#pediatrcian

[suramed-health-center]

🎉 Happy New Year from SuraMed Health Center! 🌟 Wishing you an AMAZING 2024 filled with good health, joy, and prosperity. Here's to a year of well-being and new beginnings! 🥂

[rainbow-baby-one]

Pediatric Dream Team!!

[shobhashyampediatrician]

Managing Chronic Conditions in Children

In Greater Noida West, parents are increasingly seeking specialized pediatrician services to address the unique healthcare needs of their children, especially those with chronic conditions. One such reputable practitioner catering to this demand is Dr. Vivek Shyam, renowned for his expertise and compassionate care at shobhashyam.com. This article explores the pivotal role of pediatricians like Dr. Shyam in managing chronic conditions in children, offering insights into their approaches and the evolving landscape of pediatric healthcare.

Understanding Chronic Conditions in Children: Chronic conditions in children encompass a wide spectrum of health issues that require ongoing management and care. From asthma and diabetes to congenital heart diseases and neurological disorders, these conditions pose significant challenges for both children and their families. In Greater Noida West, the prevalence of such conditions underscores the need for accessible and specialized pediatric services.

The Role of Pediatricians: Pediatricians like Dr. Vivek Shyam play a central role in managing chronic conditions in children. Their expertise extends beyond diagnosis to encompass holistic care, focusing on disease management, symptom control, and improving the quality of life for young patients. Dr. Shyam's commitment to excellence and personalized approach ensures that each child receives tailored care that addresses their unique needs.

Comprehensive Care Approach: Managing chronic conditions in children requires a comprehensive care approach that integrates medical treatment, lifestyle modifications, and family support. Pediatricians collaborate with multidisciplinary teams, including specialists, therapists, and educators, to develop individualized care plans that optimize outcomes for children with chronic illnesses. In Greater Noida West, Dr. Shyam's practice exemplifies this approach, offering a range of services aimed at empowering families and promoting children's well-being.

Patient Education and Empowerment: Empowering families with knowledge and resources is essential for effectively managing chronic conditions in children. Pediatricians like Dr. Shyam prioritize patient education, equipping parents with the information and skills needed to navigate their child's healthcare journey confidently. Through workshops, support groups, and online resources available at shobhashyam.com, families in Greater Noida West can access valuable insights and guidance on managing chronic illnesses in children.

Advancements in Pediatric Healthcare: The field of pediatric healthcare is witnessing rapid advancements, ranging from innovative treatment modalities to digital health solutions. In Greater Noida West, pediatricians leverage these advancements to enhance care delivery, improve patient outcomes, and streamline communication between healthcare providers and families. Dr. Shyam remains at the forefront of these developments, embracing technology and evidence-based practices to optimize pediatric healthcare services in the region.

Community Engagement and Outreach: Pediatricians also play a vital role in community engagement and outreach initiatives aimed at promoting child health and well-being. Through partnerships with schools, community centers, and local organizations, pediatricians foster awareness, early intervention, and preventive measures for chronic conditions in children. Dr. Shyam's active involvement in such initiatives underscores his commitment to serving the Greater Noida West community beyond the confines of his practice.

Conclusion: In Greater Noida West, pediatrician services, particularly in managing chronic conditions in children, are indispensable for ensuring optimal health outcomes and enhancing quality of life. Dr. Vivek Shyam's dedication, expertise, and patient-centered approach exemplify the standards of excellence in pediatric healthcare, reflecting a commitment to holistic care, innovation, and community well-being. Through collaborative efforts and a focus on empowerment, pediatricians like Dr. Shyam continue to make a positive impact on the lives of children and families in the region.

[emzchaos]

Oasis Springs - Lavista Inn

Don: Morning Love, couldn’t sleep again? Rebekah: Do you regret marrying me, like the way we did it? Don: No, maybe would have preferred the Drag Queen marrying us over that fake Elvis Rebekah: *Giggles* Who knew Sparkles was a pediatrcian. I though mean should we have had a actual wedding? Don: Ahh. I never thought about it and your dad missed out on walking you down the aisel Rebekah: I feel guilty after all he raised us on his own. I loved that in the moment we got married Don: You now feel guilty about it, Beka I forget sometimes things in big decisions with us.

