The Might of Mother's Milk (MoMM)!

Greetings, dear young parents!
This year, we have a lot of data from the world renowned medical journal Lancet , which I am sharing here today. If we could achieve:
i) 100% early initiation of breastfeeding in the first hour and
ii) 100% exclusive breastfeeding for the first six months
iii) Good home cooked food to complement breastfeeding from six months of age to two years of
age;
then these would be the effects seen in India:

• we could reduce1,56000 child deaths every year
• prevent 3,436,560 episodes of pneumonia
• prevent 3,900,000 episodes of diarrhea
• increase average IQ level by 3 points across all income groups.  India can add 0.6285 billion USD (approx. INR 4300 crore) annually to its gross national income, through the improved IQ. (Studies show that breastfeeding translates to better IQ, which in turn translates to better earnings in later life.)  
• Breastfeeding has the potential to reduce type -II diabetes by 35%
• Breastfeeding can reduce obesity by 26% in the 5-17 age group
• Environmental impact : Breastfeeding is a zero-emission, zero-waste process. In India, the sale of milk formulas leads to the emission of 111,226 tonnes of green house gases. (In China, this is 2,249,287 tonnes.)
• It can prevent 4915 deaths due to breast cancer (in the mother) out of a total of 70,000. (Globally, breastfeeding can prevent 20,000 deaths from breast cancer per year)

I congratulate the Government of India for:

i) starting the program MAA for the early initiation of breastfeeding and

ii) approving 26 weeks of maternity leave (by Rajya Sabha) for all working mothers, including the private sector (but not the unorganized sector yet).

SAY YES TO BREASTFEEDING! SAY NO TO FORMULA AND BOTTLES!

All About Infant Formulas

Myth: In case lactation fails, infant formulas of different makes for different age groups are the best alternatives.

Fact: Lactation nearly never fails. Breastfeeding, however, may fail, if the infant is not initiated to suckling properly. Mammary glands are modified eccerine glands, similar to tear glands and sweat glands. Breast milk is secreted only if the infant suckles properly. The more the 'emptying' in the previous feeding, the more the refilling. Breast milk also changes in composition if the baby is born prematurely, to fulfill the needs of the premature baby. Good lactation counselors are able to re-initiate breastfeeding even after gaps due to illness of the mother or other such reasons.

Let us proceed to see as to what are the ingredients of infant formulas. Most of the parents that I have met during my 35 years of practice seem to believe that these formulas are "special". The fact is, that all of them are processed from cows' and buffaloes' milk. The first step is to separate cream/fats and sell it separately at a high price. The remaining milk is called 'skimmed milk', which for many rich milk producing countries is a by-product. This milk is spray-dried and made into skimmed milk powder (SMP), which is very cheap. My research showed that all different formulas have SMP as a base ingredient. Now, inexpensive vegetable oils (some of them suspected to be from GM seeds) are mixed with the SMP base. Many of them have maltodextrins and some micronutrients . When we taught nutrition in our M.D., these additive ingredients were not mentioned anywhere. They are propagated only by the formula industry and are not proven to have any beneficial effects.
Many young parents simply believe the formulas to be beneficial simply because of the name of the multinational attached without ever having read the ingredient label!
Recommendations: The IYCF program in India recommends the following priority order for neonates and infants:
1. Own mother's milk
2. Other mother's milk (Human Milk Bank/Wet Nurse)
3. Fresh boiled bovine milk
For complimentary feeding after six months of age, home cooked multi ingredient food should be used as it is far more nutritionally superior to packaged cereals.

