Infancy in children what to do. West syndrome: infantile epilepsy. Symptoms of infant colic

Colic and gas

A common illness in young children is colic, severe pain in the baby’s intestines.

If the baby twists his legs, presses them to his chest, cries often and loudly, especially in the evenings, and often farts, you can confidently make this diagnosis yourself.

The cause most often is the swallowing of air with milk and improper nutrition of the breastfeeding mother.

After feeding, hold the baby upright to burp the air. Place it on your tummy more often. Review your mother's diet, excluding cabbage, spicy seasonings, nuts, coffee, and tomatoes. Brew dill water or fennel decoction for your baby.

By three months, colic and gas are usually gone. | | |

Skin problems

Jaundice

In the first days of life, the baby's skin may acquire a yellowish tint, even the whites of the eyes may turn slightly yellow. Don't be alarmed; your baby has neonatal jaundice. It is not dangerous and usually goes away by the end of the first month. Follow the rules of hygiene, walk more with your baby.

The newborn's skin is peeling

The skin of a full-term baby is covered with a special lubricant - a white oily liquid. It protects the delicate skin of a newborn from dry air (after all, before his birth he was in an aquatic environment) in the first hours of life. Gradually, the lubricant is absorbed into the baby’s skin almost completely.

If it was wiped off at birth, or the child was born late, which means practically without lubrication, the skin dries out and begins to peel. Frequently lubricating the baby's skin with sterile vegetable oil will help solve the problem. |

Diaper rash

The baby may experience redness, dry or weeping, in the groin, armpits, and neck folds. The reason is overheating and failure to comply with hygiene rules.

How to treat? Reduce the temperature in the nursery to +21…+22 degrees. Determine whether diaper rash is dry or wet?

If dry, lubricate with baby cream or sterilized vegetable oil. If it gets wet, use baby powder, preferably without additives or fragrances.

Rinse problem areas often with a light solution of potassium permanganate or just warm water. Don't bundle up your child. Take air baths and keep diaper rash areas open for better drying. |

Prickly heat

What does prickly heat look like? Reddened skin with clusters of small red pimples, sometimes with white purulent tips. They usually appear on the butt, neck, head, groin, armpits, and can be on the back, chest, or behind the ears.

Sometimes prickly heat can be confused with an allergy. Parents should be alert if the child itches, is restless, and the rash quickly spreads throughout the baby’s body. A pediatrician will make an accurate diagnosis.

With prickly heat, the rash does not bother the baby. It is enough to wash the affected areas with an infusion of calendula flowers, chamomile, string, and a weak solution of potassium permanganate. Lubricate with baby cream, Bipanten cream, and boiled vegetable oil. You can use pharmaceutical powder.

Diaper dermatitis (diaper thrush)

The most striking sign of diaper dermatitis is the appearance of a small rash in the form of blisters, crowded together, but not extending beyond the clearly defined border of the affected area. You can see them in the groin, perineum, in the folds of the legs, around the genitals. For treatment, it is better to use ointments based on nystatin or clotrimazole (strictly as prescribed by a doctor).

Pemphigus of newborns

Soon after birth, large bubbles (the size of a pea) filled with a yellowish liquid may appear on the baby's body. Gradually they burst, leaving a pink spot in their place. Pemphigus is treated with antibiotics and special ointments (prescribed by a doctor).

Newborn acne

Acne of newborns (infantile acne, neonatal pustulosis) - occurs in ~ 20% of newborns. A rash on the face in the form of pimples. The causes of acne in newborns are hormonal. Does not require treatment.

Mipia

White dots similar to acne are visible on the baby's face. There is no need to treat them; they will go away within two to four months.

Note to moms!

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Important:

SKIN DISEASES IN CHILDREN IN THE FIRST YEAR OF LIFE: DIAGNOSIS ISSUES

Management of newborns and infants suffering from skin diseases requires accurate decisions and prompt actions from the dermatovekerologist, the effectiveness of which largely depends on correct and timely diagnosis. Pediatric dermatovenerology has now turned out to be not only an extremely responsible, but also the most difficult area for dermatovenerologists. Despite the fact that doctors of various specialties take part in the treatment of children with skin pathologies, it is not possible to achieve satisfactory results in terms of reducing the level of the disease and increasing the effectiveness of treatment and preventive care. The number of diagnostic errors is especially high. Pediatric dermatology is closely related to the prevention of hereditary pathology, since the birth of a sick child prompts relatives to consult a doctor to determine the genetic prognosis. Increasing the level of professional nosological diagnostics is the initial and necessary condition for the development of therapeutic, preventive and medical genetic care. Brief reviews are offered on the issues of diagnosis, treatment, prevention and rehabilitation of children suffering from skin and venereal diseases.

To cure neonates and babies who suffer from skin diseases requires that dermatovenerologist should take accurate decisions and make prompt actions whose effectiveness largely depends on correct and timely diagnosis. Pediatric dermatovenereology has proven to be not only a highly crucial but the most challenging area for dermatovenereologysts. Despite the fact that physicians of various disciplines participate in the treatment of infants with skin abnormalities, there are no saticfactory results in reducing incidence rates and enhancing therapeutical and preventive care. There are a great deal of diagnostic errors. Pediatric dermatovenereology is closely associated with the prevention of hereditary pathology as the birth of an ill baby makes his relatives to visit a doctor to determine a genetic prognosis. To enhance the level of professional nosological diagnosis is a primary and essential condition for the development of therapeutical, prophylactic, and medical and genetic care. Brief reviews on 1) diagnosis, 2) treatment, prevention, rehabilitation of infants, with skin and venereal diseases are proposed.

Department of Dermatovenereology (Head: Doctor of Medical Sciences, Prof. K. N. Suvorova) of the Russian Medical Academy of Postgraduate Education. Prof. KN Suvorova, MD, Head of the Department of Dermatovenerology, Russian Medical Academy of Postgraduate Training

Introduction

In children of the first year of life, various skin lesions are detected more often than in other age groups. The pathology of the skin during this period is distinguished by the pronounced specificity of the nosological profile and the unusualness of the clinical manifestations of dermatoses, which are also known in adults, but manifest differently. A dermatovenerologist should know about special skin conditions in newborns, specific approaches to the treatment of dermatoses, and the characteristics of an infant’s body that determine its response to medications or contribute to the severity and chronicity of dermatoses and the development of complications typical for this age. In the first months of life, suddenly severe and acute dermatoses may occur, when an accurate diagnosis and urgent assistance are urgently needed, which can only be provided through the joint efforts of pediatricians and dermatologists. Secondary skin lesions may occur with congenital metabolic defects and other multiple organ syndromes with onset in infancy; a dermatologist, having an adequate understanding of such diseases, must promptly refer the child to a pediatrician and other specialist in accordance with his diagnostic assumptions. On the other hand, often the most common skin lesions are first discovered by a pediatrician who constantly monitors the child. In such cases, he should be able to suspect a skin disease and refer the child to a dermatologist. The task of a pediatrician is to identify and treat internal diseases that contribute to the exacerbation or torpid course of dermatosis, and a dermatovenerologist is obliged to correctly diagnose skin and venereal diseases, no matter what age they occur, based on professional knowledge of the semiotics of dermatoses and sexually transmitted diseases, and the ability to use special methods of nosological recognition. Knowing the basic etiological and pathogenetic methods of treating dermatoses, a dermatovenerologist must determine the stages of therapy, use different options for special treatment with a variety of topical agents, and carry out rehabilitation. According to the professional and job requirements for a specialist, every dermatovenerologist should know pediatric dermatovenerology, since there is no separate specialty in this discipline. In practice, this section, especially skin pathologies in children of the first year of life, turns out to be the most difficult for a dermatovenerologist. Based on the experience of the Department of Dermatovenerology of the Russian Medical Academy of Postgraduate Education and the children's department of the Moscow Clinical Dermatovenerological Hospital No. 14, we propose to discuss some issues related to this area.