Rebekah: I wouldn’t have married you if you didn’t. I just.. never mind we will talk more at home Don: No, speak to me about it. We are a team now and forever. Now what’s in your beautiful mind? Rebekah: I want a proper but small wedding where dad can be involved this time. Don: I love it, George will love it too and maybe we should discuss the other thing Rebekah: *Laughs Nervously* Oh I’m happy for Ronnie and Krystal but I’m not sure babies are for us just yet Don: What changed your mind? I’m not going to hate the answer Rebekah: I want to be something, no known as “The Stripper”

Don: What do you want to be? Rebekah: I was thinking about going back to being a nurse Don: *Smiles* Babe, that’s great. You’d make a great nurse. Ronnie’s sister Julianna is a nurse Rebekah: I know, she’s the one who gave me the information. She is really nice and makes me wonder how Ronnie- Don: Never met his family. He seems so shut off about them. All I know is his dad is a big time partner in Landgraab Corp Rebekah: He’s your bestfriend, shouldn’t you know his family more and his sisters- Don: Alright enough of the Harton’s for one day. I was thinking about taking my beautiful wife back to bed Rebekah: *Smiles* I will never say no to that

✨ 𝔅𝔢𝔤𝔦𝔫𝔫𝔦𝔫𝔤 | 𝔓𝔯𝔢𝔳𝔦𝔬𝔲𝔰 | 𝔑𝔢𝔵𝔱 ✨

[hahaalaine]

I think it sucks that as parents we're expected to consult experts constantly, but the only one we normally have access to is the pediatrcian.

They cannot and should not fill all the expertise that could potentially be needed. Like we are asking way too much and theyre most certainly not qualified to weigh in on everything.

I trust my pediatrician's medical knowledge but i dont want to ask them about sensory processing issues, but thats the only way i can get access to an occupational therapist. If i was to ask the pediatrician about it she would just ask me about ADHD, which is not the issue, and I'd never get that referral.

So here i am trying to play occupational therapist by my damn self to try and figure out how to get my kid to calm down enough to sleep. He can go a full, uninterrupted 16 hours filled with activities and outside time and still fight bedtime with everything he's got.

Every free resource talks about the importance of outside time and free play and all this bullshit that we already do so now i have to educate myself further into the profession. Literally doing this all by myself and badly im sure because im only allowed to talk to 1 fucking person.

[thedeafprophet]

YEAH THAT'S ALARMING FOR A PEDIATRCIAN ID SAY

BEGONE BOT

[chcrrybcmbs]

love   others   so   radically   ,   they   wonder   why   .

◜    &. ›    𝙳𝙾𝚂𝚂𝙸𝙴𝚁    。

𝗼𝗻𝗲   :   𝘣𝘢𝘴𝘪𝘤   𝘪𝘯𝘧𝘰𝘳𝘮𝘢𝘵𝘪𝘰𝘯   .

    full   name:   amity   savannah   carter.   alias:   amy   (   rarely   used   ).   age:   twenty   seven. date   of   birth:   january   seventh. place   of   birth:   kanas   city   ,   missouri.   hometown:   london   ,   england. current   residence:   los   angeles   ,   california.   nationality:   american   -   british. languages   spoken: english.   gender:   cis   woman.   pronouns:   she   /   her.   orientation:   bisexual   ,   biromantic.   relationship   status:   single.   education:   graduated   from   arno   payne   academy   of   performing   arts.   occupation:   professional   latin   and   ballroom   dancer   ,   singer   -   songwriter.

    𝘁𝘄𝗼:   𝘧𝘢𝘮𝘪𝘭𝘺   𝘵𝘪𝘦𝘴   .

    ethnicity:   nigerian   ,   german   ,   scottish. financial   status:   upper   class.   father:   anthony   carter.   nationality:   american.   occupation:   retired   pediatrcian   ,   professor   of   medicine.   mother:   cindy   payne   (   formerly   carter   ).   nationality:   british   -   american.   occupation:   dance   company   owner. siblings:   one   older   brother   &   one   younger   sister. pets:   tba. deeper   dive:   click   here.

