किशोर स्वास्थ्य

From 10 to 19 years (as per WHO standards), a teen's body changes drastically. They enters into puberty and experiences many changes from physical as well as emotional. Thus from physical shape to the personality and behavior will also change dramatically. Part of this is due to an awareness of sexuality, which is caused by monthly periods and other physical changes in body, and part is due to an increase in hormones that have an effect on mood.

Puberty-Related Growth Spurts

  • In girls, sexual development starts between the ages of 8 and 13, and have a growth spurt between the ages of 10 and 14.
  • In boys, sexual development starts between the ages of 10 and 13, and continue to grow until they're around 16.

Changes in Girls

These characteristics describe the sequence of events as girls go through puberty:

  • There is an increase in the rate of growth of height.
  • The size of uterus and vagina increases.
  • There is an increase in the size of breast
  • Pubic hair begins to appear, usually within 6 to 12 months after the start of breast development.
  • The rate of growth in height reaches its peak in about 2 years after puberty

Once girls start to menstruate, they usually grow about 1 or 2 more inches, reaching their final adult height by about age 14 or 15 years (younger or older depending on when puberty began).

Changes in Boys

Boys tend to show the first physical changes of puberty between the ages of 10 and 16 years. They tend to grow quickly between ages 12 and 15. The growth spurt of boys on average is about 2 years later than that of girls. By age 16, most boys stop growing, but their muscles will continue to develop.

Characteristics of puberty in boys include:

  • The size of  penis and testicles increase.
  • Pubic hair appears, followed by underarm and facial hair.
  • The voice deepens and may sometimes crack or break.
  • The larynx cartilage or Adam's apple gets bigger.
  • Testicles begin to produce sperm.

Q. What is healthy eating for teenagers?

Healthy diet can help teenager to look good and stay healthy:

  • Eating breakfast: Skipping breakfast does not help in losing weight, because  essential nutrients might be missed out. A healthy breakfast is an important part of a balanced diet and provides some of the vitamins and minerals required for good health. Whole grain cereal with fruit sliced over the top is a tasty and healthy way to start the day.
  • Aim to eat fruits and vegetables a day: Fruits and vegetables are sources of most of the vitamins and minerals which is essential for the body. Fresh fruit juice, smoothies and vegetables can help in balanced diet.
  • At snack time, substitute foods that are high in saturated fat or sugars for healthier choices: Foods high in saturated fat include pies, processed meats such as sausages and bacon, biscuits and crisps. Foods high in added sugars include cakes and pastries, sweets, and chocolate. Too much saturated fat can also cause high cholesterol.
  • Drink enough fluids: One should aim to drink at least six to eight glasses of fluids a day, water, unsweetened fruit juices (diluted with water) and milk are all healthy choices.
  • Eating healthy food: Foods such as  whole meal bread, beans, wholegrain breakfast cereals, fruit and vegetables. Such kind of foods are high in fibre are bulky and help us feel full for longer time.
  • Being Underweight: Not eating a balanced diet or restricting food intake can lead to deficiency of important nutrients in the body. This can lead to weight loss. Being underweight can cause health problems, so if you're underweight it's important to gain weight but in a healthy way.
  • Being Overweight: Foods rich in fat and sugar are high in calories, or eating too many calories can lead to weight gain. Try to eat lesser foods that are high in fat and sugar, such as swapping to low or no sugar fizzy drinks. A healthy balanced diet will provide you with all the nutrients your body needs.

References: http://www.nhs.uk/Livewell/Goodfood/Pages/healthy-eating-teens.aspx

Q. What are the various health issues in teenagers?

Depression:

 Depression may be defined as the state of extreme dejected, where patients who exhibit this condition may develop severe apathy towards their environment.

Some common symptoms of teen depression may be the following:

  • Decline in academic achievements 
  • Behavioral problems in friendship
  • Withdrawing from contact with family and other people
  • Lack of enthusiasm and energy. Difficulty in self-motivation 
  • Unnecessary aggression, anger and rage
  • Report of feelings of sadness and helplessness 
  • Over-reaction to criticism
  • Feels incapable of living up to the parental expectations 
  • Lacks self-esteem and suffers from guilt

Teen's mood swing:

Teen's has to go through lot of changes in their life from physical change to emotional and social changes. They have lots of things on their plate viz: friendships, studies, relationships, break-ups and many more. if the teenager is being cranky and moody. Followings things should be consider:

Quality of sleep:  According to the National Sleep Foundation USA, teens need at least eight to nine hours of sleep a night. Teens taking less sleep are more likely to be depressed and are also more likely to have suicidal thoughts. So one should make sure a good night sleep is quintessential for healthy teen.