Table 1. Diagnosis of dermatoses in infants and auxiliary studies

DIAGNOSTIC PRINCIPLES AND METHODS OF EXAMINATION

The main reason for diagnostic errors is the underestimation of the information content of the data that can be obtained using clinical and morphological analysis of skin lesions, which is a specific diagnostic method in dermatology. Dermatological examination

consists primarily of
a visual examination with
a detailed interpretation of the primary and secondary eruptive elements, supplemented by simple tests to identify a number of symptoms (Nikolsky, Unna-Daria, symptoms of the psoriatic triad, areas of loose hair, etc.) and such simple technical techniques as scratching, diascopy, examination under a Wood's lamp, hair microscopy, examination of the functions of the skin glands, analysis of the scalloped skin pattern, etc.
Under a Wood's lamp, you can not only see the green glow of hair in microsporia, which is detected in some children as early as 3 months of age, or the red fluorescence of the cystic fluid in congenital erythropoietic porphyria, but also examine weak inflammatory and dyschromic lesions that are invisible in normal lighting spots, the identification of which is extremely important for the early diagnosis of phakomatoses, since white spots and pigmentation in the first year of life may be the only visible signs of these dangerous diseases. The results of sweat tests
can also be vital revealing anhidrosis, which without appropriate correction will lead to severe disturbances in thermoregulation, febrile convulsions and even more tragic consequences of undetected malformations, accompanied by hypoplasia or dysfunction of the sweat glands.
Microscopic examination of the hair shaft
makes it possible to reliably diagnose Netherton's syndrome and many other diseases characterized by congenital hair abnormalities, some of which are associated with immune and mental disorders.

Table 2. Skin changes and lesions in newborn infants.

Notes. An asterisk indicates conditions and skin diseases specific to the neonatal period.

Table 3. Manifestation of hormonal crisis.

In the absence of such structural abnormalities, syphilitic alopecia should not be forgotten in the differential diagnosis. Additional information for early diagnosis of dysplastic genodermatoses and hereditary keratinization disorders will be provided by examination of the scalloped skin of the palms and soles. In this case, not only anomalies of flexor folds in the form of dysmorphogenetic stigmas can be identified, but also pathogenetic signs of impaired formation of papillary patterns, included in the core of the syndrome in some developmental defects. The characteristic high intensity of additional folds on the scalloped skin in the first months is often the only sign of vulgar autosomal dominant ichthyosis, while obvious peeling occurs towards the end of the year or later. The symptom of lacquered pads on the fingertips, almost devoid of epidermal ridges, which is especially pronounced in the first months of life, is characteristic of lamellar ichthyosis; gross deformations of flexor folds are typical of diseases accompanied by the intrauterine formation of rough and constricting hyperkeratotic layers. Already in the second half of the first year of life, the disappearance of papillary patterns after the resolution of the blisters can be clearly observed, which is an important sign that allows one to differentiate dystrophic epidermolysis bullosa from other types and determine the prognosis. In some cases, it is necessary to resort to vitropression and use a button probe, since in the first year, children with tuberculosis may develop not only erythema nodosum, but also, in rare cases, acute disseminated miliary tuberculosis of the skin. Through vitropresion

Characteristic yellowish-brown small spots can be detected in the case of sarcoidosis; differences in color on diascopy will allow differentiation of vascular spots and hemorrhages, deep-pigmented spots and anemic nevus.
The dermatologist should constantly use the scratch technique to identify not only Auspitz phenomena, but also hidden peeling in various dermatoses, as well as purpura, serous wells, and acantholysis. Taking an anamnesis and examining relatives
constitute the next stage of the examination.
The anamnesis is often uninformative, the patient cannot yet make complaints, and parents do not always carefully record the dynamics of the disease. It is all the more important at this age to complete the clinical and morphological analysis and family examination. When examining blood relatives, you can obtain the necessary data to confirm or exclude mendelian dermatosis. As for multifactorial dermatoses, genealogical information is important for their scientific study, but has no practical diagnostic value, since at the time of examination a relative may be in remission, and anamnestic indications are inaccurate; in addition, there is no such alternative sign as a different type of inheritance for monogenic diseases. Examination of relatives and other persons in close contact with the child is more necessary when identifying infectious or parasitic dermatosis, both to confirm the diagnosis and to prescribe effective treatment and preventive measures, however, a special need to examine the mother arises if there is a suspicion of blenorrhea, syphilitic pemphigus, diffuse Hochsinger's infiltration, osteochondritis, coriza or other lesions that may be associated with sexually transmitted diseases. Among laboratory tests,
to establish a diagnosis in the case of a suspicious clinical picture, tests confirming candidiasis or other fungal infections, scabies, and sexually transmitted diseases are required.
Pyoderma is usually diagnosed clinically, but other bacterial dermatoses should be considered. For example, if impetigo does not heal within a week with adequate treatment, it is imperative to perform tests to exclude skin diphtheria. Pathomorphological examination
of the skin is carried out in exceptional cases; it is indicated for tumors, sarcoidosis, lymphomas, Curt-Macklin spiny ichthyosis, for the differential diagnosis of nosological forms of epidermolysis bullosa.
You can perform a simple cytological analysis
of fingerprint smears from the erosion and the bottom of the bladder.
In children with pigment incontinence, 50% of eosinophils are found in the contents of the bladder. There are few other indications, since dermatitis herpetiformis with an early onset at the end of the first year of life is extremely rare, and juvenile pemphigoid and familial pemphigus Hailey-Hailey develop later. It is possible to identify differences between staphylococcal scalded skin syndrome and Lyell's syndrome: in the first, blisters occur in the granular layer of the epidermis, in the second - in the basal layer, although the diagnosis is usually made on the basis of the clinical picture. The importance of x-ray examination
of long bones in the first 3 months of life, when osteochondritis can be detected, which (at 11-111 degrees) is a reliable sign of early congenital syphilis, which is especially significant when its other signs - visceral lesions, even multiple foci of diffuse infiltration of the skin - are interpreted incorrectly and are not made serological tests. Bone radiography should be ordered when clinical signs of mastocytosis or Abt-Letterer-Siwe disease appear to determine the shape or extent of the lesions. X-rays of the jaws are of great diagnostic importance if Christ-Siemens syndrome is suspected.