    𝘁𝗵𝗿𝗲𝗲:   𝘱𝘩𝘺𝘴𝘪𝘤𝘢𝘭   &   𝘱𝘦𝘳𝘴𝘰𝘯𝘢𝘭𝘪𝘵𝘺   𝘵𝘳𝘢𝘪𝘵𝘴   .

    height:   5   foot   10   inches.   weight:   128   pounds.   hair:   naturally   brown   ,   with   long   waves   that   cascade   past   her   shoulders. eyes:   a   chocolate   brown   ,   almost   piercing   cat   eyes.   voice:   a   soothing    tone    not    too    feminine   ,   with   a   subtle   west   london   accent.   traits:   gregarious   ,   quick   -   witted   ,   positive   ,   determined   ,   insecure   ,   resentful   ,   stuck   -   up   ,   opinionated. zodiac:   capricorn. deadly   sin:   envy.   heavenly   virtue:   diligence. character   parallels:   fleur   delacour   (   harry   potter   )   ,   sarah   cameron   (   outer   banks   )   ,   cj   parker (   baywatch   )   ,   caroline   forbes   (   the   vampire   diaries   ). 

◜    &. ›    𝙱𝙰𝙲𝙺𝙶𝚁𝙾𝚄𝙽𝙳    。

dancing    was    something    that    was    heavily    cemented    in    the    carter    &    payne    families    .    amity's    paternal    grandmother    was    a    principle    ballerina    for    the    national    ballet    of    canada    while    her    maternal    grandparents    met    when    they    became    ballroom    partners    at    a    young    age    .    they'd    go    on    to    found    their    own    performing    arts    school    in    london    ,    england    arno    payne    academy    of    performing    arts    ,    which    their    children    &    grandchildren    would    attend    . 

    it    was    clear    early    on    ,    anthony    and    cindy    carter    had    drastically    different    takes    on    how    to    raise    children    .    the    first    crack    in    what    was    in    the    beginning    a    beautiful    relationship    .    her    father    had    more    of    a    guiding    approach    ,    wanting    his    children    to    make    their    own    choices    and    learn    from    them    while    cindy    preferred    a    more    hands    on    &    rigid    approach    --    not    leaving    room    for    her    children    to    so    much    as    make    a    mistake    .    from    the    moment    amity    could    walk    ,    much    like    her    siblings    ,    she    was    put    into    dance    .    it    wasn't    a    matter    of    whether    she    enjoyed    it    or    even    had    an    interest    in    dancing    .    her    mother    believed    ,    even    if    it    wasn't    something    she    stuck    with    throughout    life    it    would    instill    a    level    of    discipline    she    wanted    her    children    to    have    .    this    made    it    easy    for    amity    to    seem    like    something    of    a    problem    child    in    her    mother's    eyes    ,    never    wanting    to    go    to    rehearsals    ,    talking    back    to    instructors    .    even    at    a    young    age    ,    she    had    an    overly    opinionated    nature    about    her    and    it    seemed    no    matter    what    her    mother    did    she    couldn't    quick    scrub    that    from    her    middle    child    . 

    at    eight    ,    the    push    back    from    amity    became    too    much    for    her    mother    &    she    sent    her    away    to    england    to    live    with    her    grandparents    and    attend    their    performing    arts    school    .    it    was    the    last    straw    for    her    father    who    ended    up    filing    for    a    divorce    just    a    few    weeks    after    amity    was    sent    away    .    between    being    in    a    new    country    ,    a    new    school    ,    and    the    knowledge    that    her    family    would    never    be    the    same    it    was    alot    of    change    for    her    to    grasp    onto    at    such    a    young    age    and    inevitably    she    clung    to    the    one    thing    that    had    always    been    a    constant    --    dance    .    the    more    she    leaned    into    it    ,    the    clearer    it    became    ,    she    was    by    far    the    best    dancer    her    family    had    produced    .    she    was    only    meant    to    stay    in    london    for    a    few    months    but    she    ended    up    staying    for    ten    years    .    virtually    raised    by    her    grandparents    ,    although    she    spent    nearly    every    weekend    with    her    father    once    he'd    moved    to    london    to    be    closer    to    her    .                      

