Does your heart skip a beat when you spot an angry looking rash on your child’s tender skin? Well breathe easy, as most common childhood rashes are harmless and completely treatable with simple over-the-counter remedies.

Staring from birth, all good mothers make a daily ‘inspection’ of their baby’s skin, often without even realizing it. In an infant, a scaly scalp and diaper rashes are the most bothersome ailments.
Yellow, greasy looking and sticky scales on the scalp of a new born, is a form of dandruff, which often subsides on its own in a few month’s time. Use a gentle shampoo to wash off the scales, and if that doesn’t work, then use a 1% Nizoral shampoo, diluted in equal parts water, once or twice a week, till the scales come off. You can also try gently massaging the scales away using light coconut oil. However, do not leave the oil on the scalp, as that can worsen the scaling. Diaper rash occurs from using non-absorbent diapers, or leaving on a diaper too long, or from not keep the diaper area dry and clean. In some cases, the child might be allergic to the chemical fragrance of a disposable diaper, or the detergent used to wash a cloth diaper. It can get worse, if your child suffers from diarrhea, or if his eating habits have recently changed. The best defense is to change diapers at regular intervals, keep the area clean and dry, and let the skin breathe for a few hours. If your child has already developed a rash, then use the Sebamed diaper rash cream along with plain zinc oxide paste from the pharmacy. Use a slightly larger diaper, and allow your child’s bare bottom to breathe for a few hours everyday. A plastic sheet will protect your flooring and mattress.

Insect bite rashes usually start after the age of 2, and tend to come on and off till the age of 8 or 10, till your child’s body overcomes the allergy. The rashes are not from the bites alone, but from the allergy that is triggered from these bites. Flying insects like mosquitoes, leave bites on the exposed hands and feet. Crawling insects like fleas and bedbugs leave bites on the back and tummy. Use the Johnson&Johnson OFF® cream, which is an insect repellant safe for use in toddlers. Keep your child well covered in full sleeved clothes while playing in the evenings, especially during the summers. If you have a pet at home, make sure your pet is regularly examined by a veterinarian.

Microscopic mites cause an intensely itchy rash called Scabies, which occurs on the fingers, navel, underarms and buttocks. Scabies is contagious, and eventually, every member of the family, and several of your child’s friends will develop a severe itch. If multiple members of the household are suffering from itching, then visit your GP. The entire family may have to use an anti-mite cream like Elimite, and all clothes and bed linen may have to be washed in hot water and detergent.

Head Lice infestations spread quickly. So if you notice lice in your children, inform their school about a possible outbreak. For milder infestations, you can try to get rid of the lice manually, and use lice combs to get rid of nits (lice eggs). I would personally suggest that you use an anti-lice shampoo like RID, not just for the affected child, but for all members of the household. Apply petroleum jelly above eyelashes, if there are nits in the lash area. Get pest control done for your home once a year.

Heat rash, or prickly heat is the appearance of small itchy red bumps on the folds of the skin, or on the back, when your child’s skin overheats in summers. Avoid dressing your child in layers during the summer. Use lotions instead of cream to moisturize your child’s skin in summer, and avoid moisturizer altogether until the rash subsides. Avoid using vaporizing cough rubs on the body; this can worsen the heat rash. A heat rash is a sign that your child’s body is getting too warm, so keep your child in cooler environs, and give plenty of fluids, to avoid a heat stroke. Bathe your child in cool water, adding a spoonful of baking soda to your child’s bath tub. Keep nails short to avoid scratch marks and tears in the skin. A light dusting of cornstarch to dry skin, immediately after the bath, is helpful. Use calamine lotion over the rash, to soothe the irritation.

Does your child have dry, itchy, reddish and sensitive skin? Does your child complain of itching or irritation in winters or with woolen clothing? Does this child also have wheezing? It is possible that your child suffers from Eczema, a non-contagious condition that is part hereditary, and part allergic. Eczema, hay fever (dust/pollen allergies) and Asthma tend to run in families. During infancy, the eczema limits itself to a dry rough rash on the face. As your child starts growing up, you notice a dry scaly itchy rash on the inside of the elbow or the back of the knees. Children who were not exclusively breast-fed for the first six month’s of their life, are more likely to develop Eczema. In my experience, the right skin care regime is all that is needed to keep Eczema at bay. Bathe your child in lukewarm water, only once a day, using a non-soap cleanser like Cetaphil® cleansing lotion. You can add non-perfumed bath oils to the bath water. Seseme oil or Aveeno bath oil is a good choice. Avoid bubble baths. Baths must be quick (within 3-4 minutes), use soft towels to pat (not rub) the skin dry, and bland, non-perfumed moisturizing cream must be applied within minutes of the bath. Paraben free creams like the Sebamed kid’s cream or Exederm baby moisturizer are good buys. Moisturizer must be reapplied more frequently in winters. Avoid denims, silks and synthetic garments. If the rash persists, then insist on meeting a dermatologist, and not a GP. Dry white patches on the face are also due to eczema, which worsens in strong sunlight. Do not use sunscreens in children less than 2 years of age. Deworm your child with Mebendezole tablets once a year. Try the Banana Boat kid’s sunscreen or La Roche Posay Anthelios Pediatrics Spray for older children. Use an aloe-vera gel to soothe sunburns. Always apply sunscreen on your child during sports meet or swimming classes.

