-A neonate is a new born baby till 28 days of life according to WHO.

-Top feeds are the feeds anything apart from breast milk of the mother for new born babies.

-It is very important for the baby to feed only on mother’s milk since birth till 6 months of age.

-Common top feeds that are given include water, honey, sugar water, formula milk, cow milk, buffalo milk etc. which are not good for the baby.


-Exclusive breastfeeding is defined as breastfeeding but nothing else including water till 6 months of age of the baby. The baby can receive ORS, drops and syrups of vitamins, minerals, medicines as per doctor’s prescription. Breast feeding is the healthiest and the most ideal way of feeding the baby to achieve optimal growth, development and health.

-Babies don’t have enough immunity to fight against infections they can get outside mother’s womb after birth due to absence of IgA antibodies which act against a number of micro-organisms harmful to the baby.

-Breast milk has high levels of IgA antibodies which protect intestinal lining of the baby. Breastfeeding helps in improving the baby’s immunity by passing these IgA antibodies through mother’s milk.

-Breastfeeding hence decreases the risk of infections after birth until the baby develops its own immunity gradually and naturally and also from Vaccinations, given after birth.

-The goal is to encourage the mother to feed as many times as the baby demands, educate her about recognizing the cues from the baby when the baby is hungry, encourage her to take nutritious diet, drink plenty of fluids and proper rest.

-It is known that the baby is hungry when the baby puts hand in mouth or when the baby directs tongue to the side when that side of cheek is stroked gently with finger.

-Baby can be breastfed as many times as the baby is hungry and demands for, rather than keeping a certain time gap between two sessions of breastfeeding.

-Latching in such a way that baby’s mouth covers entire areola is equally important while breastfeeding for good amount of milk intake by the baby. Good latching also prevents mother from getting sore nipples.

-Emptying both breasts by starting feeding alternatively with each feeding is also very important for good breast milk production.

-Exclusive breastfeeding is ideal unless the baby has any complications or disease conditions that require formula milk along with mother’s milk (mixed feeding) for additional nutritional support or if the mother is not able to produce enough milk for exclusive breast feeding.
TOP FEEDS : Giving top feeds to the baby is unnecessary and inevitably exposes the baby to micro-organisms of external environment, increasing the risk of infection.

-Enterocolitis is the most common condition seen in newborns who are given top feeds. The baby develops diarrhea, vomiting leading to dehydration, improper nutrition which disturbs the normal growth and development of the baby.

-If top feeding is inevitable due to a medical condition of a baby, it is important for the caregiver to maintain proper hand hygiene while preparing formula feed and use boiled and cooled water for the preparation of the formula.It is also important for proper sterilization of the feeding bottles and nipples.

– Dr.Divya Teja Pasupuleti

Work stress and its management

Stress at the workplace has become a common phenomenon due to external factors such as technological advancement, changes in the economy of a country which might lead to better productivity and stressful working conditions. Stress can be considered as an inevitable condition at least at one point in time or another; however it can also be minimized to the extent that the productivity and health of the employee is maintained which could lead to a productive organization. Work stress is a common occurrence in multinational companies where operation is global and employees have different cultural background.

Stress isn’t always bad. A little bit of stress can help you stay focused, energetic, and able to meet new challenges in the workplace. It’s what keeps you on your toes during a presentation or alert to prevent accidents or costly mistakes. But in today’s hectic world, the workplace too often seems like an emotional roller coaster. Long hours, tight deadlines, and ever-increasing demands can leave you feeling worried, drained, and overwhelmed. And when stress exceeds your ability to cope, it stops being helpful and starts causing damage to your mind and body—as well as to your job satisfaction.

Stress is defined as an organism’s total response to an environmental condition or stimulus, also known as stressor. Stress typically described as a negative condition that can have an impact on an human being’s mental and physical wellbeing.

-Stressors can be Positive or Negative.

Work stress is also known as occupational stress.This is the adverse reaction people have to excessive pressures or other types of demands placed on them at work. Stress is not an illness but a state. However if stress becomes too excessive and prolonged, mental and physical illness may develop.

Symptoms of work stress –

  • Feeling anxious, irritable, or depressed
  • Apathy, loss of interest in work
  • Problems sleeping
  • Fatigue
  • Trouble concentrating
  • Muscle tension or headaches
  • Stomach problems
  • Social withdrawal
  • Loss of sex drive
  • Using alcohol or drugs to cope

There are many factors which cause work stress. These factors are

  • High professional demands
  • Friction in working relationships
  • Frequent changes in the working environment
  • Unclear design of task
  • Poor management style
  • poor working conditions and erratic work hours

Stress is associated with various kinds of illness like, 

  • Heart disease
  • Asthma
  • Obesity
  • Diabetes
  • Headaches
  • Gastrointestinal problems
  • Alzheimer’s disease
  • Accelerated ageing, Hair fall, wrinkled skin
  • Premature death

Stress reduction methods

  • Time management
  • Meditation
  • Proper nutrition
  • Group/social support
  • Creative imagery
  • Self hypnosis
  • Regular exercise
  • Relaxation response-quiet environment, passive attitude, comfortable position

Tips to reduce and manage job and workplace stress

  • Recognize warning signs of excessive stress at work
  • Figure out where the stress is coming from.
  • Consider what you can control and work on that
  • Reduce job stress by prioritizing and organizing
  • Manage your time well. Time management-A key to reduce work stress.
  • reduce job stress by taking care of yourself
  • reduce job stress by improving emotional intelligence
  • reduce job stress by breaking bad habits
  • Do what you love
  • Learn  to say no
  • Put a ‘Do not disturb’ sign
  • Avoid distractions

Modern life is full of hassles, deadlines, frustrations and demands. Stress isn’t always bad. In small doses,  it can help you perform under pressure and motivate you to do your best. But when you’re constantly running in emergency mode, your mind and body pay the price.

