You have just changed your baby's diaper, and went to bed, to finally rest. Suddenly, you hear a loud wail. Your baby is crying, again! This time, it is the hungry cry.

But what if we tell you that you no longer have to disrupt your rest with your baby's cry for hunger? This is only possible when you already know when to feed your baby. Babies cannot tell when they are hungry, so more often than not, parents may miss to understand they are hungry, until the hunger cry starts. But there are some cues you can look for to feed your baby!

Hunger Cues In Your Baby

Increased Activity

Your baby might become more alert and active. Thinking about food can make babies excited, so you may notice them moving around more than usual.

Head-Turning

Babies often turn their heads from side to side as if searching for food.

Mouth Movements

Look for signs like opening and closing their mouth, resembling a tiny bird waiting to be fed.

Rooting Reflex

Turning their head toward the breast, chest, or bottle is a classic hunger cue.

Sucking Motions

Babies may make sucking motions with their mouths, even if they don’t have a pacifier or bottle nearby.

Lip Smacking or Drooling

Increased drooling, lip-smacking, or sticking out their tongue are all signals they’re getting ready for a meal.

Sucking on Hands or Clothing

Your baby might start sucking on their fingers, hands, or even their clothes as a sign of hunger.

Clenched Fists

Watch for little fists clenching in frustration and impatience.

Focused Eye Contact

Babies who recognize their primary feeder might stare and follow you around the room with their eyes.

Facial Expressions

A furrowed brow or a distressed look might be your baby’s way of saying, “When’s the next meal?”

The “Neh” Sound

According to Dunstan baby language, the sound “neh” just before crying often means hunger.

Also remember that hunger pangs are strong enough to wake most babies, even from deep sleep. However, if your baby consistently sleeps for extended periods, it’s important to ensure they’re feeding frequently enough for their age.

For newborns, it’s generally recommended that they don’t regularly sleep longer than 4 hours at a stretch. Occasional long naps are fine—especially if they give you a much-needed rest! However, if your baby frequently sleeps through feeding times, consult your pediatrician to determine if gentle wake-ups for feeding are necessary.

How do you know your baby is feeding well enough?

It can be difficult to ensure that your baby is well fed, especially if you are breastfeeding, or when your baby is not of the age when he can talk. However, there are signals too for this, in fact your baby also learns how to signal that they need more milk or food.

It also depends on the age. For instance, a newborn will feed often, usually every 2 to 3 hours and sometime smore often. They feed up to 12 times every 24 hours. As your baby grows, their tummies grow too, in fact the tummy grows form a size of cherry at birth to walnut in 3 days. In a week, it is at the size of plum and in a month, it is of the size of a large chicken egg.

The "I am not hungry right now" signs for babies are:

• releasing or pushing away the breast or bottle
• closing their mouth and not responding to encouragement to latch on or suck again
• open and relaxed hands (instead of clenched)
• relaxing their body and even going a little limp
• looking around and showing interest in playing or other things
• looking content and maybe even smiling
• appearing happily drowsy and ready to go back to sleep

A new study published in The Lancet Obstetrics, Gynaecology, & Women's Health has revealed an alarming rise in infertility rates among women aged 35 years and older.

The analysis, based on the Global Burden of Disease Study 2023, found that global female infertility could affect nearly 80 million women aged 35–49 by 2036 if current trends continue.

In 2023, an estimated 53.60 million women aged 35–49 were affected by infertility. Nearly 54 million women in this age group sought fertility care, including fertility testing and assisted reproductive technologies such as in vitro fertilization (IVF).

Asia Bears Highest Burden

According to the study, Asia has the highest need for fertility care particularly East Asia reported the highest regional burden, while Australasia has the lowest. At country level, the Central African Republic had the highest reported burden, while Nepal had the lowest.

Although disparities between low- and high-income regions have narrowed, the burden is shifting toward high-income settings, where women are more likely to delay pregnancy and seek fertility testing and treatment.

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The researchers said, "This shift reflects broader social and economic changes, including delayed family planning and greater access to fertility services in some affluent regions".

"Advanced-age female infertility represents a growing global health challenge. Despite improved regional equity, low-SDI countries continue to face significant burdens. This necessitates implementing tailored public health strategies and prioritizing resource allocation to mitigate future burdens," said the researchers from China, Hong Kong, and Singapore in the paper.

To address the rising demand, the authors called for

• expanding and integrating fertility services into primary health care, reducing financial barriers to treatment,
• using innovative delivery methods,
• mobile health tools,
• improve equitable access to fertility care.

Infertility A Growing Global Health Concern

The World Health Organization defines infertility as the failure to achieve a clinical pregnancy after 12 months of regular unprotected intercourse.

Approximately 8–12 per cent of reproductive-aged couples worldwide experience infertility, with the burden disproportionately affecting women aged 35–49 years.

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The study noted that this higher risk is largely biological, driven by age-related declines in ovarian reserve and oocyte quality, which reduce natural fertility, increase miscarriage risk, and lower the success rates of assisted reproductive technologies (ART).

As populations age and socioeconomic transitions continue, the number of women exposed to advanced-age infertility risk is increasing, making it an increasingly important public health issue.

How Was The Study Conducted?

The researchers analyzed data from the Global Burden of Disease (GBD) 2023 study to provide what they describe as the first comprehensive assessment of infertility among women aged 35–49 across 204 countries and territories.

