Common Illnesses of babies Part3

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Common Illnesses of Infants and Children Part 3

• P.Naina Mohamed
• Pharmacologist

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Introduction

• Illnesses discussed in this presentation
• Mouth Problems
• Feeding Problems
• Elimination Problems
• Cradle Cap
• Hand, Foot and Mouth Disease
• Pink Eye
• Fifth Disease
• Eczema

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Mouth Problems

• Children are more prone to develop throat and
  mouth problems during their early growth and
  development phase.
• Throat and mouth problem in kids can become
  severe if not diagnosed and treated at an early
  stage.
• Common Throat and Mouth Problems in Children
• Baby bottle tooth decay
• Teething Problems
• Thumb Sucking
• Tongue Thrusting
• Lip Sucking
• Early Tooth Loss
• Epiglottitis (Supraglottitis)

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Baby bottle tooth decay

• Also called early childhood caries, nursing
  caries, and nursing bottle syndrome.
• Bacteria in the mouth
• Feed on the sugars from drinks (milk, formula,
  etc.)
• Tooth decay
• Untreated
• Pain and difficulty to Permanent teeth
  Abscessed tooth
• chew and eat into improper
  position
• crowded or crooked permanent teeth
  Infection spreading elsewhere in the body

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Baby bottle tooth decay

• Prevention
• Avoid sugary drinks
• Give plain water (Too much water is harmful to a
  baby) or a pacifier to sooth baby.
• Never dip baby's pacifier in sugar, honey, or any
  sugary liquid.
• Avoid to put baby on bed with a bottle filled
  with sugary drinks.
• Make sure you remove your breast from baby's
  mouth when she falls asleep.
• Don't add sugar to baby's food.
• Use a wet cloth or gauze to wipe baby's teeth and
  gums after each feeding.
• If drinking water is not fluoridated, fluoride
  supplements or fluoride treatments may be needed.
  
• "sippy cup" lowers the teeth's exposure to
  sugars, but constant sipping from the cup can
  still result in decay unless it is filled with
  plain water.

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Teething Problems

• Teething induces the infants drooling or wanting
  to chew on things.
• The first tooth appears during the first 6-8
  months.
• By the age of three, 20 teeth should appear in
  the child s mouth.
• Both the earlier and the delayed appearance of
  teeth is usually hereditary and is not
  necessarily related to any problems. 
• Consult your paediatric dentist, if the baby,
  does not have any teeth by the 12th month of its
  life.
• symptoms related to teething
• Red and swollen gums
• Increased quantity of saliva ( salivation )
• Anxiety and grumbling
• A change in nutritional habits
• Lack of appetite
• Difficulty in sleep
• Best ways to soothe painful gums
• Use teething rings
• Let the baby chew on a wet washcloth.
• Rub the baby's gums with a clean finger.
• Wipe off drool to prevent rashes on the baby's
  face.
• Use children's acetaminophen to relieve
  discomfort
• Call the doctor if the baby develops a fever.

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Thumb Sucking

• It's normal and healthy for infants to suck their
  thumbs, fingers, pacifiers, or toys.
• Object sucking gives children a sense of
  emotional security and comfort.
• Thumb sucking (beyond the age of 5)
• Teeth can be pushed Difficulty with the correct
  Misalignment of
• out of alignment pronunciation of words
  upper and lower jaws
• Protruding of teeth
• Create an overbite Malformation
  of roof of the mouth

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Thumb Sucking

• Tips to Help the Child Stop Thumb Sucking
• Encourage the child to stop thumb sucking.
• Scolding, nagging, or punishments make children
  defensive and drive them back to the habit.
• Give praise or rewards for time successfully
  avoiding the habit.
• Cover the finger or thumb with a band-aid as a
  reminder.
• Take the thumb or finger out of the mouth after
  the child falls asleep.
• Find out what stresses the child faces and try to
  correct the situation.
• Use dental appliances the child can wear in the
  mouth to prevent sucking. These appliances are
  cemented to the upper teeth, sit on the roof of
  the mouth, and make thumb sucking harder and less
  pleasurable.

