Diabatic care in
Unani System
De-tox, the right unani Way
Banish toxins from your body with some simple unani lifestyle changes
You have been eating out almost everday now and feel sluggish thanks to all the oil and added flavour. Which means, you could do with a detox. All you have to do is eat the right foods. Here’s how to go about it.
Stay Hydrated
You must have heard it a million times, but your body cannot function properly without water. All the unhealthy food stuck in your intestines will be flushed out of your system by the water.
Drink Tea
Green tea is also rish in antioxidants that can improve your body’s immunity. These repair damaged caused to cells and blood vessels walls by free radicals. It also helps reduce blood clots, and thus decrease the risk of a heart attack.
Fruitilicious
Fruit are rish an antioxidants and vitamins, which are required for the regeneration and repair of tissues. Include oranges, kiwis, bananas and apples in your daily diet. Opt for fresh and whole fruits rather than processed juices.
Go Green
Consume green, leafy vegetables. These are a storehouse of essential nutrients such as vitamins, calcium, iron, protein etc. Eat at least five portions of vegetables in a day.
Bean up
Soybeans are a great source of proteins. Eating junk food drains the proteins in your body. Proteins are the building blocks of your bodies. Soybean can give your body this.
Foods to Avoid
Aerated drinks
Oh come on! We all know it’s nothing but carbonated water. The carbon dioxide makes your stomach bloat, leading to acidity and obesity. So keep the CO2 away and breathe in some fresh oxygen.
It’s just oils
Saturated oil is the root cause of a number of health problems such as obesity, skin problems, diabetes, cholesterol and heart disease.
Evils of sugar
The sugar in these can lead to diabetes and hurt your body’s defense mechanism.
No to white
White processed foods like white bread and pastas are to be avoided. They have starch, which is a kind of fat that leads to obesity and cholesterol.
No to Potato
It’s basic vegetables that we eat all the time, yet at times it harms us. They contain solanine, a toxic fungus that causes gastrointestinal poisoning.
It is not always necessary to go to a spa to detoxify. You can do it yoursefl! Just make sure that you also take part in some sort of physical activity in addition to following a healthy diet. Exercise also releases toxins by making you sweat.
Dr. Syed M.M Ameen For Banner Enquiries
khaleefs@giasmd01.vsnl.net.in
S.K's Herbal Medical Hospital & Research Centre
No:36, Jani Jehan Khan Road,
Royapettah,
Chennai - 600 014.
Phone : +91-44-2848 3231 / 2848 3281 / 2848 1344
Fax : +91-44-2844 0763
Web : www.herbalniamaths.com
Editor:
Dr.Syed M.M Ameen
Asst.Editor:
Mrs.Nasreen Ameen
Children’s health in
unani system of medicine
Good parental care as per Unani System of Medicine during childhood from occurring, and can help a child grow into a healthy adolescent and adult.
A young child has physical needs, such as food, clothing, and protection from illness; emotional needs; and intellecutal needs. It is of the utmost importance that parents understand and try to fulfill these needs.
The most pressing needs of a newborn baby are mainly physical and how to take care.
Despite all parental precautions, a young child is likely to become ill. In fact, it is preferable for some diseases, such as varicella (chicken pox), to be caught during childhood rather than during adulthood, because certain infections can be much more serious in adults. Guidance on immunization against serious disease, and on the actions the parents should take if a child becomes ill.
As the child grows older, the parents can help him or her to develop psychologically so that, in this respect, the child becomes increasingly independent. However, a young child still depends on the parents to fulfill emotional needs and to provide guidance in social and intellectual development.
Strong emotional bonds are formed between the parents, particularly the mother and the baby during the first few days following birth. As the child develops, his or her emotional needs change. Parents should try to recognize these changes and adjust their own behavior accordingly. They should try to provide an emotionally secure environment for the child.
As children mature they become aware of themselves as individuals and may begin to challenge the standards of their parents. This may cause difficulties in the parent-child relationship, particularly over matters of discipline. Children also become aware of their sexuality. The growing child common problems that may confront parents during their child’s sexual development is to be taken care. It provides guidance on sexuality; on how parents can explain sex to their children; and on the difficulties that may result from the child’s increasing independence.
Breast feeding a Unani Way
In the first two to three days after birth, the mother’s breasts produce a substance called colostrum. Colostrum resembles melted butter, is high in protein, and contains antibodies that protect the baby. It helps to cleare the bowels easily of meconium, a substance in the bowels of all newborn babies. There is no artificial substitute for colostrum.
Breast milk
Breast milk is easily processed by the infant’s digestive system and helps to prevent allergies. Unlike cow’s milk, breast milk leaves an acid residue in the bowel, and prevents the growth of harmful bacteria. Breast-fed babies usually do not suffer from constipation, provided there is an adequate supply of milk. For the first few weeks bowel movements may be frequent, but these may decrease to two dirty diapers a day.
Most women find breast-feeding a pleasure once it is established, although initially it may be very painful. Emotionally, it ensures closeness with the baby; physically, it helps the womb to return more quickly to its normal size. Successful breast-feeding depends on the mother’s attitude; prenatal preparation of the breasts and nipples, and their postnatal care; a good, balanced diet, with plenty of fluids; rest; and patience.
Prenatal breast care
A well-fitting bra should be worn, both day and night, from the seventh month of pregnancy onward. From then, the nipples should be washed well each day and gently rubbed with a towel after a bath. Some physicians advise applying a bland ointment.
Flat nipples should be drawn out and rolled between thumb and forefinger. At about the eighth month, the breasts should be gently massaged, and a little colostrum should be pressed from each nipple. This helps to open the milk ducts.
Women with inverted nipples can wear devices popularly known as “shells” inside the bra during the last three months of pregnancy. If no improvement takes place, a Natural Nursing Nipple Shield is helpful when nursing.
Breast feeding
Before putting the baby to the breast, clean the breast with a cotton swab dipped in warm water, to remove any ointment. Start each feeding on the opposite side from the last.
After the feeding, wipe the nipples with cotton dipped in warm water and apply an ointment or spray. Try to avoid the use of plastic-backed milk-retaining pads inside the bra because they can make the nipples sore.
The first time
A newborn infant does not know immediately how to find the source of nourishment and satisfaction. The mother should support her breast from underneath and gently guide the nipple towards the baby’s mouth.
Although babies nurse better if they are not overdressed, agitated babies benefit from being wrapped with only one arm left free.
Breast feeding at home
Once home from the hospital, the mother’s early discomfort after the birth should quickly wear off. She can now sit well back in a low chair, feet on the floor, to nurse the baby. While nursing, wear a terry cloth apron; it makes a comfortable surface. When the baby starts to suck, the other breast may leak. Control this by firmly pressing paper tissues against the nipple.
The baby’s Temeprature
A newborn baby is unable to control body heat as efficiently as an older child. External changes in termperature can vary a baby’s body temperature considerably. Unless a baby is kept adequately warm, he or she could suffer from hypothermia. This does not means that the parents must constantly check the baby’s temperature with a thermometer, but they must be aware of potentially dangerous situations.
Cold
A baby’s bedroom must be maintained at a temperature of at least 60F (15.5oC). A thermostat heater is an efficient method of keeping the room warm throughout the night. During the winter, warm the baby’s cribe with a hot water bottle before placing him or her in it, but remember to remove the bottle first. Never use an electric blanket on a baby’s bed. Also, before putting the baby to bed, cuddle him or her. A tiny baby does not move during the night, and is unlikely to warm up. A cuddle before bed warms the baby.
Heat
During hot summer weather, a baby should wear light, loosely fitting, cool clothing. As long as he or she is protected from direct sun, the baby can lie outside in nothing but a diaper. Overdressing, causing overheating, is one of the most common reasons for irritable babies during the summer.
Never leave a small baby unattended in a car. This is especially important during the summer, because if the care is in direct sun, the baby can become dangerously over heated. A baby under the age of three months is unable to lose excess heat.
During car journeys, check frequently to make sure that the sun is not shining directly onto the baby. Also, protect the baby’s head from the sun.