Since 1990, both the age-standardized prevalence rate and disability-adjusted life years (DALYs) attributable to infertility have risen steadily, by 0.45 per cent and 0.47 per cent every year, respectively.

The study projects that infertility cases in women aged 35–49 will continue to rise, reaching nearly 80 million by 2036 in the absence of targeted interventions.

The researchers also found a 23.10% reduction in the relative disparity in infertility-related DALYs between low- and high-Socio-demographic Index (SDI) regions since 1990, indicating progress in equity while highlighting persistent structural gaps in access to care.

A 20-month-old toddler from West Bengal who suffered from recurring urinary tract infections (UTIs) for six months was eventually diagnosed with cystinuria, a rare inherited metabolic disorder that causes recurrent kidney stone formation.

About The Case

The diagnosis came after the toddler experienced persistent UTIs over a period of six months. After multiple episodes of infection couldn’t be solved despite treatment, the doctors discovered the rare condition.

Initially, the doctors believed that it could be vesicoureteral reflux, a condition in which urine flows backward from the bladder towards the kidneys.

However, more investigations revealed an unusual kidney stone caused by cystinuria, an inherited disorder that leads to excessive amounts of the amino acid cystine in urine.

As cystine dissolves poorly in urine, it can crystallise and form stones, which may block urine flow, trigger recurrent UTIs, and damage the kidneys if left untreated for a long time. Doctors at a Bengaluru hospital treated the child using a minimally invasive procedure to remove the stone.

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What Is Cystinuria?

Usually, the kidneys reabsorb cystine after filtering blood. In individuals with cystinuria, this process does not work well.

Large amounts of cystine pass into the urine. As cystine does not dissolve in urine, it forms crystals and eventually stones in the kidneys.

The condition is caused when the child inherits one faulty gene from each parent. Parents who carry one altered gene usually have no symptoms themselves.

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Symptoms & Treatment

Unlike most kidney stones, which are more common in adults, cystinuria presents during childhood or adolescence. Parents must look out for the following symptoms in their children:

• Recurrent urinary tract infections

• Pain while passing urine

• Blood in urine

• Abdominal or flank pain

• Kidney stones at an unusually young age

• Difficulty passing urine if stones obstruct the urinary tract

Although cystinuria has no cure, effective treatment and management can reduce stone formation and protect kidney function. It includes:

• Drinking large amounts of water to dilute urine and reduce the formation of stones

• Reducing salt intake

• Limiting consumption of excessive animal protein

• Medications that make urine less acidic (urine alkalinisation)

• Drugs that reduce cystine stone formation in severe cases

• Surgical or minimally invasive procedures to remove stones when necessary

Parents must seek medical attention when the child faces the following:

• Two or more UTIs within six months or repeated infections over a year

• Recurrent fever without an obvious cause

• Intense pain during urination

• Blood in the urine

• Difficulty in gaining weight

• Persistent irritability

• Recurrent abdominal or back pain

While most recurrent UTIs are caused by common anatomical or behavioural factors, persistent or unusual infections can occasionally point to rare inherited disorders like cystinuria that warrant medical attention.

Early diagnosis and timely treatment can help prevent permanent kidney damage and significantly reduce the frequency of stone formations.

Hypertension or high blood pressure is an increasingly common problem among children and adolescents; many children may not have any obvious signs or symptoms in the early phase. It is said that hypertension in children is a “silent condition,” and therefore, it is of paramount importance that doctors, parents, and teachers are aware of it to detect the condition early.

Symptoms Of High Blood Pressure In Children

While some kids might not have any symptoms at all, there are some signs that shouldn't be overlooked. Recurrent headaches or morning headaches, especially headaches in the back of the head, may occasionally be a sign of high blood pressure. Symptoms can be dizziness, blurred vision, flashers, loss of energy for no known reason, nausea, vomiting, difficulty breathing during exercise, chest pain, palpitations, or frequent nosebleeds for no obvious reason.

There can also be changes in a child's behaviour or physical appearance in the school environment that teachers might observe. Children with high blood pressure often experience headaches, frequent visits to the sick room for weak or dizzy spells and ask to go out of class to rest. Sometimes, symptoms such as difficulty in concentration, sudden drop in school performance, irritability, changes in mood or appearing unusually withdrawn are associated with underlying health problems, such as hypertension.

Some children may be more tired, winded or unwell from sports or physical activity than others and avoid it. These symptoms can be missed and dismissed as stress, poor sleep or lack of interest in studies or sports. Such symptoms may be overlooked and blamed on stress, sleep deprivation or low interest in studies or sports.

Leading Causes & Prevention

Doctors think obesity, poor diet, excessive salt intake, poor sleep, low exercise, and watching too much screen time are all factors that are driving up hypertension rates in kids and teens. Other kidney disease, heart disease, hormone imbalances, or family history can also contribute in some children.

Regular blood pressure checks on children's routine visits are very significant because many children with hypertension may be asymptomatic, experts say. Prompt diagnosis and treatment can prevent complications with the heart, kidneys, brain and eyes in the long term.

It is important that parents and teachers do not shrug off repeated complaints of headaches, fatigue, dizziness or vision problems as insignificant. Early medical assessment can be important in safeguarding a child's long-term health.

By Dr Vaibhav Meshram, Paediatrician, Ruby Hall Clinic