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Tongue Thrusting

• Tongue thrusting is the habit of sealing the
  mouth for swallowing by thrusting the top of the
  tongue forward against the lips.
• Tongue thrusting
• Exerts pressure against the front teeth
• Pushing front teeth out of alignment
• Protruding of front teeth
• Creating an overbite Interfers
  proper speech development

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Tongue Thrusting

• Causes
• Artificial nipples used in feeding infants
• Behaviors like thumb sucking and nail biting
• Premature loss of "baby" teeth
• Allergies, nasal congestion and obstructions
  contributing to mouth breathing where the tongue
  learns to stay low
• Abnormally large tongue, enlarged tonsils and
  adenoids
• Hereditary factors
• Symptoms
• Pursing of the lips and bunching of chin like a
  golf ball when swallowing
• Difficulty with speech, especially the /s/ and
  /z/sounds
• Open mouth posture with a forward tongue
  position, at rest.
• Consult a speech pathologist, if you notice
  symptoms of tongue thrusting, He can develop a
  treatment plan that helps the child to increase
  the strength of the chewing muscles and develop a
  new swallowing pattern.

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Lip sucking

• Lip sucking involves repeatedly holding the lower
  lip beneath the upper front teeth.
• Sucking of the lower lip may occur by itself or
  in combination with thumb sucking.
• Lip Sucking
• Exerts pressure against the front teeth
• Pushing front teeth out of alignment
• Protruding of front teeth
• Creating an overbite Interfers
  proper speech development
• Stopping the habit involves the same steps as for
  stopping thumb sucking.

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Early Tooth Loss

• Premature loss of a child's baby teeth typically
  occurs from tooth decay, injury, or lack of jaw
  space.
• Early loss of Teeth
• Nearby teeth can tip or shift
• Not enough room for permanent tooth
• The new tooth may emerge tilted
• Crooked or misaligned teeth
• Interfer proper chewing
  Temporomandibular joint problems
• If the child loses a tooth prematurely, the
  dentist may recommend a space maintainer. A space
  maintainer is a plastic or metal device that
  holds open the space left by the missing tooth.
  The dentist will remove it once the permanent
  teeth begin to erupt.

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Epiglottitis (Supraglottitis)

• Epiglottitis is a life-threatening infection of
  the epiglottis.
• The epiglottis is the leaf-shaped flap of
  cartilage that covers the windpipe and prevents
  food, drink, and anything else that goes down the
  throat from entering the airway.
• Haemophilus influenzae type b (Hib) bacteria
• Infect the epiglottis and other nearby tissues
• Swelling of the tissues
• Blockade of the airway and prevention of
  breathing

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Epiglottitis (Supraglottitis)

• Epiglottitis also caused by organisms such as
  pneumococci or staphylococci.
• Burns from hot drinks, swallowing foreign
  objects, injury to the epiglottis, and infections
  from chicken pox blisters are other causes of
  epiglottitis.
• Children with the highest risk are under the age
  of 1.
• Symptoms
• Sore throat Within hours, your baby's throat
  will hurt so much that she'll avoid swallowing
  and refuse to eat and drink.
• Fever Your child will run a fever of 101 degrees
  Fahrenheit or higher.
• Drooling Even if she's not normally a drooler,
  she'll start drooling profusely because it's so
  hard for her to swallow.
• Abnormal breathing sound Your baby will make a
  high-pitched noise (called stridor) with each
  inhalation. It sounds much like croup but without
  any coughing.
• Difficulty breathing As the epiglottis swells,
  your child will have trouble getting air to her
  lungs.
• Prevention
• Give the children Hib, varicella, and
  pneumococcal vaccinations.

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Feeding Problems

• Inability or refusal to eat certain foods is
  known as Feeding problem.
• Feeding problems are estimated to occur in up to
  25 of normally developing children and in up to
  35 of children with neurodevelopmental
  disabilities.
• Problems with feeding may lead to significant
  negative nutritional, developmental and
  psychological sequelae.
• Because the severity of these sequelae is related
  to the age at onset, degree and duration of the
  feeding problem early recognition and management
  are important.

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Feeding Problems

• In Breast fed Babies
• Improper Latching, Insufficient milk supply or
  Mouth sore of baby
• Inadequate feeding
• Hungry
• Get tips on how to position your baby for
  breast-feeding.
• If your baby is still having problems latching
  on, talk to your doctor or to a lactation
  consultant.
• Frequent feedings or pumping may help increase
  your milk supply. Drinking plenty of fluids may
  also help.
• If there are sores or white patches in or around
  the baby's mouth, see your baby's doctor.

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Feeding Problems

• In Bottle fed Babies
• Too Small or Clogged bottle's nipple or the
  baby's mouth SORE
• Inadequate feeding
• Hungry
• A proper bottle nipple should drip 1 drop per
  second when the bottle is turned upside down. If
  you think the nipple is clogged, unscrew the cap
  to release pressure.
• If your baby's mouth is sore, see your baby's
  doctor.