Illness
When a baby becomes ill, he or she may or may not have a temperature above normal. A reading from a thermometer is an inaccurate guide to a baby’s state of health. Other warnings signs must also be considered.
The most commong noticeable signs that a baby has an infection or illness are; a sudden loss of appetite; the baby is irritable or, alternatively, lethargic; and there may be vomiting or diarrhea. These signs are a more accurate indication than a temperature reading.
However, during an illness, the physician may ask the parent to monitor the baby’s temeprature. It is dangerous to place a thermometer in a baby’s mouth, and difficult to keep one underneath a baby’s arm for a sufficient length of time. The safest way to take the baby’s temperature is with a rectal thermometer.
A rectal thermometer has a rounded, stub end. This type of thermometer can be used for taking oral temperatures as well, so when buying a thermometer buy a rectal one.
Finally, do not keep a baby’s room too hot is he or she is ill. If the baby has a high temperature, keep him or her covered with light clothes and a sheet. The physician may recommend sponging with tepid water to keep the baby’s temperature down.
Rectal temperature
Make sure that the mercury ribbon is first shaken below the thermometer’s normal mark. Then take the baby’s rectal temperature using the method described below.
It is usually takes from 3 to 5 minutes for a rectal thermometer to register the body temperature. Although the normal body temperature varies from person to person, the average is 98.6oF (37oC) for an oral temperature, and 99.6oF (37.6oC) for a rectal temperature.
Wash the thermometer carefully after use with cool water and soap. Never use hot water, because this will break the bulb.
Taking a rectal temperature
Lay the baby on his or her back. Dip the end of the thermometer in petroleum jelly. Hold the baby’s legs up with one hand, and gently insert the bulb into the anus. Do not push if the thermometer meets anobstruction. Slide the thermometer in about 1 inch. (2½ cm). Talk calmly to the baby throughout the procedure, and do not frighten him or her by gripping the legs too tightly.
Birth to age 1 : Normal Development
Each section of the age-by-age chargs begins with an outline of the normal achievements of a child of the age group being considered. The stages of development, in this case of a baby from birth to age eighteen months, are represented in chart form. It should be remembered that these chargs can only present an outline of average development, because babies can vary enormously in the rate of their individual progress. Certain babies will be more advanced in some things and slower in others. Sometimes progress is rapid over a wide range of abilities, whereas at other times it may be held back, perhaps by illness or accident. If paretns are concerend about their child’s lack of progress, they should consult a pediatrician.
The problems and disorders that can affect a baby at birth, and in the months following birth, are illustrated in charts that emphasize the main symptoms, how to treat them, and also show other problems that can raise.
Vision
Achievements include at
Birth : closes eyelids to bright light.
Two weeks : momentarily looks at objects.
One month : briefly follows parent’s face and may smile
Two months : follows moving objects with eyes
Three months : begins to focus and starts to move head as well as eyes
Four months : looks at own hands and focuses easily on nearby objects.
Five months : looks at surroundings and searches for lost toy
Six months : looks at an picks up object
Nine months: looks at small objects
One year : interested in simple shaps
Fifteen months: recognizes simple pictures
Hearing
Achievements include at
One month: responds reflexly to loud noise (startle reflex)
Four months: opens or widens eyelids in response to loud noise
Five months : turns head to right or left toward sound
Nine months : locates noises to one side of, or below head
One year : turns head toward sounds from any direction
Speech
Achievements include at :
Three months :laughs
Seven to eight says “Da” and “Ma” “Da- months da” and “Ma-ma”
Ten months has one word with a particular meaning
One year uses a few words correc tly (for example, “dog”)
One year to develops own language eighteen months mixed with many normal words; often understood by family and enjoys experimenting with new sounds; some children speak well (for example, may describe events accurately)
Physical Movement
Achievements include at
Birth can just lift head when lying on stomach; head lags behind when pulled to sitting position.
One month may hold head up for a moment when sitting
Teeth
Developments include at
Birth in rare cases a child may be born with one or more teeth
Six months lower middle incisors
Seven months lower outer incisors
Seven to nine months four upper incisors
One year lower first molars
Twelve to upper first molars
fourteen months
Fifteen to eighteen uppder and lower eye months teeth
Disease prevention and health care
Immunization
Suggested schedule
Two months diphtheria, tetanus and whooping cough (triple) injection; oral polio vaccine
Four months diphtheria, tetanus and whooping cough (triple) injection; oral polio vaccine.
Six months diphtheria, tetanus and whooping cough (triple) injection; oral polio vaccine.
Twelve months skin test for tuberculosis
Fifteen months measles, mumps and rubella (triple or single) injections
Eighteen months diphtheria, tetanus and whooping cough (triple) injection; oral polio vaccine.
Immunization programs must begin soon after birth, as infectious diseases can be more serious in babies than in adults.
Whooping cough vaccination is not recommended if the baby has had a convulsion, if there is any sign of a brain disorder, or if there is a family history of epilepsy. If in doubt, consult a pediatrician.
Health care
Weight, length and head circumference measured on each visit. Suggested schedule
At birth pediatrician’s exami nation; PKU test: blood test, if required for legal or medical reason, for example blood group, rhesus factor, syphilis, anemia, jaundice factor; test for hypothyroidism
Birth to age 1 : disorders 1
Symptoms and signs Treatment
Allergy to cows’ milk
May include; skin rash; breathing difficulties; running nose; diarrhea; vomiting after feeding; weight loss. Consult pediatrician; avoid cows’ milk in the diet
Anal bleeding
Blood in the feces; evidence of pain (screaming) on defecation; constipation. Consult a pediatrician; give the child plenty of fluids to prevent constipation; suppositories or lubricants inserted on a gloved finger may be required
Anal swelling
Swelling at anus; red tissue protruding through anus; sometimes colic and vomiting. Consult a pediatrician or go to a hospital immediately
Anemia
Pale skin; lethargic behavior; often breathlessness when crying. Consult pediatrician; diagnosis from blood test; full investigation to detect deficiency of iron salts; small quantities of iron salts added to the diet; vitamin C given, in form of orange juice, to icnrease iron absorption; iron supplements usually given in liquid or tablet form.
Autism
Child that shows no signs of affection; lack of response to people, so that deafness may be suspected; lack of interest in cuddling; ignores interruptions; child may show repetitive mannerisms. Consult pediatrician for advice and definite diagnosis; special treatment sometimes helpful.
Bowlegs
A gap between knees when feet are placed together; generally a normal occurrence in children when they start walking Consult pediatrician for an opinion; normally no treatement necessary unless other conditions are present; condition normally corrects itself, from about age two years.
Bronchitis
Cough; fever; rapid breathing Consult pediatrician for diagnosis; keep child in warm, humid room; hospitalization for serious cases; pediatrician may prescribe antibiotics or antispasm cough mixture.
Celiac disease
Starts about age six to twelve months; loss of weight; swollen abdomen; plentiful, frothy, floating diarrhea; loss of appetite. Consult a pediatrician who will recommend a diet free of gluten, the protein in wheat and rye that causes the symptoms; gluten-free diet may have to be maintained for rest of patient’s life.
Cerebral palsy (spasticity)
Lack of movement; differences in movements of either side of the body; child seeming to be too quiet; muscles feel stiff; child failing to suck normally; one hand, or both, remaining closed. Assessment by pediatrician; repeated exami-nations, over several days or weeks required for complete diagnosis; deformities prevented by moving limbs gently, several times each day; limbs moved through normal range to teach correct position and use, and to relax muscles.
Cows’ milk is a common cause of allergy in babies, particularly if this milk is given in the first month of life.
Anal bleeding is often the result of constipation. Hard feces sometimes tear the mucosa lining the rectum, causing an anal fissure. Anal bleeding may also be due to an intussusception or a rectal prolapse, which are serious so consult a pediatrician immediately.
A prolapse of the rectum is the most likely cause of anal swelling. but sweeling may also be a symptom of an intussusception.
Blood tests should be repeated even when the condition appears to be cured. Iron deficiency anemia is the most common type of anemia, particularly in premature babies or in those that have been fed solely on milk for more than six months. In some cases anemia may be a symptom of a more serious. disease. Consult a pediatrician if there is any doubt.