Table 4. Particularly dangerous dermatoses or their episodes in newborns and infants

The above practically exhausts the range of basic studies necessary to establish a nosological diagnosis. However, to assess the severity of the condition, the presence of background disorders and intercurrent diseases, a number of laboratory tests are required,

the minimum list of which is given in table.
1. Additional studies also include some etiologically significant measures (skin biopsy examination, special tests for secondary dermopathy)
due to the rare need or inaccessibility in a dermatovenerological hospital or clinic. Attention should be paid to the need for frequent repetition of urine tests for microbial dermatoses and atopic dermatitis due to the risk of developing acute pyogenic nephritis and membrane-destructive processes, monitoring the immunogram during immunocorrective therapy, determining average weight peptide molecules and other indicators of endogenous intoxication in children with complicated atopic dermatitis and other severe dermatoses. A high level of endotoxemia is also reflected in mesenchymal, liver and paracoagulation tests, protein and hemogram. A blood test for sugar may be urgently required during treatment with glucocorticosteroids in patients with severe dermatoses; hypoglycemia and hypothalamic insufficiency are possible in seriously ill children, including those with early congenital syphilis.

Table 5. Diseases with bullous eruptions.

AGE DYNAMICS OF SKIN PATHOLOGY IN THE FIRST YEAR OF LIFE

Brief information on this issue can help in the diagnosis of dermatoses in newborns and infants. It is customary to talk about the atypicality of rashes in children of the first year who have psoriasis, atonic dermatitis, scabies, mycoses, etc. In fact, they seem atypical only to a doctor accustomed to adult patients. A more pronounced exudative component of lesions, small rash elements, localization features determined by the properties of the skin at this age and endogenous factors - this is what is typical for young patients, as well as the age-related dynamics of the disease picture and the nosological profile of the pathology. Age at the onset of the disease and the appearance of age-dependent symptoms are of great diagnostic importance. Not only the onset, but also the duration, as well as the general possibility of the occurrence of some dermatoses are limited to certain periods. For example, Leiner's disease and infantile seborrheic dermatitis are observed only in the first quarter of the year, while the onset of atonic dermatitis often occurs at the age of 3 months. At birth, the skin can only show manifestations of so-called congenital diseases, which begin to form during intrauterine development. These include some genodermatoses and rare cases of transplacentally acquired infections. Other diseases appear later, after a few hours, days, weeks, and sometimes in the second half or at the end of the first year of life. It is customary to distinguish between pathology and special conditions of the neonatal period. A number of those listed in table. 2 changes are observed only at this time, sometimes within just a few days (toxic erythema) or weeks (scleredema, sclerema), others resolve longer (adiponecrod, telangiectasia), others will last a lifetime (genodermatoses), infectious, irritative, traumatic lesions can occur at any age, but often in a different form. At the 1st - 2nd week of life, the newborn begins to show signs of a hormonal crisis (Table 3), which can last up to 3 months until the metabolites of fetoplacental hormones are eliminated. With proper care and the exclusion of drugs and products in the child and nursing mother, the metabolism of which is associated with the glucuronidation reaction (sulfonamide drugs, chloral hydrate, caffeine, alcohol), the manifestations of a hormonal crisis gradually disappear without treatment. Complications that sometimes arise are mainly associated with inadequate therapeutic effects and refusal to bathe the child, which contributes to the development of microbial skin lesions. At the end of the 1st month, many children develop manifestations of infantile seborrheic dermatitis in areas of the skin with increased sebum secretion, primarily on the head in the gneiss area, behind and in front of the ears, on the brow ridges, where accumulations of fatty yellow scales are visible against the background of erythema. Erythema-squamous lesions can also appear in the inguinal, femoral folds, and on the neck. With the end of the hormonal crisis, all seborrheic manifestations disappear, but untreated microbial complications may persist. In newborns and early infants, lesions called staphylococcal and candidal flora are common, colonizing integumentary tissues that have not yet been colonized by protective flora. They are especially dangerous in case of insufficient immunity and the presence of an entrance gate, especially an infected umbilical wound. In newborns, yeast stomatitis, sometimes intertriginous candidiasis of the folds, candidiasis of smooth skin, pseudopustular dermatitis of the trunk, vulvar candidiasis, and balanoposthitis often occur. The ducts of the sweat glands are often infected with staphylococcal flora, periporitis (vesiculopustulosis) occurs, which is facilitated by neonatal hyperhidrosis and miliaria, overheating, and poor care. With deeper inflammation of the sweat glands, multiple abscesses develop (pseudofurunculosis); they rarely appear in the neonatal period and are more common in children 3–7 months old. A specific form of staphyloderma in the neonatal period is epidemic pemphigus of newborns, which occurs on the 3rd - 5th day after birth or in the first 2 weeks in the form of multiple conflicts, leaving erosions with fragments of tires and crusts. Unlike syphilitic pemphigus, which can appear at the same time mainly on the palms and soles, pyococcal pemphigoid of newborns mainly affects the skin of the torso and very rarely the palms and soles. Less common at an early age is streptococcal infection in the form of erysipelas, spreading mainly from the navel and proceeding severely, or in the form of papular-erosive streptoderma (syphil-like papular impetigo). Similarities with syphilitic rashes are seen in the appearance of large dense papules, which, however, after opening, conflicts on their surface quickly erode and are surrounded by a rim of exfoliated epithelium, and most importantly, are not accompanied by other clinical and laboratory signs of syphilis. Since papular-erosive streptoderma affects the skin of the buttocks and adjacent areas, many identify it with diaper dermatitis. Others consider diaper dermatitis and diaper rash to be a traumatic lesion, which is often infected with streptococcal, candida and other flora (streptococcal and candida diaper rash). A characteristic symptom of diaper dermatitis is the smell of ammonia (ammonia dermatitis). In newborns, diaper dermatitis is rare, most often detected at 2 months of age, although it can be observed in children from 2 weeks to 8-9 months and is a typical disease of infancy. Diaper and seborrheic dermatitis are often combined with perianal dermatitis, which can occur in the first days of life or from the 2nd week and, according to the literature, lasts 7 - 8 weeks (however, we observed it later, even in children older than 1 year suffering from atopic dermatitis and intestinal dysbiosis). In the second half of the first year of life, other forms of streptoderma are more often observed: bullous and periungual impetigo, interginous streptoderma in the postauricular and other folds, later erythematous-squamous streptoderma, and in weakened sick children with poor care - ecthyma. Viral diseases appear, most often molluscum contagiosum, less often - herpetic infections. All types of microbial skin lesions can complicate the course of atopic dermatitis, the most common disease in the second half of the first year of life. Allergic dermatitis is rare, but simple contact dermatitis, resulting from the irritating effect of care products containing detergents and disinfectants, saliva, and diapers, is quite common. Skin lesions become more noticeable after sun exposure in patients with xeroderma pigmentosum, erythropoietic porphyria, and congenital erythema telangiectatica with dwarfism (Blum's syndrome). Hereditary poikilodermic and telangiectatic syndromes and phakomatoses, hereditary palmoplantar keratoderma, atrophying keratosis pilaris, which is often mistaken for “diathesis,” hair shaft dystrophies, congenital pachyonychia, and variable erythrokeratoderma are manifested. When the child begins to crawl and stand, blistering lesions appear for the first time or worsen in some epidermolytic types of epidermolysis bullosa. In the second half of the first year, secondary damage to epidermolysis bullosa (milium-like epidermal cysts, scars, changes in nails) becomes more distinct, the presence or intensity of which makes it possible to differentiate its numerous nosological forms (more than 20 diseases) with some certainty. In some diseases, different age-dependent signs and stages of development of the clinical picture consistently appear throughout the year. In Bloch-Suliberger syndrome, linear bullous lesions that occur in the first days and weeks against the background of erythematous and urticarial exanthema are already replaced in the first months by a hypertrophic stage with warty and lichenoid rashes, and after 6 months symptoms of the pigmentary and atrophic stages are formed. Between the 6th and 7th month, the picture of epidermolysis bullosa herpetiformis Dowling-Mehr, a frequently occurring but rarely recognized nosological form, becomes pathognomonic. In the first days, the newborn has blisters on the fingers and toes, then on the palms and soles, from the 2nd month - outbreaks of vesicular rashes on the face and in the submandibular area, between the 2nd and 6th months the appearance of blisters of a somewhat proximate nature is noted. smaller than the palms and soles, and after 6 months, spreading to the skin of the extremities, the blisters form distinct herpetiform groupings with central healing, which is an important differential diagnostic feature, very clear in subsequent years, when a herpetiform rash appears on the body. The high diagnostic value of age-dependent symptoms and the dynamics of the appearance and frequency of different groups of diseases is due to the fact that they not only complement the picture of the disease and the number of positively considered signs, but can also play the role of negative signs that reliably exclude one or another proposed diagnosis.