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Feeding Problems

• Babies who don't latch on correctly fall alseep
  while nursing. It's not unusual for younger
  babies to fall asleep while nursing.
• If your baby is not latching on properly,
  carefully break the suction and try repositioning
  your baby.
• Check your baby for growth and weight gain.

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Feeding Problems

• PYLORIC STENOSIS
• Enlargement of lower part of the stomach
• Prevention of food passing in to the intestines
• Throwing up large amounts of milk with forceful
  vomiting
• Contact your baby's doctor right away

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Feeding Problems

• LACTOSE INTOLERANCE
• Inability to digest lactose (a sugar found in
  milk and other dairy products)
• Lot of gas and stomach discomfort
• Ask your baby's doctor if you should switch to a
  soy formula.
• Toddlers may also have soy or rice milk.

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Feeding Problems

• COLIC
• Baby cry intensely after meals
• Rubbing your baby's stomach gently, or rocking
  your baby in a rocking chair or cradle may help
  relieve the pain.

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Feeding Problems

• DEVELOPMENTAL PROBLEM
• Little interest in food or have a slow weight
  gain
• See your baby's doctor.

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Elimination Problems

• BREAST FEEDING
• yellow and runny bowel movement (Diarrhea)
• Many small infants will also have runny bowel
  movements until they build up enough bacteria in
  their large bowel to make formed movements.
• Don't let your baby drink too many juices, as
  this may also cause diarrhea.

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Elimination Problems

• LACTOSE INTOLERANCE (cow's milk) or CELIAC
  DISEASE (wheat)
• Diarrhea after the feedings
• Infants who are lactose intolerant may benefit
  from switching to a soy formula.
• Toddlers may also have soy or rice milk.
• Children who have celiac disease should avoid
  cereals that contain gluten.
• See your baby's doctor.

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Elimination Problems

• Gastrointestinal infection
• Frequent, watery bowel movements
• DIARRHEA
• Dehydration
• Encourage your older child (older than 2) to
  drink water and other clear fluids.
• Ask your doctor about giving your baby or toddler
  an oral rehydration solution (ORS).
• Avoid giving your baby too much fruit juice, as
  this may cause diarrhea.
• See your doctor if your child is younger than 6
  months of age and has diarrhea.
• Also, see your doctor if your child's diarrhea is
  severe if he or she also has a fever, vomiting
  or severe abdominal pain if his or her stools
  look bloody or slimy or if he or she is
  dehydrated.

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Elimination Problems

• HIRSCHSPRUNG'S DISEASE (a condition that affects
  the wall of the large intestine)
• CONSTIPATION
• Hard, pellet-like stools
• Strain to have a bowel movement
• Add more fluids to your child's diet.
• If your child is an infant, make sure that he or
  she is getting enough formula or breast milk.
• If your infant takes formula, use a low-iron
  formula.
• If you think your child might have Hirschsprung's
  disease, see your doctor.

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Elimination Problems

• Inability to digest wheat (CELIAC DISEASE) or
  milk (LACTOSE INTOLERANCE)
• Gas, bloating and diarrhea
• Eliminate foods that make your child sick from
  his or her diet.
• Talk to your doctor about treating your child's
  intolerance of milk and dairy products with
  lactose enzyme.
• Soy formula may be an appropriate substitute for
  infants who have lactose intolerance.

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Elimination Problems

• HEMORRHOIDS or an ANAL FISSURE
• Pain with bowel movements
• Child to hold a bowel movement for many days
• See your doctor if the pain is not better in a
  few days.

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Cradle Cap

• Cradle cap is a yellowish, patchy, greasy, scaly
  and crusty skin rash that occurs on the scalp of
  recently born babies.
• Cradle Cap also known as infantile or neonatal
  seborrhoeic dermatitis, crusta lactea, milk
  crust, honeycomb disease.
• Cradle cap most commonly begins sometime in the
  first 3 months.

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Cradle Cap

• Antibiotics (Just before delivery or First week
  of life)
• Kill beneficial bacterias preventing yeast growth
• Fungal infection on the Scalp (Cradle Cap)

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Cradle Cap

• Mother's hormones still in the baby's circulation
• Overactive sebaceous glands
• Release of greasy substance that makes old skin
  cells attach to the scalp

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Cradle Cap

• Home remedies
• Massage the affected region with coconut oil,
  olive oil, Jojoba oil. Applying these may help
  loosen the scales and make them wear away easily.
  