For reference of ingredients of some popular infant formulae, please visit the links here:
https://www.amazon.in/Nestl%C3%A9-Starter-Infant-Formula-Probiotics/dp/B00I4SZJUG

https://www.amazon.in/Nestle-Nan-Pro-Infant-Formula/dp/B00HQFRQRC

https://www.google.com/imgres?imgurl=https%3A%2F%2Fbrucebradley.com%2Fwp-content%2Fuploads%2F2012%2F11%2FFormulaGerber.jpg&imgrefurl=https%3A%2F%2Fbrucebradley.com%2Ffood%2Fbabys-first-encounter-with-big-food%2F&docid=gfTeXXED-KXXDM&tbnid=sA2Q2DhZbMN1TM%3A&vet=10ahUKEwiXn9fRzbfmAhXi7HMBHRbMCMQQMwhsKAEwAQ..i&w=1024&h=768&bih=625&biw=1280&q=infant%20food%20ingredients&ved=0ahUKEwiXn9fRzbfmAhXi7HMBHRbMCMQQMwhsKAEwAQ&iact=mrc&uact=8

https://www.arlafoodsingredients.com/industries/early-life-nutrition/early-life-nutrition-ingredients/ingredients--concepts/infant-nutrition/

For further information on breastfeeding and complementary feeding, please visit: http://www.bpni.org/

For risks involved with formula feeding and bottle feeding, please visit: http://www.infactcanada.ca/RisksofFormulaFeeding.pdf

Please do not buy into the marketing tactics and feed a sub standard product to your child. In poor tropical countries like India, another concern is about sterility of baby food. While fresh milk is usually boiled before feeding and thus made sterile, formulas are not boiled after reconstitution and run a risk of infection. Complementary foods made at home are not only cheaper, but superior in all aspects. 

Doordarshan News: BPNI experts talk about breastfeeding scenario in India

Please see the full report from DD News here: https://www.youtube.com/watch?v=HZrMqZlzi2g&feature=youtu.be

We continue to urge mothers to breastfeed their new born baby within an hour of being born.

Melinda Gates says Breast Milk is a miracle potion

Hindustan Times recently published this interview with Melinda Gates in which she quotes the benefits of breastfeeding your child. It is ironical that WABA (World Alliance for Breastfeeding Action), the organisation which started the whole concept of breastfeeding promotion week, gets no mention. Neither does BPNI(Breastfeeding Promotion Network of India) or IBFAN (International Baby Food Action Network). These organizations have been promoting and educating people about the benefits of breastfeeding for a good thirty years now. But of course, it takes an American billionaire to be heard! This is a bittersweet moment. I am thankful that Mrs. Gates has taken up the right statistics and is making and effort to educate people. But I am disgusted that our media houses refuse to publish the exact same thing when it comes out of Indian agencies!
However, the facts are out- breast milk IS the best food for your newborn.

All about vaccinations

Vaccinations are essential preventive medicines, which have greatly reduced infant mortality rate. India has been proud to be polio-free because of government policies to make the polio vaccination essential for every child under five years of age.
However, there is now a plethora of vaccinations available and this post is an attempt to the guide the parents to make a good choice. Here are the facts:

1. Manufacturers claim efficacy figures (say, 85% with one dose or 93% with two doses etc.) and also report side effect figures (say, 1 in 10000 patients report a side effect). These figures are not easily understood by the consumer into their own context.

2. Vaccinations are effective only if more than 85% of a large sample set (e.g. an entire nation) benefits from taking the vaccination over a long period of time. (For example, if a vaccination was tested on only 200 people claims an efficacy of 90% for one year, it does not mean anything). They are not individual treatment drugs (except the Rabies vaccination).

3. The usual cry of "if you can afford it, why not take it?" is  fraudulent method of pushing non-essential expensive (and in many cases, inadequately tested) vaccines to rich parents. The immunization acquired due to large-scale immunization (called "herd immunization") cannot be achieved by immunization of a select few of the population.

4. Vaccinations are drugs, and require a clinical trial. The only licensing authority in India is the Drug Controller General of India(DCGI). Imported vaccinations also need to be re-licensed by the DCGI. "WHO Prequalification" is NOT an adequate license to sell in India.

