Introduction to Singhania Clinic
Location
Singhania Clinic is located in Dubai Healthcare City. Al Razi building 64 block A room
1004.
Appointments
Saturday :8:30 AM to 6:30 PM
Sunday: 8:30 AM to 6:00 PM
Monday: 8:30 AM to 6:30 PM
Tuesday: 8:30 AM to 6:30 PM
Wednesday: 8:30 AM to 6:00 PM
Website: https://www.singhaniaclinic.com/
Newborn Screening Tests
Newborn screening for early detection of medical disorders began in the early 1960’s
and has gradually been expanded and improved. Today these tests identify about 3000
newborns nation-wide each year with serious underlying medical conditions. Most of
these infants are diagnosed before symptoms occur and have improved lives because
of early diagnosis and treatment.
Required Blood Screen
Newborns are screened for many medical disorders. Prior to being sent home from the
hospital, newborns have their blood drawn, placed on a special filter paper, and sent to
a central state lab for testing.
Early Hearing Detection
Newborn hearing screening is usually done before discharge from the hospital.
Intervention for hearing impairment during the first six months of life significantly
improves language development in these infants. Without newborn hearing screening,
hearing loss is not generally diagnosed until the second year of life.
Car Safety Seats
All children should sit properly restrained in the back seat of the car until age 13. Air
bags can cause serious injury to children in the front seat. Infants and children up to 40
pounds need to be restrained in a car safety seat with a harness.
All infants and toddlers should ride in a rear facing car seat until they are at least 2 years
of age. Serious injuries are five times more likely to occur if your child is in forward facing
safety seat.
Immunizations Protect Babies
Medical experts agree that the development of immunizations was one of the most
significant medical advancements of the 20th century. Prior to immunizations, parents
could expect that every year :
Polio would paralyze 10,000 children
Rubella would cause birth defects and mental retardation in as many as 20,000
newborns
Measles would infect as many as 4 million children, killing 3000
Diphtheria would be one of the most common causes of death in school age
children
A bacteria called Haemophilus influenza type B would cause meningitis in 15,000
children, leaving many with mental retardation or hearing impairment
Pertussis would kill 8,000 children, most under the age of 2 years
Today, thanks to the development and widespread use of vaccines, the frequency of
these illnesses has been vastly reduced, and in some cases almost eliminated.
Media Alert
Although your child is very young, or perhaps not yet even born, this is a good time for
parents to consider the risks and benefits of mass media (T.V, Movies, Videos, Computer
games) exposure and set family rules for media time.
Time spent with the media can displace creative, active and social pursuits. In response
to excessive media exposure in many American homes and the increasing evidence of
harm done to our children by this excessive exposure, the AAP has issued a set of
recommendations for television and video viewing for American Children.
Recommendations:
The American Academy of Pediatrics recommends that children less than 2
years of age avoid all screen time, including phone, tablet, TV, or video viewing.
Despite the AAP recommendation of no television and video viewing for children
less than 2 years of age, 14%of infants are watching more than 2 hours of media
a day. Certain television programs and DVD’s are promoted for this age group,
but research on the early brain development shows that babies and toddlers
have a critical need for direct interactions with parents and other significant
caregivers for healthy brain growth and development of appropriate social,
emotional and learning skills. We encourage you to read daily to your child
starting at birth to promote their language development, literacy, and bonding
with you.
For children 2 and older, the AAP recommends no more than 1 to 2 hours a day
of media exposure. We recommend no more than an hour a day for children
ages 2-6.
Children should not have television sets in their bedrooms
Breastfeeding
Breast milk is the optimal nutrition for your baby. There are many health benefits of
breastfeeding including reducing risks of infection, asthma, overweight, and obesity for
your child. Many breastfeeding mothers feel that breastfeeding is harder at the
beginning than expected, so do not be discouraged. Ask for help.
Starting to Breastfeed
When breastfeeding your baby, you should be comfortable. Hold your baby in your lap
with their head slightly raised and resting on the bend of your elbow. Hold your baby
comfortably close and guide the nipple into your baby’s mouth. With your hand cupping
your breast, gently stroke the baby’s lip nearest the breast. They will turn their head and
hunt for the nipple. This is called the rooting reflex. If they have trouble grasping the
nipple, try rolling the nipple with your finger and thumb to get the nipple more erect. If
the breast seems to close off the baby’s nose, position them so that their chin touches
your breast and pull their belly close to you. Allow your baby to nurse both breasts,
alternating the breast that you begin with. After 10-15 minutes your baby will take in
80-90% of the milk, although you may certainly permit them to nurse longer if they
desire. Try to nurse your baby every 2-3 hours, although babies are often drowsy and
difficult to feed the first day or 2. Do not be discouraged if every feeding does not go
well. Supplementation with formula is discouraged unless there is a medical need.
