Pediatrician, how to choose one.
Posted by: Prajakt on: February 5, 2009
While we were occupied with the thoughts of labor, delivery and our baby, one thing we completely forgot was finding a good pediatrician.
We completely overlooked the fact that we will need a pediatrician immediately after delivery for general checkup of the baby and in case of urgency we might even need an expert. I would advice all the parents that like they work hard to get a good Gynecologist, they must work hard to to also find good general pediatrician and a Neonatologist, just in case you need one.
I suggest following few things you should look for while identifying a good pediatrician.
- Ensure that he is competent (this was no brainer
) and spends time with parent explaning everything parents want to know. - Is available in case if emergencies.
- Does not ask for unnecessary investigations and medications.
- He empowers parents so that they can manage day to day problems.
- He is neither too young nor too old, early forties is ideal.
Though Ayush was born with cord around neck, he was delivered safely and thankfully he didn’t need any special attention from the Pediatrician at birth. But 20 days after birth he picked up lever infection (another post for this) and at that time we absolutely had no idea about a good Pediatrician in Pune and then we had to spend time finding out good Pediatrician. Following are few recomendations in Mumbai, Thane and Pune.
- Dr. Bhavesh Mithiya @ Kaushlya Hospital, Thane
- Dr. Sachin Shah @ Aditya Birla Hospital, Chinchwad, Pune (Neonatologist)
- Dr. Nandkishor Kabra @ Surya Children Hospital, Santacruz (West)
- Dr. Subhash Dalal @ Bhatiya Hospital, Mumbai
- Dr. Anand Pandit @ FC Road, Pune
BTW, Neonatology is a very specialized domain. Ensure that the hospital has a good neonatal itensive care unit and a good Neonatologist is associated with it.
I am back !!!
Posted by: Prajakt on: February 4, 2009
It’s been a while that I have written anything here. Lots of things happened in between.
Ayush is now more than 5 months old. He has already started to roll over, can sit for couple of minutes without support and we have recently started to give him solids.
He is a cute boy (every parent things his child is the cutest) and gets lot of attention where ever we go. He is sort of a crowd puller .
There are long list of experiences we went through in last few months and I will try to catch up on most of it in next few days while I continue to update on his current progress.
Delivered Safely !!!
Posted by: Prajakt on: August 28, 2008
On Thursday 21st August 2008 morning at 11.03 AM ‘bundle of joy‘ weighing 3.06 kgs (6.72 pounds) was safely delivered. It was an exhilarating experience and I am happy I was part of the whole event. Dakshata and yet-to-be-named-boy are doing fine.
For us the overall experience of pregnancy is like a typical Hindi movie, it started with a extremely happy moment when we first heard the good news, then it slowly progressed for next 9 months with mostly happy moments and few sad (discomfort) moments and at the climax there were some ‘heartbeat missing’ moments but movie ended on an extremely happy note, leaving lots of loose ends for a definite sequel .
On Wednesday 20th August we went for the sonography just before the expected due date. The BioPhysical score of the baby was 4 out of 10, primararily because of low breating movements and low heart acceleration, both of these are related. Though the fluid and limb/body movements were fine but this low score needed urgent appointment with our Doctor. When we met our doctor she said something is wrong inside and baby is distressed. This meant Dakshata would need active monitoring and immediate admission to hospital. This could lead to a cesarean delivery but Dakshata was not mentally prepared for this.
We admitted Dakshata to hospital at around 1:30 PM. Immediately NST (Fetal Non-Stress Test) was conducted followed by another sonography and color doppler. All of these test were normal. This was a big relief. Doctor, after consulting with us, decided to induce labor. Baby was already full term and matured to be delivered.
Induction was started with a cervix ripening process at 8:30PM and then Dakshata was into natural labor at 4AM. Then she progressed into active labor after that. During the complete process baby was actively monitored using NST. By 7:30AM her contraction were already very strong and pain was unbearable. Thanks to the epidural that she had enough energy left for pushing. At 11:03 baby was finally delivered with one loop of cord around neck.
I am happy that I was with Dakshata in labor room through out. This was a big support for Dakshata and I would advice to every ‘to-be-father’ to be inside labor room with their wife. This would need lot of courage but prepare yourself for that. Carry either lemon juice or glucose water or any juice along with you. Talk to your doctor in advance and insist on this. I must say that in our case all the doctors and supporting staff were very co-operative and supportive. This simplified lot of things.
I remember a colleague of mine mentioning that after his first baby his respect for his mother increased by 10 times, now I understand the meaning of the statement. No matter how much you mentally prepare yourself, how much you read, the real experience is completely different. Nine months and last but definitely not the least, labor, takes lot of toll on mother’s body. I remember one of the doctor mentioned to Dakshata in labor room, “think how our moms delivered without epidural“, how true it is. From the whole experience I would advice all the to-be-mothers that prior to labor they must prepare themsleves physically, walk alot, keep your body fit, eat healthy, learn breating excercises (they really help), read all about labor, learn to conserve energy and get ready to face it.The end of this is so stunning that I can assure you, you will not feel the pain when you will hear the first cry of the baby, first glimpse of the baby.
