How to know that your child is diabetic clinically ?

The are many manifestations and signs in any diabetic patient , the age of the biabetic child to be manifested clinicaly is usually at the early school age and rare before that , which is called the type 1 diabetes mellitus or insulin dependent diabetes mellitus ( as the treatment is essentially insulin ) . From those

How to deal with any febrile patient at home ?

There are certain steps which we should follow in managing the febrile patient at home , as most of the patient will not need to be admitted to the hospital , most of the patients will be managed at home.

1-Bed rest is an important initial

Disadvantages of breast feeding

Disadvantages of breast feeding

Considering the above title there is no agreement about if there are actual disadvantages or side effects to breast feeding in general , but we can consider a group of risk factors that is associated with breast feeding :

1-Transmission of infections as the

Factors produce and Eject Breast milk and reflexes .

Factors produce and Eject Breast milk and reflexes .

The process of breast feeding is controlled by hormone and reflexes that regulate and control the breast feeding process .

FACTORS INCREASING THE PRODUCTION OF THE BREAST MILK :

1- Prolactin: is hormone from the anterior pituitary having receptors in the glands of the breast stimulates the production of milk 

2- Breast evacuation : stimulates the receptors for milk production , when the baby evacuates the mother's breast .

FACTORS THAT CONTROL THE EJECTION OF MILK :

1- oxytocin : from the posterior pituitary helps in ejection process 

 2- Suckling reflex : which may be psychological factor and also reflex at the same time , but it is proved it is the main factor that triggers milk ejection .

LET DOWN REFLEX :

Responsible for releasing of the milk in response to oxytocin.

Factors stimulating is : - Hearing the baby cry and thinking of the act 

                                     - Suckling reflex 

Factors that inhibit it is : fatigue , anxiety and stress .

Program of Brest feeding ( onset , pattern , duration ), clostrum and mature milk

There are certain important tips to achieve good and effective breast feeding 

ONSET : 

Breast feeding should start from the first day as early as possible , immediate after delivery the baby must be given to the mother for breast feeding . 

PATTERN :

The concept which must e respected here is that breast feeding is related to demand , once the baby demanded the mother should reply , average times per day is 8-10 times per day . Scheduling feeding is not preferred ( feeding on regular intervals ) , as it affects the flow of the milk. 

DURATION OF BREAST FEEDING :

An infant less than 6 months should be exclusively beast fed ( only breast milk ) . Starting from the 6 month weening should start with completion of breast feeding for 1 year or more . 

STAGES OF LACTATION ( COMPOSITION OF BREAST MILK AND STAGES OF ITS PRODUCTION) 

1-Colostrum : it is the earliest milk from the mother which is about 60 ml/day these amount is low but no other formulas or extras should be given. Colostrum is secreted in the first 2-3 days high in proteins and immunoglobulins and lower in fat and carbohydrates .

2- Transition milk : it starts 5-7 days after delivery ( after colostrum ) , and continues for about 2 weeks and it is midway between the clostrum and the mature milk . 

3- Mature milk : is the milk after the previous 2 stages and contains 87% water to meet the needs of the baby .

Causes for tall stature and obesity

Tall stature and obesity

What is tall stature ?

Tall stature is accurately estimated by growth curves , in growth curve tall stature is above 95^th percentile .

What are the causes of tall stature ?

There are 2 types of tall stature to be considered proportionate and disproportionate .

Proportionate tall stature is mainly

What is precocious puberty ?

Precocious puberty

Definition : Puberty at an age earlier than 8 years in females and 9 years in males .

There are 2 types of precocious puberty , true precocious puberty and pseudo precocious puberty .

True precocious puberty :

What is puberty

3 main events in puberty

Puberty is a period of life in which there is morphologlical and physiological changes in males and females in this period males and females is shifted to an adult stage from an infantile stage .

Age of onset of puberty :

Age of onset varies according to nutrition , socioeconomic status , racial and genetic

Causes of small head in babies .