5. Ministry of Health (Government of India) is the only authority that notifies inclusion of a vaccinations in the Indian Immunization Programmes. In case of epidemics like Swine Flu, please visit a government hospital. Do not blindly take individual vaccination. A few months ago, there was much hue and cry about a swine flu breakout. Many of those cases turned out to be common cold/ flu. The only beneficiary of this public scare were the vaccine manufacturers, who got rid of their near-expiry stock.

In conclusion, please stick to the immunization schedule listed by the health ministry. Mission Indradhanush lists the seven vaccinations which are absolutely essential : diphtheria, whooping cough, tetanus, polio, tuberculosis, measles, HIB and hepatitis B. In addition to these, tetanus and rabies vaccinations may be administered in case of accidents and mammal bites respectively.  Do not fall prey to powerful MNCs pushing unnecessary expensive vaccinations under the garb of philanthropy. Exclusive breastfeeding is proven to boost immunity against many types of pneumonia and against many viruses and bacteria that cause diarrhoea, leading to the hypothesis that breastfed children may not require a rotavirus vaccination.  

Update: GOI has announced four more vaccinations to included in Indradanush programme soon.

Maggi and the trend of unhealthy snacks

Recently, Maggi has been thrown into the news for having high MSG content. MSG(Mono Sodium Glutamate) is the Sodium salt of Glutamate proteins- a common flavour enhancing additive that has many ill effects on health and many studies have linked it to diabetes. (some facts here: http://www.msgtruth.org/whatisit.htm)

Even without MSG concerns, Maggi/instant noodles are NOT a healthy snack, not even the "atta" or "oats" variants. They are highly processed foods that are carbohydrate-heavy: they do not provide the essential vitamins, minerals or  fibre required for a growing child. Nor do they have significant amounts of protein. It is much better to use grain which are less processed- like wheat and rice, as found in any Indian home, to make fresh healthy food for your children. Even other snacks, like biscuits, wafers and chips are over processed and have a lot of fats and carbohydrates and not enough nutritional value. No wonder our cities have shown such an increase in the number of overweight children!

Nestle products have come under questioning worldwide many, many times. But these are multinational corporations that have the wealth and power to get away with it most of the time. Even the Indian government policy advocates fresh home-cooked food for children. Keep your child's snacks simple and fresh- a well washed apple or a home cooked soup is any day a better snack than the over marketed, well-advertised packaged food that tries to lure us in.

Wasteful Expenditure on Child Health: Skincare

Skincare for Newborns

Scenario: The massage of newborns has been practised since time immemorial. It is believed that massage helps strength of muscles and bones. This wrong belief led to mushrooming of tens of brands of baby oils and baby cosmetics. To the contrary, in tropical countries, pediatricians have been observing more and more allergic dermatitis and seborrhoeic dermatitis.

Fact: A multicentric review article on neonatal skincare published Indian Pediatrics July 2010 issue clearly states that neonatal skin should not be rubbed at all because of loose connection between upper layer of skin (epidermis) and the lower layer of skin (dermis), as friction can cause blisters. Oil application on scalp can lead to blockage and hence swelling and infection of natural oil glands (sebaceous glands) and lead to seborrhoeic dermatitis. The crusty itchy deposit that you may have noticed on an infant's head is a result of excessive oiling of scalp. All baby soaps or shampoos are synthetic detergents, disguised under the label  'syndets'. But the consumer should notice that they claim only about having a pH matching that of human skin (balanced pH). They don't at all mention allergenic potential of all the chemicals in the ingredients.

For the consumer's interest, an MLA of Maharashtra, many years ago, had admitted a single line PIL against a big MNC asking “please tell us as to what is 'baby' in your product”? (http://articles.economictimes.indiatimes.com/2005-03-16/news/27489620_1_fda-commissioner-the-fda-baby-product) Till today, there has been no answer. Recently Maharashtra FDA terminated the license of a famous company as carcinogens and allergens were found in its baby talc. (http://www.mumbaimirror.com/mumbai/others/Johnson-Johnsons-licence-for-cosmetics-cancelled/articleshow/19760664.cms). The aforementioned article in Indian Pediatrics concluded by cautioning against the use of any synthetic detergents or baby oils. Only coconut oil is recommended, that too, only in winter, never in hot and humid weather (which prevails for a long time in a large part of our country). It is sad that even this very scientific article was supported by a grant from Johnson and Johnson. No funding was received for writing this blogpost though!