• Gently washing the area with clean water may help
  clear the scales.
• Apply a baking soda paste (Mix half cup water
  with a teaspoonful of baking soda) on the
  affected region of the skin. Wash it away after
  10 minutes. Then use soft tooth brushes or
  bristle brushes to remove the scales. If they do
  not come away immediately, leave them.
• Do not prick them or use force. They may come off
  after a day or two.
• Mild steroid creams or antifungal creams may also
  work well to remove the scales.
• If there is Cradle Cap on face or around the
  eyelids, use diluted baby shampoo to cleanse the
  area. Pour 3-5 drops of baby shampoo into half
  cup warm water. Use the solution to gently scrub
  the area. You may also use diluted baking soda
  solution as a cure.
• If there is redness or inflammation in the
  affected area, you may use cortisone creams for
  Cradle Cap cure. These are sold over the counter
  and easily available for use.

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Avoid Baby Oil

• Avoid using baby oil which is mineral oil.
• It is a very inexpensive product to make and
  doesnt spoil easily, which is why it is used by
  manufacturers.
• Baby oil is made from a petrochemical byproduct
  which may harm babys skin.
• When ingested, its been linked to a multitude of
  serious health problems.
• Baby Oil (Mineral Oil)
• Difficult to absorb by the skin
  Inhalation into lungs
• Clogs pores
  Affects normal functioning of lungs
• slowing the skins ability
• to eliminate toxins
  serious respiratory conditions

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Hand, Foot, Mouth Disease

• Hand, Foot, Mouth Disease is Contagious.
• Hand, foot, and mouth disease is a common viral
  illness that most often affects babies and
  children under age 5.
• Symptoms
• Fever, mouth sores, and skin rash.
• How it spreads
• Viruses that cause hand, foot, and mouth disease
  are passed in saliva, nasal mucus, and fluid from
  mouth blisters of infected people.
• Your child can also catch it by touching anything
  touched by a person who has it.
• Prevention
• Frequent hand washing helps prevent the spread of
  hand, foot, and mouth disease.
• Your child should also avoid close contact or
  sharing food or utensils with other kids.
• If an infected child has been to your house, wash
  toys and household surfaces that may harbor the
  germs.
• Disinfect them, using 1 tablespoon of bleach to 4
  cups of water.
• Treatment
• There is no specific treatment for hand, foot,
  and mouth disease.
• Give acetaminophen for pain and fever.
• Analgesic mouthwashes and sprays can numb painful
  mouth sores.
• If you are concerned about your child's symptoms,
  call the doctor.

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Pinkeye

• Pinkeye is Contagious
• Pink eye, or conjunctivitis, is an irritation of
  the eye and lining of the eyelid.
• Symptoms
• Itching, burning, redness, increased tearing or
  discharge, sensitivity to light, and crusting on
  the lids or lashes. 
• How it spreads
• Viruses, bacteria, allergens, or irritants can
  cause pinkeye.
• When a virus or bacteria is the cause, children
  can catch it easily by touching a contaminated
  surface and then touching their eyes.
• Prevention
• Wash hands frequently with soap and warm water.
• Use an alcohol-based hand sanitizer.
• Do not allow children to share towels, pillows,
  washcloths, or other items with someone who is
  infected.
• If somebody at home with pinkeye, wash
  pillowcases, sheets, washcloths, and towels in
  hot water and detergent to avoid spreading it.
• Treatment
• Mild conjunctivitis often gets better on its own.
  
• Artificial tears and cold packs can help relieve
  dryness and inflammation.
• If your child has eye pain, fever, vision
  problems, headache or intense redness, or she is
  not better within a couple of days, call her
  doctor.

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Fifth Disease

• Fifth Disease is contagious and is a viral
  illness usually affects school-age children, most
  commonly in winter and spring.
• It usually begins with low-grade fever, headache,
  and stuffy or runny nose. But the primary symptom
  is a bright red rash that starts on the cheeks
  giving the appearance of slapped cheeks and can
  progress to the trunk, arms, and legs.
• How it spreads
• Parvovirus B19, which causes fifth disease, is
  spread through saliva, sputum, and nasal mucus.
• Prevention
• Fifth disease is most contagious in the "stuffy
  nose" phase, before the rash begins, so it is
  difficult to prevent.
• Avoid contact with children who are coughing and
  sneezing.
• Frequent hand washing especially before touching
  their eyes, nose, or mouth.
• Treatment
• Fifth disease is usually mild and requires no
  treatment other than rest.
• If needed, acetaminophen or anti-itch medication
  may help relieve symptoms.
• Parvovirus B19 can cause serious complications in
  people with a weakened immune system or chronic
  anemia, or in women who are pregnant. Then it's
  important to see a doctor.

