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QUESTION: Sir,
My son is 25 months old, I need your advise regarding a few major concerns i have about him-
1. He does not speak as yet; all his milestomes have been on time (walking, sitting etc.). he says 'mama', 'papa', 'baba' and other words like these, tries to imitate his father singing but he will not address mummy as mama or papa as papa.
he uses a lot of gestures to tell us what he wants, he understands all instructions like sit down, bring forward your hands, wear shoes or socks or his pyjamas (even tries to wear them on his own), brings forward his hands to shake hello with everyone.

2. he does no effort to chew his food, it appears as if he does not he can chew. I have to puree everything I feed him

3. he still has an erratic sleep schedule! I make all efforts to keep hm awake during the day or maybe let him sleep an hour or two and not more than that, but even then he gradually keeps shifting his waking up in the morning such that his afternoon nap extends till the evening and then for the next few days he will sleep throughout the day and stay awake all night.

Is this normal; how should i deal with these issues?

I am writing not very much in detail, but wud be glad to share any more information you might want to know.

Please advise

ANSWER: here are the explanations:

1. He does not speak as yet; all his milestomes have been on time (walking, sitting etc.). he says 'mama', 'papa', 'baba' and other words like these, tries to imitate his father singing but he will not address mummy as mama or papa as papa.
==== this is as per 13 months age. so surely delayed speech. its likely that he may have some other delay which can only be picked by specialist. so get him screened by developmental pediatrician. If in mumbai, i may guide.

he uses a lot of gestures to tell us what he wants, he understands all instructions like sit down, bring forward your hands, wear shoes or socks or his pyjamas (even tries to wear them on his own), brings forward his hands to shake hello with everyone.
=== again this is as per age 13-14 months.



2. he does no effort to chew his food, it appears as if he does not he can chew. I have to puree everything I feed him
==== u need to get rid of milk based feeds and then there are simple exercises to train chewing with simple games.

3. he still has an erratic sleep schedule! I make all efforts to keep hm awake during the day or maybe let him sleep an hour or two and not more than that, but even then he gradually keeps shifting his waking up in the morning such that his afternoon nap extends till the evening and then for the next few days he will sleep throughout the day and stay awake all night.
== thats fine. often this is decided by amount of fat in feeds.

Is this normal; how should i deal with these issues?
== fine.


I am writing not very much in detail, but wud be glad to share any more information you might want to know.
-=== detail me some birth history. weight history and feeding history.
Please advise
= sure

---------- FOLLOW-UP ----------

QUESTION: Thanks for your reply sir.
I stay in delhi, is it possible you guide me regarding the developmental paediatrician.

I would however like to add that we have been taking him to a paediatrician (a leading paediatrician with Appollo group of hospitals), he examined him in detail and  suggested that we send him to a playschool few times a week and then he would probably come up with words. (we are working in that direction)

regarding his birth history, everything was normal during pregnancy and he was delivered by an elective C-Section. his birth weight was 3.4kg. his present weight is 14kg.
regarding feeding history, he was weaned when 4 months of age. presently i feed him khichdi, dal chawal, daliya, banana, egg mostly but I have to puree all this for him.

any other details, I would be glad to share.the speech delay as mentioned by you has really put me in a lot of stress!! Also you have mentioned exercises totrain chewing,where can i get information regarding these??

Answer
Though speech delay is common in India... it needs complete developmental evaluation to study associated issues.
Playschool will help as a form of therapy but it cannot bypass a visit to occupational therapist and speech therapist and developmental screening.
Your pediatrician can surely help in this matter. I think Dr Veena Kalra practices developmental pediatrics in Delhi.


Exercises in chewing can also be advised by speech therapist. Often a vibrating toothbrush doesnot help. But a simple method of sitting with child,.. eating with child.. having a chewing competition with child often helps.

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