Many autistic children are intelligent and some show relatively advanced behavior in one particular respect. Some autistic children develop a special relationship with one person.
If the condition persists, an orthopedic specialist should be consulted, particularly if bowlegs are associated with club foot. A child may appear to have bowlegs because of the. normal bulge of the outer sides of the calves, when compared to the inner side. Bowlegs are diagnosied by the separation of the knees.
Bronchitis may develop after a cold and is some times accompanied by vomiting or diarrhea. Bronchiolitis, commonly called “wheezy” bronchitis, is the most common variety and may be an indication that asthma. will develop later in childhood, particularly in a child who has eczema. The condition may also be associated with cystic fibrosis.
The pediatrician may examine the feces for excess fat, or carry out tests to determine whether the small intestine is absorbing sugar and iron properly. A diagnosis of celiac disease is usually confirmed by making a biopsy of the small intestine. In some cases the biopsy is repeated after six months of gluten-free diet.
Cerebral palsy mayoccur if the baby is premature, if the baby has severe jaundice at birth, if the mother had diabetes during pregnancy, or as the result of a birth injury.
Birth to age 1 : disorders 2
Symptoms and signs Treatment
Chest deformities
Funnel breast, a depression of the breastbone resembling a funnel; pigeon breast, a protuberance of the chest in front; altered shapes of the normal chest. Surgical treatment seldom needed but may be given for cosmetic reasons. Discuss with pediatrician, because operation may be dangerous.
Cold : Fever; running nose with nasal mucus and cough; sometimes diarrhea. Keep in warm room; plenty of fluids; consult pediatrician who may give antihistamine drugs to dry nasal secretions; pediatric nose drops may be used for few days, particularly before feeding, because sucking is difficult with a blocked nose.
Colic : Screaming and drawing up of knees in small baby Further “burping” of child after feeding; sips of sweetened water; cuddling; change of diaper; all these may be necessary.
Colic, infantile (three-month colic)
One to two hours of recurring colic; taking place most evenings in one-to three month old baby If simple measures fail consult a pediatrician; antispasm medicine before baby’s meal.
Conjunctivitis
Red eye with sticky discharge. Keep eye clean by bathing with warm, weak salt solution two or three times a day.
Constipation
Occasional passing of hard feces; may accompany a fever sometimes occurs after diarrhea or vomiting. Increase fluids by mouth; in older babies more fruit and vegetables produce a larger stool; children’s suppositories may help restart defecation.
Convulsions : Sudden body rigidity and loss of consciousness; sometimes followed by generalized shaking that lasts between fifteen and sixty seconds; convulsion may be followed by continued unconscious ness, for several minutes before return to normal color and consciousness.
Hold baby on side with head down to allow any vomit to leave mouth and to prevent inhalation of vomit into lungs; do not try to force anything into mouth; consult a pediatrician.
“Cradle cap”
Brown, flaking skin on scalp; flakes become thick if not treated; this is a normal and common occurrence. Rub regularly with baby oil or olive oil; shampoo regularly and carefully; comb and brush flaking skin away. If scalp becomes red or looks sore, consult a pediatrician.
Funnel breast is rarely associated with underlying disorders, but pigeon breast may be associated with congenital heart disease, asthma, or rickets. In some cases, funnel. breast may be an inherited condition.
A young baby may still have some protection against colds because of immunity transferred from the mother. Nevertheless, older children with colds should not go near the baby and the mother should wear a mask if she is developing a cold.
Serious causes of colic include intestinal obstruction and intussusception. It is also associated with some
infections, particularly ear infections.
The colic may be due to abdominal discomfort and pain after crying, because the crying causes air to be swallowed. The baby may cry because it is bored, or because it has been fed in a hurry. Feed the baby slowly with small amounts of solids and keep the baby sitting up ina chair for a short time after feeding.
Conjunctivitis commonly occurs with a cold or other virus illness. If the discharge is increasing, discuss the condition with your pediatrician. Conjunctivitis is often. contagious and cloths or towels used for the patient should not be used by other members of the family.
Constipation is commonly due to insufficient fluid in the diet. Constipation and anal bleeding may be due to a painful crack in the anal skin, whereas constipation and colic may indicate an intestinal obstruction. Prolonged
constipation, from birth, may be due to Hirschsprung’s disease or cretinism. Breast-fed babies may have a normal stool only about once or twice a week.
Convulsions are most commonly caused by high fever, brain damage at birth, or epilepsy. If the convulsion occurs with a high fever, sponge the baby down at once with tepid water, and keep temperature below 102oF (39oC) with repeated sponging and pediatric aspirin.
“Cradle cap” improves naturally as the baby grows and usually disappears by age one.
Birth to age 1 : Disorders 3
Symptoms and Signs Treatment
Diarrhea
Liquid stools; often occurring without illness; blood in feces or colic are more serious symptoms; severe diarrhea, or diarrhea with vomiting may cause dehydration. Avoid fruit and vegetables in diet; kaolin mixture, from pharmacist, may produce more solid stools; give plenty of fluids to avoid dehydration; consult pediatrician if diarrhea persists for more than two hours; more than five diarrheal stools in a small baby can cause rapid dehydration.
Dry skin
Dry, scalelike appearance of areas of skin; surface of skin flaking off. Consult a pediatrician; use creams to keep skin moist.
Dwarfism
A baby who does not grow at the normal rate; slow development of a particular part of the body. Consult pediatrician; treatment depends on cause; diagnosis from X rays, blood tests, or associated symptoms.
Ear problems : ear pain
Crying; restlessness; holding ears; other indications that the child has earache.
Earache is a sign of infection or inflammation of the ear; consult a pediatrician for antibiotic or other appropriate treatment.
Ear problems; ear pulling
A child constantly pulling on an ear. Ear pulling is not a sign of infection. Babies like to play with their ears and may pull them when tired or bored.
Eczema
Red, roughened patches on the skin causing irritation and scratching. Discuss with pediatrician; careful use of hydrocortisone creams; antihistamine drugs; use of specially medicated cleansers in place of common soap when washing; avoidance of wool clothing and, occasionally, certain foods. Gloves worn at night will help prevent scratching.
Eye problems : blocked tear duct
Persistent flow of tears from one or both eyes. Consult a pediatrician; if condition persists, it can be relieved by passing a small probe down the duct to clear it.
Dehydration is dangerous and a pediatrician must be consulted as soon as possible if signs of dehydration appear. Celiac disease and cystic fibrosis are serious causes but diarrhea may occur with almost any respiratory or other infection, for example cold ear infection, or bronchitis and may also be caused by antibiotics.
Dry skin, it its most severe form, is a congenital abnormality. In hot climates.
sweating may aggravate the problem.
Some babies are small because their parents are small and a premature baby is usually a small baby. Feeding problems, or heart disease may also inhibit normal growth. Failure to grow normally may be due to a
serious condition such as celiac disease to some disorder such as cretinism or to a congenital anomaly such as achondroplasia.
A discharging ear sometimes occurs after a prolonged period of crying in a child who has a cold and this may be a sign of an infected middle ear and of a burst.
eardrum. Continued discharge may cause soreness on the side of the neck and cheek. Remember to check for deafness when the ear seems better.
A baby over age ten months may indicate that an ear is hurting by crying, by holding the ear, or by refusing to allow anyone to touch the ear. Ear pain often occurs with a cold or a throat infection.
Vomiting may occur. Recurrent ear pain may be due to swollen adenoids blocking the Eustachian (auditory) tube, Check for deafness.
In babies eczema generally starts on the scalp or face, but in older children it develops most commonly in the creases of the elbows, and behind the knees and ears, although it can occur anywhere on the body. Bleeding and infection may occur from scratching. The condition seldom develops before the age of three months and usually improves after age three years. Eczema varies greatly in severity.
from time to time and from one baby to another. There is usually a family history of allergy. In some children, after the natural improvement of eczema, asthma may develop. The use of desensitizing injections against allergies seldom helps eczema. Smallpox vaccinations must never be given to a child with a history of eczema.
A blocked tear duct in a baby is a tear duct that was not fully opened at birth. Sometimes blockage is caused by conjunctivitis or by a cold if the
infection has spread to the tear ducts.