Causes of small head in children (Microcephaly )

Causes of microcephaly is related closely to mental retardation , as in mental retardation the brain is not growing well and this leads to small head microcephaly .

A-        Genetic causes

1- Autosomal dominant

2- Autosomal recessive

3- Syndromes like Down Syndrome – Edwards Syndrome – cri du chat syndrome .

What is delayed puberty causes ?

Delayed puberty

What is delayed puberty ?

The puberty is delayed when the puberty is delayed to 13 years in females and 14 years in males .

The 5 most common causes of convulsions in a baby in the 1st 28 days of life

1- Decreased oxygen to brain tissue :

After failure of resuscitation after delivery 

 

2- Cerebral stroke ( mostly thrombosis) leading to infarction 

What is APGAR scores ? and Hypoxic Ischemic Encephalopathy .

Simply the APGAR score is a score suggest the baby status , determining whether the baby is breathing well or not , also it determines the degree of asphyxia if present . 

Causes of Brain asphyxia in a newly born ( neonate ) , Why the baby does not respond to resuscitation ?

In many occasions after we do resuscitation to a newly born neonate the neonate does not respond to all the steps we do , here there is a serious pathology or failure in the technique of resuscitation steps itself . The causes of failure may be : 

problems of preterm infant ( complications of prematurity )

Usually preterm infants are liable to many problems respiratory , cardiac , etc...... . This makes it is hard to deal with a preterm baby in the medical issue . 

 

1- Respiratory : 

- Respiratory distress syndrome is the major problem in the premature

What is moro reflex , when it diseppears ?

Moro reflex is one of the simple reflexes that can be made by the examiner or by the mother , the question here is what positive or negative moro reflex means , how it is done ? . First I will begin with the stimulus ( action made stimulate the appearance of moro reflex in the child . 

Failure to thrive ( When the baby is not growing well ? )

In many occasions babies are not growing well especially in the first year , which is the period of growth . There are many causes babies are not growing well in this topic I will mark the most common causes for that . There are 2 groups of causes babies are not growing well , first is non organic causes ( meaning that there are no diseases ) and this is the condition in about 95% in babies , the second one is organic here the babies have certain disease in 5% only . 

When and how to begin weaning ? and what types of food to introduce in weaning ?, How to start weaning ?

When and how to begin weaning ? 

The age of 4-6 months is ideal to begin weaning as :

1- iron stores of the baby become depleted at this age 

2- Caloric intake of breast milk alone is not sufficient . 

3- Digestive enzymes of the baby become mature

Factors indicating adequate breast feeding and minor problems with Breast feeding and its mangement .

Indicators of adequate breast feeding 

For the mother :

- Marked filling before breast feeding ( indicate good breast filling ) . 

- Let down sensation ( milk flow from one breast while nursing from the other ) . 

Proper Breast feeding positioning with video description , Signs of good baby attachment .

Positioning of breast feeding 

1- The infant should be elevated to the height of the breast 

2- The infant's body should face the mother , with all the body supported not only the neck 

3- The infant's neck should be straight . 

7 protective elements in breast milk

Breast milk has many advantages to the infant , as nutritional and immunologic benefits which makes the mother's milk the first choice especially in the first 6 months of the baby's life . In this topic we will concentrate on the protective ( immunologic ) advantages of the breast milk:

 

1- Bifidus factor : 

This factor is oligosaccharide in nature present in the colostrum ( milk in the first 2-3 days from the mother's breast ) and mature milk ( milk from the mother's  breast after the first 2-3 weeks of lactation ) , this factor favors

How to asses the Nutritional status of the baby

There are 4 ways by which we can asses the nutritional status of any baby as stated by the WHO :

1- Anthropometric measures : 

These are measures indicating the nutritional status of the baby :-

- Height for the age : for every child there is growth curve by which we can know if the baby is normal , low normal , etc..... , If the height is decreased in relation  to the age this indicate chronic malnutrition . 

-Weight for the age : if decreased it indicate acute malnutrition 

- Skin fold test : by punching the skin of the baby we can detect loss in the subcutaneous fat if present .