness of skin and eyes. There
like dust mites, pet dander and mould spores thrive
is redness and burning sensation in the eyes and an
in poorly ventilated spaces making children
increase in cases of conjunctivitis.
susceptible to allergies. Also, an increase in indoor
activity due to the cold weather increases the
Abrupt changes in the temperature weaken the
transmission of respiratory infections among family
immune system, making children more susceptible to
members.
cold and respiratory infections. There has been an
increase in the number of respiratory infections due to
There is a need to put a check on increasing allergies
viruses and bacteria like adenovirus, rhinovirus and
and infections to prevent morbidities as they
influenza group of viruses. Rising temperatures prolong
significantly affect overall health, school attendance
the pollen season, exposing children to higher allergen
and quality of life.
levels for a longer duration. Altered precipitation
contributes to mould growth exacerbating respiratory
symptoms in susceptible individuals.

This is what you can do to protect

These environmental changes challenge the adaptive
your children from allergies and
capacity of the paediatric immune system leading to
respiratory diseases:
increased allergic response. The hygiene hypothesis
has led to decreased exposure to diverse
• Educating caregivers about environmental
microorganisms in an urban setting, which can triggers
compromise immune tolerance increasing the risk of
• Promoting breastfeeding
allergic diseases. Conversely, a rural environment,
which is rich in microbial diversity confers protective • Avoidance of crowded places

effects. Urbanisation disrupts the delicate balance of • Minimising exposure to pollutants

microbial exposure which is crucial for immune
• Use of mask
development.
• Avoidance of food containing preservatives
and colouring agents, processed food

• Encouraging healthy eating habits with intake

of green vegetables and fruits

• Encouraging outdoor activity in green spaces

• Addressing indoor allergen exposure needs

efforts in household hygiene practices, improving
ventilation and allergen avoidance strategies

• Most important vaccination against common

respiratory infections Influenza vaccine,
Pneumococcal vaccine and MMR vaccine

We can significantly decrease allergies and infections

with these strategies.
 February 2024

Golden Hour of
Neonatal Life:
Need of the Hour
Dr. Jalil Mujawar
Consultant Paediatrics & Neonatology
Sahyadri Hospitals Momstory,
Hadapsar Annexe

Neonatal medicine is the science of newly born babies. The

importance of neonatal care in the first 60 minutes of postnatal
life is unreplaceable.

This concept was spoken about as early as in the 1970s by Dr. R

Adams Cowley, but this has been in focus since the initiation of
maternity and obstetric care.

This concept has been shown to be very effective in decreasing

the issue in newborn health.

We at MOMSTORY, give utmost importance to the health of

mothers and their newborn babies.

COMPONENTS OF THE
GOLDEN HOUR
 February 2024

Antenatal
Counselling and
Team Briefing
Whether a baby is delivered at full term or babies who are born early, there are certain risks
which need to be considered and taken care of.

Alongside the assessment of risks, it is very important for us to make sure that parents are
educated about those risks and are updated about ongoing support during delivery.

Antenatal counselling especially before a preterm delivery has many benefits for parents like
reducing parental anxiety, and increased knowledge, facilitating informed decision-making
by expecting parents.

We at MOMSTORY are fully ready with personnel and equipment to give you the best care in
NEONATAL MEDICINE.
 February 2024

Why Breastfeeding
Is Important
Dr. Jalil Mujawar
Consultant Paediatrics & Neonatology
Sahyadri Hospitals Momstory, Hadapsar Annexe

Breastfeeding is one of the best things a mother can

give a baby, which helps her baby not only in the
newborn period but also in adulthood. Yes, the effect of
breastfeeding imparts good health, superb IQ and
improved immunity, even in adulthood.

Health Benefits

All paediatricians, UNICEF, WHO, and organisations all over

the world recommend direct breastfeeding in all healthy
babies, as soon as possible, at least in the first golden hour
of life. They also promote exclusive breastfeeding at least
till 6 months. They support & encourage mothers to
continue the same till 2 years. It’s like “AMRIT” as described
in the Indian culture.

Why is it recommended?
A breastfed baby will have all the nutrients, calories, fat,
proteins, minerals and growth factors essential for their
development.

At different ages of babies, the mother produces different
milk, sometimes high on protein, sometimes high on fat,
and sometimes more nutrients as needed for the child’s
development.
For moms, it creates bonding between them and the baby,
gives them the hormones which promote healthy
parenting behaviour. It also helps their uterus to come
back to pre-pregnancy size faster and can help in
contraception as well.

It has tremendous health benefits to the baby, and of

course to mother too. It is very useful for perfect weight
gain, and maintenance of good bacteria in your child’s
intestines.
 February 2024

How shall I increase my chances

of making breastfeeding
successful?
Learn the technique from the staff, doctors,
and lactation experts while you are at the Signs of
hospital. Religiously try breastfeeding the
baby even if the milk flow is less or more. Good Feeding –
TRYING IS THE KEY TO SUCCESS.