Are there skin rashes in children which could be potentially dangerous? If the rash is associated with fever, body ache, red eyes, throat pain, joint pains and/or gland swellings in the neck or pits, then it is usually a sign of a viral fever. The rashes tend to appear all over the body, starting from the face, then spreading downwards. If your child develops a fever, followed by appearance of rash, visit your dermatologist without delay. Keep your child isolated in a separate room, away from his/her siblings. If you’re pregnant, then inform your gynecologist about your child’s rash, and have them speak to your dermatologist as well. Talk to your pediatrician about vaccine options for your other children. Viral rashes usually disappear on their own in a week to ten days. Until then, your child needs bed rest, nutritious food, lots of fluids, Tylenol for fever or pain, and Cetrizine syrup for itching. Apply Calamine lotion on the rashes. DO NOT give Aspirin to children, as it can cause serious brain and liver damage. If you notice chicken pox rashes near the eyes or nose, then consult an Ophthalmologist. Children with Asthma or Diabetes must be monitored closely by a physician during this time.

Lastly, let me add a quick note on ear piercing. I am not in favour of the age-old Asian and Middle Eastern practice of piercing a girl’s ears while she is still a baby! Wait for 6-7 years, let your daughter come to you asking for earrings. That’s when you know she is ready! Get the piercing done by a dermatologist or a registered nurse, using the ear piercing gun, and follow your doc’s instructions to avoid infections. Make sure that your child is fully immunized against Tetanus, as per her age. Use only gold studs for the first month, to avoid allergies.

There are some questions a young mother has always wanted answers to, but was too afraid to ask her busy doctors. There is a lot of confusion and misinformation when it comes to basic issues of skin care and grooming in infants and children. Your dermatologist is best equipped to address your concerns. Read on, for advice from the experts

1) What kind of toiletries and skin care products does my child need?
Soap-free and detergent-free liquid cleansers with a pH of 5.5 are ideal for infants and children, especially if they have dry skin or eczema. Cetaphil products are recommended by most dermatologists. You can add non-perfumed bath oils to the bath water. Seseme oil or Aveeno bath oil is a good choice. Bubble baths are meant to be treats and not a daily routine, as the chemicals and perfumes in bubble bath can irritate the genital area of young children. SLS free baby shampoos are mild, do not cause eye watering and are safe for daily use.
Moisturizers must be fragrance free, containing vegetable oil or lanolin. Sebamed and Aveeno products are very good. Use lotions in summer and creams in winter. Bland petroleum jelly or cocoa butter are free from toxins and preservatives and are best suited for kids with itchy and ultra-sensitive skin. Baby oils and paraben containing cold creams can make your child’s skin darker in the sun.
As a rule, dermatologists recommend “no sunscreen” for baby’s less than 6 months of age, and it is ‘preferably avoided’ in children under 2 years of age. If your baby is out in the sun, use a cap and umbrella. Full-sleeved clothing helps as long as it’s a comfortable fit, light-weight and breathable. For kids under the age of 2, try a calamine or zinc based sunscreen. After the age of 2, you can use sunscreens suitable for kids. Banana Boat, Vichy, Sebamed and La Roche Posay have sunscreens meant for the pediatric age group.
Talcum powder is useful to absorb moisture in the nappy area. They can prevent maceration in the skin fold of baby’s who have very fragile skin. Boric acid in talcum powders can cause vomiting, diarrhoea, lung inflammation and seizures in baby’s. Accidental inhalation is a potential hazard so I would not use a powder puff and I would only use talcum to powder a baby’s bottom or rub some around the neck fold and armpit using my fingers.

2) Does my little one really need oil massages?
Infant massage is an age old tradition which has passed down generations and has stood the test of time. It is a good way for mother and baby to bond with each other. And it also has multiple health benefits like strengthening the baby’s muscles and joints, improving digestion, colic relief, relief from teething pains, facilitating sleep, improving circulation and building your baby’s immunity to fight infections. Ask an elder in the family to teach you how to massage your infant, or learn it online from the innumerable videos available on the internet. Use mineral oil (like Johnson’s baby oil) if your baby has normal skin. Use olive oil or almond oil if your baby has dry skin. Do not apply oil inside the baby’s ears. Massage should be followed by a bath to wash off excess oil.

3) My baby was born with a lot of body hair. What can I do about it?
All baby’s are born with fine downy “lanugo” hair. It protects fetal skin from shrivelling up in the hot amniotic fluid. This hair falls off on it’s own in a year’s time, and in some cases, it may persist till the 2nd or 3rd year, especially if excessive body hair runs in your family. In some Asian countries, mothers use a wet mix of flour and milk with a pinch of turmeric and almond oil to rub onto the baby’s skin and pull out the hair. This is only a temporary fix and the hair will grow back every time the exfoliation is discontinued. It can also irritate your baby’s sensitive skin, so dermatologists do not endorse this practice.