Changes Around Day Three
For the first 2-3-days your breasts produce small amounts of milk called colostrum,
which is rich in protein and protective antibodies. Colostrum is all your baby needs in the
beginning. Around the 3rd day the amount of breast milk and the fat content of your
breast milk should increase. Your breasts may feel larger and full. If the fullness is
excessive and uncomfortable, it is called engorgement. Frequent feedings can help
relieve and prevent engorgement. It is a temporary problem.
Nipple pain is common during the first few weeks of breastfeeding. The pain is felt when
the baby initially latches on and takes its first few sucks. Improper latch on may
contribute to nipple discomfort. Don’t hesitate to see a lactation consultant if you are
having nipple pain. Plain lanolin or vitamin E oil from a capsule applied directly to the
nipples can also be helpful, especially if nipples are dry and cracking.
Frequency of Feedings
After a first day or two of often erratic nursing, most breast fed infants will nurse 8-12
times in a 24 hour period for the first month. The AAP discourages rigid feeding
schedules for breastfeeding babies. Restricted feedings, especially in very young
infants interfere with successful lactation and have been associated with failure to
thrive (poor weight gain) in infants.
Voiding and Stooling
The number of wet diapers can help you assess whether or not your infant is obtaining
sufficient breast milk after leaving the hospital. The rule of thumb that can help you
determine hydration the first week is the same as how many days old the baby is. In
other words, a one day old should void at least once; a two day old should void at least
twice etc. on occasion the urine stain in the diaper may look coral coloured, this is due to
normal crystals in the urine. This should clear as your baby’s feedings improve.
Your baby’s first stools are dark and tar like for the first few days. After a few days the
stools become looser and vary in colour. These stools are called transition stools. Ny the
end of the first week or before breast - fed infants stools are yellow, seedy, and often
watery. Breast fed infants tend to have more stools than formula fed infants. Three to
five stools a day are common, and some breast fed infants have small stools with
almost every feeding for the first few weeks. happily , most infants slow down on stol
frequency around a month of age.
Vitamin D Supplementation for Breastfed Infants
The APP recommends that vitamin D supplementation be given to breastfed infants
starting in the first month of life. Vitamin D is needed to develop and maintain strong
bones as well as help your baby’s immune system.
Breast fed infants are at risk for vitamin D deficiency and rickets due to the low vitamin
D content of breast milk. Vitamin D is also made naturally in the body with exposure of
skin to sunlight; however, infants should not have significant exposure to sunlight. The
recommended dose of vitamin D from birth to 12 months of age is 400 IU.
Diet and Breastfeeding
While breastfeeding, eat a balanced diet. A mother’s breast milk is flavoured by the
foods eats. These first taste experiences will influence later food preferences by your
child., so having a variety of foods in your diet in the future. Spicy foods and foods that
cause indigestion or gas may bother your baby. Eat these sorts of foods in moderation
while breastfeeding. Your body needs added calcium (from milk products and dark leafy
vegetables) and iron (prenatal vitamins and food sources). Never take any medication
routinely (except prenatal vitamins) without letting your baby’s doctor know. An
occasional laxative, antihistamine, acetaminophen or ibuprofen is okay.
Formula Feeding
Seated comfortably and holding your baby, hold the bottle so that the neck of the bottle
and the nipple are always filled with formula. This helps the baby to get the formula
instead of sucking air. Air in their stomach may give them a false sense of being full and
may also make them uncomfortable. If your baby has trouble sucking, make sure the
nipple hole is big enough.
Do not prop the bottle and leave the baby to feed himself. The bottle can easily slip into
the wrong position so that they suck in air or they may choke. Propping the bottle is also
associated with ear infections. Remember that your infant needs the security and
pleasure of being help at feeding time.
Preparing the Formula
Infant formulas are available and can give complete nutrition to your baby (though not
as good as breast milk). When you use powdered formula, one scoop of powder is
mixed with 1 oz of water. Bottle sterilization is important.just before feeding, remove4 a
bottle from the refrigerator and warm it in a pan of hot tap water for a few minutes, or
use a bottle warmer. Test the temperature of the formula by shaking a few drops on the
inside of your wrist. Do not use microwave oven for warming. The milk heats unevenly,
which may burn the baby.
How Much Formula and How Often?
In the first 24 hours most formula fed infants feed about every 3 to 4 hours and will only
take 30 to 60 ml of formula per feeding on average. In fact most babies lose a few
hundred grams over the first couple of days of life. Then over the next few days your
baby’s appetite will increase and by the end of the first week most babies are taking
about 120ml of formula per feeding and are gaining weight rapidly.
