[Blog] Ep 49. A Pediatrician’s Guide to Optimal Health for Your Child

Ft. Dr Nihar Parekh

In a fast-changing world filled with parenting trends, health myths, and conflicting advice, raising a healthy child can feel overwhelming. On an enlightening episode of the “Modern Indian Parent” podcast, host Sanchita Daswani speaks with Dr. Nihar Parekh, a renowned pediatrician, who offers a grounded and practical guide for parents seeking clarity. This blog summarizes the key takeaways from their conversation, structured to follow the flow of their engaging discussion.

Introduction

Dr. Nihar Parekh shares his experience of treating children in his practice and demystifies many common parenting concerns. As he speaks, it becomes clear that his approach is both evidence-based and rooted in empathy for modern parental anxieties.

Obsession with Weight & Height as Parents

A recurring concern in Indian households is the focus on a child’s weight and height. Dr. Nihar explains that this obsession is rooted in cultural expectations and generational beliefs. A chubby baby is often equated with a healthy baby, and physical comparisons begin as early as infancy often fueled by family, friends, and social media.

He stresses the need for a mindset shift:

• External appearance does not always reflect internal health.

• Pediatricians must reassure parents when a child’s growth is within a healthy range.

• Comparisons to other children, or even to one’s own childhood, should be avoided.

According to Dr. Nihar, the key lies in breaking this cycle of comparison and instead focusing on individualized health.

How Do We Know Our Child Is Growing Well in the First Year?

In the early months, every gram gained or missed can become a cause for alarm. But growth, as Dr. Nihar notes, follows predictable patterns.

He outlines a few important milestones:

• At birth, Indian babies typically weigh between 2.5 to 3 kg—this is normal.

• Weight should triple by the first birthday, reaching around 7.5 to 9 kg.

• Beyond one year, weight gain slows to 1 to 1.5 kg per year.

• More important than the scale is the timely achievement of developmental milestones like sitting, crawling, or holding the head up.

Dr. Nihar points out that parents often worry unnecessarily when the weighing scale doesn’t move quickly. But a child who is active, alert, and meeting milestones is almost always growing just fine.

What Determines Height of a Child and What Should Their Height Be?

Height can also be a source of anxiety. Parents frequently wonder if their child’s stature is normal, especially when others around them seem taller.

Dr. Nihar offers a rational perspective:

• Genetics are the biggest influence on height—particularly how the parents grew as children.

• Nutritional support, vitamin D, and physical activity are essential but won’t override genetics.

• Major growth spurts typically occur between ages 5–7 and again during puberty.

He advises using benchmark heights (e.g., ~100 cm at age 4) to track progress. If a child appears short for their age, an X-ray of the left wrist can help assess bone age and determine if there’s a medical concern.

What to Do If Your Child Is Short?

When a child’s height falls below the expected range, the first step is assessment—not panic.

Dr. Nihar outlines a structured approach:

• Pediatricians may request an X-ray of the left wrist to assess bone age. This reveals whether the child’s skeletal growth aligns with their chronological age.

• If the bone age is within 1–1.5 years of the child’s actual age, the growth is considered normal, and no intervention is necessary.

• If the gap exceeds two years and the child was born small for gestational age, further evaluation may be warranted.

• In medically significant cases, growth hormone therapy might be an option—strictly under pediatric endocrinologist supervision.

However, Dr. Nihar is clear: growth hormone treatment is not a cosmetic tool to make children taller. It is reserved for children whose short stature has a confirmed medical basis and is affecting their development or emotional well-being.

Ultimately, in the absence of a medical issue, the best course of action is to focus on nutrition, ensure adequate physical activity, and allow time.

Do Our Kids Need Milk?

Few foods spark as much debate as milk. Traditionally seen as a vital part of a child’s diet, milk is now under scrutiny for causing bloating, appetite suppression, and even contributing to nutritional imbalances.

Dr. Nihar’s position is refreshingly practical:

• Beyond age one, milk is not essential if a child has a balanced diet.

• Dairy products like curd, paneer, and buttermilk are better tolerated and equally nutritious.

• Many Indian children have mild lactose intolerance, which can impact digestion and appetite.

He urges parents to focus on real foods instead of relying heavily on milk as a fallback option.

Dr. Nihar also points to another compounding issue: the replacement of food with snacks, especially sugary or highly processed ones. These might offer temporary peace at the dinner table, but they erode a child’s appetite and taste for real, nourishing food.

He warns:

• Sugary treats can suppress hunger for 5–6 hours.

• Even “sugar-free” or natural products may hide forms of sugar.

• Many parents are misled by branding and social media marketing.

• Homemade food remains the safest and most reliable choice.

