COMMON HEALTH PROBLEMS DURING INFANCY

INTUSSUSCEPTION

Intussusception is a rare, serious disorder in which one part of the intestine slides inside another part.

DEFINITION
Intussusception

is a rare but serious disorder in which part of the intestine either the small intestine or colon slides into another part of the intestine. This "telescoping" often blocks the intestine, preventing food or fluid from passing through. Intussusception also cuts off the blood supply to the part of the intestine that's affected.

Intussusception

is the most common cause of intestinal obstruction among children. Intussusception is rare in adults.

SYMPTOMS

Severe abdominal pain that comes and goes (intermittent pain) Stool mixed with blood and mucus (sometimes referred to as "currant jelly" stool because of its appearance) A lump in the abdomen Swollen (distended) abdomen Vomiting Diarrhea Fever Dehydration Lethargy Shallow breathing

 The

first sign of intussusception in infants is usually sudden, loud crying caused by abdominal pain. Infants who have abdominal pain may pull their knees to their chests when they cry. The pain of intussusception comes and goes, usually every 15 to 20 minutes at first. These painful episodes last longer and happen more frequently as time passes.

CAUSES
Unknown Viral

infection or a growth in the intestine, such as a polyp, lymph node or tumor, may trigger it.

RISK FACTORS
most

common cause of bowel obstruction in children between the ages of 3 months and 6 years majority of cases occurring among children younger than 1 year affects boys twice as often as girls Malrotation, a condition present at birth (congenital) in which the intestine doesn't develop correctly.

COMPLICATIONS
cut off the blood supply to the affected portion of the intestine tissue of the intestinal wall to die

result in a tear (perforation) in the intestinal wall

can lead to peritonitis

TESTS AND DIAGNOSIS

blood

and urine tests fecal occult blood test

To confirm a diagnosis: X-ray or other abdominal imaging Air or barium enema

TREATMENTS AND DRUGS

giving a child fluids through an intravenous (IV) line putting a tube through the child's nose and into the stomach (nasogastric tube) to allow the intestines to decompress use a barium or air enema to correct the telescoping intestine If the intestine is torn or if an enema is unsuccessful ---surgery

PREVENTION

can't be prevented

FAILURE TO
THRIVE

DEFINITION
Description applied to children whose current weight or rate of weight gain is significantly below that of other children of similar age and sex.

CAUSES
Chromosome abnormalities such as Down syndrome and Turner syndrome Defects in major organ systems Problems with the endocrine system, such as thyroid hormone deficiency, growth hormone deficiency, or other hormone deficiencies Damage to the brain or central nervous system, which may cause feeding difficulties in an infant Heart or lung problems, which can affect how oxygen and nutrients move through the body Anemia or other blood disorders

 Gastrointestinal

problems that result in malabsorption or a lack of digestive enzymes Long-term gastroenteritis and gastroesophageal reflux (usually temporary) Cerebral palsy Long-term (chronic) infections Metabolic disorders Complications of pregnancy and low birth weight

 Emotional

deprivation as a result of parental withdrawal, rejection, or hostility Economic problems that affect nutrition, living conditions, and parental attitudes Exposure to infections, parasites, or toxins Poor eating habits, such as eating in front of the television and not having formal meal times

SYMPTOMS
height, weight, and head circumference that do not match standard growth charts weight falls lower than 3rd percentile (as outlined in standard growth charts) or 20% below the ideal weight for their height The following are delayed or slow to develop: a. Physical skills such as rolling over, sitting, standing and walking b. Mental and social skills c. Secondary sexual characteristics (delayed in adolescents)

EXAMS AND TESTS

physical exam ---check the child's height, weight, and body shape detailed history is taken---prenatal, birth, neonatal, psychosocial, and family information. The following laboratory tests may be done: Complete blood count (CBC) Electrolyte balance Hemoglobin electrophoresis to determine the presence of conditions such as sickle cell disease Hormone studies, including thyroid function tests X-rays to determine bone age Urinalysis

TREATMENT
depends on the cause of the delayed growth and development Nutrition-educating the parents to provide a wellbalanced diet Psychosocial-improving the family dynamics and living conditions

POSSIBLE COMPLICATIONS

Permanent mental, emotional, or physical delays can occur.

PREVENTION
Early detection at routine well-baby examinations and periodic follow-up with school-age and adolescent children.