    amity    went    on    to    collect    a    rather    impressive    resume    in    the    dance    world    ,    winning    nearly    every    competition    she    entered    .    it    was    in    2015    ,    after    meeting    one    of    the    judges    on    dancing    with    the    stars    during    a    competition    that    she    agreed    to    enter    the    show    as    a    pro    .    with    more    eyes    on    her    and    a    camera    on    her    behind    the    scenes    her    personality    really    shined    and    the    public    feel    in    love    with    her    .    she    went    on    a    four    year    stretch    with    the    show    ,    winning    two    of    the    season's    and    cementing    herself    as    one    of    the    more    popular    &    more    creative    pros    .    after    a    lifetime    of    doing    the    same    thing    ,    she    ventured    out    of    her    comfort    zone    and    started    dabbling    in    other    things    :    creating    a    make    up    &    lingerie    line    and    even    singing    .    her    family    likes    to    call    it    the    hollywood    effect    .    in    2019    ,    she    didn't    return    to    the    show    though    ,    instead    focusing    on    her    other    ventures    .    that    didn't    mean    she    was    out    of    public    eye    though    .    it    seemed    like    no    matter    what    she    did    the    public    found    a    way    to    talk    about    it    .    her    relationships    becoming    heavily    documented    ,    songs    she    wrote    dissected    to    attach    them    to    whoever    her    significant    other    was    at    the    time    (    and    she    had    plenty    that    were    public    knowledge    )    .    it    became    so    invasive    that    she    ended    up    moving    back    to    kansas    city    for    a    while    to    simply    get    away    from    all    the    lights    and    cameras    .             

    while    back    home    she    rekindled    her    relationship    with    her    mother    ,    a    relationship    that    was    estranged    from    the    moment    amity    landed    in    london    when    she    was    eight    .    even    taught    at    her    mother's    academy    for    performing    arts    for    a    year    before    she    inevitably    returned    to    los    angeles    and    back    to    the    show    that    in    essence    catapulted    her    into    fame    .    she's    now    been    back    in    los    angeles    for    just    over    two    years    and    has    found    enough    footing    to    deal    with    the    attention    that    comes    with    such    a    lively    city    .    

◜    &. ›    𝙷𝙴𝙰𝙳𝙲𝙰𝙽𝙾𝙽𝚂    。

coming soon ... probably .

[savera-child-clinic]

Dr. Supriya Rastogi – the best Pediatrcian in Faridabad shares tips for making cold and cough season a little easier on her young patients. Read on for her ten tips to survive cold and cough season.

[kalpeshdr]

Neonatal Respiratory Distress Syndrome - Dr. Kalpesh Patil

Neonatal respiratory distress syndrome (NRDS) occurs when the baby's lungs are not fully developed and cannot supply enough oxygen, causing respiratory problems. It usually affects premature babies.

It's otherwise called infant respiratory distress syndrome, hyaline membrane disease, or surfactant insufficiency lung disease. Regardless of having a comparable name, NRDS isn't identified with intense acute respiratory distress syndrome (ARDS). Dr. Kalpesh Patil is one of the Best Pediatrician in Pune who is highly experienced in this field.  

Why does it happen?

NRDS for the most part happens when the baby’s lungs have not produced enough surfactant.

Composed of protein and fat, this substance keeps the lungs swelling and prevents them from collapsing. A baby ordinarily starts producing surfactants at some point between weeks 24 and 28 of pregnancy. Most babies breathe normally by 34 weeks. If your baby is born prematurely, you may not have enough surfactant in your lungs. NRDS can affect babies who are not preterm.

For instance, when:

·         The baby is underweight

·         The baby's lungs did not develop properly

·         The mother has diabetes

Approximately half of all babies born between the 28th and 32nd week of pregnancy develop NRDS.

Recently, the use of steroid injections that can be given to mothers during preterm birth has reduced the number of premature babies born with NRDS.

What are the Symptoms of NRDS?

The indications of NRDS are regularly observable following birth and deteriorate over the accompanying not many days.

They can include:

·         Blue-coloured lips, fingers, and toes

·         Rapid, shallow breathing

·         Flaring nostrils

·         A grunting sound when breathing

Diagnosing NRDS:

Various tests can be utilized by doctor to analyze NRDS and preclude other potential causes.