Moods and possible depression: The teen years are often highlighted as "the best years of life". Some teens may develop depression. Parents/guardians should watch for symptoms such as appetite or sleep changes, lower energy levels, and irritability. Lots of teens go through mild changes and are not depressed. But if one sees big swings in teen's usual behavior, then it should be taken seriously. Talking to the children and providing a shoulder will help a teen to get himself out of depression.

Acne:

A pimple begins with the pores in the skin become clogged with a type of oil called sebum, which normally lubricates the skin and hair. Acne is common during puberty due to hormonal changes, causing the skin to overproduce sebum. Because many oil-producing glands are on the forehead, nose, and chin, this area the T-zone is where a person is most prone to pimples.

Here are some tips to help prevent breakouts and clear them up as fast as possible:

  • Teen should wash his/her face twice a day with a mild soap. Gently massage the face in circular motions.  After cleaning apply an over-the-counter (no prescription needed) lotion containing benzoyl peroxide. This will decrease oil and bacteria.
  • Don't pop pimples: Popping pimples can push infected material further into the skin, leading to more swelling and redness, and even scarring.
  • If one wears glasses or sunglasses, make sure that it is cleaned frequently to keep oil from clogging the pores around your eyes and nose.
  • Remove makeup before going to sleep.
  • Keep hair clean and out of your face to prevent additional dirt and oil from clogging your pores.

Skin should be protected from the sun. It may seem like a tan masks acne, but it's only temporary. A tan may worsen acne, not improve it. Tanning also causes damage to skin that will eventually lead to wrinkles and increase risk of skin cancer.

De-worming

Q. Early warning signs of over use of alcohol, drugs, or other substances?

Some of the signs include:

  • Eyes become reddish and teens generally complaints about their health, such as being overly tired: If teen frequently uses over-the-counter eye drops.
  • Teen may show lack of interest in school or there may be a drop in grades.
  • Chemical-soaked rags or papers, which may mean that teen is inhaling vapors
  • Other signs stains on teen’s clothing, hands, or face.

Q. What are the side effects of alcohol on teen's health?

Short-term side effects of using alcohol include:

  • Lack of co-ordination and sluggish reflexes
  • Reduced concentration
  • Nausea and vomiting
  • Flushed appearance
  • Blurred vision and slurred speech
  • Intense moods, e.g. aggression, elation, depression
  • Headache
  • Teen may have blackouts

Drinking alcohol regularly  and for long time leads to physical, emotional or social problems. These may include:

  • Long term consumption of alcohol may lead to diseases like cirrhosis of the liver, cancer, especially of the mouth, pharynxlarynx, esophagus, bowel (in men) and breast (in women)
  • A range of diseases affecting the heart and blood, and including stroke and hypertension
  • Alcohol dependence
  • Harm to the unborn baby through mixing alcohol and pregnancy or alcohol and breastfeeding
  • Skin problems
  • Reproductive issues, such as sexual impotence or a reduction in fertility
  • Concentration and term memory problems
  • Depression

Q. How addiction develops?

  • As the drug use gradually increases over time like smoking with friends at the weekend, or taking ecstasy at a rave, or cocaine at an occasional party, for example, can change to using drugs a couple of days a week, then every day. Gradually, getting and using the drug becomes more and more important to you.
  • If drugs helps in fulfilling a need, there may be a chance that teen might start relying on it. For example, if a teen may take drugs to calm his/her self  during anxiety or stressful situation, which will energize the teen or make him/her more confident in social situations if you normally feel shy.
  • Similarly, if teen takes drugs to fill a void in life, there may be a risk of crossing the line from casual use to drug abuse and addiction. To maintain healthy balance in life, teen needs to have other positive experiences, to feel good in your life aside from any drug use.
  • As drug abuse takes hold, teen may miss or frequently be late for work or school and job performance may progressively deteriorate, and he/she will start to neglect social or family obligations.

Help teen to quit alcohol, drugs or other substances :

  • Talk to the child early about his or her behavior change.
  • Keep teen busy with meaningful activities, such as sports, or other groups.
  • Expect teen to follow the household rules.
  • Keep talking with teen. Praise the child for even the little things he or she does well.

Know your  child’s friends. Having friends who avoid cigarettes, alcohol, and drugs may be your teen’s best protection from substance abuse

Q. What are the safety tips for teens?

Driving safe:

  • Avoid using cell phone or text while driving. It is advisable to stop the car and attend the call.
  • Always practice safe driving and obey the driving laws and traffic signs.
  • Buckle up for safety and make sure all passengers use their safety belts as well.
  • Don't drink and drive or use drugs and drive or ride in the car with anyone whose is drinking or on drugs.
  • Be a courteous driver on the road
  • Encourage safe driving with peers and friends
  • Keep your parents informed about the where abouts.