4) Tell me something about good diaper habits.
Diaper rash occurs from using non-absorbent diapers, or leaving a diaper on for too long, or from not keeping the diaper area clean and dry. In some cases, the child might be allergic to the chemical fragrance of a disposable diaper or baby wet wipes, or the detergent used to wash a cloth diaper. It can get worse if your child suffers from diarrhoea, or if his eating habits have recently changed. The best defence is to change diapers at regular intervals, and kept the area clean and dry. If your child has already developed a rash, then use Decitin diaper rash cream along with plain zinc oxide paste from the pharmacy (for eg. RashFree cream). Use a slightly larger diaper, and give your baby’s bottom some “air time” for a few hours every day. A plastic sheet will protect your flooring and mattress. Your dermatologist may prescribe an anti-fungal cream for a few days to treat super-added yeast infections.

5) How should I take care of my baby’s teeth and gums?
Teach your child to develop and maintain healthy oral habits from an early age. For baby’s younger than 6 months of age, wrap a clean wet cloth around your index finger and use it to wipe your baby’s tongue and gums clean. Teething rings should be cleaned regularly and chilled before use. When the first tooth comes in, use a soft bristled tooth brush without tooth paste and continue massaging gums and teeth with a clean wet cloth. Make your child’s first dental appointment by his first birthday. Brown or white stains on the teeth indicate dental decay, and must be treated quickly or they may damage the permanent teeth as well, even before they appear. You can start using baby toothpaste after 18 months of age, in consultation with your local dentist on brands with or without fluoride. Do not let your child fall asleep with a bottle or pacifier. By age 3, your child should be completely weaned off the bottle, pacifier and/or thumb sucking. Brush their teeth twice a day, and ensure that they do not swallow the paste (you can do that by cleaning out their mouths with a clean wet cloth). By age 6 or 7, your child will be able to brush on his own.

6) My little girl is losing a lot of hair, what can I do?
The ‘100 hair a day’ rule applies to kids as well and in 9 out of 10 cases, these fears are largely exaggerated. However, temporary hair shedding can be noticed in children after a period of illness or psychological stress. Anemia, malnutrition and thyroid disorders can also cause hair fall in children. Sometimes the hair fall could be caused by fungal infections of the scalp or a medical condition known as ‘diffuse alopecia areata’. These conditions can only be diagnosed by trained dermatologists. Cancer and trichotillomania (compulsive hair pulling) are rare causes of hair fall in kids. The MOST common cause of hair thinning in young girls is generally a result of tight hair braids, tight clips, rubber hands and pony tails!

7) Which insect repellent cream should I use for my kids?
Insect repellent creams contain a pesticide called DEET, which is not safe for daily use in kids. Try an herbal alternative, or get an insect repellent bracelet for your kid. If you wish to make your own insect repellent lotion at home, use lemon juice, apple cider vinegar or witch hazel diluted 1:1 in boiled water, as a base for your homemade concoction. These ingredients also act as preservative, so your potion will last a couple of weeks at least. Add 15 drops of eucalyptus oil (for kids older than 3 years), lavender oil, citronella, lemongrass, peppermint oil and/or neem oil. Place this preparation into a spray bottle for easy and convenient use.

8) When can I get my daughter’s ears pierced?
The earlier you get it done, the wiser. Baby’s between 4-8 months of age are less likely to struggle and the ear piercing can be done smoothly and without accident. The skin of a young infant heals a lot faster as well. Wait for at least 4 months, so your child can get 2 tetanus shots before she gets her ears pierced. If you have not done it by then, you can always wait till your daughter is old enough to ask for it. Older girls are responsible enough to care for their own studs and keep their hands off it. Always mark the lobes first and ensure that you are completely satisfied with the position and symmetry of the markings. Gold, titanium and nickel-free stainless steel studs are the safest to use. Clean the pierced area with alcohol swabs and apply antibiotic cream for a week after the piercing. Leave on the initial stud for 2 months at least, as the freshly pierced skin tends to contract as it heals. Prefer studs to hoops as the stem is thicker, so the hole won’t close up or shrink. Consult a dermatologist if you notice swelling, redness, pain or pus discharge which persists for more than 2 days after a piercing.

9) My child gets prickly heat every summer.
Heat rash, or prickly heat is the appearance of small itchy red bumps on the folds of the skin, or on the back, when your child’s skin overheats in summers. Avoid dressing your child in layers during the summer. Use lotions instead of cream to moisturize your child’s skin in summer, and avoid moisturizer altogether until the rash subsides. Avoid using vaporizing cough rubs on the body; this can worsen the heat rash. A heat rash is a sign that your child’s body is getting too warm, so keep your child in cooler environs, and give plenty of fluids to avoid a heat stroke. Bathe your child in cool water, adding a spoonful of baking soda to your child’s bath tub. Keep nails short to avoid scratch marks and tears in the skin. A light dusting of corn starch to dry skin, immediately after the bath, is helpful. Use calamine lotion over the rash, to soothe the irritation.