These include:

·         A physical assessment

·         Blood tests to measure the amount of oxygen in the baby’s blood and check for a disease

·         A heartbeat oximetry test to measure how much oxygen is in the baby’s blood utilizing a sensor attached to at the tip of their finger, ear, or toe

·         A chest X-Ray to search for the distinctive appearance of the lungs in NRDS

Treating NRDS:

The primary point of treatment for NRDS is to assist the baby with breathing.

Treatment before birth

If there is a risk of administration 34 weeks before pregnancy, treatment with NRDS may be started before birth. You might have a steroid infusion before your baby is delivered. A second dose is typically given 24 hours after the first.

The steroids stimulate the advancement of the baby’s lungs. It's assessed that the treatment prevents NRDS in 33% of premature births. You may likewise be offered magnesium sulfate to lessen the risk of developmental issues connected to being born early.

On the off chance that you take magnesium sulfate for more than 5 to 7 days or a few times during your pregnancy, your baby might be offered additional checks. This is on the grounds that delayed utilization of magnesium sulfate in pregnancy has in uncommon cases been linked to bone issues in newborn babies.

Treatment after the birth

Your baby might be transferred to a ward that gives expert consideration to premature babies (a neonatal unit). If the symptoms are mild, additional oxygen may be needed. It is usually given by an incubator, a small mask on the nose or face, or a tube of the nose. In case symptoms are more serious, your baby will be attached to a breathing machine (ventilator) to one or the other to help or assume control over their breathing. These treatments are started regularly in the maternity ward before being transferred to the neonatal ward.

Your baby may likewise be given a dose of artificial surfactant, for the most part through a breathing tube. Evidence proposes early treatment within 2 hours of delivery is more advantageous than if treatment is postponed. They'll likewise be given fluids and nutrition through a tube associated with a vein.

A few babies with NRDS just need help with breathing for a couple of days. In any case, a few, generally those born extremely prematurely, may require support for quite a long time or even months. Premature babies frequently have multiple issues that keep them in the emergency clinic, yet for the most part, they're all right to return home around their expected delivery date. The timeframe your baby needs to remain in the clinic will rely upon how early they were born.

What are the Complications of NRDS?

Most babies with NRDS can be effectively treated, even if they are at high risk of developing further problems in the future.

·         Air Leaks: Air can here and there spill out of the baby’s lungs and become trapped in their chest cavity. This is known as a pneumothorax. The pocket of air puts additional pressure on the lungs, making them collapse and prompting extra breathing issues. Air leaks can be treated by inserting a tube into the chest to permit the trapped air to escape.

·         Internal Bleeding: Babies with NRDS may have bleeding in the lungs (pulmonary hemorrhage) and brain (cerebral hemorrhage). Pulmonary hemorrhage is treated with air pressure from a ventilator to stop bleeding and blood transfusions. Cerebral hemorrhage occurs very often in premature babies, but most bleeding is mild and does not cause long-term problems.

·         Lung scarring: Here and there, ventilation (starting within 24 hours after birth) or surfactants to treat NRDS scars in the baby's lungs are affected, which affects their development. These scars are called bronchopulmonary dysplasia (BPD). Indications of BPD incorporate fast, shallow breathing and shortness of breath. Babies with severe BPD usually need extra oxygen from a tube that goes into the nose to help breathe. This is typically stopped following a couple of months when the lungs have healed. Yet, children with BPD might require regular medication, like bronchodilators, to assist widen their airways and make breathing easier.

·         Developmental inabilities: In case the baby’s brain is damaged during NRDS, either due to bleeding or an absence of oxygen, it can prompt long-term developmental inabilities, like learning difficulties, movement issues, impaired hearing, and impaired vision. However, these developmental issues are not typically serious. For instance, 1 survey assessed that 3 out of 4 kids with developmental issues just have a mild inability, which ought not to prevent them from leading a normal adult life.

