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New Indian Express
01-07-2025
- Health
- New Indian Express
Treating hormonal issues at birth can ensure normal growth in kids
Hormonal disorders in children can have significant physical, emotional, and social impacts. These conditions can affect growth, development, and overall well-being, making early diagnosis and treatment essential. Understanding these issues can help parents and caregivers take proactive steps to support their child's health and development, says Dr Riaz I, Professor, Paediatric and Adolescent Endocrine Clinic, Government TD Medical College, Alappuzha, in an interview with Unnikrishnan S. Edited excerpts: Q: What are the most common hormonal disorders in children? The most important endocrine disorder in children is hypothyroidism, especially congenital hypothyroidism, a condition present at birth, where the thyroid gland doesn't produce enough hormones, often due to gland maldevelopment. It's the most common preventable cause of intellectual disability. Early diagnosis and treatment at birth can ensure normal growth and brain development. Other common hormonal disorders include type-1 diabetes mellitus, acquired hypothyroidism, growth hormone deficiency, precocious puberty, delayed puberty, congenital adrenal hyperplasia, obesity & metabolic syndrome, hyperthyroidism (Graves' Disease) Q: What early signs should parents watch for? Abnormal growth patterns: It is important to record the height and weight of every child in a growth chart at periodic intervals. Slowing down or accelerated height or weight gain, falling off, or jumping across growth percentiles on a growth chart are all signs of an endocrine disease. Signs of diabetes: Frequent urination, excessive thirst, weight loss, bedwetting, or genital fungal infections. Puberty issues: Early signs (before 8 years in girls, 9 years in boys) or delayed signs (after 13 in girls, 14 in boys). Hypothyroidism: Fatigue, sleepiness, constipation, cold intolerance, jaundice, poor activity in newborns. Hyperthyroidism: Heat intolerance, sweating, unexplained weight loss, diarrhoea, irritability. Unusual hair growth or acne: Could indicate excess adrenal hormones or polycystic ovary syndrome (PCOS) in girls. Skin changes: Dark, velvety skin in folds (acanthosis nigricans) may suggest insulin resistance. Menstrual irregularities: Absent, delayed, or irregular periods in adolescents can point to hormonal imbalances. Q: Are there any preventive measures parents can take to avoid hormonal disorders in children? While not all hormonal disorders can be prevented, early detection and a healthy lifestyle play a key role. For example, congenital hypothyroidism can be silent at birth, so it is essential to check thyroid levels in all newborns. Early treatment can prevent intellectual and physical delays. Encouraging a balanced diet rich in fruits, vegetables, whole grains, and lean proteins is also important. Limiting sugar, salt, fats, and junk foods can help prevent obesity and insulin resistance, which are linked to various hormonal issues. Ensuring that children get at least an hour of physical activity or play each day is crucial for maintaining a healthy weight and supporting hormone balance. Lastly, regular paediatric checkups to monitor growth and development are important. Early identification of any deviations allows for timely treatment of potential endocrine disorders. Q: What are the current treatment options for children diagnosed with hormonal diseases? Treatment for hormonal disorders in children varies based on the condition but generally focuses on restoring normal hormone levels and supporting growth and development. Common treatments include: Type-1 diabetes: Managed with insulin therapy (injections or pump), regular blood glucose monitoring, dietary adjustments, and self-care education Hypothyroidism: Treated with oral levothyroxine (synthetic thyroid hormone), with regular thyroid function tests to adjust dosage Hyperthyroidism: Treated with antithyroid medications and beta-blockers for symptom relief. In some cases, radioiodine therapy or surgery may be needed Growth hormone deficiency: Managed with recombinant human growth hormone injections, growth tracking, and periodic IGF-1 testing Precocious puberty: Treated with GnRH analogs to delay puberty. Further evaluation for underlying causes, such as CNS lesions or adrenal disorders, is also necessary Delayed Puberty: Often requires watchful waiting for constitutional delays, but hormone therapy (testosterone or estrogen) may be used if a pathological cause is found or if puberty is significantly delayed Congenital adrenal hyperplasia: Managed with glucocorticoids and sometimes mineralocorticoids, along with salt supplementation in salt-wasting forms. Growth, puberty, and adrenal crisis prevention are closely monitored Q: How do hormonal imbalances affect children socially and emotionally? How can we support them? Hormonal imbalances can lead to low self-esteem and body image issues in children due to delayed growth, early or late puberty, weight gain, or excessive hair growth. This may cause social withdrawal, embarrassment, and bullying. To support them, it's important to address the underlying condition with prompt treatment, provide proper counselling, and create a supportive, understanding family environment.
New Indian Express
08-05-2025
- Health
- New Indian Express
Experts push for rabies vaccine in children before dog bites
THIRUVANANTHAPURAM: Administering the rabies vaccine before a dog bite may seem unusual to many parents. However, a rise in rabies infections among children has prompted health experts to recommend pre-exposure prophylaxis (PrEP) for all children under the age of 14 before any animal attack occurs. The Indian Academy of Pediatrics (IAP) and the Kerala Government Medical Officers Association (KGMOA) have jointly called for the inclusion of PrEP in child healthcare protocols. Providing general immunity against rabies not only helps prevent deaths but also reduces the need for expensive rabies immunoglobulin (RIG), which is administered in addition to the standard post-bite vaccine. While previously seen as an excessive measure, the surge in rabies cases and the high cost of post-exposure treatment have made PrEP a necessary intervention. Dog bite cases in Kerala have seen a dramatic rise - from 60,000 in 2013 to over 3.16 lakh in 2024. Human fatalities have also increased, with 14 rabies deaths reported so far this year, and an annual toll of 20-25 deaths in recent years. Children remain the most affected. Globally, rabies claims around 59,000 lives annually, with 18,000-20,000 of those in India. Of these, nearly 40% are children. 'Children are most vulnerable. Many have died even after receiving the vaccine post-bite due to the challenging nature of the bites,' said Dr Riaz I, president of the IAP Kerala Chapter. 'We recommend PrEP for school-going children to prevent such tragedies.' Dr Riaz also pointed out the difficulty of administering rabies serum in sensitive bite locations like eyes, underlining the advantage of pre-exposure vaccination. The KGMOA has urged the state to form a task force to implement a universal PrEP programme, starting with children. 'Over 35% of dog bite victims are children. We must prioritise them,' said Dr Sunil P K, KGMOA president.
