Healthy Child and Newborn Monitoring
Newborn and child monitoring includes regular monitoring of the health and development of the child at predetermined intervals and taking necessary protective measures during the period from the time of birth to the end of adolescence. During the follow-up and monitoring, examinations are applied to the children and their families are constantly informed about them. Follow-ups from the neonatal period should be done at the moment of birth (and for the first days following, every day while the mother is in hospital), day 7, every month until 6 months of age; after 6 months, at 9, 12, 15, 18 months; afterwards, regularly at the ages of 2, 3, 4, 5, 6, 8, 10, 12, 15 years. Your doctor is a Child Health and Pediatric Specialist, so you need to bring your child to regular check-ups not only when he/she is sick, but also when he/she is healthy.
Newborn / Infant Reflux
Since the digestive systems of babies have not yet reached sufficient maturity, reflux in healthy babies up to 18 months is considered physiological, that is, normal. Although reflux is considered normal, the problems caused by reflux impair the baby's quality of life. Hiccups, restlessness, excessive crying, frequent and intermittent vomiting, inability to gain weight, weight loss, wheezing, and frequently recurring lung infections are common symptoms of reflux. Diagnosis is made by examination and history, as well as tests when deemed necessary.
Growth and Developmental Delay
In children, the most important finding indicating growth is height growth, therefore deviations from the defined normal growth curves and remaining fixed shows the possibility of growth and developmental delay. Factors determining growth and development can be listed as nutrition, familial and hormonal factors. Being below the growth curve, which can only be related to the height of the parents, can also be seen in many chronic diseases. The need for treatment is decided as a result of your doctor's follow-up.
Eating Disorders
Refusing to Eat
The common problem of almost all mothers is children who have no appetite and refuse to eat. The most common age group is between 4 months and 3 years.
Although refusal to eat, loss of appetite may be due to a simple or serious infection, the main problem is the erratic eating behaviors that a child gains.
If growth and developmental delay in the child is not caused by refusal to eat, a cause-focused therapy is designed, including especially behavioral change and regulation.
Obesity
Due to the rapidly changing dietary habits in recent years, unfortunately, the obesity is also the major problem of children in our age. Obesity causes many problems, from orthopedic problems to diabetes, fatty liver to heart attack, social mocking of the child by his/her friends to serious psychological disorders.
As much important as the growth and developmental delay of the child is the tendency of the child's weight to be above normal for his age and height, which require attention and action at an early age.
Have your child's routine follow-up of healthy children and when you notice a change in eating habits, share it with your doctor.
Lung Diseases
LUNG INFECTIONS Bronchiolitis
It is a lung disease seen in children younger than 2 years of age (especially more common in male infants aged 3-6 months) in winter and early spring. Infection is usually caused by viruses.
The disease begins as a runny nose, sneezing, mild upper respiratory tract infection. Often around child is someone showing flu symptoms.
Its symptoms include decreased appetite, cough, wheezing, whistling while breathing, shortness of breath, mild or high fever, and it can sometimes be treated with oral medications, but other times it requires hospitalization or even intensive care.
Constipation
It is defined as slowed intestinal transit, decreased frequency of pooping, painful pooping due to the slowing down of the digestive system in children due to various reasons. The frequency of pooping differs according to each age and may also vary among children. It may create a vicious cycle where hardened poop leads pain during defecation and tears in the anus which lead to even more pain, causing one to retain poop, which further hardens the retained poop.
Although the cause of constipation is mostly behavioral problems, it can also occur due to malnutrition and some chronic diseases. Treatment is focused on the cause and requires patience from the family.
Iron Deficiency Anemia
Contrary to popular belief, anemia is not a decrease in the amount of blood in the body, but a decreased or dysfunctional hemoglobin in the red blood cells, which is one of cell types in the blood and responsible for distributing oxygen to the body.
Although the disease does not show many symptoms when it is at the onset and moderate level, anemia accompanied with iron deficiency in infancy negatively affects the neurological and physical development of the child.
The symptoms encountered in the late periods include paleness, weakness, fatigue, palpitation, hair loss, wounds around the mouth edge, as well as desire to eat soil (parts falling from the wall), match tips, etc. so-called pica. The disease is diagnosed by careful examination of the patient and blood tests.