Birth to age 1 : Disorders 4
Symptoms and Signs Treatment
Eye problems : cataract
Eyes with opaque lens; appearance of a gray spot, seen through the iris; clouding of lens may or may not interfere with vision. Consult ophthamologist; severely opaque lens should be surgically treated when the child is six months old.
Eye problems : squint
Eyes look in diferent directions; one eye that appears to wander, independently of the other, from object at which child is looking; symptoms may be noticed as early as age six or eight weeks. Examination by ophthalmologist to ensure both eyes are healthy and that one is not merely nearsighted and “lazy” treatment required if squint persists or is present at age six months; cover normal eye to allow weak eye to develop; early surgery, at about age one, produces good results if squint is due to lack of muscle balance.
Failure to thrive
A baby showing slow physical development; slow weight gain; lethargy; a baby that appears weak and seldom cries. Consult a pediatrician if the condition persists for more than three week.
“Fat baby”
Baby is overweight and lethargic; late walking; appearing to be behind expected physical achievements. Discuss feeding with pediatrician; reduce sugar and carbohydrate intake; avoid sweetened drinks between meals; increase fresh fruit and vegetables in diet.
Feeding problems; food fads
Refusal of many different kinds of food; preference for one or two particular foods. Parents should be firm and produce a normal nutritious meal; end meal by leaving baby hungry if baby will not eat food that has been refused; give all the originally intended foods; repeat at next meal until baby starts eating disliked food.
Feeding problems : Foods refusal
Refusal to feed; particularly when a new food is introduced. Baby may have eaten enough or may wan to drink; try some other item of food before trying the unwanted food again; further refusal may be ignored at the first meal but the next day try again and be prepared to stop meal if baby will not eat it.
Fever
Baby who appears hot, fussy, flushed, or lethargic; chills and shivering; baby thirsty but refusing food; feeling cold at onset, but then feeling hot; fever confirmed by taking temperature. Give plenty to drink; give pediatric aspirin mixture to reduce fever; if fever over 104oF (40oC), consult pediatrician as soon as possible; sponge baby with warm water or put in bath; call pediatrician if other symptoms occur or if you are anxious.
Green feces
Green feces being passed; occurring with diarrhea. In young babies, increase amount of milk; give clear fluids if diarrhea occurs; treat as diarrhea faces will return to normal color when diarrhea stops.
Notes Notes
A cataract in a baby is a congenital abnormality that can be caused by the mother’s having contracted rubella during.
pregnancy
There is often a family history of squint. The sudden onset of squint at any age needs thorough investigation.
Failure to thrive is most commonly caused by inadequate nourishment, or by an illness, such as congenital heart disease. The condition may also be a result of a lack of affection, and this should always be considered as a possibility. Other possible causes include cerebral palsy cretinism celiac disease cystic fibrosis and lack of pituitary growth hormone.
The condition is rarely, if ever, due to disease. Obese parents tend to have obese children. Overweight babies usually grow into overweight adults, partly because of the family eating habits, and partly because parents consider the obese shape to be a healthy one.
In some cases obesity results from too many sweet foods. Food fads are usually associated with feeding problems, such as food refusal, that have not been controlled. In general, there is no harm in selecting foods for which the child has shown a preference, provided that the child does not try to manipulate the parents.
It is normal for a baby’s appetite to diminish after about twelve months, because the growth rate also down. Refusal of a food that has been previously eaten is usually a sign that the baby wants to assert itself. A gradual approach allows the parent to be sure the baby is not becoming sick, vomiting or experiencing diarrhea. Once the baby has been able to refuse one food it may refuse more as a way of defeating the parent. Every baby and child should be allowed one or two dislikes.
Fever is often the first symptom of another illness, for example, a cold and is sometimes associated with diarrhea or vomiting. A fever usually disappears in twenty-four hours if treated sensibly. Recurring fevers, with no obvious cause, must be assessed by a pediatrician.
Green feces occur with diarrhea and are caused by unchanged bile salts leaving the intestine. The condition is commonly a sign of underfeeding in young babies. look for the underlying causes of the diarrhea. Green feces may also occur when the baby is given fruit juice for the first time.
Age 5 to age 11 : Disorders 1
Symptoms and Signs Treatment
Anxiety
Crying; nailbiting; tics; stuttering; frequent nightmares; recurrent unexplained pains; school phobia. Discover reason for anxiety; discuss problem with pediatrician.
Baldness (alopecia)
Patchy loss of hair from scalp; or sudden, total loss of hair from scalp; exposed skin clear and smooth; stumps of hair round edge of patch. Consult pediatrician; investigate any possible emotional cause of baldness; otherwise, only treatment is hair transplant, or wearing a toupee.
Boil
Small, red, painful lump; sometimes fever; boil develops a head within three days; boil bursts, releasing pus; pain subsides. Antibiotics; local steam heat to bring boil to a head; clean surrounding skin with rubbing alcohol. If red streaks appear radiating from boil, if a lymph gland becomes tender, or if boils recur, consult a physician.
Chilblains
Mild frostbite; numb, white area on fingers, toes, ears, or nose; red, burning, swollen, intensely itching area as skin warms up; blistering and ulceration in severe cases. Loose-fitting, warm hand and footwear; in severe cases, tablets to increase blood flow to skin; cream to reduce itching; dry dressing to prevent chilblain from being rubbed; improve nutrition to treat chilblains, and also to prevent condition recurring.
Chorea, Sydenhams (St Vitu’s dance)
Involuntary twisting movements of arms and legs; associated with rheumatic fever; grimacing; develops from fidgeting to controling movements lasting several months; movements cease in sleep. Hospitalization and assessment; sedative drugs if sever; penicillin to prevent further attacks of rheumatic fever.
“Clumsy” child
Child moves awkwardly; bad at games; bumps into things; drops things; falls over frequently; slow to learn hand skills. Refrain from constant nagging; allow child to practise hand skills; speak to pediatrician if concerned.
Color blindness
Inability to tell difference between red and green; or occasionally yellow and blue.
None.
Notes Notes
Children, like adults, become anxious. Some children openly express anxiety, and can tell parents their problems. Other children express their anxiety through rebellion, or anger. A child may be anxious because of stress between the parents, or strange behavior in the family. Another common cause of childhood anxiety is the fear of failure, a reaction against parents who constantly push the child. If a child suffers from a stammer or tic, constant nagging increases the anxiety, and the annoying habit. Once the cause of the child’s anxiety is known, the problem should not be too difficult to solve.
If this condition is left untreated, the hair grows back of its own accord, bt the child’s and the parents’ anxiety is increased. Baldness in children is sometimes brought on by a serious emotional shock.
Single boils may occur at any time, but recurring boils appear most commonly on the buttocks and at the back of the neck, especially in boys between ages eight and ten, and in the armpits at puberty. Recurring boils are not caused by poor hygiene, but frequent showers help to clear the skin. The physician may also recommend antiseptic soaps and creams, and antibiotic lotions. Recurring boils are sometimes associated with the development of diabetes, and a test of the child’s urine is advisable to exclude this possibility. In general, boils heal themselves, and immunity to staphylococcus bacteria, the most common cause, develops naturally.
Chilblains occur when the surface blood vessels constrict in cold weather. Tight shoes encourage chilblains. Children with a tendency to develop chilblains must keep warmly wrapped up at the first sign of cold weather. Once a chilblain has formed, it cannot be cured. It usually resolves itself within two weeks.
There is no cure, but this rare condition eventually improves of its own accord. Formal schooling is missed for the duration of the disease, so speak to the pediatrician about the possibility of arranging education for the child while he or she is being treated.
Many children are clumsy for no appearent reason, but sometimes clumsiness is caused by “minimal brain damage” at birth, which is thought to be like a mild cerebral palsy. Slow improvement does occur, but the child needs patient and understanding teaching from the parents.
This is an inherited genetic disorder occurring more often in boys than girls. It often goes undiscovered until the child has an eye test, either by an ophthalmologist, or during a medical examination. Color-blind people are unable to take up certain professions, for example, piloting aircraft.