SEVERE, DANGEROUS AND ACUTE PROCESSES

It is always necessary to remember that infants can develop severe skin diseases, sometimes with lightning-fast dynamics, the prognosis for life of which is uncertain if medical care is untimely. They can be associated with infection or intoxication, an unusual reaction of the body, immune disorders or genetic defects. The most well-known and significant diseases are presented in table. 4. Scleredema and sclerema, which develop in the 1st week of life, sometimes from the 2nd to 3rd day, and are manifested by swelling of the subcutaneous tissue, have some similarities, but their prognosis is different. Scleredema is considered as a cold injury of newborns against the background of a number of disorders and diseases of the child or mother; among the complex of therapeutic measures, warming is important. Sclerema, which develops in premature, weakened, malnourished and dehydrated children, can be fatal; glucocorticosteroid hormones and symptomatic drugs are used in its treatment. Pyococcal pemphigoid and erysipelas are especially severe in newborns against the background of omphalitis and umbilical sepsis. Exfoliative dermatitis of newborns, described by Ritter in 1878, was considered a malignant variant of pyo-coccal pemphigoid. Now it is identified with staphylococcal burnt skin syndrome, which can occur at an older age, but in newborns in the 1st week of life it is especially severe, accompanied by high temperature and intoxication. Beginning with cracks and redness of the skin near the navel and mouth, a sudden eruption of large superficial blisters, the lesion within a few hours takes on the character of generalized hyperemia with swelling, erosion, with detachment of the epidermis resembling a burn, with a positive Nikolsky sign. The cause of this acute toxic skin lesion is associated with exposure to epidermolysins secreted by phage group II Staphylococcus aureus and the presence of an active focal infection in the upper respiratory tract or other organs. Skin lesions are quickly controlled by systemic administration of antibiotics. Leiner's disease begins after 3 weeks of age, is acute and severe, manifested by widespread erythema and desquamation, diarrhea, and severe malnutrition. The cause of the disease is considered to be congenital immune deficiency, accompanied by a decrease in the opsonic activity of serum against yeast-like fungi, impaired phagocytosis, and deficiency of complement component 5. In stool tests, staphylococci, gram-negative flora, and yeast-like fungi are detected in patients. After the 3rd month of life, this disease does not occur. Toxic epidermal necrolysis and Stevens-Johnson syndrome are observed at any age, but, unlike staphylococcal scalded skin syndrome, they occur less frequently in children of the first year of life than in adults, although cases of Lyell's syndrome have been described even in newborns. It can develop as early as 2 days after taking a drug that caused a specific autoimmune reaction against epidermocytes, although the average time is about 2 weeks. The danger and severity of this disease are associated not only with internal multisystem damage, widespread involvement of the mucous membranes (with staphylococcal burnt skin syndrome they are not affected), but also with the possibility of sepsis, since erosions are colonized by Staphylococcus aureus and gram-negative flora. Other bullous diseases also tend to be complicated by secondary infection, and there is a risk of pyogenic damage to the kidneys or other organs, but the frequency and severity of complications vary. To assess the prognosis and early initiation of adequate measures, it is necessary to have a clear understanding of the diseases listed in Table 5.

Conclusion

Reliable nosological recognition of skin diseases in newborns and infants must be carried out as soon as possible. This opportunity is ensured by visual accessibility of the organ, subject to professional performance of clinical and morphological analysis of eruptive elements, correct assessment of age-dependent symptoms, specific differential diagnosis within the nosological profile of each age segment, knowledge of the age-related evolutionary dynamics of skin pathology.

Literature:

1 . F. Zverkova. Skin diseases of young children. Saint Petersburg. - Sothis. -1994 — 235 p. 2. K.N. Suvorova, A.A. Antonev, N.P. Kuznetsova, I.O. Malova. Skin and venereal diseases in children. .Irkutsk, - Irkutsk University Publishing House. -1995. 3. Yu.K. Skripkin, G.Ya. Sharapova. Skin and venereal diseases. - M.: - Medicine. -1972. 4. Yu.K. Skripkin, F.A. Zverkova, G.Ya. Sharapova, A.A. Studnitsin. Guide to pediatric dermatovenerology. - A.; Medicine. - 1983.

Conjunctivitis

Conjunctivitis in an infant is a rather serious problem. With this disease, the eyes turn red and purulent discharge accumulates in their corners. After sleep, the child has difficulty lifting the eyelashes that have stuck together.

For relief, you can wash your eyes with infusion of chamomile, calendula, or weak tea leaves. You need to wipe each eye from the outer corner to the inner one with your own swab. The doctor will prescribe treatment, usually eye drops. Clean your eyes before each instillation of the medicine. |

Oral thrush

White, uneven spots appear in the child's mouth on the tongue and inner surface of the cheeks. They are coarse and greasy, looking like pieces of cottage cheese or leftover milk. But, unlike milk stains, these are not washed off from the baby’s tongue. You can distinguish thrush like this - the remaining milk disappears during the break between feedings, the spots of thrush, on the contrary, spread throughout the oral mucosa.