10) My kid is embarrassed about her birthmark
In most cases, kids only become embarrassed about their physical imperfections when their parents obsess over it and make them feel self-conscious. Get a plastic surgeon’s opinion, but keep in mind that a vast majority of birthmarks are completely harmless. Birthmark removals are rarely doctor recommended, and are done solely for cosmetic purposes. Depending upon the type of birthmark, your doctor may offer you laser treatments or surgical removal. If these sound too drastic to you, try camouflage make-up to cover up birthmarks which are flat and level with the skin. These last for up to 16 hours and are water-resistant. Just a little touch-and-dab make up can make a world of difference to your child’s self-esteem.

Upto 20% of all children suffer from “the itch that rashes”. Eczema can be particularly frustrating because there is no cure and multiple triggers can set off that nasty itch. Here’s how parents can cope..

Who develops Eczema?

“Eczema” is a broad term that encompasses a wide range of skin rashes that leave the skin red, itchy, oozy, scaly and irritated. About 65% of kids with eczema have developed the problem by age 1, and 90% of kids affected by eczema develop the symptoms before their 5th birthday.

What does Eczema look like?

In infancy, eczema appears as red dry scaly rash on the head, scalp, neck and diaper area, with perhaps a few scattered rashes over the back or abdomen.
As the child grows and begins to crawl, the rashes begin appearing over the forearms and shins. In the early days, the rash is red and moist. As the days progress, it turns pink and scaly.
During the toddler and pre-teen years, the rash is generally worst on the body folds – like the inside of the elbows, the armpits and the back of the knees. In severe cases, the rash may spread to involve large parts of the body. As the child continues to itch for weeks or months, the skin turns dark, thick and lined, like the bark of a tree.
During the teen years, most children begin to outgrow their eczema. However, some may continue to have flare ups during winters or periods of emotional distress. Some may continue to have dry itchy rashes on their hands for several years, along with a general tendency for skin sensitivity.

What puts my child at higher risk for Eczema?

Eczema often runs in the family. “Atopy” is a condition of increased risk for skin, respiratory and eye allergies. Most kids with Eczema come from families with “atopic individuals”. This means, people in this family have a tendency for Eczema, Asthma, Hay Fever and allergic eye itching. In fact, a lot of kids who suffer from Eczema may also have Asthma or Hay Fever.

What triggers Eczema?

The main problem with this condition is itching. This is why Eczema is known as the “itch that rashes” rather than the rash that itches. An itch leads to scratching. Scratching leads to the appearance of rash. The rashes make the skin itchier. This leads to the vicious itch-scratch-itch cycle.
Potentially everything under the sun, including the sun, can cause your child’s skin to itch!

Dryness of the skin in winter can lead to itching.

Prickly heat in summer can lead to itching.

These children are particularly sensitive to mosquito bites, artificial jewellery and fragranced cosmetics/toiletries.

Some of these children may be sensitive to their own sweat, and excessive sweating itself can lead to itching and rash.

Rough clothing like wool and denim can irritate the skin. Clothes washed in harsh laundry detergent can also irritate the skin.

Children with eczema are particularly prone to developing skin infections. This is because healthy skin forms a natural barrier against the entry of germs and infection. But eczematous skin is weak and broken and cannot resist pathogenic invasion. Certain skin infections like herpes, fungal rash and Scabies are naturally itchy. The itching induced by these infections can also flare up your child’s Eczema.

Food allergens have also found to play a role. Dairy, poultry, gluten, seafood, soy and nuts are amongst the most common culprits. Staying away from the offending food can keep the itch under control. However, parents may find it hard to identify food allergies if the child is allergic to multiple food items, or itchy on a daily basis due to other irritants like soap or fabric.

Your child’s skin might also be sensitive to dust, pollen, mold, animal hair and smoke (from tobacco or burning wood).

Stress and emotional distress do not cause Eczema, but can definitely worsen it. A caretaker (like a beloved grandparent) moving away, first day at school, a strict parent/teacher or exam woes – parents will notice a link between emotional distress and itch. Older children might even itch to seek attention.

Is Eczema is a modern-day disease?

Eczemas have always existed but modernization has definitely led to an increase in all kinds of allergy. Breastfeeding has been found to protect children from eczema. Over-sanitization, indiscriminate use of vaccines and antibiotics, and living in air-conditioned and carpeted homes and offices have played a role in the increasing incidence of allergies.
Playing in the mud, having a pet from a young age, and the occasional intestinal worm infestation can help in maturing your child’s immune system.

Are there supplements or herbs that can help?