In summary, neonates need to be bathed (splashed) only with plain clean water. No rubbing should be done on skin. Wrap and dry them in plain cotton sheets (preferable over rough towels). No soap, detergent, talc or oil should ever be used during first couple of months. Skin health is maintained by internal nutrition, i.e. Exclusive breastfeeding for first six months and thereafter adequate complementary feeding with home cooked foods. Benefit of “kinesthetic stimulation” can be achieved by gently pressing leg and arm muscles while feeding.

Baby oils, talc, soaps and other cosmetic products are wasteful expenditure worth thousands of rupees. They cause discomfort to the newborn and take another couple of thousand rupees for treatment, all of which is completely avoidable.

Child Friendly School Initiative Program (CFSI) under IAP Action Plan- 2011

Children spend an immense amount of time in school. It is our duty to make this wonderful place of learning safe and enjoyable for them. To do the same, Indian Academy of Pediatrics had formulated a 5 point action plan, which was published in March 2011, Volume 48, Number 3 issue of the Indian Pediatrics journal.

These are the 5 points of action, as given by Dr. T.U. Sukumaran, President of IAP-2011:

1. No physical punishment in school: The physical punishment may do more harm than benefit. However in unavoidable situations, the child may be punished by other non-physical methods.

2. Avoid excess baggage: Excess weight of the school bag may lead to backache, neck pain, school phobia etc ("The School Bag Syndrome"). The ideal weight of the bag should be less than 10% of the child's body weight. Bag weight can be reduced by many methods: (a) The age of admission for KG class should be 4 years and first standard 6 years, (b) in lower primary classes bag weight can be reduced by having a provision for keeping books in the school (c) for different terms we can have separate textbooks (d) a file system is an effective method in higher classes.

3. Provision for adequate number of toilets: There should be at least one urinal per 60 students and one latrine per 100 students, with provision for daily cleaning.

4. Provision for safe travel: Travel to and from the school should be safe. Travel in two and three wheelers should be discouraged and overcrowding to be avoided.

5. Well equipped class rooms and adequate play grounds: The number of students in a classroom should be limited to 40. The class room should have enough space (10 square feet/student or 400 square feet/classroom) and there should be appropriate furniture and proper ventilation. The school should have an adequate playground and a minimum of 4 hours per week to be allotted for sports and cultural activities.

These five simple provisions are still not provided in many of our schools. Schools play a major role in the successful upbringing of a child and should facilitate a healthy childhood.

Disclaimer: These 5 action points are published in the journal Indian Pediatrics as cited above. I do not have the copyright to them. I am merely trying to popularize them among more people. 

Annexure to Tonics and Appetite Stimulants

Cyprohepatidine was introduced in Indian market about twenty years ago as an anti-allergic drug. It was promoted across India by the pharma industry using aggressive marketing. After some time, it came to be known that this anti-allergic agent was extremely sedating, indicating potential toxicity to the brain. Also, it was discovered that its therapeutic dose/toxicity ratio was very low. As a result, it lost popularity.

During post-marketing surveillance, it was revealed that the drug increases appetite as one of its side effects. The industry was quick to start marketing  it as an appetite stimulant.As the drug was originally licensed as an anti-allergic, its use as an appetite stimulant is irrational as well as illegal. If a new clinical effect is discovered by chance, then according to provisions of rule 122 of Drugs and Cosmetics Act of India, the drug must undergo a re-trial.

Alert: Cyprohepatidine is too toxic a drug to be used as an ingredient in appetite stimulants. As such, all appetite stimulants are irrational. This drug is not marketed as an appetite stimulant anywhere else in the world and has been withdrawn as an anti-allergic too. 