Age 5 to age 11 : Disorders 4
Symptoms and Signs Treatment
nfectious diseases : measles (rubeola; morbilli)
Fever; dry cough; sore throat; runny nose; red eyes; tiny white spots (Koplik’s spots) inside mouth; then red spots developing into a pinkish red rash behind ears; rash spreads over face, onto limbs and trunk; lasts three to five days. Keep temperature down with aspirin; sponging with tepid water if necessary; nourishing fluids until appetite returns; antihistamines to reduce nasal congestion; wash eyes if crusted; nurse in a quiet darkened room; physician may give injection of gamma globulin.
Infectious diseases : meningitis
Sometimes cold-like symptoms for two days; then severe headache; vomiting; convulsions; in some cases, red rash on skin and inside mouth; stiff neck; dislike of light. Urgent medical attention; isolation in hospital; study of cerebrospinal fluid to confirm diagnosis; rapid treatment necessary to prevent development of the disease; antibiotics; nourishing diet with plenty of fluids.
Infectious diseases : mumps
Fever; headache; salivary glands in front of ears and under jaw swell and become painful after two to three days; swelling remains for up to ten days; eating and swallowing may be painful. Keep temperature down; sponging with tepid water if necessary; give plenty of fluids; nourishing diet with soft food; frequent mouthwashes and drinks; painkilling drugs; ice packs held against glands may give some relief.
Infectious diseases : poliomyelitis
At first an influenza-like illness; fever; aching muscles; then temporary improvement followed by relapse; high fever; headache, dislike of bright light. In about one case in ten this relapse leads to muscle weakness and paralysis and in rare cases, death.
Urgent medical care; complete bed rest; hospitalizaiton; painkilling drugs; mechanical respiration needed if respiratory muscles paralyzed; paralysis treated by physiotherapy; muscle tendon transplant if paralysis is permanent.
Infectious diseases : rubella (German measles)
Mild fever; sore throat for one or two days; fine, pink rash behind ears, spreading over face, then body; rash lasts two or three days; tender, swollen glands at back of head and joint pains may last longer. Keep temperature down; nourishing fluids when appetite is poor.
Infectious diseases : scarlet fever
High fever; sore throat; headache; vomiting; stomach ache; fine, red rash beginning around neck and on chest, spreading over body; area around mouth remains pale; skin peels on and after seventh day; tongue is whith initially, then bright red spots appear; exhaustion. Keep temperature down; sponging with tepid water if necessary; nourishing fluids by mouth when appetite is poor; antibiotic drugs to overcome throat infection.
Notes Notes
Measles is highly infectious. It has an incubation period of upto fourteen days, although it usually develops in ten days. The child is infectious from the onset of fever until five days after the rash first appears. A child who has come into contact with measles should be kept in quarantine for fourteen days. Complications, should they occur, may be serious. They include chest infections, sinusitis, middle ear infections, and encephalitis, an inflammation of the brain. The latter needs urgent hospital treatment. Measles vaccination is given at the age of fifteen months, and provides nearly complete protection against the disease. Even the rare cases that are not fully protected, suffer only a mild form of the disease. Older children who have not been immunized should be given measles vaccine if their health is poor.
Meningitis is spread by meningococcal bacteria. There is a slight chance that other members of the family will catch it. This is prevented if all contacts take appropriate antibiotics or sulphonamides. The child stops being infectious two days after antibiotic treatment begins. A child who has come into contact with meningitis should be kept in quaranteine for two weeks (two days if the child takes antibiotics). Complications are not common, but include arthritis, nerve paralysis, deafness, abscess inside the skill that pressess on the brain, and collapse culminating in death.
Mumps is usually mild in childhood, and not as infectious as other childhood diseases. It has an incubation period of twelve to twenty eight days, but usually develops within eighteen days. The child is infectious for two days before the onset of symptoms until ten days later, or until two days after the swelling has subsided, whichever is longer. A child who has come into contact with mumps should be kept in quarantine for twenty-eight days. Complications include deafness, encephalitis, meningitis, and inflammation of the pancreas or thyroid gland. Inflammation of one or both tetes is fairly common after puberty. Similar inflammation of ovaries is rare. Vaccination may be carried out in the second year of life.
Poliomyelitis is a highly infectious disease. Although many children can be affected by it and suffer from flu-like symptoms only, the serious cases result in meninigitis, paralysis, and even death. It has an incubation period of upto twenty-one days, but usually develops within fourteen days. The child is infectious for about three weeks after the onset of illness. A child who has come in contact with polio must be kept in quarantine for twenty-one days. Three doses of oral vaccine in infancy give complete immunity with no side effects.
Rubella is a mild childhood disease, but specific diagnosis is essential in case the child has come into contact with a woman who is in the early stages of pregnancy. If this is the case, the pregnant woman must consult her physician. Rubella has an incubation period of upto twenty one days after last contact, but usually develops within fourteen days. The child is infectious for seven days before the rash appears until five days after the rash appears. If quarantine is advised it should be maintained for twenty one days, but most schools do not exclude children exposed to this infection. Immunization is offered to boys and girls at about age one.
Scarlet fever is a streptococcal infection that affects the throat, and also causes a rash. Contacts sometimes get the same throat infection without the rash. Children seldom complain of a sore throat during the illness. It has an incubation periods of one to three days. Throat swabs are taken after the illness to ensure the infection has cleared. A child who has come in contact with the disease should be kept in quarantine for three days. Complications include rheumatic fever, acute nephritis, hair loss, and ear infection, but all complications are reduced by early antibiotic treatment. There is no immunization available, but antibiotics are given to the contacts to prevent further spread.
Age5 to age11:Disorders 3
Symptoms and Signs Treatment
Thumb-sucking
Child sucks thumb when tired, when worried, or for comfort. Appeal to child’s sense of vanity; do not use physical restraints.
Tic (habit spasm)
Rapid, repeated movement of face or body; twitch worse when child concentrates; part of body affected works normally when required; blinking and grimacing commonest forms; twitch disappears during sleep. None; discover reason for possible anxiety; do not try to stop child twitching; do not mention twitch.
Tonsil and adenoid problems
Inflamed tonsils; sore throat; blocked nose; snoring; earache; sometimes deafness. Acute infections treated with antibiotics; consult pediatrician who may recommended surgical removal.
Truancy
Child who sets off for school but does not arrive; sometimes forges parent’s note; does not tell parents about absence from sch Discuss problem with pediatrician and teacher; discover whether other children are encouraging child to join them, then talk to parents; treat child with love and understanding; try to find out underlying worry.
Warts
Small nodules, usually on hands and fingers. Warts on sole of foot (verrucas) may be painful. Assessment by pediatrician; removal by means of liquid nitrogen, dry ice, acid, foot soak, or electric cautery (burning); most disappear without treatment.
Worms
In many cases symptoms are not apparent; in others, worms may be visible in feces; sometimes intermittent diarrhea; flatulence; abdominal distension; anal itching, particularly at night. Assessment by pediatrician; treatment with appropriate antiworm medicine.
Notes Notes
Thumb-sucking is a harmless habit until it begins to affect the position of the permanent teeth. Explain to the child that the habit is pushing the teeth forward, and that to correct the position, the child may have to wear braces in the future. Wearing a glove at night, or painting the thumb with a bitter substance, may help to remind a child who has decided to stop the habit anyway. Soreness of the thumb may become painful, because of moisture or because of friction from sucking. In such cases the child usually changes to suck the other thumb.
A tic may result from a habit that used to have a useful purpose, for example, flicking hair out of the eyes. The habit continues even when the hair is cut. If the parents constantly nag the child to stop, another tic of a different nature is likely to develop. They are most common between the ages of eight and twelve, and tend to improve as the child gets older.
Tonsils and adenoids build body immunity and are important parts of the body’s resistance to respiratory disease. If scarring occurs as a result of repeated infections their usefulness is reduced and it may be necessary to remove them. Children of school age encounter many infections, and at this age the tonsils and adenoids are proportionally at their largest.
The truant child usually has a history of bad behavior at school, and a poor school record. Helping the child with homework, and involving yourself in the work, may be enough to take the anxiety out of school. Accompany the child to the school in the morning.