It is necessary to treat thrush, because it causes pain in the baby’s mouth. He sucks worse or refuses to take the breast altogether.

When breastfeeding, a mother can also become infected with thrush. Therefore, before breastfeeding, treat the baby’s oral cavity with a gauze or bandage napkin soaked in a solution of baking soda (add 1 teaspoon of soda to a glass of warm water).

Sterilization of nipples and bottles is required; when breastfeeding, thoroughly rinsing the breasts before and after feeding. To treat thrush, special drugs based on nystatin are used. The doctor will select and prescribe them.

What complications are possible?

If the causes of the disease are not identified in time or were interpreted incorrectly, the infant may experience the following consequences of the development of the disease:

• hydrocephalus
• mental retardation
• emotional and mental disorders
• excruciating headaches that cannot be gotten rid of either with medications or folk remedies
• disability

The prognosis for the treatment of ICP in infants with early diagnosis of the problem is optimistic. If the level of cerebrospinal fluid is greatly increased, the doctor usually prescribes appropriate surgery.

You should not refuse it: after postoperative recovery is completed, the child begins to feel better, issues with appetite are resolved, and headaches go away. Reviews about such treatment are positive if it is carried out under the guidance of a competent specialist.

If parents notice alarming symptoms in time and do everything that a competent specialist recommends, the consequences of the disease can be quickly eliminated or reduced to the proper minimum. Traditional medicine (herbs, plants) can only be used after full consultation with your doctor.

Problems with stool

Constipation

A breastfed newborn may poop once every five days. And this is normal if the baby is calm, cheerful, and eats well. It’s just that mother’s milk is absorbed almost completely.

However, we can say with confidence that he is constipated if the baby has difficulty defecating, cries, and the feces have a very thick consistency.

How to help a little sufferer? Gently massage your tummy with light clockwise movements. Alternately press your legs bent at the knees towards your tummy, as if kneading it. If the child was unable to poop and after these procedures, he strains and cries, then you can give the baby lactulose syrup or use a suppository with glycerin. |

Diarrhea

Very frequent (more than 4-5 times a day) loose stools with mucus, accompanied by abdominal pain, bloating, and sometimes even vomiting, is a sign of diarrhea.

Be sure to call a doctor or an ambulance without delay. After all, with severe diarrhea, dehydration quickly sets in.

Before their arrival, you need to give them more water to drink. From the age of one month you can dilute Smecta, 2 sachets per day. You need to drink it like this for three days. | |

INFANT in children is not an officially registered disease

, therefore, in this case, doctors transferred their functions to healers, shamans, conspirators and other specialists of this kind. There is a Russian proverb: a baby took someone. This is how they characterize a person who has a physical disability, which was left after an illness suffered in childhood, or a difficult birth. This mysterious disease is also called the adjective “infantile”, and the child’s mouth and eyes become distorted, and the whole body is twisted. last up to three seconds. Attacks can last for several minutes several times a day. The recommendations of traditional healers boil down to the fact that during an attack, the baby is placed on a white sheet and covered with a wedding dress or veil. When he calms down, you should give the child tea brewed from pink peony petals collected from twelve flowers (a teaspoon per glass of boiling water). But if this procedure is refused, infantile illness can transform into epilepsy. In parallel with the procedure, you should quietly read the prayer to the Mother of God and the “Our Father,” praying to the Lord God to send health to the sick baby.

Actually, cramps are movement disorders in which muscles involuntarily contract; they arise suddenly and appear in paroxysms or constantly. Seizures occur as a result of brain irritation. This painful condition can occur with a sharp rise in temperature, or after a fright. Convulsions have been observed in young children with constipation and worms; The cause of infantile seizures can also be any disease of the nervous system.

Description of the symptoms of the so-called baby in children

These types of seizures often occur during sleep. Signs include pale skin and distortion of facial features. The baby’s eyes roll back, the mucous membrane of the lips turns blue; limbs are cramped, sometimes accompanied by vomiting. In severe cases, the seizures often follow one another, the child's breathing becomes heavy, foam may appear on the lips, involuntary bowel movements occur, and it is said that everything can end in death.

To quickly normalize the child’s condition during infancy or, as they like to say, a baby in children

To prevent these seizures, an environment of complete peace should be created around the child. There should be silence and dim light; the presence of unnecessary people in the nursery is undesirable.

If there is a reason for the convulsions, call a doctor or ambulance immediately. Before their arrival, apply a damp towel to the child’s forehead; The child should be undressed, covered with a sheet and from time to time wet different areas of the body with cool water - back, arms, legs, chest

After the convulsions are over, you need to give the child an enema of boiled water at room temperature with a few drops of table vinegar (not the essence). This is necessary in order to prevent recurrent seizures.

A baby who has frequent seizures should be given fish oil daily.

And when the temperature rises, children who have had convulsions are given an infusion of violet pubescent herb (also known as infant or heart herb). To prepare the product, take up to three grams of dried and crushed raw materials, pour a glass of warm boiled water and leave in a sealed container for a couple of hours, then filter. In the first three years of life, a teaspoon is given orally three times a day.

In addition, during the period of colds, a child is recommended to drink an infusion of lush clove herb for cramps. To prepare the product: about four grams of dried raw material, ground into powder, brew with a glass of boiling water and leave in a closed container for a quarter of an hour, then filter, and give a teaspoon three times a day before meals.

Infantile colic

- these are various forms of physical discomfort in children in the first months of life, accompanied by a certain set of symptoms. According to medical statistics, up to 25% of all babies suffer from colic. They begin at 2-4 weeks of life and last from several weeks to several months.

Types of anemia in children under one year old

Slow or stopped production of red blood cells causes anemia in the infant.

Types of anemia in infants:

• Anemia of premature babies

  – recorded in every child born prematurely, determined in the maternity hospital;

• Iron deficiency, or hypochromic

  – recorded in 80% of all cases;

• Hemolytic

  – occurs when there is a Rh conflict between mother and child, as well as when a pregnant woman is infected with toxoplasmosis, rubella, or herpes;

• Nutritional

  – is formed against the background of a monotonous diet, poor in vitamins and microelements;

• Anemia as a result of infection

  – may be a symptom of pathology;

• Autoimmune

  – irregularly shaped red blood cells in this type of anemia lead to oxygen starvation;

• Yaksha-gayema ​​anemia

  – characterized by an enlarged liver, hyperthermia, pale skin, the appearance of shortness of breath and heart murmurs, a sharp decrease in hemoglobin, although the number of red blood cells remains within normal limits;

• Hypoplastic anemia

  , which has a high percentage of deaths, and
  hemoblastosis
  (leukemia) - occurs due to suppression of the activity of red blood cells by leukocytes due to impaired immunity, or due to impaired synthesis of red blood cells.