Self defense:

Self-defense means doing everything possible to avoid fighting who threatens or attacks you. Self-defense is all about using your head not your fists.
Use your brain: Those who are threatened and tries to fight back "in self-defense" actually risk making a situation worse. The attacker, who is already edgy may become even more angry and violent. The best way to handle any attack or threat of attack is to try to get away.
The best way to avoid such situation is to trust your intuition combined with the common sense.

Avoid taking risks:

Another way of self-defense is doing things that can help you stay safe. Here are some tips:

  • One should understand his/her surroundings: One should walk or hang out in areas that are open, well lit, and well traveled. Try to become familiar with the buildings, parking lots, parks, and other places walk. Pay attention to the situations where someone can hide such as staircases or bushes.
  • Avoid shortcuts that take through isolated areas.
  • If one is going out at night, travel in a group.
  • Teens should keep their parents informed about their daily schedule like classes, sports practice, club meetings, etc.
  • Body language: Be confident about where one is going and act alert.
  • When riding on public transportation, sit near the driver and stay awake. Attackers look for vulnerable targets.
  • Carry a cell phone if possible.
  • Be willing to report crimes in neighborhood and school to the police.

Q. Is there any national health programme in India for adolescents?

The government of India has a comprehensive package for meeting the multiple health needs of the adolescents and offers a roadmap for programmes and priorities that aim to address adolescent health ARSH (Adoloscents reproductive and sexual health) is included as a part of RMNCH+A. The National ARSH strategy provides a framework for a range of sexual and reproductive health services to be provided to the adolescents. The strategy incorporates a core package of services including preventive, promotive, curative and counseling services. Effective implementation of policies and programmes has progressed from the past few years and has lead to strengthening of Adolescent Friendly clinics and subsequently the outreach programmes.

Periodic health check-ups at the village health and nutrition days are conducted to provide services to adolescent girls who cannot access the clinic based services. The success of the programme being effective service delivery by the ANM and ASHA and selection and training of peer educators at the village level.

http://nrhm.gov.in/nrhm-components/rmnch-a/adolescent-health/adolescent-reproductive-sexual-health-arsh/background.html

Various programmes for adolescents are:

School health programme:

The School Health Programme was launched to address the health needs of school going children and adolescents in the 6-18 year age groups in the Government and Government aided schools. The programme entails biannual health screening and early management of disease, disability and common deficiency and linkages with secondary and tertiary health facilities as required. This is the only public sector programme specifically focused on school age children. The focus is to address the health needs of children, both physical and mental, nutrition interventions, promotes physical activities and counseling and provision of fixed day immunization coupled with education. Weekly Iron Folic acid Supplementation, WIFS, along with biannual deworming as proposed would be linked with the school Health Programme.

http://mohfw.nic.in/WriteReadData/l892s/2099676248file5.pdf

Weekly Iron folic acid supplementation (WIFS):

Weekly supplementation of 100mg elemental Iron and 500ug Folic Acid (IFA) is effective in decreasing incidence and prevalence of anemia in adolescents, MOHFW has launched the Weekly Iron and Folic Acid Supplementation (WIFS) Programme for school going adolescent girls and boys and for out of school adolescent girls. The Programme envisages administration of supervised weekly IFA Supplementation and biannual deworming tablets to approximately 13 crore rural and urban adolescents through the platform of Government aided and municipal school and anganwadi Kendra and combat the intergenerational cycle of anemia. 

http://www.wbhealth.gov.in/newsletter/ofw_ad.pdf

Menstrual hygiene scheme:

The Ministry of Health and Family Welfare (MOHFW) has introduced a scheme for promotion of menstrual hygiene among adolescent girls in the age group of 10-19 year in rural areas. The pilot is being implemented in 152 districts across 20 States in the country, wherein supply in 105 districts is through central procurement with quality assurance guidelines is through local Self Help Groups. The sanitary napkin packs (containing 6 pieces each) is branded as ‘Free days’.

http://nrhm.gov.in/nrhm-components/rmnch-a/adolescent-health/menstrual-hygiene-scheme-mhs/background.html

External link/ References

  • PUBLISHED DATE : May 14, 2015
  • PUBLISHED BY : NHP CC DC
  • CREATED / VALIDATED BY : NHP Admin
  • LAST UPDATED ON : Sep 16, 2015

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The content on this page has been supervised by the Nodal Officer, Project Director and Assistant Director (Medical) of Centre for Health Informatics. Relevant references are cited on each page.