One of his strongest recommendations is for parents to begin reading labels and questioning popular products that are marketed as “healthy” or “organic.” Just because something is trending online doesn’t make it suitable for every child.

When Do You Need to Give Your Kids Medicines vs Home Remedies?

When a child shows signs of illness, it’s natural for parents to reach for medicine. But Dr. Nihar encourages discernment.

He recommends:

• Avoiding medications if the child is sleeping, playing, and feeding well despite a cold or mild cough.

• Turning to home remedies like steam inhalation or warm fluids in the early stages.

• Introducing medications only when symptoms worsen or persist.

• Trust your instincts but consult your pediatrician for anything prolonged or unusual.

• Antibiotics are not for viral infections.

For fever, he advises trying basic cooling measures before administering paracetamol or ibuprofen, and only visiting a doctor after 48 hours unless symptoms escalate.

Do All Babies Under 1 Need Supplements Like Vitamin D and Iron?

Vitamin D supplementation is non-negotiable in Dr. Nihar’s view, especially since sunlight exposure has drastically reduced in modern life.

His supplementation guidelines are:

• Vitamin D: Essential for all infants, whether breastfed or formula-fed.

• Iron: Necessary for breastfed babies, and especially premature infants.

• Other vitamins: Only needed in special cases, such as for premature babies or those with poor weight gain.

He notes that while iron is beneficial, it can cause side effects like constipation or stomach upset, and should be used judiciously.

Why Are So Many Kids Low in Iron?

Iron deficiency is increasingly common among Indian children, even those who appear healthy.

According to Dr. Nihar, the causes include:

• Vegetarian diets lacking iron-rich foods.

• Overreliance on processed snacks and refined carbs.

• Replacing full meals with quick fixes or starchy options.

He emphasizes that a child who skips green vegetables and lentils regularly may require supplementation, especially between ages 5 and 8 when needs are higher.

What Is Contributing to Childhood Obesity?

Sanchita warns of a looming crisis: by 2030, one in ten obese children globally may be from India. The factors are layered and often lifestyle-related.

Dr. Nihar explains the key contributors:

• Excessive screen time leading to inactivity.

• Sugary foods and beverages creating calorie surpluses.

• Associating food with screens, which leads to mindless eating.

• Overfeeding during non-hunger moments.

He explains that fat cells created during childhood can remain dormant until puberty, when they suddenly expand, leading to visible weight gain.

How Much Screen Time Is Okay?

Screen time is now a parenting battleground. While total avoidance may be unrealistic, boundaries are crucial.

Dr. Nihar’s recommendations:

• Under age 2: No screen time.

• Ages 2–5: Maximum of 40–60 minutes per day.

• Larger screens and purposeful content (like movies) are preferable to random scrolling.

• Avoid eating in front of screens to break the association between screen and food.

He has observed serious behavioral issues, including aggression, social withdrawal, and even screen-induced autism symptoms, stemming from excessive screen exposure.

Why Are Sensory Processing Disorders So Common Now?

From refusing textured foods to avoiding messy play, many children today show signs of sensory discomfort.

Dr. Nihar believes the root lies in modern parenting habits:

• Over-pureeing foods beyond 10 months of age delays oral development.

• Lack of tactile exposure (sand, grass, water) limits sensory adaptation.

• Excessive screen use reduces real-world interaction.

While some cases stem from deeper conditions like autism or ADHD, many resolve with patience and gradual exposure to textures and new experiences.

Biggest Parenting Tip from Dr. Nihar

If there is one message Dr. Nihar wishes parents would internalize, it is this: stop comparing.

Comparisons to other children, siblings, or even one’s own childhood create unrealistic expectations. Each child develops at their own pace, shaped by unique genetics and environments.

Dr. Nihar encourages parents to:

• Respect their child’s individuality.

• Be flexible rather than rigid in their expectations.

• Recognize that a calm and open-minded parent is the foundation of a healthy child.

His most powerful message, however, is directed not at the child, but at the parent.

“A parent needs to change themselves before expecting their child to change. So the law of dynamics here stems from the parents. If the parents are open-minded, don't compare, and give their child the freedom to grow, it's going to significantly reduce the stress on them—and that’s going to show on their child, who will be a much happier, healthier individual.”

This insight reframes parenting not as a project of molding a child into perfection, but as a journey of reflection and self-awareness. When parents work on their own expectations, fears, and habits, they create the emotional space for their child to thrive.

Conclusion

Parenting in today’s age may be complex, but as this conversation shows, it can be made simpler by focusing on consistency, balance, and listening—both to your child and your trusted doctor. Dr. Nihar’s advice helps bring calm to the chaos, with practical wisdom that resonates with every parent navigating health choices for their child.