Symptoms of colic in babies

Many children in the first months of life periodically cry and scream - this is considered the result of the infant’s body adapting to new environmental conditions. But in many cases, their crying can be, if not eliminated, then minimized with properly organized care, including breastfeeding on demand, sufficient tactile contact, etc. With colic, children cry for 3 hours a day or more, their cry loud, heartbreaking, and almost impossible to cope with. Colic attacks occur in infants at approximately the same time (usually in the evenings). The heartbreaking cry of a baby is usually accompanied by a number of symptoms: the child’s stomach becomes “tight”, the face turns red, the knees are pulled up to the stomach, the child may also arch in pain. Relief is usually associated with the passage of gases, defecation, and sometimes the condition of a sick child improves after feeding.

Causes of a runny nose in a baby

The causes of a runny nose at the physiological level in infants may be as follows:

• copious discharge from the nose may appear along with the eruption of the first teeth;
• it happens that when regurgitating, some part of the milk gets into the nose and, in order to remove the coagulated lumps, the secretion of mucus can be increased;

If we talk about the pathological causes of a runny nose in an infant, we can distinguish two main ones:

• infectious and inflammatory diseases - often rhinitis in newborns is associated with the development of a respiratory disease;
• allergies - a runny nose may indicate an individual intolerance to some substances often contained in the air (plant pollen, animal hair, dust).

In any case, no matter what the reason causes a severe runny nose in an infant, an examination by a pediatrician is necessary. If a newborn has a temperature, it is better to call a doctor at home; if there is no temperature, you should go to the appointment yourself.

You especially shouldn’t put off going to a medical facility if your baby has a cough, watery eyes, won’t latch onto the breast, or becomes whiny or apathetic.

Possible causes of infant colic

Immaturity of the digestive tract

Traditionally, colic has been associated with immaturity of the digestive tract of children. Infant colic is a reaction of the newborn’s body to a new way of eating (not through the umbilical cord) and to the colonization of the baby’s hitherto sterile intestines with microflora. The main cause of colic is increased gas formation, and they can be aggravated by certain foods (fresh vegetables and fruits containing a large amount of fiber, dairy products, black bread, etc.) included in the diet of a nursing mother. In most infants, colic goes away once the gastrointestinal tract has stabilized and the baby gains the ability to pass gas independently and/or begins to have bowel movements more regularly.

Dysbacteriosis

In Soviet and post-Soviet pediatrics, one of the causes of colic in infants was considered dysbacteriosis, that is, a violation of the intestinal microflora. Currently, this point of view is being actively criticized because, firstly, the microflora in children in the first months of life is constantly changing, and this is considered the norm; secondly, the diagnosis of “dysbacteriosis” itself is not included in the International Classification of Diseases and is not recognized by many doctors. True, it has been noticed that often in breastfeeding mothers who took antibiotics or some other medications in the first days after giving birth, children suffer from colic more than other babies (antibiotics can actually affect the composition of breast milk and cause disruption of the child’s intestinal microflora).

Gastroesophageal reflux

Gastroesophageal reflux is the passage of acid from the stomach into the esophagus, causing physical discomfort. This happens most often in a horizontal position, so the child suffers more if he lies down and feels relief in a vertical position.

Increased physical and psychological sensitivity of the child

Another version of the occurrence of colic in infants is the increased sensitivity of some of them to irritating environmental factors (too cold or hot, wet diaper, bright light, change of weather, etc.). This sensitivity is aggravated in the child by an emotionally traumatic feeling of loss. mother's womb. Thus, from the point of view of supporters of this version, colic is a phenomenon that has not only a physiological, but also a psychological nature. Indirect confirmation of this is the fact that colic in some infants can be alleviated by methods that have nothing to do with the impact on the gastrointestinal tract: rocking in a sling or in a special vibrating cradle, carrying in the arms, certain sound effects.

Emotional instability of the mother (during breastfeeding)

It has been proven that with emotional disorders and stress that a woman experiences (including as a result of postpartum depression), the composition of her milk changes under the influence of hormones. It is possible that these hormones provoke attacks of colic in infants.

Features of the sucking process

Incorrect attachment of the baby during breastfeeding is also considered one of the reasons for the development of infant colic, since the baby swallows too much air (which causes pain in the stomach). Alternatively, the flow rate of mother's milk is too high (this is due to the physiological characteristics of individual women), which is why the baby choke during sucking and, again, may swallow air.

Infant migraine

It is also possible that colic in babies is a result of “infant migraine”. However, this point of view has not yet been proven.

Lactose intolerance to breast milk

This is another version that has been unreasonably popularized in recent years. In fact, lactose intolerance in breast milk can indeed be the cause of pain in the gastrointestinal tract, but this phenomenon is quite rare and requires a lot of special tests to diagnose it. In many cases, when mothers notice a connection between attacks of colic in infants and the feeding process and conclude that they are lactose intolerant and need to transfer the child to artificial feeding, these conclusions are unfounded.

Baby development

During the first year of life, a baby grows by an average of 25–27 cm. The height of a one-year-old child reaches 75–77 cm[2].
Average height and weight gain in the first year of life[2]

During the first year of life, the baby gets acquainted with the world around him, he develops motor skills, mental and physical abilities. Development occurs in stages. Each stage begins at a certain age, which may differ slightly from one child to another. The development of abilities depends both on genetic predispositions and the environment in which the child grows up, and on how much time adults devote to the child.

First 4 weeks

Crying newborn, a few days after birth

8 week old baby
During its first 4 weeks, a newborn goes through a transitional stage from intrauterine to extrauterine life. At this stage, the baby is not able to control his arms and legs, but has a set of innate physiological reflexes.

Of the most important, the following innate reflexes should be noted:

• search, proboscis and sucking reflexes are components of the instinct to search for food and eat it [3];
• a protective reflex helps the baby turn his head so as not to suffocate if he is turned face down on his stomach.

These and many other innate reflexes are often used in pediatrics to diagnose the health of an infant. The most important reflexes for diagnosis are: symmetrical cervical-tonic, asymmetrical cervical-tonic and labyrinthine tonic [4]. Inducing innate reflexes can also serve as exercise for the baby, developing its motor system [3]. Such reflexes may include: grasping, crawling and support.

In addition to unconditioned congenital reflexes, the baby begins to develop conditioned reflexes. According to experimental data, already at the age of 20 days, an infant is able to remember events, which, in turn, means that he can develop conditioned reflexes to external influences[5].

Along with innate reflexes, newborns also have innate preferences. For example, infants may look at some images longer than others. Robert L. Fantz (English)Russian during experiments showed that infants prefer structured images to unstructured ones, among which more attention was paid to faces and concentric circles [6].

Already from birth, babies can imitate the facial expressions of adults, depending on the level of development of their motor skills. One of the experiments in which this phenomenon manifested itself was the work of T. Field and her colleagues. Infants aged one and a half days showed happy, sad and surprised facial expressions. Independent observers, based on the child's facial expression, were able to guess in 70% of cases the facial expression that the baby was imitating. Based on the results, the authors of the experiment concluded that from birth a baby is able to recognize at least 3 different facial expressions[7].