Megaloblastic Anemia
The main reason for this form of anemia, which is seen especially in children who do not eat meat, in people who are vegetarian / vegan or suffer from intestinal malabsorption, is the deficiency of folic acid and vitamin B12 in the body. Symptoms may include fatigue, weakness, loss of appetite and weight, forgetfulness, muscle weakness, red and painful tongue, abnormal hand and arm movements, loss of sensation in the hands and feet, and difficulties in walking and using the hands.
The treatment of the disease is focused on the underlying cause.
Allergy and Allergic Diseases
Allergy and allergic diseases have a wide spectrum ranging from simple sneezing attacks, nose and eye itching to swelling and obstruction of the trachea with edema. As the cause of allergic diseases, environmental factors are as much important as the genetic predisposition (mother, father, sibling, 1st and 2nd degree relatives).
There is no treatment method which will completely eliminate allergic diseases as they are mostly genetically transmitted. However, they are diseases that can be completely kept under control with early diagnosis as well as good and correct treatment.
The aim of treatment is to provide the patient with a more comfortable life with minimal or no complaints.
The main allergic diseases include:
-Allergic Rhinitis: itchy nose, constant nose playing, sneezing, runny nose and stuffy nose
-Atopic Dermatitis: It starts on the cheeks in infancy, then spreads to other parts of the face and progresses with red, itchy recurrent lesions that can be seen on the nape, wrists, arms, abdomen and legs. Many findings such as dry skin, frequent skin infections, and increase in palm lines suggest atopic dermatitis. Besides detection and removal of the causative agent in treatment, it is also important to apply a treatment that calms the symptoms during exacerbations.
Asthma
Asthma: It is the condition of the airways being hypersensitive to environmental stimuli (allergens - house dust mites, pollen, cat, dog, cockroaches, etc. - viral respiratory diseases, cigarette smoke, air pollution). As a result of this hypersensitivity, edema, namely swelling, occurs in the airways. This swelling narrows and clogs the airways, preventing the transmission of air in places and causing respiratory distress, that is, asthma attacks.
Symptoms include persistent dry cough, wheezing, whistling sound while breathing, chest tightness, shortness of breath. Asthma, which is seen in attacks, is recurrent and patients often do not have any complaints between attacks. The diagnosis of asthma triggered by some allergens and exercise (crying, running and playing..) is made by patient examination, detailed history and (according to the age of the patient) pulmonary function tests.
Chronic Cough
Cough is a very important reflex that clears the airways of small involuntary particles and the body's own secretions, preventing them from escaping and settling in the lungs. It is considered normal for healthy children to cough about 10-12 times in a 24-hour period. Cough is divided into acute (less than 15 days), subacute (15 days-1 month) chronic (longer than 1 month) coughs.
Although the causes of chronic cough are quite a lot, they can be roughly listed as bacterial bronchitis, pertussis, pneumonia, tuberculosis, foreign bodies entering the lungs, reflux, asthma, nasal discharge. Treatment is directed towards the underlying cause.
◦ Tuberculosis in Children
Tuberculosis in children is often of adult origin. Close and long-term contact between an adult with tuberculosis and a child increases the risk of transmission of the disease to the child.
The probability of developing tuberculosis disease in a child who has been in contact with the disease and has received the bacillus (TB microbe) varies according to the age of the child. The younger the child, the greater the risk.
Tuberculosis is a very insidious disease and its symptoms do not bother the patient too much. Symptoms include fever (usually 37.5-38.6), cough lasting more than 2 weeks, pain in joints and bones, weakness, appetite and weight loss. After the treatment is arranged by the Child Health and Diseases / Pediatric Chest Diseases physician, the treatment continues under the controls and follow-up of the Tuberculosis Clinics.
◦ Cystic Fibrosis
For cystic fibrosis, which is a genetic disease, a screening test has been performed with blood taken from the heel since 2015 in our country. The main problem in patients who mostly present with respiratory tract problems is that the secretions of all glands in the body (respiratory tract, sweat glands, bile ducts, etc.) are extremely thick and these dark secretions cause plugs.
Symptoms start from the neonatal period and are most often manifested by persistent cough, recurrent pneumonia, and inability to gain weight. Most of the babies with cystic fibrosis make their first poop late in the newborn period. In addition, as an important finding, the family states that when they kiss their babies, they get a "salty" taste due to the disorder in the sweat glands.