As a small gift to Dakshata I have decided to give Dakshata’s name as middle name for my baby. I sincerely hope my family would agree for this. She deserves it.
P.S: We have decided to name the baby as “Ayush“. Check out some initial pictures here (http://picasaweb.google.co.uk/prajakt/Aayush)
Pregnancy and weight gain
Posted by: Prajakt on: July 31, 2008
Two things we consiously monitored during the whole pregnancy were weight gain and blood pressure. We just bought a weighing machine and monitored and kept record of weight gain. Dakshats’s did loose some weight in first month and we were little worried about it but doctor explained that beacuse of fatique and vomiting that could happen. She got back on track after first month.
Weight gain is much more rapid in second and third trimester. You would gain any where between 1.5-1.8 kg in first trimester, 5-5.5 kg in second trimester and 5-6Kg in third trimester. Overall weight gain would be anywhere between 12-14Kg. Following is the distribution of weigh gain -
- Baby’s weight – 3.6kg
- Placenta – 675g
- Amniotic Fluid – 900g
- Uterine Enlargement – 900g
- Breast Tissues – 900g
- Increase in Blood Volume – 1.8kg
- Fluid in maternal tissues – 1.8kg
- Fats – 3.2kg
Its very important to keep track of the weight gain. Excess weight gain because of fats could be bad and less weight gain could indicate about baby’s growth.
Pregnancy Diet
Posted by: Prajakt on: July 31, 2008
First question that came to our mind was “What should be my diet?”. We also received lots of suggestions from people about what she should eat and what should be avoided. According to our doctor following were required in her diet for her and baby’s good health,
- Proteins, Calories and Fats
- Vitamin C
- Fibers
- Calcium
- Iron
Doctor does prescribe iron and calcium supplements but it is also advisable to consume it from food. Dairy products are best source for calcium and also fats. Calcium and fat are very essential from second trimester when baby’s accelerated growth starts.
We initially tried to follow a military discipline, prepared diet chart etc. But soon we realized that it was just too stressful. So then we decided to just follow normal routine. Just added some fruits in the daily routine. Followed proper timings for meals. Never stressed ourselves with consciously following a diet chart. This made the overall 8 months relaxed. This strategy atleast for us ended up to be very good. We also did not avoid eating out, just ensured that we ate at clean and hygienic places. Apart from Papya for first trimester we ate almost everything (including panipuri, shev puri, pav bhaji )
Latest ultrasound
Posted by: Prajakt on: June 20, 2008
- In: Ultrasound| video
- 2 Comments
We had another 30th week ultrasound and this time we did it in Thane Ultrasound Center
after a very strong recommendation by a friend. Its a very well equipped laboratory and I must say it matches with the facilities at Hiranandani Hospital but I must that Hiranandani was way too good in terms of over all experience, the appointment queues are better managed and they have better facilities. In Hiranandani they projected the ultrasound images on a big television so that mother and relatives get much better view. BTW, below are some movie clips from latest ultrasound,
The Blank Slate
Posted by: Prajakt on: June 20, 2008
After writing about Garbhsanskar, I have had numerous discussions with Dakshata, parents, friends and relatives and this thought provoking topic kept on stimulating me. During the time I have read quite a few articles, blogs and books around this topic. A friend passed on a wonderfully written book The Blank Slate by Steven Pinker. Its a master piece, very well researched and equally well written book. Its a highly recommended and must read book. Below I am reproducing some content from the book.
The three laws of behavioral genetics may be the most important discoveries in the history of psychology. Yet most psychologist have not come to grips with them, and most intellectuals do not understand them, even when they have been explained in the cover stories of newsmagazins. It is not because the laws are abstuse: each can be stated in a sentence, without mathematical paraphernalia. Rather, it is because the laws run roughshod over the Blank Slate, and the Blank Slate is so ebthrenched that many intellectuals cannot comprehend an alternative to it, let alone argue about whether it is right or wrong.
- The First Law: All human behavioral traits are heritable.
- The Second Law: The effect of being raised in the same family is smaller than the effect of the genes.
- The Third Law: A substantial portion of the variation is complex human behavioral traits is not accounted for the effects of genes or families
He has provided lots of arguments, studies and references to prove above three laws. Essentially what these three laws means is, genes determines a fair bit of our personality, parenting or family environment has almost negligible effect on our personality and remaining of our personality is determined by our peers. (thats a scary thought for a father in waiting … )
So does this mean that there is no point in teaching our children good values, having good environment at home and treating them well. Steven has a very good answer for that as well “We may not hold their tomorrows in our hand but we surely hold their todays, and we have the power to make their todays very miserable”.
My learning from the book is, don’t be extremists either way. Try to provide your children with good environment at home and outside and help them pick good peers. They will turn out to be good human beings. Do not over do on parenting.
