Q: My grandmother wraps up children in a bed sheet all the time so that they cannot move. She says it makes them sleep better.

A: She is following an ancient practice called “swaddling”. This involves wrapping the baby so that its hands and legs are inside the sheet. Newborn babies sleep better when they are swaddled as it makes them feel they are still in the womb. But this should be discontinued after 10-14 days as the baby needs to move its arms and legs freely to grow and develop normally.

By-pass surgery

Q: I am a 58-year-old woman. I underwent hysterectomy at 40. Of late, I’ve been developing a vague chest pain while climbing stairs. I consulted a cardiologist. He did an angiogram and said I had triple vessel block and advised immediate by-pass surgery. A second surgeon, however, said that since I had well-developed collaterals, there was no need for surgery now. He advised revaluation with a stress test every year.

A: I would go with the more conservative approach and not of the knife-happy surgical team. If your collaterals are well developed, you can probably continue indefinitely without a problem. You need to make sure the collaterals stay patent by walking an hour a day on level ground and maintaining your ideal body weight.

Vitamin deficiency

Q: I feel very tired all the time. My muscles pain and I cannot eat any spicy food. I went to a physician who prescribed a battery of tests. Finally, he said I had vitamin D deficiency, anaemia and vitamin B12 deficiency. I am only 37.

A: Vitamin D deficiency is common in India and much of the time it goes unrecognised. It may occur because of our lifestyle (remaining indoors) or it may be a genetic problem. A lot of research is being carried out. The deficiency makes the bones weak and this is reflected as muscle pain.

The stomach contains some cells that are essential for the body to bind and absorb vitamin B12. If those cells are damaged or wasted away, you will not only develop intolerance to spicy food but also adequate amounts of vitamin B12 will not be absorbed. Vitamin B12 is essential for red blood cell formation. That is why you are anaemic.

Your doctor will be able to treat all of this with medical supplements. Once your body responds, your symptoms will disappear.

TV and chips

Q: My niece is 10 years old. She is 150 cm tall and weighs 50 kg. I think she is fat. She watches cartoons all day and eats potato chips. Please advise.

A: Being fat or thin is a perception which may be incorrect. You need to find her ideal body weight using the calculation 23 x 1.5 x 1.5 = 51.75 (height in metre squared multiplied by 23). As per the calculation, if you have measured her height correctly, she is not overweight. On the other hand she may have no muscle mass, poor posture and a general round appearance. She does, however, need to curtail her television viewing, stop snacking and become physically more active.

This often involves a change of lifestyle for the whole family. Children learn a great deal by watching their parents and other family members.

Anti-obesity pill

Q: I want some tablets to lose weight. All this advice about diet and exercise really depresses me. Exercise makes my body ache and diets make me hungry.

A: Weight gain and loss are usually gradual processes. When we gain weight, we are probably unaware of it until our clothes become tight and people make unkind remarks. Very rarely do people weigh themselves regularly. For many, maintaining the ideal body weight involves a lifetime of concentrated effort.

Try to control your total calorie intake. Say no to second helpings and avoid fat-filled snacks. Jog, walk or run for an hour every day. That way your body will utilise the food you consume more efficiently.

There are no “weight control” tablets. There are appetite suppressants but they have been banned in India as well as abroad as they were found to cause dangerous, non-reversible, life threatening side effects.

Taking thyroid hormones to increase your basal metabolic rate or steroids to “bulk up” is equally dangerous. Some advertised commercially available weight loss supplements contain these.

Pregnancy puff

Q: I have wheezing. I think it’s asthma. I am now pregnant and my doctor switched me from tablets to inhalers. Are they safe for the baby?

A: Inhalers deliver the medicine direct to your lungs which will help you stop the wheezing. Tablets, on the other hand, enter the bloodstream and go all over the body, including the lungs. Many also cross the placenta and reach the baby. Your doctor is right — inhalers are better.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in