Nestle in trouble for violating the IMS Act

Tehelka's coverage of Nestle violating the IMS Act : www.tehelka.com/infant-milk-substitutes-act-violation-nestle-haryana-congress/

Please do read it!

Wasteful Expenditure on Child Healthcare: Tonics and Appetite Stimulants

Scenario: Close to 95% parents routinely demand tonics or appetite stimulants from their pediatricians, especially after recovery from an infection/ illness.

Fact: Good appetite is a sign of well-being. It is natural, therefore, that it will be reduced whenever the child is ill (barring exceptions like diabetes, where appetite increases). Appetite will be naturally restored once the underlying disease has been treated. Not surprising, therefore, that our standard textbooks of medicine and pharmacology, have no mention of appetite stimulants. Treat the underlying illness and the appetite will come back. To make up for weakness, increase in the intake of normal balanced diet- this is what we were taught. Indian market is flooded with hundreds of such formulations which sell on the wrong beliefs (peculiar to Indians that such tonics are beneficial). Beware of alcohol in these concoctions which might give feeling of false well being. These are not even manufactured in most countries of the developed world. The marketing gurus took advantage of the Indian psyche and designed these bottles long-necked to resemble a giraffe -symbolic of tall height, a trait that many parents want in their child. We fell prey to such gimmicks.

Further: Drugs labelled 'tonics' are fake and are not recommended. But there are some which contain Iron. These re the beneficial ones and essential to Indian children as close to 80% of Indian women and children are anaemic. These are called 'haematinics' (not tonics). A good haematinic should contain an Iron salt equivalent to 20-30mg of elemental Iron per 5mL of syrup or 50-100mg per tablet (or capsule) for adults. (Cheaper ones are as good as more expensive ones). Dosage must be exacted for each individual as Iron can be toxic in overdose. So- NO SELF MEDICATION, PLEASE.

If a child does not eat well,this can be because of one or more causes:
1. True disease: In this case, get the disease diagnosed and treated
2. Force-feeding leading to food rejection: Never force feed your child.
3. Child having eaten few pieces of candy/chocolate/chips/other junk food just before mealtime: Junk food ruins balanced meals. Parents should propose the condition to the child that a good meal will be ended by sweet dish (one piece of chocolate/candy etc). Young children should not set conditions that they will eat the meal after they get to eat the junk food!
4. Big NO to feeding while watching TV.
5. Starting from breastfeeding, feeding should be child-guided and on demand. Don't follow the clock too strictly.
6. Meal-time behaviour disorders are usually coupled with general indiscipline which is a part and parcel of what we call 'spoilt child syndrome'. To correct this, parents/family are given counselling on one on one basis.

To summarize, appetite stimulants and tonics are useless/unneeded. These are sold mostly in India. Lack of health education, tendency to look for shortcuts and a 'pill for every ill' culture prevalent in our country is propagated by qualified doctors and quacks alike.
Outdoor Play and exercise are the best known appetite stimulants to my knowledge and belief!

Wasteful Expenditure On Child Health: Teething Aids

Teething is an important milestone in childhood and is thus a part of normal growth pattern. Unfortunately, it is often linked to many signs and symptoms , for which many medications are erroneously given to children.

Symptoms wrongly attributed to teething	Medicine/Intervention Commonly Used
Pain in the gums	Teethers/ teething gels
Headache	Hair oil and massages
Fever	Various antibiotics and analgesics
Diarrhoea	Ghutti/gripe water, anti diarrhoea medication
General, to ease teething	Calcium preparations (allopathic/homoeopathic)

Fact: Teething is a natural process. Medical textbooks do not mention any medical intervention for teething. Medical science interprets teething as a signal for the child being ready to eat solid food and it advocates initiation of “complimentary feeding”. A normal infant will usually have four to five episodes of viral diarrhoea and four to five episodes of viral respiratory infection, both associated with mild grade fever and headache. As teething is a long drawn process, so people misinterpret coincidence as correlation , but teething does not cause any of these symptoms. Oil massaged on head cannot in any way affect gums! Massages are enjoyable to all mammals, so it is no surprise that infants enjoy it too. I have seen infants developing scalp irritation because of excessive oil application. Expensive almond oil and fancy baby oils are both irrational.