Warts are thought to be caused by a viral infection. They are not usually uncomfortable unless they appear on the foot, where the pressure of walking on them hurts the foot. Verrucas are mildly infectious, so a child with verucas should not be permitted to go barefoot, for instance, in a swimming pool. The foot should be covered with a protective slipper, to prevent other children catching the infection. Sometimes “seeling” warts appear around the site of a wart that has been removed. In many cases warts disappear naturally after a few months.
Worms that infect the human intestine include hook worms, pin worms, round worms, tapeworms or whip worms.
Age 11 to age 18 : Normal Development
Normal development of children between the ages of eleven and eighteen is extremely varied. This section of the age-by-age charts gives general indications of the normal changes that parents and their children can expect. A list of the most common problems and disorders encountered at this age follows this outline.
Adolescent development is closely related to situations at home, in school, and in the community. These circumstances affect mental and emotional development particularly. In addition to this, physical growth and sexual development do little to help, and may do much to complicate, the process of growth up. An understanding of this process, from the information given, will help parents to appreciate what their child is going through in the crucial, and sometimes difficult, transition from child to adult.
Physical growth
Developments include at :
Eleven to sixteen years in girls most rapid growth
occurs between age eleven and fourteen; in boys it occurs between age twelve and sixteen; height increases, on average, by six to twelve inches; weight by between fifteen and sixty pounds; legs grow first; then hips, chest and shoulders develop; and finally the trunk increases giving depth to the chest.
Sixteen to eighteen years growth complete in girls; in boys it usually continues, slowly, for a year or two more; in some cases there is “delayed adolescence”, in which a growth spurt occurs at this age.
Female sexual development
Developents include at :
Eleven to fourteen development of hips may be noticeable since age nine; early breast development evident from age ten; breast swelling rapidly from age twelve, with nipple pigmentation; size of vulva increases; hair grows in pubic region and in armpits; onset of menstruation between age ten and sixteen.
Fourteen to sixteen years breasts fully grown; slight
vaginal secretion is normal; armpit and pubic hair fully developed.
Male sexual development
Developments include at :
Twelve to sixteen years increase in size of penis
and testicles; sponta- neous erections; appearance of pubic hair; temporary breast swelling occurs in ten percent of boys; voice beginning to deepen.
Fourteen to sixteen years full development of pubic
hair; appearance of armpit and facial hair; nocturnal emission of sperm; deep voice.
Emotional understanding
Developments include at :
Twelve to fourteen years friends tend to be of own
sex; interests mainly concern school, sports and home; particular interest in factual information; no real interest in moral, social or political questions.
Fourteen to sixteen years interest in opposite sex
with “dating” tendency to stay in groups; steady friend or companion often changes every few weeks; bursts of great enthusiasm often fail to last; admiration of “cult” or public figures, often of same sex; transient homosexual phase; ability for abstract thought now fully developed.
Sixteen to eighteen years deeply involved with opposite sex; rejection often causes consider- able sense of hurt; wanting to be accepted as mature and adult; rebellious against authority; sexual anxieties and problems sometimes conflict with other interests and schooling; friends tend to be of similar stage of rebellion against authority; most adolescents are interested in politics, and particularly in ideas that are anti-establishment.
Disease prevention and health care
Immunization
Health steps to be taken at :
Twelve years : tetanus injection
Twelve to eighteen years
annual skin test for tuber culosis should be considered if the person is likely to come into contact with the disease; diphtheria injection; oral polio vaccine; immuni- zation for foreign travel where necessary (for example, against cholera, typhoid, hepatitis, typhus, yellow fever) or any other disease likely to be encountered.
Health care
Health steps to be taken at
Twelve to fourteen years
annual medical and dental checkups; dis cussion about emotional, physcial and sexual changes that are taking place; importance of personal morality and ethical values must be stressed by parents; contraception should be explained.
Fourteen to eighteen years annual routine medical anddental checkups; informal discussion of sexual matters; explanation of veneral disease; encourage the child to visit physician or dentist alone.
Age 11 to age 18 : Disorders 1
Symptoms and Signs Treatment
Acne
Disfiguring pustules on face and neck; particularly affecting forehead, cheeks and chin; also chest, back, and shoulders; severe cases resulting in scarring. Keep hair and skin clean; creams that cause skin to peel sometimes used to expose blocked pores; supervised ultraviolet light treatment helps in some cases; antibiotics in severe cases.
Anorexia nervosa
Loss of weight; often extreme emaciation; failure to eat; sometimes vomiting after meals; monthly periods cease; skin sometimes becomes covered with fine hair; denial that there is a problem. Persuade patient to see physician; psychiatric care; drug therapy; in severe cases, intravenous feeding is necessary.
Anxiety
Irritability; agitation; nail-biting; inability to sleep well; inability to concentrate. Attempt to discover underlying worry; physician or school counselor may help.
Bornholm disease (pleurodynia)
High fever, headache; severe muscle pain in chest; illnes lasts between four and seven days. Aspirin or stronger painkilling drugs; high fluid intake; bed rest; consult physician.
Chancroid
Pustule or ulcer on genitals or anus; abscess in groin; ulcer sensitive and inflamed; smelly discharge from ulcer. Consult physician; drug therapy; abstinence from sexual intercourse.
Cystitis
Frequent and painful urination; cloudy urine; sometimes fever; in some cases, blood in urine. Consult physician; urine tests; antibiotics.
Delinquency
Violence; overt aggressiveness; rebellion against parental authority, and against society; stealing; “gang” activities. Parents should discuss the problem with people who are accustomed to dealing with adolescents, for example, a physician youth officer, school counselor, or social worker, constructive group activity; team work.
Depression
Moodiness; persistent lack of enthusiasm; feelings of failure; sleep difficulties; feelings of isolation and loneliness; drop in standard of school work; overeating; anorexia nervosa; thoughts of suicide. Keep adolescent involved in family affairs; show friendship and affection; discuss realistic worries; seek the advice of a physician if condition continues; drug therapy may help.
Notes Notes
Acne is a disfiguring complaint occuring at an age when physical appearance is important. In nearly all cases, the problem gradually disappears after about age twenty. Parents should be sympathetic and help to maintain the child’s self-confidence. In girls, acne is often worse just before menstruation. Some types of skin are more likely than others to develop acne.
Anorexia nervosa is much more common in girls than boys. The girl usually denies that anything is wrong. She is often convinced that she is obese, despite evidence to the contrary. This is a psychological illness. One interpretation is that the girl is trying to stop herself becoming an adult, thus avoiding social and sexual responsibilities. It is a sign of underlying insecurity and depression. A milder type of anorexia nervosa may occur when the girl alternates between periods of weight loss, and periods of excessive eating and weight gain. Both disorders are different from “crash” dieting and slimming crazes, and should not be confused.
Anxiety is a common problem during adolescence. The child may be worried about examinations, about school activities, or about making friends, particularly with the opposits sex. The parents should try to appear interested and helpful without forcing the child to tell them about the problem. If it is a sexual problem, the child may find difficulty in talking about it. If the symptoms continue, suggest a visit to the physician. Depression sometimes accompanies the anxiety that stems from a feeling of failure at school.
Bornholm disease is an infection spread by a virus. The pain is so acute that the illness may be confused with pleurisy. A relapse may occur if the patient is too active in the month following the illness. Depression and fatigue frequently occur in the course of recovery from Bornholm disease.
A chancroid is a rare but highly infections sexually -transmitted (venereal) disease. It is distinct from the syphilitic chancre, which is a painless ulcer. Chancroid often leaves a scar.
Cystitis is an infection of the bladder. It is more common in girls than boys because the female urethra is shorter, and infecting organisms from outside the body can reach the bladder more easily. It may occur for no apparent reason, and is sometimes caused by sexual intercourse, or by the use of internal tampons during periods. Recurring attacks need careful investigation, because they may be associated with a more serious disorders.
Delinquency is a social, rather than medical, problem. It is most likely to occur in adolescents who have a disturbed family background. The liking for “gang” activities can often be successfully redirected into them work. The pressure within the group help to discipline the delinquent. Youth clubs and social work may also help.