[dairy-farmer]

The low key ironic part is that the underage pregnancy!Bruce would be somewhat more mentally stable in the way he is finally letting go of some of his grief lmao not at all healthy but it’s working

I think in someway Alfred is willfully blind and I am kinda interested in seeing his perspective on Babies Jason Martha and Thomas would he ever allow himself to realize these are Bruce’s babies or just think it a fucked up but working way of working through his grief

Actually now that I’m thinking about it I would love to see what Alfred is thinking because you see some glimpses of his thinking when they decide to name the baby after Jason asking if they are sure

in that verse i think alfred does start out not knowing that they're bruce's kids. he is stuck in his own grief and he can't do much to help bruce who also won't help himself. until the neighbor boy comes along and at that point alfred only knows abou tim second hand until he starts to live with them when bruce has signed him out of school and asked for alfred to home school him in the duration of his pregnancy. that's their first in person meeting, where alfred is teaching tim math and english literature and he's...well he's worried is the simplest way to put it.

he's worried in the same way that society would be about a very young and expectant mother. master bruce clearly has an affection for the young darling and seeing him is what caused him to ask if bruce was dealing with the home situation because a child pregnant so young had to be ringing alarm bells not to mention the father and all the details regarding that mess. alfred figures out that the reason that bruce and tim must be so close is because bruce is going to adopt tim's baby. that he approves of albeit he is worried because bruce's grief is still so fresh and a child, especially a new born one will require a lot of attention and care. but bruce is putting in the effort and alfred sees that. he sees him build the nursery, and furnish it with toys and gadgets. he sees bruce gently lead tim to the rocking chair by the crib and smile as tim giggles as it tips back and forth in a smooth motion. bruce is involved, and he's taking careful care of the baby's mother, and he's looking into the case because surely some criminal activity must've occurred for young master timothy to be in the situation he is but every time he inquires, as the due date approaches, master bruce deflects. he says things like timothy is unsupervised a lot of the time, that bruce is trying to look out for his best interests. which alfred agrees with, the poor boy could use all the support he could get given his circumstances.

but then other details come in. how master bruce is always the first to rush to timothy when he's the slightest bit ill, when he has the smallest craving. he's carrying master bruce's soon to be adopted child so his concern is fitting. he refuses to consult doctor leslie which catches alfred's attention but that's soothed by the fact that timothy is being seen by his own pediatrcian. alfred has no idea who that doctor is though because bruce is the one who takes timothy to his appointments. alfred's a little concerned, but that reaches new heights when master bruce confides the child's name.

it's going to be a boy, bruce tells him, the slightest bloom of happiness and excitement on his face. alfred feels the same feeling begin to bubble at him as well but it stalls when bruce tells him the name.

jason.

named after jason todd, master bruce tells him. to honor him he says. that he wishes he could've seen. could've met, could've held his new baby brother. he's sure he would've loved him and alfred is...unsure.

master bruce has only recently taken a turn for the better. he's returning home from patrol less injured, he's not being as violent that's true. but those are recent changes. master bruce's life is going to undergo a massive shift with a child that will be entering his care. but it will be so soon after master jason's death. and he will be naming the child after him as well and its...its a heavy burden to put on one so young.

but master bruce looks so happy, so expectant for alfred's equally as happy reaction so...so alfred doesn't voice his doubts, his concerns. he just asks if bruce is sure.

alfred should've suggested that he be the child's primary caretaker. at least for a few months. at least until master bruce has...stabilized more. but he knows that would be met with fierce rejection. master timothy will be taking an active role as well, bruce would protest. he wants timothy to be able to interact with the child, even take on a bit of the role since he is the child's parent as well and that has alfred very concerned because timothy is much too young for such a responsibility and has already quietly confided to alfred during their lessons that he's happy baby jason will be going to a loving home with bruce as his father.

but alfred does not voice those thoughts either. he keeps quiet and when baby jason arrives, he keeps careful watch. he helps clean timothy up from the home birth even though he'd expressed great concern over timothy's health about things going wrong. but timothy's body was developed enough and the baby was small enough that they both came out alright. he cannot hold back the trickle of his disapproval though. births for young mothers could very easily be horribly traumatic. timothy should've been in the hands of a doctor despite both his and bruce's insistence that the birth take place at home. jason is not a quiet child. he is shrill and loud and he eats so messily and loudly and he's...so much like master bruce when he'd been young.