Garbhasanskar
Posted by: Prajakt on: May 17, 2008
This has been one topic which has stimulated my thought process for quite some time. Garbhsanskar is a sanskrit word. It can be divided into two parts – “Garbh“, which means womb and “sanskar” which means good values. So it means passing on good values to the fetus while its in the womb by parents. The story of Abhimanyu is well known in the Mahabharata. Abhimanyu, the son of Arjuna, learned how to enter the Chakravyuha (the strategic arrangement of warriors to entrap and defeat the enemy) when he was in his mother’s womb. Abhimanyu had heard and remembered the narration of the technique by Krishna to Subhadra during her pregnancy.
There is tons of literature available in India regarding this topic. Also there are hundreds of Garbhasankar classes run by doctors, yoga gurus, babas etc etc. It attempts to teach it in the mostly unreasonable and unrealistic spiritual and religious context. It would suggest set of shlokas and mantras in sanskrit (which most of us cannot parse and understand), religious books, devotional songs, visit temples, prayers, meditation etc. According to them, parents and particularly mother can help to determine the future of the baby. BTW, the most popular CD and book is this.
Let me try to explain what I understand as Garbhsanskar and why it is important. It would be very interesting to hear your opinions on this very controversial topic.
I think there are three stages of Garbhsanskar – pre conception, conception and during the pregnancy.
Pre-conception
Pre-conception stage is really about the health of the mother and her physical fitness for the pregnancy. During pregnancy mother would undergo lot of physiological and hormonal changes, this stage is about preparing yourself, mentally and physically, for all of those changes. For example, it is well established that folic acid deficiency is responsible for neural defects and mental disorders. Similarly vitamins, sugar, hormones and other chemicals have a role in the birth of physically and mentally healthy baby. So the pre-conception stage of Garbhsankar deals with the diet and health of the mother. All of us know that environment and surrounding has profound effect on all kids. So this stage is to ensure that the environment where baby is going to grow for next 9 months is healthy, I call it as the Womb Environment.
Conception
This stage is about the genes. Features unborn would inherit from parents. This is complete lottery. Science clearly states that genes are immutable. So no matter what you read, what you eat, what you listen, it is not going to change your genes and one cannot control what the unborn will inherit from mother and father. So any literature or tales which suggests that eating a particular type of food can ensure the baby fair color is all bogus. This topic needs a separate details post.
During Pregnancy
All the efforts during this stage is directed towards keeping expectant mother happy. We know that stress, frustration, anger, irritation etc produces certain type of hormones which can potentially have some effect on the prenatal baby. So the traditional Grabhsankar suggest shlokas, mantras, prayers etc but I think any activity which can help mother happy is fine, it could art, music, movies, prayers anything.
Today, science has proved that intrauterine baby can not only listen, touch, feel but also can respond by its own way . 60 % of brain development occurs in intrauterine period. The suggestions against horror movies, action movies, loud music etc is I believe because it can disturb the sleeping baby. It has nothing to do with passing on bad values.
I think all of this is directed towards keeping expectant mother happy & making pregnancy a joyful experience. What do you think?
The real challenge starts after the birth .
Doctor or Hospital?
Posted by: Prajakt on: May 6, 2008
This is one question each and every parent in India face. I also went through same process of discovery, confusion and then final decision. This post will clearly help some prospective parents.
Our requirements were very simple -
- Doctor should spend time with us
- Listen to our questions and patiently answer our queries
- Understand our anxiety
- Available to help us in urgency
- Should be in late 30s, so he/she is enough experienced at the same time aware about new technologies
- Should be accessible in terms of distance and traffic
- He/she should be associated with a good hospital
After the good news was confirmed, I called up few friends who have had deliveries in Thane in recent times and then we visited various doctors in Thane. But I found out that everybody here was very busy, they had long queues, uncomfortable waiting periods on every visit and poor appointment management systems. Even if you take prior appointments every doctor had their own algorithms to prioritize the queue. I could see women in 9th month waiting for hours for appointment. It was just absolute chaos.
Then we got few good references from friends about Dr. Suneeta Phadake in Aundh, Pune. We visited her and we liked her in first few minutes. She was knowledgeable, experienced, sensitive and sensible. The problem was, she was in Pune. This meant that we will have to travel every month until 8th month and then move to Pune in 9th month of pregnancy. Also she won’t be available in case of urgency during first 8 months. But we were just so impressed with her that we decided to go ahead and if pregnancy progresses without any complications, we would continue with her. Decision turned out to be very good until now because she has really helped us to cope with the anxiety and stress in first 6 months very nicely.
One thing which we completely forgot from our list of requirements was to check out the hospital she was associated with. I realized that its very important to choose the hospital which has separate maternity ward. I realized that environment in maternity homes is completely different than in a general hospital where all kinds of patients check in. Apart from really fatal deliveries, which are rare, the atmosphere is mostly cheerful and full of happiness in maternity wards. Thats when we rushed to check out the hospitals Dr. Suneeta was associated. We decided to prefer Ratna hospital over Kodbaghe, even though its little far off because it has separate maternity floor and lots of choices of rooms.
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