From birth to 2 months, infants reflexively make sounds associated with physiological processes or stress[8]. At this stage, babies do not yet know how to use sounds for communicative purposes.

In the first days after birth, the baby is already able to distinguish the mother’s voice, which was explained during the experiments of A. DeCasper and M. Spence. During the last 6 weeks of pregnancy, pregnant women often read the same childhood story out loud. After birth, infants' sucking reflex increased when this story was read, compared to other stories[9].

The volume of sounds to which a newborn is capable of responding is 60 decibels[9].

One month

At the age of 1 month, visual perception of objects is focused on exploring the boundaries of objects[10]. If you show a baby geometric shapes, he will study their edges.

The baby begins to master basic movements that are not determined by innate reflexes: grasping and throwing[11]. At this age, lying on his stomach, the baby is able to briefly raise and hold his head[12].

Two month

By the second month, the baby is able to distinguish between red, green and blue colors, as well as brightness. According to the experiments of Robert L. Fantz (English) Russian. Robert Funtz, infants can distinguish two white stripes that differ from each other in brightness by 5% [13].

Starting from 2 months, the baby is able to use sounds for communication. He may laugh in response to an adult talking to him, or in response to his smile[8]. Also, the baby already knows the basic properties of his native language and is able to distinguish it from foreign ones, as shown by studies conducted by A. Christophe and J. Morton. During the experiment, recordings of speech in different languages, spoken by different people, were played to an English-speaking infant. The nature of sucking changed if English was replaced by a foreign language, but did not change if one foreign language was replaced by any other[14].

Three months

By 2–3 months, infants’ color vision is the same as that of adults[13].

The volume of sounds that a 3-month-old baby can respond to is approximately 40 decibels[9].

Four months

By 4 months, the baby develops a long-lasting smile and the frequency of crying decreases[8]. The infant is able to control his hands under visual control, and can also touch and grasp objects moving at high speed[15]. The development of control over the movement of one’s own fingers begins[16].

The level of intelligence already makes it possible to establish cause-and-effect relationships: the baby can find relationships between visual, tactile and auditory data. If the baby accidentally touches the rattle with his hand, he will try to repeat the same actions to make the rattle make sounds again[11]. Also, the baby can already correlate the movements of the lips and the sounds they make, which was found out in the course of research by P. Cool and A. Meltzof [17]. Infants were simultaneously shown two videos without sound, with an audio speaker placed between them. The films featured images of individuals pronouncing the sounds "a" and "i", respectively. Either the sound “a” or the sound “i” sounded alternately from the speaker. Infants looked longer at the video that matched the spoken sound.

Six months

The development of motor skills and visual perception leads to the fact that from 6 months the baby is able to determine the size of objects regardless of the distance to them [18]. From 6-7 months, babies actively wave objects, rub them and throw them, which at this stage is the main form of studying the world around them. These actions allow the infant to explore properties of objects such as surface character and weight[16].

According to one of Claes von Hofsten's experiments [17], from the age of 6 months, infants are able to predict the future position of objects in linear motion, but it is extremely difficult for them to determine the position if the trajectory is nonlinear. During the experiment, the infant was shown the linear movement of an attractive object, which was briefly hidden behind a small rectangular screen, and then appeared at the other end of the screen. After several demonstrations, when the object disappeared, the child was already looking at the border of the screen from where the object was supposed to appear. If after six demonstrations the direction changed, then the infant successfully coped with determining the future position of the object.

Seven months

Beginning at 7 months, infants are able to distinguish the distance to objects. This ability was discovered by K. Grandur[19] during his experiments on the perception of the size of objects. The infants were offered two toys of different sizes. After 5 minutes of playing with the toys, the children were shown the same toys, but of the same size and from the same distance. It turned out that children were drawn to the toy that was initially smaller in size (i.e., visually seemed closer than the other toy).

Eight months

Eight month old twin sisters

Eight month old baby;
the overall features of the face are usually larger in comparison to the face. From the age of 8 months, the baby’s intellect actively develops. According to the findings of Jean Piaget[11], at this stage of life, the baby develops practical intelligence: he knows about the constant existence of objects and is able to search for them, even if they are not in sight.

The volume of sounds that an 8-month-old baby can respond to is approximately 30 decibels[9].

Ten months

At 10 months, the baby is able to sit, which allows him to better explore objects with his hands: both hands are used in studying objects (one fixes the object, and the other studies it) [16].

Twelve months

From 12 months, infants begin to experiment with objects and their own actions on them[11]. They no longer just try to repeat certain actions, or reproduce a previously obtained effect, but also figure out the relationships between objects, actions and effects.

Twelve-month-old babies already have an idea of ​​the goals of certain actions. For example, according to experiments[20] conducted by György Gergely and his colleagues, a child is able to predict that a gray ball moving in a straight line towards a barrier should jump over it. If the ball jumps over an invisible barrier, it will surprise the child.

Infants begin to actively use the pointing gesture to direct the adult's attention to objects and to the baby's reaction to them (joint attention). According to research by Ulf Lickowski and his colleagues[21], infants looked at objects more often if an adult paid attention not only to the object of the infant's attention, but also to the infant's face, making emotional comments on the object[22].

Treatment of infant colic

Since the exact cause of colic in babies is not established, each family has to develop its own strategy for treating colic, and do this based on “trial and error.” In general, pediatricians give the following recommendations.

If the suspected cause of the child’s anxiety is digestive problems and increased gas production

In this case, it is worth trying in various ways to speed up the passage of gases and, if possible, prevent the appearance of new ones. To do this, you can give the child a abdominal massage and special gymnastics (press the legs bent at the knees to the child’s stomach, pressing properly on the stomach); After feeding, it is recommended to carry the baby vertically for 10-15 minutes so that he burps air. Some doctors recommend placing the baby on his stomach as often as possible during this period.

If the baby is breastfed, the mother can try adjusting her diet. The effectiveness of this measure for the treatment of colic in infants, however, has recently been called into question, because many studies show that the composition of breast milk is less dependent on the mother’s diet than was commonly believed. If there is increased gas formation, the use of a gas outlet tube can also help, but many doctors recommend using it only as a last resort.

The effectiveness of carminative drugs of the simethicone group (Smecta, Espumisan, Bobotik, Sab Simplex, etc.) is not confirmed by independent clinical studies. Therefore, the use of these drugs is unjustified.

If the suspected cause of colic is general physical and emotional discomfort

In this case, pediatricians recommend trying to recreate conditions for the child that are close to the conditions of the mother's womb. To do this, it is necessary to provide the child with maximum tactile contact (carry him in your arms, in a sling, practice co-sleeping, place the baby with his bare stomach on the parent’s stomach (“kangaroo position”)); rock him in your arms, in a vibrating cradle, stroller. Many babies are helped by “

Infantile colic (R10.4) is a paroxysmal acute pain in the abdominal cavity of a functional nature in children of the first year of life. If functional abdominal pain occurs in children of the first year of life, a diagnosis of infant colic is made. The incidence of this disease is about 45% of all visits to the pediatrician for abdominal pain.