he demands a bottle be on hand and prepared at all times, and once he figures out that master timothy can be a source of food he is always vying for his attention much to master timothy's amusement. after the birth master timothy sticks around, not that alfred was looking to chase him away but he's taken aback by how much timothy is interested in baby jason.

master bruce is taken with him. enthralled and captivated by him. he's everything that new parents are and he is absolutely unfaltered by the dirty diapers and midnight feedings and the whimpering cries.

alfred worries for him, keeps expecting him to crack under the additional pressure, the duties. work in gotham has piled up now that bruce is working alone and without a partner. alfred expects him to struggle to regress. but he doesn't. he's fine.

then several months later master timothy is pregnant once again and alfred's concern returns tenfold. he knows master timothy has been informed of safe sex practices. he's offered to take him to nearby clinics for birth control. master timothy has refused, stating he wouldn't be needing them. alfred hadn't been in the birthing room, only master bruce had. alfred could only imagine the pain and fear the young one had felt, perhaps enough to put him off from having children of his own (but he and master bruce play with and care for baby jason so frequently they're basically raising him together).

alfred confronts maser bruce, asks him about the investigation and the case that he'd conducted with master timothy's first pregnancy. bruce to alfred's surprised is as distressed as he is. he repeats how timothy is still so small, so young, how he's only recently healed from birth and what if this time isn't as smooth. he worries for master timothy's education, his future, his family, his friends who hasn't seen since he got pregnant with baby jason and alfred is...pacified by the worry. knowing that master bruce will surely take on master timothy's case with the utmost urgency.

that changes a bit when bruce tells him the name. thomas. sweet thomas. thomas wayne will live again and there's a softness in bruce's eyes that warms alfred's heart and disturbs him.

two babies join the household and then timothy is pregnant with a third and alfred puts his foot down. he demands to know what is happening and bruce is silent, quiet. staring at the blood test he'd conducted on timothy and he says one word with such a hollowed fury that it scares alfred. "jack"

jack. jack drake. timothy's father.

alfred goes so lightheaded he could faint. jack drake is responsible for this. for those two sweetly chubby infants sleeping in the manor and for the third on the way and...and and alfred had a clear moment where he imagines going up, getting his shot gun, and making his way next door.

but he doesn't. because bruce says he will deal with it. a baby and a set of twins later and jack drake dies and alfred is relieved but timothy is a broken child. ruined by what he experience and he does not cope well. more children join them and alfred implores for bruce to help timothy but bruce is so taken by his children and alfred will admit most days he is too but timothy. timothy. who thinks of timothy?

alfred was cooking one day, warming bottles for the children and timothy had gotten this...look in his eye. his stomach had been fat with another child growing and timothy had pressed far too close to alfred, had leant his head and nearly tickled alfred's mustache with his lips. for a moment alfred had thought timothy was leaning in to kiss him. for a moment he'd been so frozen he thought he'd let him.

that was when alfred began calling master dick more frequently, to stay with them. to help babysit. and alfred hated to admit it but he was relieved when timothy turned his attention to dick.

master dick understood the situation and he was a good man. he'd never take advantage of timothy who was so clearly troubled and so desperatly needed support.

bruce supports timothy. they talk often, spend time together. alfred sees bruce hug him close and kiss his cheeks with low whispered words between them.

and alfred is happy something is being done.

then baby jason grows older. he gets a familiar sour looks when he's upset and...alfred refuses to believe it.

it's his eyes playing tricks on him. his mind trying to erase any trait that isn't timothy's and therefore must be jack's by turning it into master bruce's features when he'd been that age.

martha is a sweetly rosy cheeked baby girl, kind and well behaved and she has the late thomas wayne's strong brows. alfred conforts himself with the fact that not all the children remind him of the waynes. timothy's third child and set of twins very closely resemble him with hints of jack that tug on their coloring.

alfred cannot believe- will not believe. so he does not.

master bruce would never, could never ever - even on his darkest day impregnate a child.

alfred refused to ever even entertain the thought.

so he doesn't.

he works, he cares, he nurtures those wonderful children and watches them grow up. watches them grow with familiar features and he ignores the thought that sparks in the back of his head that says 'that's bruce's nose' 'that's his chin' 'those are his eyes'. he tucks them to the back of his mind and firmly ignores them.

he lives and when he's alone with bruce he bites his tongue on that words that want to spill out.