If your child suffers from dry skin, then oral intake of omega-3 and omega-6 fatty acids can help. Dietary sources include oily fish like cod, egg yolk, olives, almonds, walnuts, tofu and flaxseed.
Some studies have found Vitamin D supplementation to be helpful in combating eczema.
Probiotics have also been prescribed with some benefit. Increasing fish and probiotic intake during pregnancy can protect your child from eczema. Probiotics can be found in fermented food like yoghurt, yeast and sauerkraut. Lactobacillus rhamnosus and Bifidobacteria are most commonly prescribed in Atopic children. Indiscriminate use of probiotics however could leave to bowel dysregulation.

Are there any tests to diagnose Eczema?

There are some basic tests which parents can do from home –
1) Elimination diet tests – Eliminating one food item/group from the diet. For instance, dairy or poultry. It is recommended to eliminate the said food item for at least a week to interpret the results. If the itching subsides, it indicates a possible allergy to that particular food item.
2) Repeat Open Application Test – If your child is allergic to various soaps or moisturizers, this is a useful test to carry out before trying any new cosmetic. Apply the said cream or toiletry, twice a day to the inner elbow for a week. If your child develops redness, rash or itch, he is most likely allergic to the said product.
Consult your Dermatologist or Allergologist regarding clinical blood tests (like the RAST test) or skin tests, namely ‘Prick Testing’ and ‘Patch Testing’. Your doctor will choose the test depending upon your child’s history and symptoms.

How can I manage my child’s eczema?

Protect your child from anything that makes her itch. Skin care and clothing care is the first step towards this goal, and should be treated as a lifestyle modification rather than a temporary fix.

1) Bathe your child not more than once a day with lukewarm water. Give him a quick bath with a mild soap-free cleanser like Cetaphil cleansing lotion. Prefer Syndets over Soaps. Avoid bubble baths , fragranced toiletries, massage oils and long showers. Diluted bleach baths are very helpful if your child suffers from repeated skin infections secondary to the eczema. Pat dry after a bath. Vigorous rubbing can trigger the itch.

2) Use bland moisturizing creams all over the body within minutes of towel-drying. It may take some trial-and-error to find the right emollient. Creams work better than lotions. Seek your dermatologist’s opinion on brands.

3) Protect your child from insect bites.

4) Keep your child’s skin well covered with soft garments. Avoid wool, silks and denim. Avoid fabrics that leech colour. Pre-wash all new clothes and bed linen before use. Do not let your child crawl or sit on carpets and rugs.

5) Use fragrance-free liquid detergents to wash your child’s clothes and bed linen. Make sure to rinse off the detergent thoroughly before use. Using an unscented fabric softener can be helpful.

6) Wet wraps are helpful in soothing itchy skin and can help seal-in the moisture after applying emollients.

7) Keep your child’s nails short and filed. Put mittens on while your child sleeps, to prevent him from scratching.

8) Saliva is a known cause of eczema around the mouth. Avoid using wet wipes. If your baby tends to drool, use petroleum jelly on your baby’s cheeks and chin before meal time and nap time.

9) Skip “herbal” remedies like neem oil, eucalyptus oil and other essential oils like lavender or chamomile. Kids with eczema cannot tolerate several herbal formulations.

10) Treat skin infections promptly without resorting to over-enthusiastic use of oral antibiotics. Prolonged itching from Scabies or a fungal infection can lead to secondary eczema.

11) Dust and pollen is all around us. If your child has tested positive for dust or pollen allergy, then consult an Allergologist for advice on how to reduce dust and pollen in your environment. Simple measures like dust-mite pillow covers, vacuuming, air filters and humidifiers can help.

12) Avoid hand sanitizers. Let your child carry Cetaphil cleansing lotion to school instead. Most schools now avoid carpets and soft toys as a lot of kids suffer from eczema and respiratory allergies. Inform your child’s teachers about any food allergies. Leave some emergency cortisone cream or Cetrizine syrup with the school nurse.

13) If your child needs sunscreen, select a plain Zinc Oxide based sunscreen which is hypoallergenic.

14) Good sleep can help is soothing the symptoms of eczema. However chronic and severe itching can ruin your child’s sleep. Sedative antihistamines like Cetrizine are helpful in providing itch relief and a good night’s sleep. Eczema has been associated with co-morbidities like depression, attention deficit hyperactivity disorder, epilepsy and heart disease. These may be caused by accumulated lack of sleep over the years.

ps: My blogs are not meant as a substitute for a proper medical consultation. Eczema manifests in multiple forms – from Atopic Dermatitis to Pompholyx to Nummular Dermatitis and much more. Each child is unique in his symptoms, clinical presentation, triggers and response to treatment. Consult a good dermatologist for diagnosis and guidance.