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Eczema

• Eczema is not Contagious.
• Eczema, or "atopic dermatitis," affects about one
  in 10 babies and children.
• It can begin before a child's first birthday and
  almost always by age 5.
• Eczema begins as an itchy rash on the face,
  elbows, or knees that may spread to other areas
  including the scalp and behind the ears.
• Cause
• Genes and environmental factors are believed to
  cause eczema.
• Prevention
• Dry skin is a trigger, so moisturize the child's
  skin often, especially after baths.
• Wear soft clothes in fabrics that "breathe" such
  as cotton.
• Avoid perfumed soaps or lotions as well as bubble
  baths because they can irritate the skin.
• Recognize signs of skin infection and treat them
  early.
• Treatment
• Cool baths can help relieve itching.
• Corticosteroid creams or ointments, topical
  medications,
• Tar preparations,
• Antihistamines to relieve itching,
• Oral or topical antibiotics for infections that
  can accompany flares.

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Viral Vs Bacterial Infections/Use of Antibiotics

• Viral Infections
• The vast majority of the illnesses that the child
  will experience will be caused by viruses. 
• They are infectious organisms that multiply
  within various cells of the body and they are
  very hard to kill or inhibit while not harming
  the bodys cells at the same time. 
• Because of the ability of viruses to hide
  within the bodys cells progress toward
  anti-viral therapy has been slow. 
• There are effective therapies for some serious
  viral infections such as systemic Herpes Simplex
  infections and HIV, but there are no (with the
  exception of Flumadine for Influenza A and
  Tamiflu for Influenza A B) safe and effective
  therapies for the common viral illnesses such as
  colds, tonsillitis, gastroenteritis (vomiting and
  diarrhea), etc. 
• These viruses are spread from person to person by
  close physical contact, contacts with bodily
  fluids such as stool, vomitus, nasal secretions
  and saliva as well as aerosols generated by
  coughing and sneezing. 
• The larger the number of people that your child
  has contact with, the greater the likelihood of
  acquiring such an infection. 
• The bodys immune system recognizes each of these
  unique viruses and generates an immune response
  which ends the infection and renders the child
  immune to that particular strain. 
• As there are no specific therapies for the
  majority of common viral infections, we are
  currently limited to symptomatic treatments aimed
  at relieving discomfort and supporting the child
  with adequate fluids and calories while we await
  the successful ending of the infection by the
  childs immune system. 

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Viral Vs Bacterial Infections/Use of Antibiotics

• Bacterial infections
• A smaller number of your childs infections will
  be due to bacteria which can be specifically
  treated with antibiotics. 
• Antibiotics are selectively toxic to the bacteria
  when used in proper dosage and duration examples
  include middle ear infections (otitis media),
  sinusitis, certain forms of pneumonia, etc. 
• This distinction between a viral infection and a
  bacterial infection rests on several factors
• a thorough history of symptoms and exposure
• a careful physical examination and
• laboratory tests in selected cases (white blood
  cell count, urine analysis, cultures of blood,
  urine, tonsillar swabs, spinal fluid).
• Antibiotics given for viral infections are
  totally ineffective and they increase
• the likelyhood of secondary yeast infections
• chances of the patient becoming allergic to that
  class of antibiotics 
• a growing and very serious problem with the
  emergence of multiple resistant organisms caused
  by the overuse of antibiotics.  Infections with
  these organisms are very dangerous, as there is a
  very short list of drugs that are still effective
  against them. 
• Parents and pediatricians to do their best to
  reach as accurate a diagnosis as possible and use
  antibiotics very cautiously. 

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References

• CURRENT Diagnosis Treatment Pediatrics, 21e
  William W. Hay, Jr., Myron J. Levin, Robin R.
  Deterding, Mark J. Abzug, Judith M. Sondheimer
• Pediatric Clinical Advisor Instant Diagnosis
  and Treatment , Second Edition
• Lynn C. Garfunkel, Jeffrey M. Kaczorowski,
  and Cynthia Christy

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References

• http//www.cdc.gov/parents/infants/diseases_condit
  ions.html
• http//www.nlm.nih.gov/medlineplus/commoninfantand
  newbornproblems.html
• http//www.nichd.nih.gov/health/topics/infantcare/
  conditioninfo/Pages/basics.aspx
• http//children.webmd.com/treating-common-illness-
  10/slideshow-infant-symptoms
• http//www.clinicalpediatrics.com/Management-of-Co
  mmon-Illnesses-of-Infants-and-Ch.html