'answer me honestly master bruce and do not do me the disrespect of lying. are any of childre that master timothy birthed over the years biologically yours? did you sire any of those children that poor boy carried over the years master bruce?'

alfred never asks. what if master bruce lies? what if he tells the truth?

alfred does not know which one would be more devastating so he stays silent. and he chooses to believe what he was told even though every bit of alfred knows that the child he's holding belongs to master bruce.

the grief that would come with the knowledge would be too much to bear.

but.

but...master bruce is happy. genuinely so.

master timothy is happy is well. in fact alfred doubts there is a time where master timothy is happier than when he is full with child.

years ago alfred had been terrified he was going to lose master bruce within months of master jason but now...now he has a full house. grandchildren in and out of the manor every day, visiting, stay for dinner, bringing gifts and caring for their young siblings. master bruce has looked like he's never been lighter.

and alfred...alfred cannot ruin that.

perhaps he is the worst kind of monster in remaining complicit. in suspecting wrong doings having been done under the roof he cares for but what would come of it?

master bruce would be one DNA test and one police phonecall away from prison and where would that leave all these children?

without their father. pariahs. the media would never leave them alone. they'd be harassed and prodded all their lives.

so alfred says nothing. he stays silent.

and most days...most days he forgets he even feels guilt.

which only makes the feeling worse when he does remember.

------

i love answering asks about this prompt!!!!! it was SUCH an amazing concept and i hope the anon that originally sent knows how incredible it was!!!!!

[vampire-crimson]

two kinds of medical scientists:

“i went for school for this so therefore im right your wrong checkmate fuckers”

and “what the fuck stop being transphobic literally nothing is that simple” 

and im glad he’s the latter

[suramed-health-center]

Are you in search of comforting pediatric care for your little one? SuraMed Health Center is here for you and your family! The health and safety of your child is our number one priority. 🌐 suramedhealthcenter.com

[anderson-residence]

Random thoughts and headcanons and things that i’ll need to elaborate on but I’m posting just so I don’t forget:

Pediatrcians for android kids

Medical training ‘dummies’ that are androids

YK/android kids sicknesses

Baby Alive toy advanced ai sentience

[dawnblade]

yknow what definitely didnt fucking help with the doctor thing though was when i had to do some evaluation with my pediatrcian when i was in like high school and iirc one of the questions they asked was, like, my romantic preferences or some shit???? and, like, obvi my brain was a mess back then too and i never dated and had severe self image issues, and at the time that manifested as me id'ing as asexual so i pretty much put down "none" as my preference

and when the doc got to that he basically like, laughed it off and was like well if you were going to marry would you marry a boy or a girl? and i felt so embarrassed and put on the spot that i just said "i guess both" even though i really had no fucking idea

and in that SAME visit, i actually did bring up the idea that i might have social anxiety, and he asked me a couple questions and then was like "well you can talk to me fine so i dont think its an issue"

i felt so like, embarrassed and stupid after that visit and im pretty sure all it did was make it even more difficult for me to try to talk to my doctors about my issues

[davidkayeee]

What activities have I engaged in to meet my short-term/long-term goals?

I can say that reviewing and studying well are the activities that meet my short-term/long term goals. An example of my short-term goal is to pass the semester and an example of my long term goal is to be a successful occupational therapist and Neurodevelopmental Pediatrcian someday. Studying well is one of the keys in order to achieve these short and long term goals. I am studying well not just to pass the subject, but also to understand people and help them with their difficulties in the future.

[tre54321wq]

From Resp. Dr.Raju Shah's post.

MR campaign has started in Gujarat for children aged 9 months to 15 years old. This MR vaccine will be given free by government. Vaccine will be given to all the children irrespective of past history of MMR or Measles vaccine.

Let us all Pediatrcian and clinicians help in making this Public Health Program a grand success.

Don’t believe in false news and articles in the today’s news paper. It is propaganda of Antivaccine lobby. There are no serious side effects of this vaccine. Please do not have any fear.

We have eradicated Polio & Smallpox in our country. Now it is time to control Measles and eliminate Congenital Rubella Syndrome. Let us all strive to make this program grand success.