Adolescnce is a difficult time in which many social and personal adjustments must be made. The adolescent has to cope with increasing responsibility, sexual problems, often important examinations, and the realization that social pressures and conflicts commonly suppress individual interests. Teachers at school often notice a change in the standard of the child’s work.
Age 11 to age 18 : Disorders 3
Symptoms and Signs Treatment
Sexual Problems
Anxiety about sexual appeal and ability; ignorance about sex; fears of homosexuality. Parents, school counselors and a physician should answer questions frankly and openly; informal talks in small groups, with an adviser who is experienced in dealing with adolescent sexual problems.
Suicidal tendency
Talk or threat of suicide; commonly a result of depression. Stay near teenager; contact a physician; try to give reassurance; lock away sleeping pills and potentially dangerous drugs; remove car keys until assistance arrives.
Syphills
Firm, painless ulcer (chancre), usually on genitals, sometimes on other parts of body, for example, lip; scar forms after about three months.
Immediate assessment by specialist; drugs; avoidance of all sexual contact.
Tinea
Itching, irritation, and inflamed patches of skin; often with blisters; can affect feet, groin, scalp and nails. Antifungal preparations from drugstore; if infection persists, consult physician; keep area clean and dry; use medication twice daily, or as directed.
Tuberculosis
Gradually increasing fatigue; general feeling of ill-health; slight fever; night sweats; weight loss; swollen lymph glands, particularly in the neck; cough, sometimes with bloodstained sputum. Diagnosis from chest X-ray; blood and skin tests; specific drug therapy for a minimum of one year; bed rest, with a nutritious diet.
Typhoid and paratyphoid fever
Slowly developing fever; headache; slight cough; constipation; scattered pink spots on body; confusion and restlessness; followed by diarrhea; dehydration; possibly death. Hospitalization; blood and urine tests; antibiotics, such as chloramphenicol and trimethoprim; intravenous fluids; convalescence.
Typhus
Headache, fever, shivering attacks for one or two days; followed by high fever for ten to fourteen days; generalized, measles-like rash about fifth day; irritability; sometimes coma. Hospitalization; remove lice or ticks; antibiotics.
Vaginal discharge
Discharge from the vagina; a pale, milky discharge is normal; a colored, smelly, irritating, or painful discharge is not normal.
Usually none necessary. For irritating or offensive discharge, assessment by a gynecologist; test for infection; appropriate drug therapy.
Notes Notes
Anxiety and depression are often a direct result of sexual worries. Parents should answer questions truthfully and respect the adolescent’s need for privacy. They should encourage discussion and try not to be disturbed by differences between their children’s and their own moral codes and views. Adolescents need to make up their. own minds without feeling that they have failed to keep up with their parents’ standards. Most anxieties about sex are due to ignorance, and to the stories spread at school about sex. teenagers commonly feel physically inadequate and they need to know that transient bisexual attractions are normal.
Talk of suicide should always be taken seriously, because talk of suicide or attempted suicide is commonly a cry for help. If the ideas persist, or if an attempt is made, a physician must be consulted.
Syphilis is usually diagnosied in the primary stage, when the chancre appears. Secondary syphilis may develop, with fever and a rash lasting for about ten days, about two months. after the chancre has formed a scar. Syphilis is potentially an extremely serious disease and anyone who is in doubt about it should consult a specialist.
Tinea is commonly referred to as “Athlete’s foot” when it affects the feet. It is caused by a fungal infection, which can spread from person to person, by walking barefoot in. public places, or by borrowing shoes or clothing.
Tuberculosis is rare in countries with a high standard of living. Immunity in the form of a vaccination (BCG) is available, and is recommended for children in places where the risk of contracting tuberculosis is significant. Tuberculosis is usually caught from human carriers, and in these cases the bacteria are inhaled into the lungs. It can also be contracted from the milk of infected cows. This type (bovine tuberculosis) infects the lymph nodes. The bacteria can also infect bone, kidney, and brain tissue.
The fever takes up to three weeks to develop. The patient is considered to be infectious until at least six stool cultures are clear of the infection. Complications include pneumonia, perforation of the intestine wall leading to peritonitis, and chronic infection of the gall bladder. Sterilization of water, and careful cooking of all food are wise safety measures. Immunization greatly reduces the severity of the disease if it is contracted.
Typhus is a group of diseases transmitted by lice or ticks, either between people, or from rodents to people. These diseases include the classical typhus, Rocky Mountain spotted fever; Q fever; and scrub fever. Complications include pneumonia, meningitis, and heart problmes if the condition is not treated at an early stage. Vaccines are available to persons who are traveling in dangerous areas.
Many healthy women have a slight discharge. Over-enthusiastic washing and douching only aggravates the condition. It is normal for a girl to have a pale, milky discharge for up to two years before the onset of menstruation. A similar discharge may occur a day or two before and after menstruation, and at the time of ovulation in the middle of the month. However, if the discharge is colored, or offensive, there may be an infection.
Age 11 to age 18 : Disorders 3
Symptoms and Signs Treatment
Mononucleosis, infectious
One to two weeks of lethargy; general ill health; headaches, followed by fever; other symptoms may include severe sore throat, difficulty in swallowing, swollen neck caused by enlarged lymph nodes, enlarged lymph nodes felt in armpits and groin, faint rash, jaundice, physician may detect enlarged spleen. Consult physician; diagnosis from blood tests; painkilling drugs; occasionally antibiotics to reduce risk of secondary infection.
Nonspecific urethritis (NSU)
Slight, milky discharge from urethra; frequent urination, pain on urination; symptoms rare in girls. Assessment by specialist; drug therapy; abstinence from sexual intercourse.
Obesity
Excessive fatness of body and face; in severe cases, knock-knees; backache and recurrent respiratory diseases. Reduce food intake; exercise.
Periods, failure to start
Girls not menstruating by age fifteen Discuss with physician; gynecological assessment six months later; sometimes assessment of hormone levles; in rare cases, hormone treatment.
Periods, heavy
Excessive bleeding; prolonged bleeding; often accompanied by low abdominal pain; loss of clots of blood. Assessment by gynecologist; examination to investigate possibility of infection; drugs to control blood flow, pain, and irregularity of periods.
Periods irregular
Intervals of up to three months between periods, variable severity of periods. Usually none necessary; consult gynecologist if worried.
Periods, painful
Low abdominal, colicky pain for first day or two of menstruation; low backache; pain down outside of thighs; sometimes vomiting; sometimes fainting. Assessment by gynecologist; regular doses of painkilling drugs; antispasmodic drugs and occasionally, antinauseant drugs may be used; in severe cases, three to four months of hormone treatment.
Premenstrual tension
Irritability; depression; headache; feeling of “heaviness” breast tenderness for a few days before the onset of a period; some girls show antisocial behavior and poor school performance before the onset of menstruation.
Speak to gynecologist; drugs to reduce excess body fluid; sometimes hormone therapy.
Notes Notes
Symptoms of mononucleosis vary considerably in severity, and may appear only as a low grade fever with minimal sore throat. The worst phase of the illness lasts about seven or ten days, and is followed by a gradual but steady improvement over several weeks. During the acute phase the patient may be able to eat only soft foods, such as jello and ice cream. It is essential that the fluid intake is kept high. During convalescence extra rest is necessary, because excessive activity can cause a relapse.
This is a common sexually-transmitted (venereal) disease, caused by one or more organisms that have not been definitely. identified, It is important that both partners are tested and treated, even if one has had no symptoms.
Obesity is a common problem. Overfeeding may have started at birth. Parents who tend to overeat encourage similar eating habits in their children. An increase of weight at puberty is natural, due to the hormone changes occurring at this time. If parents are concerned about their child’s weight, they should discuss the problem with a physician. A child should eat a high-protein diet with plenty of fresh fruit and vegetables. Parents should approach the problem with understanding and sympathy, because an obese teenager is often eager to cooperate in an effort to lose weight, whereas parental rejection can lead to secret overeating.