MOMSTORY follows the Baby-Friendly During pre-feed the fullness of breasts is important.
Hospital Initiative led by WHO & UNICEF And post-feed, the emptiness of your breasts is a
because of which you will get all the help good indicator.
to succeed in the art of breastfeeding. The
kangaroo mother care technique also helps Babies get calm after feeding.
you with good milk production, making the
baby calm and increasing the chances of
A few good long naps and few short naps for the
your baby growing well with skin-to-skin
baby indicate their level of satisfaction.
contact, which stimulates the baby’s
developing neurons.
6-8 times urination per day.

Good weight gain as per experts.

Points I should know before

getting started:

It’s normal for babies to lose around 7-10% of

their weight.

Size of the breasts has nothing to do with the

amount of milk they can produce.

Nipple pain may be present, which can be

cured with simple care.

At least 8-10 feeds a day are expected, but

the need of each baby varies.
 February 2024

Case Study
Pneumonia In Children - An Inflammatory
Lung Condition
Pneumonia which is an infection of the lung parenchyma is
very commonly seen in children. It can be viral or bacterial
in origin. Pneumonia usually responds to treatment in a
due course of time. But sometimes pneumonia can result
in complications and develop pleural effusion or
empyema. This is a condition in which there is a collection
of either a fluid (effusion) or pus (empyema) between the
two layers of the pleura. The pleura is the layer which
covers the lung.

Pneumonia And Its Treatment

For A 2 Year Old Patient

Now here we describe a case of a two-year, We also gave an injection to break the septation between
four-month-old child who presented to us with a history of the pus called a streptokinase. We injected it in the pleural
cough and fever of a high grade in nature for one week. space for 5 days to break the pus locule. But the child's
Initially, the patient was treated with oral antibiotics and condition was not improving and the fever continued. On
medicines to control the cough. But because the fever was further evaluation, it was found that this child had not
not settling down and due to the chronicity of illness, the received the pneumococcal vaccine.
patient was referred to us.

On admission, an X-ray showed a left-sided, complete

whiteout of the lung. And he had mild difficulty breathing,
so he was given oxygen. On further evaluation, it was
noticed that this child had got pleural effusion. So
ultrasound was done to know the amount of fluid which
was approximately 50 to 100 ml. So initially, he was
treated with IV antibiotics. But subsequently, we put a
small needle in the chest and to our surprise, pus was
drained out. We put a catheter to drain out that pus and
almost 150 to 200 ml of pus was drained out . On further
evaluation, it was found that an organism called
streptococcus pneumoniae was isolated from this pus.
Prioritise Giving Your Child
The Pneumococcal Vaccine
Now here we want to stress that such life-threatening and
complicated pneumonias, generally can be prevented by
giving pneumonia vaccine called a pneumococcal
vaccine. Only a partial cover also can prevent such
complications. But unfortunately, this child had not
received the vaccine and landed into complications. We
gave him antibiotics to control the infection. We drained
the pus, but his condition was not improving.
 February 2024

Video-Assisted Trans
Thoracoscopic Surgery To Treat
Small Pockets Of Puss
So ultimately, his CT scan of the chest was done which showed multiple small, small pockets of a pus.
And subsequently, he required a surgery called VAzTS, (video-assisted trans thoracoscopic surgery) , in
which a small scope was inserted in the chest and the pus was drained out. And ultimately, all the
infective elements from the lung were removed. So this is a major surgery, but considering the clinical
situation, sometimes we need to consider this option. Subsequently, after the surgery, the child settled,
his lung started expanding and the child recovered. And he was discharged on the 26th day after the
admission. By explaining this case, we want to emphasise the importance of vaccines, so please don't
ignore the vaccines as they prevent life-threatening illnesses. And secondly, timely management of
medicines usually prevents such complications. But even if the complication arrives, our team is also
competent to manage such cases. Now such patients need a multidisciplinary approach. It needs the
involvement of a team with a paediatric intensive care specialist, the involvement of an infectious
disease specialist, a paediatric surgeon, and trained resident medical officers and excellent staff, so that
they will monitor the child very continuously and with an excellent lab backup, to get to the diagnosis.

Take Home Message - Don’t Ignore The

Importance Of Pneumococcal
Vaccine For Your Child

So the take-home message from this case is that don't ignore

vaccines. Vaccines are there to prevent the complicated
disease in a child. Secondly, if the child is sick don't delay the
treatment. Consult your paediatrician as early as possible.
Get the child treated early. And thirdly follow up with the
paediatrician. This child is completely normal now. Lung has
been fully expanded and he is back to the school. We have
advised the parent to give the vaccination.

Thank you.
Dr Sagar Lad
Senior Consultant Paediatrics & Neonatology
Sahyadri Hospitals Momstory, Nagar Road
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