Calcium preparations are heavily overprescribed and mostly irrational. Homoeopathic Calcium medicines for teething are labelled “Made in Germany” but are in fact not even licensed to be used in most of Europe! It is better to give children stainless steel home utensils (with smooth, rounded edges) in place of teethers.

Conclusions: Teethers, teething gels, expensive massage oils and calcium preparations for facilitating teething are all wasteful expenditure on child health.

To my mind, “tooth eruption” is a misleading term. Teeth do not erupt like volcanoes! They are gently unveiled out of gums as the jaw grows.

Wasteful Expenditure on Child Health : Gripe Waters and Ghuttis

Myth: Gripe water/ ghutti are routinely administered to newborns and infants in the belief that they will improve digestion and relieve abdominal pain.

Fact: Exclusively breast-fed children do not require any additional nutrition for the first six months. If the child is bottle/formula-fed, the child will have more diarrehoa and tummy upsets, but ghuttis and gripe water will not help anyway.

Answers to common queries:

• My child has writhes and his/her face turns red. Does this mean he/she has abdominal pain?
  These writhing movements are normal “ choreoathetoid” involuntary movements during infancy, and in fact show normalcy of the neonate. These do not require any medication. Breastfed children are not likely to have abdominal pain. Excessive crying in otherwise normal infants is usually due to fever, defective “latch on” while suckling and hence inadequate milk intake (for details, visit www.bpni.org . You can also find manoeuvres to treat colicky crying on this site). 
  
  
• Why do elders say that ghuttis/gripe water aid in comfortable sleep?
  In the '80s, while working with committee for protection of child consumer , Indian Academy of Pediatrics, our group found that many gripe waters had alcohol content. Many ghuttis were found to contain opium. The children were sedated into sleep, leading to false belief that these aid in comfortable sleep. One of the gripe waters had so much alcohol that three teaspoons of it to a newborn was equivalent to one pint of beer consumed by an adult! We campaigned and got alcohol and opium removed from gripe water and ghutti.

Further : A newborn has reverse sleep pattern, i.e. they sleep during day and are wakeful during the night. All crying in infants does not indicate pain. Crying is the only means of communication a newborn has.

Excessive crying in neonates may be normal communication, fever (for which your doctor will prescribe paracetamol in appropriate dosage) or unexplained colicky crying (for which simple manoeuvres are sufficient).

Ten-twelve stools per day in breastfed children is not indigestion.

Ghuttis/gripe waters are an avoidable wasteful expenditure on child health.

Formula/bottle-fed children tend to have more infective diarrhoea and abdominal pains. Ghuttis/gripe water will have some carminative effect, but that is not a real treatment of any infection. Infections should be treated by a doctor.

Warning: Any medicine that is labelled “elixir” could have alcohol in it and most of the therapeutic effect might be attributed to alcohol rather than other ingredients.

How much sugar is your child drinking?

Packaged drinks tend to have a lot of sugar in them and not many parents realize how addictive it can be. I came across this wonderful picture on http://en.ilovecoffee.jp/posts/view/120 which illustrates how much sugar goes into some popular drinks. Although it was made in the American context, I think it is useful here as well:

Disclaimer: I don't have any rights over this image. It was created by the artist Ryoko at en.ilovecoffee.jp. I am merely sharing it since I believe this is something every parent should know.

The pomegranate myth

Myth: Pomegranate/ pomegranate juice increases haemoglobin or blood

Fact: Pomegranate does not have much iron, so it has little or no effect on blood.  ( Full nutritional details of pomegranates can be read from here : en.wikipedia.org/wiki/Pomegranate#Nutrients_and_phytochemicals) 

Further: Children should be given whole fruit and as many different types of fruit as they are willing to eat.