The age that menstruation begins depends on the family, race, and health of the individual. The menarche (onset of menstruation) usually begins between the ages of eleven and fourteen, but is commonly delayed until the age of fifteen or sixteen. Breast and pubic hair development occur first. Rarely, the membrance that partly covers the vaginal entrance (hymen), closes it completely. Menstruation occurs, but the menses cannot escape. This may cause local discomfort.
Occasionally the first period is heavy and prolonged, and periods tend to be heavy until they become regular. Emotional stress often makes the problem worse. Frequent, heavy periods can cause anemia, and a physician should be consulted in case dietary iron supplements are required.
It is normal after the first period for subsequent ones to be irregular. A second period may not occur for three months, but the intervals lessen and regularity is usually achieved within the first year, although some girls never become regular. This may cause problems in the future, particularly when estimating the delivery date of a baby, or if trying to use the rhythm method of contraception. Sometimes irregular periods are caused by anxiety, or nervous disorders such as anorexia nervosa.
About ten percent of girls between the ages of fourteen and eighteen have periods that are sufficiently painful to prevent them attending school. This may be due to an infection of the womb or ovaries, and the gynecologist should evaluate this possibility. Periods are often more painful during times of anxiety and stress.
Mild premenstrual symptoms are normal, but if they occur frequently and severely, seek the advice of a specialist.
Burping a baby
All babies swallow air when they suck, whether nursed at the breast or on the bottle. The air collects as a bubble in the baby’s stomach, and causes discomfort and sometimes pain. The baby stops nursing and begins to cry. Many Unani Doctors advise a pause about halfway through the feeding in order to burp the baby.
The amount of air a baby swallows depends on both the flow of milk from breast or bottle, and on the baby’s sucking ability.
It is important that all air bubbles are expelled at the end of the feeding as well, or the baby will cry soon after being put back to bed.
There are many different kinds of nipple available for baby bottles. Some are long, some short; some are made of hard rubber, some of soft. The nipples can have a small, medium, or large hole. By buying a selection, the one that is most comfortable and most effective in your baby’s mouth can be found. The ability to suck also varies according to the baby’s age and whether he or she is hungry. A one-week-old baby who is slightly jaundiced and sleepy, for example, needs a medium-hole or large-hole nipple. A baby who is in this condition, sucking through a small hole, swallows a lot of air in an effort to get the milk, and falls asleep exhausted and uncomfortable. But if the hole is too large, the milk gushes through so fast that the babymay choke or vomit afterward.
Controlling the milk flow is more of a problem when the baby is breast-fed. If this does not help and the milk is still coming so fast that the baby is gulping, take him or her off the breast after two or three sucks. Allow the baby then to take one breath before returning to the breast. Do not sit the baby up for burping too often; it only makes the infant cry, and disrupts the feeding.
Spitting
A baby who nurses too quickly may vomit slightly after the feeding. Throwing up a small amount of milk is often called spitting and is nothing to worry about. Even if the baby throws up the entire feeding occasionally, there is no need for alarm. If the vomiting occurs repeatedly, however, consult a pediatrician.
When burping a baby in the upright position, the baby’s chin resting on your shoulder, be sure to protect the clothing in case the baby should spit or vomit.
Gas pains
A baby who has swallowed too much air may be unable to expel the bubbles by burping immediately after being fed. The resulting discomfort can last for a few days, and demands a great deal of patience. A reliable sign indicating gas is that the baby may take two or three gulps of milk, draw away from the breast or bottle, and arch the back.
Nurse the baby slowly and try to be relaxed. Walking slowly round the room with the baby All babies swallow air when they suck, whether nursed at the breast or on the bottle. The air collects as a bubble in the baby’s stomach, and causes discomfort and sometimes pain. The baby stops nursing and begins to cry. Many Unani Doctors advise a pause about halfway through the feeding in order to burp the baby.
The amount of air a baby swallows depends on both the flow of milk from breast or bottle, and on the baby’s sucking ability.
It is important that all air bubbles are expelled at the end of the feeding as well, or the baby will cry soon after being put back to bed.
There are many different kinds of nipple available for baby bottles. Some are long, some short; some are made of hard rubber, some of soft. The nipples can have a small, medium, or large hole. By buying a selection, the one that is most comfortable and most effective in your baby’s mouth can be found. The ability to suck also varies according to the baby’s age and whether he or she is hungry. A one-week-old baby who is slightly jaundiced and sleepy, for example, needs a medium-hole or large-hole nipple. A baby who is in this condition, sucking through a small hole, swallows a lot of air in an effort to get the milk, and falls asleep exhausted and uncomfortable. But if the hole is too large, the milk gushes through so fast that the babymay choke or vomit afterward.
Controlling the milk flow is more of a problem when the baby is breast-fed. If this does not help and the milk is still coming so fast that the baby is gulping, take him or her off the breast after two or three sucks. Allow the baby then to take one breath before returning to the breast. Do not sit the baby up for burping too often; it only makes the infant cry, and disrupts the feeding.
Spitting
A baby who nurses too quickly may vomit slightly after the feeding. Throwing up a small amount of milk is often called spitting and is nothing to worry about. Even if the baby throws up the entire feeding occasionally, there is no need for alarm. If the vomiting occurs repeatedly, however, consult a pediatrician.
When burping a baby in the upright position, the baby’s chin resting on your shoulder, be sure to protect the clothing in case the baby should spit or vomit.
Gas pains
A baby who has swallowed too much air may be unable to expel the bubbles by burping immediately after being fed. The resulting discomfort can last for a few days, and demands a great deal of patience. A reliable sign indicating gas is that the baby may take two or three gulps of milk, draw away from the breast or bottle, and arch the back.
Nurse the baby slowly and try to be relaxed. Walking slowly round the room with the baby in your arms sometimes helps to start him or her nursing again. Another method is to change the baby to a different nursing position, so that he or she sits upright or less flat, for example. When the condition improves, make sure that the baby returns to the usual feeding position.
Inexperienced paretns or baby sitters commonly try to bring up a baby’s gas by striking him or her sharply on the back. But this only makes the baby tense and even less able to release the bubbles. Sometimes such patting may actually cause the baby to throw up some milk.
The illustrations on these pages show some of the best ways to help the baby during the process of nursing, but if no success is achieved within a few minutes, continue with nursing anyway, following the usual routine.
Reluctant nursers
Because the liver does not work at full capacity for sometime after birth, some babies may become slightly jaundiced. This condition makes a baby sleepy and disinclined to suck during the first week, when it is important that a baby does drink enough. To encourage a baby to nurse, push gently and rhythmically with the forefinger under the baby’s chin. But be patient, because the baby may fall asleep again.
Restless nursers
Older babies who for one reason or another feel insecure tend to be restless at nursing time. If they can, they wave their arms about, scratching at the bottle, or hitting the breast. Such a baby should be held close to the body and wrapped in a blanket from the waist down. The baby’s arms may be left free if they are kept out of the way. One arm can be tucked behind the feeder’s back, while the other hand can be held. Hold the baby firmly, but not roughly, because this may make the baby struggle even more.
Burping the newborn baby
Sit the baby up in your lap, facing off to one side, with your forearm across his or her chest and stomach. Tilt the baby forward slightly, and diagonally away from you. Slide your forearm up the baby’s chest until the baby’s head rests in the palm of your hand. Then place your other hand in the middle of the baby’s back, applying gentle pressure upward.
Burping an “older” baby
An older baby needs to be supported only by one hand under his or her armpit. Again the baby’s head should be tilted slightly to the side and the body tilted forward. It is useless to continue to burp the baby, however, if air has not come up by the end of nursing. Some babies do not need burping or may release gas through the rectum.
Burping halfway through nursing
Most babies resent being interrupted when they are nursing, but in general it is worth annoying them in order to burp them halfway through the feeding. Sit the baby up in your lap. Place one arm across the baby’s chest, with your other hand stroke the baby’s back using upward movements only.
The over the shoulder position
Another way to burp an infant is to hold the baby against your body, with his or her chin resting on your shoulder, and to apply slight pressure to the middle of the baby’s back with the palm of your hand. This position is recommended for a baby who is crying. Walk round the room carrying the baby and speaking softly, or distracting him or her in some way.
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