SUDDEN
INFANT DEATH SYNDROME

DEFINITION
unexplained

death, usually during sleep, of a seemingly healthy baby occur in children between 2 months and 4 months of age rarely occurs before 1 month of age or after 6 months.

CAUSES
Suffocation vomiting

or choking birth defects- brainstem defects infection Prematurity Hypersensitivity to cows milk

RISK FACTORS
Male. Boy babies are more likely to die of SIDS. Between 1 month and 6 months of age. Infants are most vulnerable during the second and third months of life. Premature or of low birth weight. Your baby is more susceptible to SIDS if he or she was premature or had a low birth weight. Black, American Indian or Native Alaskan. For reasons that aren't well understood, there appears to be an association between race and the risk of SIDS.

 Placed

to sleep on their stomachs. Born to mothers who smoke or use drugs. Exposed to environmental tobacco smoke. Born during the fall or winter months. Overheated. Recently recovered from an upper respiratory infection.

Also at risk are babies whose mothers had: Inadequate prenatal care Placental abnormalities such as placenta previa, a condition where the placenta lies low in the uterus, sometimes covering the opening of the cervix Low weight gain during pregnancy Their first pregnancy at younger than 20 years of age Anemia History of sexually transmitted diseases or urinary tract infections

PREVENTION
Put your baby to sleep on his or her back. Be sure your baby is placed to sleep on his or her back when in the care of others. Don't smoke. Select bedding carefully. Place your baby to sleep in a crib or bassinet not in your bed. Keep your baby nearby. Consider breast-feeding. Offer a pacifier. Moderate room temperature.

colic

DEFINITION
If your baby cries about the same time each day and nothing you do seems to offer comfort, your baby may have colic. Colic is often defined as crying more than three hours a day, three days a week for more than three weeks in an otherwise well-fed, healthy baby.

SYMPTOMS
Predictable

crying episodes. Intense or inconsolable crying. Posture changes.

- affects 25 percent of babies - usually starts a few weeks after birth and often improves by age 3 months - ends by age 9 months in 90 percent of cases

CAUSES
Unknown lactose

intolerance immature digestive system maternal anxiety the way a baby is fed or comforted

TREATMENTS AND DRUGS

simethicone probiotics

(Mylicon)

LIFESTYLE AND HOME

REMEDIES
Feed your baby. Offer a pacifier. Hold your baby. Keep your baby in motion. Sing to your baby. Use gentle heat or touch. Give your baby some private time. Mix it up. Consider dietary changes. Let someone else take over for a time.

TRISOMY 21
DOWN SYNDROME

DEFINITION
a

genetic disorder that causes lifelong mental retardation, developmental delays and other problems most common genetic cause of severe learning disabilities in children, occurring in one in every 700 to 800 infants

SYMPTOMS
Flattened

facial features Protruding tongue Small head Upward slanting eyes, unusual for the child's ethnic group Unusually shaped ears

Poor

muscle tone Broad, short hands with a single crease in the palm Relatively short fingers Excessive flexibility

CAUSES
More

than 90 percent of cases of Down syndrome are caused by trisomy 21. A child with trisomy 21 has three copies of chromosome 21 instead of the usual two copies in all of his or her cells. This form of Down syndrome is caused by abnormal cell division during the development of the sperm cell or the egg cell.

RISK FACTORS
Advancing

maternal age. Having had one child with Down syndrome. Being carriers of the genetic translocation for Down syndrome.

COMPLICATIONS
Heart defects Leukemia Infectious diseases Dementia Sleep apnea Obesity Other problems- gastrointestinal blockage, thyroid problems, hearing loss, skeletal problems and poor vision.

TESTS AND DIAGNOSIS

Ultrasound. The doctor uses ultrasound to measure a specific region on the back of a baby's neck. This is known as a nuchal translucency screening test. When abnormalities are present, more fluid than usual tends to collect in this tissue. Blood tests. Results of the ultrasound are paired with blood tests that measure levels of pregnancyassociated plasma protein-A (PAPP-A) and a hormone known as human chorionic gonadotropin (HCG). Abnormal levels of PAPP-A and HCG may indicate a problem with the baby.

CLEFT LIP AND CLEFT PALATE A cleft is an opening or a split in the upper lip, the roof of the mouth (palate) or both. Cleft lip can affect one or both sides of the upper lip.

SYMPTOMS
Usually,

a cleft or split in the lip or palate is immediately identifiable at birth. Clefts can appear as only a small notch in the lip or can extend from the lip through the upper gum and palate.