Yellow fruits like mangoes and papayas for vitamin A, citrus fruit like oranges, guavas and 'ber' for vitamin C. From six months to two years, children require many calories for growth, so they should be given thick, cooked gruel like cereals, pulses, khichdi, cooked green vegetables etc. Cooking is recommended because it destroys germs. Fruits can be risky because if overripe, they can cause infective diarrhoea. 

While pomegranates are delicious, there are many other inexpensive fruits and vegetables that provide far more vitamins and minerals. 

Baby Walkers: Dangerous and Detrimental

Baby walkers are used in the belief that it would help in learning how to walk.

Fact: Use of walkers delays natural walking, as the weight falls on the pelvis and children learn to push it with both feet. Children takes steps (natural walking) only when weight falls on the soles of the feet, preferably naked feet. 

Further: Walkers have been officially banned in the UK (http://news.bbc.co.uk/2/hi/health/735786.stm) and many other countries (for example, Canada: https://ca.answers.yahoo.com/question/index?qid=20130724063326AAqedWZ) because of risk of injury due to toppling, especially from staircases.

Mild lip and gum injuries are common, while serious head injuries may also occur (which caused the ban).

You can also read about dangers of baby walkers in the New York Times: http://consults.blogs.nytimes.com/2010/02/22/the-dangers-of-baby-walkers/?_php=true&_type=blogs&_r=0

Medicine for Children

Children cannot be treated as miniature adults. Therefore, medication for children have different specifications. A medication for adults cannot simply be “scaled down” to become a children's medicine by merely reducing the dose. Ideally, a paediatric drug should be separately tested for safety and efficacy in different age brackets. For example, 0-7 days / 7days-1month / 1month to 1year old children etc. , but this is seldom done. There are some drugs which are allowed for adults but are banned for paediatric use. Let us take the example of two such medicines -

1. Ofloxacin : Allowed for adults but not recommended for children under 18 years of age. It is not even listed in authentic PDR (Physician's Desk Reference), but is heavily prescribed and also dispensed without prescription in India for common infections. The syrup form is even labelled “for paediatric use”, which just illustrates the dismal state of drug regulation. Please beware!
2. Nimesulide : It was banned in dozens of countries about four years ago due to a cases of liver failure reported in the United Kingdom. Yet, it is continued sold with and without prescription in India, even after being banned for children after prolonged efforts consumer activists.

Please, do not self-medicate your child! Please cross-reference safety and efficacy of children's medication from the internet, reference books or package inserts. Don't rely entirely upon your doctor or the pharmacists. Many developed countries dump their discarded drugs into the developing world.Many freely available drugs are not suitable for children.

Introduction

I am an MD paediatrician (Registration Number: MCI2919) with 35 years of professional experience and 25 years of work in protection of child consumer, some of which was done as a member of Committee for Protection of Child Consumer, Indian Academy of Paediatrics. I was motivated by reading a chapter on child advocacy in one of my textbooks way back in 1977. It was stated that as children cannot speak for themselves, every qualified pediatricians must speak for them , in matters that adversely affect or pose a danger to their health, be it medicines, toys, clothing, toiletries/cosmetics, electrical fittings or baby food. In my day to day practise, I have found that at present there is no organization that is willing to undertake this awareness campaign. The reason is obvious- the money involved in marketing children's products is enormous. No individual can counter the propaganda and misinformation of multinational giants that pump out advertisements, inducement and commissions offered for sale of these products especially vaccines, medication and cosmetics. The intention of this blog is to disseminate authentic information with references as well as personal clinical experience.

I, Dr. Dinesh Khosla do hereby swear in full adherence to Medical Council of India's code of ethics that I have not for past years, and will not in future accept any financial inducements in cash or kind, from any manufacturer of children's consumer goods.