Since the most important complaints of the patient are related to the respiratory system, treatments for the respiratory tract are very important. Although there is no definitive treatment for the disease, gene therapy studies are still ongoing.
Infectious Diseases
Upper Respiratory Infection
Upper respiratory tract infections (URTI), also known as colds and flu, are caused by viruses and the child does not need antibiotics. However, sometimes a bacterial infection can be added to it. Children can have URTIs 4-8 times a year.
Symptoms can be listed as fever, hoarseness, sore throat, cough, sneezing. If sore throat, difficulty in swallowing, fever are prominent, if there is an inflamed appearance on the tonsils, a throat culture and rapid throat swab test should be performed when your physician deems it appropriate, and the treatment should be arranged accordingly.
The most important danger of throat infection that is not properly and adequately treated (due to the early discontinuation of antibiotics by the family) is the children who come to us with cardiac rheumatism in the future. For this reason, it is vital for the family to use the antibiotic given to the child as and for the duration recommended by the physician.
Ear pain is most common in children due to otitis media. In middle ear infections, which almost always start with a viral agent, bacterial infection is added to it. In middle ear infections that absolutely require antibiotics, painkillers should be given regularly (for 48 hours) until the antibiotic shows its effect for ear pain that upsets the child very much.
Stomach and Intestinal Infections
Stomach and intestinal infections, which are encountered with food poisoning, bacterial infections at school age, manifest themselves in the form of rota diarrhea, also known as toxic diarrhea, more often in infancy.
The most common symptom is abdominal pain, which may be accompanied by vomiting and diarrhea. Treatment is based on age and cause.
Urinary Infections
Urinary Tract Infections
Urinary tract infections, which can lead to permanent kidney damage as a result of improper or inadequate treatment, are the most common infections in children after upper respiratory tract infections. In addition to preventable causes such as stopping the antibiotic earlier than recommended, improper cleaning after the toilet, urinary retention, constipation, it should be investigated whether there is a structural disorder (urine leakage from the urinary bladder to the kidney, obstruction by factors such as stone tumor, etc.) in recurrent urinary tract infections.
Disease symptoms include unexplained fever, vomiting, restlessness, loss of appetite, abdominal pain, burning during urination, frequent urination, change in urine color and/or odor. Diagnosis is made by urinalysis and urine culture, while treatment is 10 days of antibiotic therapy.
Endocrine Diseases
Diabetes Monitoring
Type 1 Diabetes (Childhood Diabetes)
Childhood diabetes, which is not insidious as in adults, can be recognized early with a little careful observation.
In children, drinking a lot of water, going to the toilet frequently, new-onset bedwetting, not gaining weight despite having a good appetite or weight loss may be the first signs of childhood diabetes.
It goes away with the lack or absence of hormones that balance the blood sugar level, the reason for which we cannot fully explain.
Type 2 Diabetes (Adult Type Diabetes)
Although it is called adult type, we see type 2 diabetes in children more frequently than before, due to the deterioration of nutritional habits (more consumption of foods that we call fast-food). The disease, in which inactivity and obesity are the most important risk factors, often starts with hormone resistance that balances blood sugar levels. The not-to-be-ignored symptom of hormone resistance that balances blood sugar levels: dark discoloration under the arms, neck, groin (folds). Once the diagnosis of diabetes is made, it is possible to reverse the irreversible disease before the disease progresses, when the hormone resistance that balances the blood sugar level is noticed.
Kidney Diseases
Kidney diseases in children are mostly congenital disorders. Signs and symptoms related to kidney diseases are mostly understood from the disorders, changes and differences encountered in urination and urination.
Heart Patients
Heart diseases in children are mostly congenital disorders. Most commonly, it is encountered with the sound of the heart, which we call "murmur", which is noticed during the cardiac examination performed by the pediatrician during routine follow-up of healthy children and newborns. This sound heard in children without any disease is often called an innocent murmur.
Even if the murmur heard is an innocent one, it should definitely be evaluated by a Pediatric Cardiologist with ECO (echocardiography) if your physician deems it necessary.
Cardiac rheumatism is the leading cause of subsequent heart diseases, and the cause (due to early discontinuation of antibiotics by the family) is due to a throat infection that has not been treated well and adequately. Symptoms of heart disease in children are fatigue, bruising during exercise (crying and sucking for babies), fatigue quickly, excessive sweating, and shortness of breath, which should not be neglected.