By the end of the first week most formula fed babies feed less often than breast fed
infants. Your formula fed infant will need 6-8 feedings per day for the first month.
Feeding schedules are best decided on using your baby’s hunger cues as guidance.
The amount of formula per feeding varies somewhat between babies.
Formula Storage
Prepared formula should be stored in the refrigerator and must be used within 48 hours.
Prepared formula left at room temperature for more than 1 hour should be thrown
away. At the end of each feeding, throw away any formula left in the bottle.
Crying
All babies cry each day. Crying is your baby’s way of saying “I’m hungry”, “i have a belly
ache”, “i, wet or dirty”, “i'm hot, or “pick me up, I’m bored”. Sometimes babies cry for no
apparent reason or to get rid of excess energy. Pay attention to your baby’s cries. You
will soon learn what your baby’s cry means. Take a deep breath if you feel yourself
getting frustrated or mad. These feelings are normal. Call a friend or relative to talk
about it. If you think your baby is crying more than normal; call your baby’s doctor and
have your baby seen.
Sneezing, Hiccups, Eye Crossing
All newborns sneeze. Sneezing at this early stage does not mean allergies. Sneezing is
the only way a baby can clear his nose of mucus, lint, or milk. All babies hiccup. Hiccups
are normal and usually go away within 5-10 minutes.
Many newborns briefly cross their eyes. This is normal in the first month or two, but
should resolve by two months of age. If eye crossing continues to be noticed after 2
months, let your baby’s doctor know.
Burping
Burping your baby helps remove swallowed air and decreases spitting up. There are
several different possible burping positions for your baby, such as over your shoulder,
across your lap, or even seated leaning forward on your lap. Once your baby is in a
comfortable burping position, simply pat or rub their back gently until you hear the burp.
Burping two times a feeding for a minute or two is generally plenty. More burping may
be needed if your baby is a “spitter”. Some babies do not swallow much air during
feedings and may need very little burping.
Bathing and Other Basics
Most infants need a bath only 2-3 times a week. Withhold regular tub baths until the
cord has dried up and fallen off. Until then sponge bathe and keep the cord dry. The
face, neck and diaper area may need daily cleaning. Use mainly water for the first few
weeks. Soaps are very drying to newborns skin and should not be used. Use mild soap
daily to clean diaper area. If your baby’s skin seems excessively dry, feel free to use an
unscented moisturizer or pure coconut oil. You may shampoo your baby’s hair with a
baby shampoo or liquid baby soap. Use a soft brush to scrub the scalp.
Nails
Keep nails clean and short. Use special baby nail cutters. If you cut the nails have
someone help you. One person hold the baby’s hand or foot while the other clips the
nails.
Vaginal Mucus
Little girls may have white mucus in their vagina with occasional streaks or blobs of
blood during the first few weeks of life. This is caused by hormone changes following
birth. Simply wipe away front to back while cleaning and bathing. The mucus may take a
month to resolve completely.
Uncircumcised Baby Boys
Clean the outside of the uncircumcised penis as you would any other part of the baby’s
body. The foreskin of the uncircumcised penis is normally attached to the tip of the penis
in layers of tissue. As the baby grows, the skin will eventually separate and allow the
foreskin to slide back naturally. You should never try to force the skin back as this could
cause bleeding and possible infections. In some boys, the skin retracts by one year of
age; in others, full foreskin retraction may occur as late as adolescence. As long as your
baby can urinate normally, you should not be too concerned about whether the foreskin
retracts yet.
Care of a Diaper Area
Change your baby’s diaper as soon as possible after each bowel movement or urination
and keep baby’s bottom as dry as possible. At each change, pat dry, do not rub. Then
apply diaper cream.
The Home Environment
Room Temperature
Room temperature should be kept fairly stable. After the first few days your infant’s
temperature control is just as effective as your own, so you may keep the room as cool
or warm as you like. If it is warm in your house and you’re walking around in light
clothing, then all your infant needs is a diaper and shirt. If you would be uncomfortable
then your baby probably would be also. It is normal for babies hands and feet to feel
slightly cool and be splotchy coloured. If you are concerned about your baby’s
temperature, take his temperature with a thermometer.
Friends and Relatives
Friends and relatives will want to hold and hug your baby. Anyone who is ill, even with
minor illnesses, should stay away from your newborn. Have each person wash their
hands before holding the baby. Don’t take your baby shopping or around large groups
of people for at least the first two months.
Smoking
If you or another family member is a smoker, one of the best ways to protect your
newborn’s health is to quit smoking. Smoking in the household increases the number of
your baby’s respiratory illnesses and ear infections, your baby’s chance of dying from
SIDS, and may even increase your baby’s long term cancer risk.