CAUSES

Genetic factors- Either the mother or the father can pass on genes that cause clefting.

Environmental factors- Cigarette smoking Lack of folic

RISK FACTORS

Family history. Parents with a family history of cleft lip or cleft palate have a higher risk of having a baby with a cleft. Cleft lip is more likely to be inherited than is a cleft palate. Race. Clefts are more common in children of American Indian, Hispanic or Asian descent. Black children are least likely to have a cleft. Sex. Males are twice as likely to have a cleft lip. Females, however, are about twice as likely to have a cleft palate. Environmental factors. Exposure in early pregnancy to cigarette smoke, alcohol or illicit drugs may put a baby at higher risk of developing a cleft.

COMPLICATIONS
Feeding.

Ear

infections and hearing loss. Dental care and tooth development. Speech and language. Psychological challenges.

TREATMENTS AND DRUGS

Surgery
Cleft lip repair between birth and 3 months Cleft palate repair by 1 year of age Follow-up surgeries between age 2 and late teen years

Therapies

speech and psychological therapies.

PREVENTION

Genetic counseling. Your doctor will advise you on what genetic testing can tell you, such as how much a history of clefting in both your families increases your risk, as well as how blood or DNA samples can test for chromosomal syndromes. Prenatal vitamins.

IMPERFORATE
ANUS

CAUSES
abnormal

development of

the fetus occurs in about 1 out of 5,000 infants.

SYMPTOMS
Anal

opening very near the vaginal opening in girls Missing or misplaced opening to the anus No passage of first stool within 24 - 48 hours after birth Stool passes out of the vagina, base of penis, scrotum, or urethra Swollen belly area

TREATMENT
Surgical

reconstruction of the anus is needed. If the rectum connects with other organs, repair of these organs will also be necessary. A temporary colostomy is often required.

POSSIBLE COMPLICATIONS Bowel incontinence

Constipation Intestinal

blockage

OTITIS MEDIA
Ear infection, middle ear

DEFINITION
among

the most common illnesses of early childhood three out of four children have had at least one ear infection by age 3
most

ear infections clear up on their own within a few days Most children stop having ear infections by age 4 or 5

SYMPTOMS
Complain of pain in their ears Tug or pull at their ears Cry more than usual Have trouble sleeping Fail to respond to sounds Be unusually irritable Develop a fever of 100 F (38 C) or higher Develop a clear fluid that drains from the ears Have headaches

CAUSES
viral infection- colds o The middle ear lining becomes swollen from the viral infection, and fluid builds up behind the eardrum. Because children's eustachian tubes are narrower and shorter than those of adults.

MIDDLE EAR

The middle ear is connected to the back of the nose and throat by a narrow passageway called the eustachian tube. In a middle ear infection, the tissue inside the middle ear becomes swollen and may fill with fluid.

RISK FACTORS
Age- 6 and 18 months are the most susceptible to ear infections - common from ages 4 months to 4 years Group child care- exposed to more viruses causing cold Feeding position Season Reduced air quality- exposed to tobacco smoke or higher levels of air pollution Family history

COMPLICATIONS
Short-term Long-term Ruptured

hearing loss hearing loss

eardrum

TESTS AND DIAGNOSIS

Tympanometry. This test measures eardrum movement. A soft plug is inserted into the opening of the ear. The plug includes a device that changes air pressure inside the ear.

Acoustic reflectometry. During this test, the doctor uses a hand-held instrument to project sounds of varying frequencies into the ear. How the sounds are reflected off the insides of the ear can tell the doctor how much fluid is inside the ear.

TREATMENTS AND DRUGS

1. A wait-and-see approach first 72 hours for children who: Are older than age 6 months Are otherwise healthy Have mild signs and symptoms or an uncertain diagnosis 2. Antibiotic therapy Children younger than 6 months old Children and adults who have had two or more ear infections in the past 30 days

. Drainage tubes Surgery-myringotomy

3

PREVENTION
Keep

your child away from sick children Protect your child from secondhand smoke Breast-feed your baby for at least six months If you bottle-feed, hold your baby in an upright position.

FEBRILE SEIZURE

DEFINITION
A convulsion in young children caused by a sudden spike in body temperature, often from an infection.