Half knowledge is more dangerous than no knowledge; and the vaccination drive has perhaps become a victim of its own success. Here’s why rejecting immunization is dangerous for your child and your community –

The immunization drive has been so successful and effective in controlling a wide range of mutilating and potentially life-threatening contagious diseases – that it has been widely acknowledged as one of the top ten medical achievements of the 20th century. Parents of our generation have never seen the crippling effect of Polio, the scourge of Small Pox or the terrifying lockjaw and seizures caused by Tetanus. Parents of the previous generation have forgotten how dangerous these illnesses used to be. However, with more and more people rejecting vaccines, several conditions like Measles, Polio and Whooping Cough, are making a comeback even in developed nations like the United States. The world had come so close to permanently eliminating these diseases at the turn of the century. Sadly, in less than two decades, it looks like the medical community will once again have to push the boulder to the top of the mountain, so to speak.

Fear-mongering about vaccinations and their supposed lack of safety is not a new phenomenon. Most people tend to react with fear, resistance and suspicion when faced with anything that is new and unfamiliar. When Edward Jennar introduced the small pox vaccine in 1802, the rumour mills insisted that the vaccine would turn you into a cow! The objections could be based on sanitary, religious, political, philosophical or scientific grounds. Rallies have been organized, documentaries have been made and lawsuits have been filed, going up to the Supreme Court.
But before understanding the history and the psychology behind the anti-vaccination movement, let us first review the various reasons why every doctor of every speciality strongly recommends immunization.

Immunizations can literally save lives. It can save you from death and disability. It is safe and effective and this has been proven through decades of study and data. Vaccines undergo years of research, testing and modification before they are approved for clinical use. The testing and data collection never end.

They are very affordable, especially if you consider the cost of treating a deadly infection, along with valuable time lost at school or work.

Getting your child vaccinated not only protects your child, but protects the community at large; as your child will not be responsible for endangering the health of another child. Over 90-95% of the population must be vaccinated to prevent outbreaks. Infections like Measles and Rubella are so contagious that a single ill child can infect 12-15 children and this can very quickly trigger an outbreak. It protects the truly vulnerable like infants, pregnant women and children suffering from Leukemia and AIDS, who cannot take vaccines due to their badly compromised immune system.
Vaccinations can protect future generations as well. For instance, vaccinating boys against Mumps can protect them from infertility and vaccinating girls against Rubella can protect their future children from blindness, deafness and cardiac abnormalities.

So why are so many parents refusing to get their child vaccinated?

In Jennar’s time, people felt that infecting their children with the lymph of a cowpox blister by making a nick in the skin is unsanitary, unnatural, cruel and unchristian. People resented the government making vaccines mandatory in the interest of public health. They believe it infringes on personal liberties and their right to control their bodies as well as those of their kids. In some states, the government slapped vaccine refusers with penalties, their children were denied school admissions and insurance companies refused to provide coverage to unvaccinated individuals.

Some parents refuse vaccination because they believe that diseases like Measles and Whooping Cough are almost unheard of, and therefore their child will remain protected by herd immunity, even without vaccination. However, herd immunity only works if over 95% of the population has been vaccinated. This means that herd immunity only works when nearly all children are vaccinated. This will protect kids who are on Chemotherapy or suffer from AIDs. These children are at high risk of contracting any kind of infection, but cannot take vaccines due to their compromised immune system. In several pockets of USA where many parents have refused vaccines, outbreaks of Measles and Whooping Cough have been reported after several decades. Besides, herd immunity does not work against infections like Tetanus, which are contracted through infected wounds and are not passed on from person to person.
Parents think they will get their kids vaccinated when and if an outbreak is declared. This does not always work. Diseases like Measles are so contagious that your child might contract it from a friend even before the friend develops the actual symptoms! It takes 2-3 weeks to develop immunity after a vaccine shot, and your child is at risk of contracting an infection in that time. Also, most vaccinations require multiple doses to develop full immunity, so one random shot might prove to be worthless.

The biggest blow to the immunization drive was delivered by a (now) disreputed gastroenterologist named Andrew Wakefield. In 1998, he published a study in a leading medical journal named Lancet, on how the Measles vaccine was causing Autism in children. This is perhaps one of the most hideous and damaging medical hoaxes of all time. Autism is a poorly understood ailment caused by multiple known and unknown factors. The media caught hold of this study and various documentaries were made with parents of autistic children speaking with anguish and vexation. This study is now discredited on various counts. Wakefield based his conclusion on a sample size of 12 children, which is a very small number for any credible scientific study. 5 of the 12 children were subsequently found to have pre-existing conditions. On further investigation, it was found that Wakefield had accepted a large sum of money by anti-vaccination groups who paid him to find a link between vaccinations and neurological conditions. Investigations revealed that Wakefield had falsified and manufactured data to achieve a biased conclusion. Even Wakefield refused to elaborate his “research” on a larger sample size of patients to try and replicate his initial findings. He was eventually stripped off his medical licence in 2010. The Lancet formally retracted the paper in the same year. Most importantly, numerous large-scale studies and research projects have subsequently confirmed that there is NO evidence to connect MMR and DPT vaccinations to Autism and other neurological conditions. Even UK’s National Autistic Society issued a statement to this effect, and encouraged parents to continue vaccinating their children.