You can protect yourself by recognizing the signs and symptoms of stress and taking steps to reduce its harmful effects

– Dr. Prerna Gaur

Useful links

An approach for diagnosis and management of “vaginal discharge”

“Vaginal discharge” is the term used to describe the fluid that comes out of vagina. There are two types of vaginal discharge which are normal and abnormal.

Normal vaginal discharge: This is usually clear, white discharge which is not associated with any bad smell. Women can have vaginal discharge at different times like these.

-During periods women can have little vaginal discharge

-During their ovulation which is 2 weeks before she gets her period

-During pregnancy due to hormonal changes

-If they are on oral contraceptive medication

-Women will have comparatively less vaginal discharge after menopause.

Abnormal vaginal discharge: It is usually associated with the following symptoms and it requires treatment based upon the cause.

-Itching and pain around vagina, fever, bad smelly discharge, pain while passing urine, pain while having intercourse, change of colour which looks like curd/cheese, greenish, grey etc., bleeding after intercourse can also be noticed. There are several conditions which can cause abnormal vaginal discharge and some of them are

-Infections like candidiasis, Trichomoniasis, Bacterial vaginosis, Chlamydia trachomatis, Gonorrhea.

– A retained foreign body such as a tampon, condom, or vaginal sponge.

-If they use scented soaps, fragrances or wipes to clean that area.

Vaginal discharge during pregnancy:

Increased amount of vaginal secretions are thought to be normal due to the increased blood flow to the vagina and surrounding glands during pregnancy. It is normal if it is not associated with pain, itching, redness, fever, burning sensation while passing urine, foul smelling discharge etc. If a pregnant woman experiences any of these, visiting their treating doctor/Gynecologist is must for a physical examination to rule out possible causes.

Investigations needed:

In most of the cases empirical treatment is started without doing any investigations. Women with persistent or recurrent vaginal/vulvar symptoms should be examined and investigated.

Urine analysis, Random blood sugar, Vaginal or endocervical swab,Ultrasound abdomen and pelvis

How we can treat abnormal vaginal discharge:

Treatment completely depends upon the cause. For example if infection is the cause then we need to treat that infection, we must know for every infection the treatment is different and using medication for long time without doctor’s advice is not recommended.

For some specific infections like sexually transmitted diseases the partner will also need treatment. Treating partners is necessary and it will reduce relapses.

Recurrent infections even after treatment must be examined and evaluated for the possible cause.


How to prevent abnormal vaginal discharge:

-Avoid using wipes, scented soaps or fragrances. Instead of them use V wash which is safe but only for external use.

-Avoid intercourse till the time you receive treatment.

-Avoid satin or polyester undergarments instead of that use loose cotton undergarments. Change undergarments 2-3 times in a day.

-Keep the area clean and dry.

– You can use panty liners instead of sanitary pads during your last days of period when you have only spotting.

-Douching (forceful insertion of liquid inside vagina to rise it out) must be avoided.

-Don’t use hair removal creams for removal of hair in the perineal the area.

Drink plenty of water at least 2 to 3 liters, eat a well-balanced meal, plenty of fresh fruits and vegetables, skimmed milk and curd as it is also a rich source of probiotics  which are needed for normal bacteria growth in the vaginal secretions


– Dr.​​Alekhya Yelamanchili



October 15th is day dedicated to increasing awareness and understanding about the importance of hand washing with soap as an easy, effective, and affordable way to prevent diseases and save lives in both medical and non medical fields.It is a campaign to motivate and mobilize people around the World to improve their hand washing habits by washing their hands with soap at critical moments throughout each day.

When hands are contaminated with disease-causing bacteria and viruses, these pathogens can enter the body or pass from person-to-person. Once these bacteria and viruses enter the body, they can cause a wide range of infections. Hand washing is one of the major measures in preventing contagious diseases that are spread by bacteria and viruses. Some examples include-Cold Sores-( Herpes simplex virus type 1), Common Cold, Conjunctivitis (Pink-eye),Pinworm Infection, Diarrhoea, skin infections like Impetigo. And now with the evolution of more dangerous diseases like The swine flu and Ebola, the importance of handwashing needs to be stressed even more.


Handwashing with soap is estimated to reduce incidents of diarrhea by 30% and respiratory infections by 21% in children under the age of five

It is important to turn handwashing into a habit. Turning handwashing with soap before eating and after using the toilet into an ingrained habit can save more lives than any single vaccine or medical intervention, cutting deaths from diarrhea by almost half and deaths from acute Respiratory infections by one-quarter.

On Global hand wash day, we are sharing some important points regarding it-

Importance be explained to everyone – It is very important to accept the importance of this simple technique and spread this message to each and every individual , be it in hospitals, schools , offices, factories or homes! A simple reminder poster near dining room/wash basin area about the technique is an excellent tool.

Arrange for soaps/hand washes– In order to make this successful, a soap and clean water must always be made available

Effectiveness– Keep in mind that it is as effective as a vaccine and yet is the cheapest method of disease prevention.

Keep in mind the best hand washing technique – A pictorial representation if available near basins is excellent tool for reminder of the best and most effective way to wash hands.

Remember to especially wash hands when

  • after using the toilet or changing nappies
  • before,during and after preparing food
  • between handling raw meat and cooked or ready-to-eat food
  • before eating
  • after using a tissue or handkerchief
  • before and after attending to sick children or other family members.
  • after smoking
  • after handling waste material or working in the garden
  • after handling animals




Written by:

Dr. Afroze Fatima