SYMPTOMS
Have a fever usually higher than 102 F (38.9 C) Lose consciousness Shake or jerk the arms and legs on both sides of the body Roll his or her eyes back in the head Have trouble breathing Lose urine Vomit Cry or moan

CLASSIFICATION
Simple febrile seizures. These are the most common. They last from a few seconds to 10 minutes and stop on their own. After the seizure, your child may cry, act confused or be quite sleepy. Complex febrile seizures. A complex febrile seizure lasts longer than 15 minutes, occurs more than once within 24 hours or is confined to one side of your child's body.

CAUSES
Most common. The most common cause is a typical childhood illness, such as a middle ear infection or roseola a viral infection that causes swollen lymph nodes, usually in the neck, and a rash. Less common. A less common but very serious cause of sudden fever with seizures is an infection of a child's brain and spinal cord (central nervous system), such as meningitis or encephalitis.

Post-immunization seizures

If a febrile seizure occurs, it's caused by the fever that may accompany the vaccination not by the vaccination itself.

TREATMENTS AND DRUGS

Donts fever medications during a seizure child in a cooling tub of water
Dos child to remain lying on the carpet or a bed

HEALTH
PROBLEMS COMMON IN

TODDLERS

BURNS

DEFINITION
Burns are injuries to tissues caused by heat, friction, electricity, radiation, or chemicals.

CHILD SAFETY: HOW TO PREVENT

BURNS
Child safety at home 1. Reduce water temperature 2. Avoid hot spills-Don't drink or carry hot beverages or soup while holding a child. When you're using the stove, turn the handles of your pots and pans inward. Don't hold a baby while cooking. 3. Establish 'no' zones- Block access to the stove and fireplace, and make space heaters and hot water heaters inaccessible. 4. Unplug irons- Store items designed to get hot, such as clothes irons, unplugged and out of reach.

5. Test food temperature. 6. Cover outlets.

Child safety outdoors

1. Watch grills and fire pits. Don't allow children to play near these potential hazards. 2. Check car seats. Before placing your child in a car seat, check for hot straps or buckles. If you park in direct sunlight, cover the car seat with a towel or blanket. 3. Forgo backyard fireworks. Leave fireworks to the trained professionals.

Fire

safety 1. Lock up matches and lighters. 2. Be careful with candles and cigarettes. 3. Keep your fireplace clean.

POISONING

DEVELOPMENTAL ABILITIES RELATED TO RISK OF INJURY

 Explores

by putting objects in mouth Opens drawers, closets and most containers Climbs Cannot read labels Does not know safe dose or amount

INJURY PREVENTION
Place all potentially toxic agents out of reach or in a locked cabinet, including cosmetics, personal care items, cleaning products, pesticides, medications. Caution against eating nonedible items, such as plants and personal cosmetic products. Immediately put away medications or poisons; replace child-guard caps properly. Administer medications as a drug, not as candy. Do not store large surplus of toxic agents. Never remove labels from containers of toxic substances.

ACCIDENTS
MOTOR VEHICLES

DEVELOPMENTAL ABILITIES RELATED TO RISK OF INJURY

Walks,

runs, and climbs Able to open doors and gates Rides tricycle Throws ball and other objects

INJURY PREVENTION
Supervise

child while playing outside. Do not allow child to play behind a parked car. Do not permit child to play in large cardboard containers. Lock fences and doors if not directly supervising children.

DROWNING

DEVELOPMENTAL ABILITIES RELATED TO RISK OF INJURY

Able

to explore if left unsupervised Has great curiosity Helpless in water; unaware of its danger; depth of water has no significance

INJURY PREVENTION
Supervise

closely when near any source of water, including buckets. Never, under any circumstance, leave unsupervised in bathtub or around bathtub filled with water. Keep bathroom doors closed and lid down on toilet.

FALLS

DEVELOPMENTAL ABILITIES RELATED TO RISK OF INJURY

Able

to open doors and some windows Goes up and down stairs Depth perception unrefined

INJURY PREVENTION
Place gates at top and bottom of stairs. Keep doors locked. Apply nonskid decals in bathtub or shower. Keep cribs rails fully raised and mattress at lower level. Avoid using mobile walker, especially near stairs or drop-offs. Dress child in safe clothing. Select play areas with soft ground cover.

CHOKING AND
SUFFOCATION

DEVELOPMENTAL ABILITIES RELATED TO RISK OF INJURY

Put

things in mouth

May

swallow hard or inedible pieces of food

INJURY PREVENTION
Avoid

large, chunks of meat. Avoid fruit with pits, fish with bones, hard candy Choose large toys and without removable parts.

MERRY CHRISTMAS AND A BLESSED NEW YEAR!!!