There has also been a lot of concern about the toxic nature of some of the preservatives in vaccines like Thimerosal. This Mercury derivative was allegedly linked to various neurological conditions. Even though no concrete evidence was ever found linking the two, most vaccines now do not contain this preservative. Cases of Autism continue to rise even though Thimerosal is no longer used in childhood vaccinations since 1999.

There are still a lot of conspiracy theories that allege that mandatory vaccinations are a result of an unholy nexus between the Government and Pharma companies, to profiteer by creating a panic about infectious diseases “that are’nt so bad anyway”. The truth is that, several companies stopped manufacture of the DPT vaccine after Wakefield’s damaging study. The profit margin on vaccines is lower than that on drugs. And the cost of treatment far exceeds the cost of immunization. Yes, Pharmaceutical companies DO indeed work for profits. But if they were only concerned about the financial bottom line, they would focus more on keeping diseases active to produce more and more medicine, rather than vaccines.

There have also been vaccine refusals on religious grounds. In several Islamic nations, rumours began to spread that vaccinations are a conspiracy of the United States and United Nations. It was claimed that these medications are designed to cause impotence and diarrhoea, specifically amongst Muslims, and were meant to sterilize the believers and reduce their population. Unfortunately, the poorest and most downtrodden have been worst hit by this stance, resulting in the resurgence of Polio in Afghanistan, Pakistan and Nigeria. People travelling to and from these countries are likely to contract illnesses and carry them across international borders.

Some opposed vaccines as the preservatives might include Gelatin, which is derived from pork. The Rubella vaccine is manufactured from cell lines derived from aborted foetuses. This was misconstrued to mean that actual foetal parts were used to create vaccines. However, several religious leaders have advised that gelatin taken in medicine via non-oral route is not against religious tenets, and that in matters of life and death, even religious texts allow exemptions.

The HPV vaccine was created with the intention of preventing cervical cancer. However, many worried that the vaccine would encourage young women to turn promiscuous as it protects against certain strains of genital warts.
Some parents are too paralysed by fear and confusion to take a decision. Some believe that their children are protected as long as they’re breast-fed and therefore, vaccinations can be delayed. Some believe that general hygiene and good diet can protect against disease. And if a child does contract an ailment despite that, then modern medicine is now well-equipped to treat such an infection. They feel that it is better to acquire an infection and develop immunity to it in the “natural” way, rather than using vaccines which may not provide 100% protection anyway. All of the above views are either flawed or factually incorrect. Many parents are shocked and alarmed at the idea of injecting infants with multiple vaccinations in a single shot. They feared it would overwhelm their child’s immune system. However, various studies over several decades have proven that vaccines are safe even in preterm infants.
No medication is 100% safe and that is true for vaccinations as well. However, given their tremendous efficacy, the incidence of side effects is negligible. There is still no effective medication for infections like Polio, Tetanus or Hepatitis. So when in doubt, BELIEVE IN THE SCIENCE.

Crisis tends to hit the household when medical help isn’t handy. The mind freezes as panic takes over, and you end up doing something silly like putting toothpaste on a burn. Here’s what you should do..

(1) The “Do’s and Don’ts” of skin burns-

Has your child burnt his hand with a firecracker? Have you had hot oil splatter on your face? What does one do while you wait for a doctor’s appointment? Should I wrap a towel over it? Or should I soak the part in water?
How you manage your burn in the first 24 hours will dictate how the burn will eventually heal and if you’ll be left with a scar. Splash cool water on the burnt area for several minutes, and apply ice on it for a few seconds, 2-3 times a day to soothe the area. Do not apply egg white to the burn. Raw eggs harbour multiple bacteria which can infect the wound. Do not use bandaids or fluffy cotton. Do not pop any blisters. Cover the area with wet gauze like Sofratulle. Apply an antibiotic ointment like Fucidin. It is important to keep the area moist with unscented antiseptic creams. If you don’t have one, then use Vaseline petroleum jelly. Wash the affected skin with an unscented antibacterial Triclosan soap. Take pain medication like Paracetamol or Tylenol.
Dermatologists no longer prescribe Silverex cream as the silver content can stain and darken the skin. Turmeric is an excellent home remedy for superficial burns. But avoid turmeric in open wounds which are oozing, as the turmeric forms a dry cake over the wound which peels off the fresh skin underneath.
Most importantly, make an urgent appointment to meet with your dermatologist at the earliest. For deep and extensive burns, rush to your nearest hospital and ask for the services of a plastic surgeon. Your dermatologist/plastic surgeon team can also work together on healing any residual marks or scars from the burn.

(2) Does your child have Chicken Pox?

Does your child have fever and little itchy watery blisters over his body? Chicken Pox is not fatal or dangerous in children. Give tepid sponging for fever, and Paracetamol for aches and pains. Chicken Pox does not leave any marks or scars, unless the blisters have been popped. Cetrizine will help with the itching, and let your child wear mittens as an added measure. Your child’s caretaker during this period should be someone who has already had Chicken Pox, as they are now immune to the virus. Your child can have a cool shower, but do not use towels for drying. Let your child’s body dry naturally under a fan. Make sure they stay out of the sun, get plenty of rest, fluids, and clean nutritious home-cooked meals. Warm saline gargling can soothe a sore throat. Apply Calamine or Soframycin cream to the blisters. Use Cetrilak shampoo if there are blisters and scabs on the scalp as well. When all the blisters turn into dark scabs, you can tell that your child is no longer contagious. Keep a close watch for similar symptoms in other family members.

