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Namasthe
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Dear XXXX
The most likely cause of recurrent wheezing could be allergy , especially to dust.


I would advise you the following, which i am sure will definitely help

1. Steam inhalation: It will be a good habit to cultivate. Steam inhalation for 10-15 minutes each session twice a day. Give it regularly even if she is alright. It helps reduce nasal congestion and also clears the nose. You can buy a good quality electronic steamer
2. Monticope suspension: It has antihistaminic and mast cell stabilizer which will help reduce airway hyper reactivity and reduce the incidence of future attacks. It has to be used for 4- 6 months after which it can be stopped. 2.5 mg of Montelukast once daily
3. Wash the bed sheets pillow covers and cloth of baby in hot boiling water: It will remove the dust , mites and allergic substance present in it.
4. Decoction: To a cup of milk + 20 tulsi leaves+ 1 spoon of turmeric + small piece of ginger + 4 black pepper + 2 spoon of sugar. Bring it to boil. Filter it and feed her warm daily. It will reduce airway congestion and also Tulsi will boost immunity
5. Chyawanprash : 1 teaspoon twice a day will be beneficial to build up immunity
6. Himalaya Septilin syrup 5 ml twice a day will also boost immunity. Continue giving her for 3-4 months.


If the symptoms persists then consult Respiratory physician for detailed assessment.

Regarding his weight gain , I would advise the following

1. Deworming with antihelmenthic: Tablet Albendazole 400 mg single dose only
2. Syrup Aristozyme 5 ml thrice a day before food: It will help improve appetite
3. Proper diet: Well balanced nutritional diet is very important


It is important that you start introducing a variety of food in your toddler's diet gradually. These will provide the calories, proteins, vitamins and minerals that are essential for his growth. The amount of food eaten would vary from child to child and would also depend on when you introduce a particular food to your toddler. Most of the times it is "Try and Error" method. Lots of patience would be required from your end to find out what is that diet which tickles your toddlers tastebuds which also contains maximum nutrients. You need to try multiple ones and find which your child loves to eat amongst those.

One recipe which the kid will like is as below

Ingredients needed: Ghee( 2 spoons), Whole wheat flour ( 2 spoons) , Pista( 50 gms), Cardomom ( 6 in number), Almonds( 50 gms), Khajur( Dried dates 50 gms), water/milk

In a pan pour 2 spoons of ghee, heat it, add 2 spoons of wheat flour (Atta), cook it till golden brown on low flame till its slightly golden in color. Add 2 Cups of water or Milk and keep stirring it continuously making a thin water paste( same like sira consistency). To this add powdered mixture of rest of ingredients grinded in mixer ( pista, almond, khajur, cardomom).
Supplement baby breakfast with this recipe, and also can be consumed at night when child is hungry. In this way his quota for milk will also be fulfilled.

This recipe is nutritious and will also help gain weight.


I would also suggest a diet plan ( you can modify it according your customs and convenience): Proper diet is very important


Monday
Early Morning: 1 cup milk and 2 almonds soaked overnight and peeled. Almonds needs to be crushed into smooth paste like texture.
Breakfast: 1-1½ moong dal cheela (Moong dal dosa) or plain ghee dosa with coriander chutney.
Mid morning: 1 fresh fruit cubed into small pieces or 1 cup of fruit or vegetable juice or 1 cup of tomato or vegetable soup.
Lunch: ½ cup chicken or mutton kofta curry with ¾ cup rice or 1-2 chapattis.
Evening snack: Fruit smoothie (Seasonal like XXXXXXX puree) and 1 wholegrain cracker.
Dinner: ½ - 1 cup dhal khichri, ½ cup seasonal vegetables like methi, palak, or lauki.


Tuesday
Early Morning: 1 cup milk.
Breakfast: ½ cup cereal such as ragi (nachni) or XXXXXXX cooked in whole cream milk with chopped nuts such as almonds, walnuts, raisins and pistachios.
Mid morning: 1 fresh fruit cubed into small pieces or 1 cup of fruit or vegetable juice or 1 cup of tomato or vegetable soup.
Lunch (Curd optional): ½ cup dal, 3-4 spoonfuls of seasonal vegetables such as methi, lauki, etc. with ¾ cup rice or 1-2 chapattis.
Evening snack: Corn chaat or fruit chaat.
Dinner: ½ cup baked vegetables with cheese and 1 slice whole wheat bread.


Wednesday
Early Morning: 1 cup milk and 2 almonds soaked overnight and peeled.
Breakfast: ½ cup bhaji with 1 or 2 pavs.
Mid morning: 1 fresh fruit or 1 cup of fruit or vegetable juice or 1 cup of tomato or vegetable soup.
Lunch (Curd optional): ½ cup egg curry (1 whole boiled egg), ¾ cup rice or 1-2 chapattis.
Evening snack: 1 banana puree with ½ cup milk.
Dinner: ½ cup mutton stew with vegetables like beans and peas and 1-2 appams.


Thursday
Early Morning: 1 cup milk.
Breakfast: 1 whole wheat buttered toast with 1 egg omelette.
Mid morning: 1 fresh fruit or 1 cup of fruit or vegetable juice or 1 cup of tomato or vegetable soup.
Lunch (Curd optional): ½ cup potato soya gravy and 1 parantha or ¾ cup rice.
Evening snack: A whole wheat bread coriander or tomato chutney sandwich.
Dinner: ½ cup tomato fish curry,¾ - 1 cup rice.


Friday
Early Morning: 1 cup milk and 2 almonds (paste like) soaked overnight and peeled.
Breakfast: ½-1 cup suji upma with vegetables such as beans, peas, carrots and coconut.
Mid morning: 1 fresh fruit or 1 cup of fruit or vegetable juice or 1 cup of tomato or vegetable soup.
Lunch (Curd optional): ½ cup butter chicken or chicken curry with ¾ cup rice or 1-2 chapattis.
Evening snack: ½ cup moong sprouts salad with tomatoes, onions, coriander and lemon juice.
Dinner: ½ cup palak paneer, 1 chapatti or ½ - 1 cup rice.


Saturday
Early Morning: 1 cup milk.
Breakfast: 1 parantha stuffed with egg bhurji or scrambled, hard boiled or poached eggs with toast.
Mid morning: 1 fresh fruit or 1 cup of fruit or vegetable juice or 1 cup of tomato or vegetable soup.
Lunch (Curd optional): ½-1 cup rajma with ½ – ¾ cup rice.
Evening snack: 1 chicken nugget with 1 small slice of garlic bread.
Dinner: 1 cup pasta in tomato sauce with vegetables such as cabbage, peas and cauliflower and ¼ cup fresh green salad with tomatoes, onions and carrots.


Sunday
Early Morning: 1 cup milk.
Breakfast: 1 parantha roll with a stuffing of paneer and other seasonal vegetables.
Mid morning: 1 fresh fruit or 1 cup of fruit or vegetable juice or 1 cup of tomato or vegetable soup.
Lunch (Curd optional): ¼ cup haryali chicken cooked in spinach puree with ¾ cup rice or 1-2 chapattis.
Evening snack: 1 slice walnut/fruit bread with ½ cup milk.
Dinner: ½ cup de-boned and mashed fish and potato curry with ½-1 parantha.

Occasionally, you may want to serve desserts. Do remember to keep your toddler's daily sugar intake to about 1-2 tsp, and use honey or jaggery (gur) to sweeten the dessert instead of sugar.


Do get back to me if you need any further assistance, will be glad to assist you.


Take Care

Best Regards
Dr Deepak Kishore
MBBS,MS,MCH
Consultant Pediatric Surgeon

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