Sudden Infant Death Syndrome
SIDS is the leading cause of death in infants older than one month of age. SIDS is most
common in babies 2-3 months of age and is less common after 6 months of age.
Highlights from the AAP recommends:
1. Back to sleep: placing your baby to sleep on their back is the most effective way
to prevent SIDS. since the back to sleep campaign began in 1992, the incidence
of SIDS has decreased by over 50%. All newborns, full term and prematures,
should be placed on their backs to sleep as soon as possible after birth. Side
sleeping is not safe and not recommended. Babies who sleep on their backs are
less likely to vomit and choke than babies who sleep on their stomachs. Only
once your baby can roll back to belly and belly to back at 5-6 months of age are
they allowed to remain in the sleep position that they choose.
2. Infants should sleep in a safety approved crib, portable crib, play yard crib,
bassinet. Car seats and other sitting devices are not recommended for routine
sleep. Also wedges and positional products that claim to keep your baby on their
backs are not recommended.
3. Bumper packs are not recommended bumper pads have been shown to
increase the likelihood of suffocation, strangulation from the bumper ties, and
becoming entrapped between the mattress and the bumper pads.
4. Avoid pillows, quilts, comforters, sheepskins, stuffed toys and other soft objects in
the infant's sleep area. These items increase the risk of your baby suffocating.
5. Smoking: any smoking in the baby’s environment, but especially smoking by an
infant's mother, increases the risk of SIDS.
6. Breastfeeding helps protect against SIDS
7. Consider offering a pacifier at bed and nap times. Pacifier use has been found to
protect infants from SIDS. it is recommended that infants be put to sleep with a
pacifier, beginning at 1 month of age. It should not be forced if the infant refuses
or be reinserted once the infant is asleep.
8. Do not let your baby get too hot. Keep the room where your baby sleeps a
comfortable temperature. In general dress your baby in no more than one extra
layer than what you wear.
Tummy Time: Back to Sleep, Tummy to Play
Now that babies are sleeping on their backs, the incidence of SIDS is going down, but
the frequency of head - shape and neck mobility problems is going up. Some experts
say that close to 10 percent of all babies now have some flattening on the back side of
the head and/ or neck mobility problems due to spending a prolonged amount of time
lying on her tummy is the best way to prevent or treat these head and neck problems.
Tummy time will also help strengthen your baby’s neck and back muscles and help
develop skills needed for rolling over, sitting, and crawling. By two weeks of age, tummy
time should be an important part of your baby’s daily routine starting with just a few
minutes at a time, 2-3 times a day. Here are a few tummy time tips:
1. Place your baby on a firm but comfortable surface, like a blanket or quilt on the
floor. Tummy time must always be supervised. Placing your hand on the baby’s
bottom may help shift weight from the upper body.
2. If your baby is still unable to lift her head, place a rolled towel or small pillow under
the chest and armpits, with their arms out in front.
3. You may need to lie or sit in front of your baby and entertain them so that she
learns to enjoy tummy time.
4. Gradually increas tummy time as your baby gets stronger and more comfortable
with being on their stomach. Thirty to sixty minutes a day of tummy time will
prevent most head flattening and neck mobility problems, although it may take a
couple of months to increase this time duration.
Well Child Checks and Immunizations Schedule
The keystone to pediatric care is preventive medicine. During each checkup, your child
will receive a complete physical examination, growth measurements, necessary
immunizations and / or screening tests appropriate for age. Your provider will also
discuss nutrition and these development with you. Please feel free to ask questions
during these visits
Vaccination Schedule for UAE
Birth to 2 weeks
BCG
Hep B
mandatory
2 months
DPT+Polio+Hib+Hep B (6 bugs)
Pneumococcal
Rota
Mandatory
Rota Optional
4 Months
DPT+Polio+Hib+Hep B (6 bugs)
Pneumococcal
Rota
Mandatory
Rota Optional
6 Months
DPT+Polio+Hib+Hep B (6 bugs)
Pneumococcal
Rota
Mandatory
Rota Optional
9 Months
Meningococcal Meningitis
Optional
12 months
MMR
Chicken Pox
Meningococcal Meningitis booster
Only MMR
mandatory
18 Months
DPT-Polio-Hib
Pneumococcal
mandatory
2 years
Hep A (2 doses at 6 month interval)
Typhoid
Both Optional
4 to 6 years
DPT-Polio
MMR
Chicken pox
Only Chickenpox
optional
10 to 12 years
Tetanus or Tetanus +Pertussis
combo booster
Meningitis booster
Others
Influenza - every year
Human Papillomavirus Vaccine for
girls 9 to 11 years (3 doses)
Optional