(3) Suffering from a nasty sunburn?

This is what happens when you’re not sunscreen-smart. But lectures aside, how does one manage sun burn? Have a cold shower, apply cool compresses to the affected area and use Calamine or Aloe Vera based moisturizing lotions several times a day to take the edge off the sting. Drink plenty of fluids and electrolytes, and take anti-inflammatory pills like Ibuprofen for some pain relief. Sunscreen may sting your skin at this point, so keep the sun burnt area covered with clothing and stay indoors till your skin heals. However, if your skin is swollen, blistered or extremely painful, then rush to your dermatologist. Sunburns can be particularly severe in children, and requires immediate medical attention. Multiple episodes of sunburn, especially in childhood, increase your risk of developing skin cancer as an adult. So do not skip the sunscreen.

(4) Head lice invasion in your household?

When it comes to head lice, home remedies do not always work. Mums use vaseline petroleum jelly and mayonnaise to coat their kid’s scalp as a treatment for head lice. This does not always work in suffocating the lice or their eggs. It may only stun them for a while, and you will still have to use a lice comb to get the lice out. Besides, it’s a nightmare to wash all that mayonnaise out!
If your kid has been around someone with lice, then use olive oil and a hot towel instead of vaseline. But if you SEE lice on your child’s head, then consult a dermatologist for medical management. Shaving your child’s head or swimming in chlorinated water will not get rid of head lice.
Lice shampoos must be used by ALL members of the family. Permethrin containing lice-shampoos work the best. If there are nits on the eyelashes, apply a generous layer of petroleum jelly to your child’s eyelashes while he/she is asleep. Wash off the next morning. Remember to clean the lice comb in hot water, vinegar or Lysol. Wash all clothes and bed linen at the end of the treatment. Skipping these simple steps is the most common reason for treatment failure.

(5) Are pinworms tormenting your child?

You might actually be able to see the tiny white thread worms around your child’s anus. You might also find them in your child’s underwear. The itching is worse at night leading to crankiness and restless sleep. In female children, it can cause vaginal itching as well. They can even irritate the urethra and cause bed-wetting episodes in children who have been potty-trained. You can gently stick a piece of cellotape to your child’s anus and get rid of the worms and their eggs. You can also apply menthol or camphor based cream on your child’s bottom, to suffocate the worms. This is only a temporary measure so your child can have a peaceful night till you can get them to the doctor’s office the next day.
Encourage hand hygiene to avoid infection in the future.

(6) How can I avoid catching a skin infection from my pet?

– Check your pet regularly for fleas, sores or patchy hair loss. If you see a rash, non-healing wound or areas of bald skin on your pet’s fur, take him to a vet without delay.
– If you or your pet suffer from an open wound, keep the wound covered. MRSA, a particularly virulent and antibiotic-resistant strain of the bacteria Staph Aureus, can be spread from animals to human. Do not let your pet lick your wounds.
– Scabies and fungal skin infections can be passed on from animals to humans. If you are adopting a stray, make sure to take your new pet to a vet for a thorough examination, followed by prompt treatment if found necessary.
– If you have suffered a bite or a puncture wound from an animal or pet, consult your physician at the earliest, even if the injury was accidental. The risks are higher if the animal was a stray, if the wound was deep enough to draw blood, and if the bite is closer to the head or neck.
– Wash your hands before and after handling pets.

(7) What should I do if I’m stung by an insect?

If you were stung by a snake or a scorpion, do whatever you can to find yourself in a hospital at the earliest. If you are stung by a bee, wasp, spider or caterpillar, here’s what you can do till you can meet your doctor.
Place an icepack on it. Keep the affected limb elevated for some time. Do not itch or shake vigorously as it encourages the spread of the venom. Apply Hydrocortisone cream every 4-6 hours. Take an antihistamine like Cetrizine or Benadryl. Take an anti-inflammatory drug like Tylenol or Ibuprofen, if you have pain and swelling. Meet your doctor if the rash/pain worsens over the next 12-24 hours.

Home remedies and old granny’s concoctions, while well-meaning, do not always work. In fact in some cases, they’re bad advice which can make matters worse. Your first aid kit at home must contain the following basic OTC medications – Betadine (preferable to Dettol or Savlon), Hydrocortisone 1% cream, Aloe Vera, Calamine lotion, Tablet Benadryl, Tab Paracetamol, Tablet Ibuprofen and Mupirocin ointment. These medications can provide relief till you can get an appointment with your doctor. In some cases, they can even relieve your symptoms completely and save you a trip to the hospital. Be Aware, Be Smart!