The development of infant colic seems to be a consequence of poor nutrition of a nursing mother and a practically healthy child. This is the mother's consumption of hot and spicy foods while breastfeeding, or foods that increase gas formation, including whole cow's milk. With artificial feeding, this is the use of poorly prepared, unadapted or age-inappropriate milk formulas. The occurrence of colic is promoted by an unbalanced diet, early introduction of juices, fruit purees, vegetable dishes, cow's milk and other types of complementary foods.

The causes of intestinal colic include impaired feeding technique, rapid sucking or swallowing air during sucking, emotional discomfort of the child, anxious state of the mother, asocial living conditions and deprivation.

The formation of infant colic occurs during pathological childbirth, injuries to the cervical spine, intestinal dysbiosis, changes in the hormonal status of a nursing mother, in particular, a lack of production or metabolism of progesterone.

The action of causative factors is realized against the background of morphofunctional, primarily enzymatic, immaturity of the gastrointestinal tract and imperfection of the nervous regulation of the intestine. This causes disruption of the digestion and absorption of milk components and other foods, which leads to increased gas formation, stretching or spasm of certain parts of the intestine and thereby provoking visceral abdominal pain of a spastic nature.

Degrees of anemia in infants

The severity of the condition with anemia in an infant is divided according to the level of hemoglobin and the concentration of red blood cells:

• Mild degree

  . Laboratory parameters: red blood cells – 3 million/l, hemoglobin – 90-110 g/l. The condition does not require treatment; it is corrected by introducing a more varied diet into the diet of a woman in a state of lactation. In case of transient anemia, the pediatrician monitors the child’s condition and prescribes special medications.

• Average degree

  . Laboratory indicators: red blood cells – 2.5 – 3 million/l, hemoglobin – 70-90 g/l. With this degree of anemia, the child lags behind the age norm in his physical and mental development, and the functioning of the gastrointestinal tract and cardiovascular system is disrupted. The child feels dizzy, suffers from shortness of breath, often suffers from colds and infectious diseases; children with anemia of this degree are usually lethargic and weak. This degree of pathology most often requires medical supervision in a hospital setting and treatment with iron supplements.

• Severe degree

  . Laboratory indicators: red blood cells - less than 2.5 million/l, hemoglobin - below 70 g/l. In an infant with this degree of anemia, the kidneys and intestines, the hematopoietic system, the respiratory and circulatory systems are affected, and dystrophy appears.

Symptoms of infant colic

The following is considered characteristic of an attack:

• onset at 1–4 months of age, usually in the evening;
• restlessness of the child, prolonged crying;
• facial skin hyperemia, cramped legs;
• bloating and rumbling in the stomach;
• reduction or disappearance of symptoms following the passage of gases and feces;
• recurrent nature of symptoms;
• the duration of symptoms is more than 10% of the time of day.

Initially, attacks of acute abdominal pain occur 1-2 times a week and last about 20 minutes. Subsequently, the frequency and duration of attacks increases, intestinal colic worries daily, and continues with short breaks for up to 5 hours a day. It should be emphasized that intestinal colic is not characterized by any changes in stool, as well as in the behavior and appetite of the child in the non-attack period.

Anatomical and physiological features

Infants have delicate, easily vulnerable skin and underdeveloped excretory ducts of the sweat glands. Sweating doubles during the first year of life, but is often inadequate (may increase with cold weather). Apocrine sweat glands do not function. Hair growth at this age is slower; during the first year of life, its thickness increases from an average of 0.06 mm to 0.08 mm. At this age, both the mass of subcutaneous tissue and the number of fat cells increase rapidly. Infants have a greater ratio of subcutaneous tissue mass to body mass than adults. At birth, the fat content in the subcutaneous tissue is 35.5%; over the course of a year it increases to 56%[1].

The bone tissue of infants contains less minerals than that of adults. The periosteum, which is thicker than in adults, participates in the formation of new bone tissue. Ossification points gradually appear, calcium salts accumulate in the skeleton, and the bones harden. During the first year of life, the calcium content in bones increases on average by 3.5 times (from 28 to 100 g). Physiological curves of the spine appear. The sutures between the bones of the skull present in a newborn child become denser by 3-4 months, the small fontanelle closes by 4-8 weeks; large fontanel - by the end of the first year of life. The shape of the chest is barrel-shaped, with horizontal ribs. The first milk teeth appear at 6-8 months; at one year of age there should be 8 teeth[1].

The muscular system is poorly developed, the ratio of muscle mass to body weight is noticeably less than that of an adult. Muscles, especially flexors, in newborns have increased tone, which normalizes in the arms by 2-2.5 months, in the legs by 3-4 months, and the usually bent state of the limbs disappears[1].

Already formed bronchi have a narrow lumen, their muscle and elastic fibers are poorly developed. The elastic tissue of the lungs is underdeveloped. During the first year of life, the number of alveoli increases; accordingly, the respiratory surface of the lungs increases 4 times in the first year of life, and the minute volume of breathing increases from 635 to 2200 cm3. The breathing rate gradually becomes less frequent. In normal infants, there are approximately 3 heartbeats per breath. By 8 months, the heart doubles its mass, mainly due to thickening of the myocardium. The pulse gradually becomes less frequent: at the age of one, its frequency does not exceed 120 beats per minute. The child’s urinary system develops, the weight increases and the structure of the kidneys improves, the volume and elasticity of the bladder increases, and by the end of the first year the number of urinations decreases to 15-16 times a day [1].

Treatment of infant colic

First, a set of predominantly non-drug treatment and preventive measures should be carried out aimed at relieving spasms and increased gas formation in the intestines, normalizing the child’s nutrition and feeding techniques, and creating a favorable moral and psychological climate in the family.

When breastfeeding, it is necessary to limit or completely eliminate whole cow's milk and gas-forming products in the mother's diet. At the same time, fermented milk products must be included in the diet of a nursing mother.

When artificial feeding, you need to follow the correct technology for preparing formulas and not use formulas enriched with iron in the diet. In between feedings, as well as during an attack, you need to place the baby on your stomach; tactile contact between the skin of the baby’s abdomen and the skin of the mother’s abdomen is necessary.

If there is no effect from non-drug corrective measures, medications are used to reduce increased gas formation, which have an antispasmodic and carminative effect.

The ineffectiveness of therapy over the course of a week indicates the possible organic nature of pain in the abdominal cavity, which requires additional diagnostic measures.

Symptoms of the disease

If you begin to treat this disease in time, it is possible to maintain the child’s full health. To do this, it is important to reliably determine the presence of problems in this area in the early stages.

Symptoms that should alert parents:

• rapid increase in head circumference, disproportionate increase in forehead
• a convex fontanel that does not decrease in size (it may even increase)
• restless state of the baby (crying, painful reaction to changes in weather, poor weight gain, lack of appetite, loss of coordination of movements)
• divergence of the skull bones
• vision problems, unnatural looking eyes

Dr. Komarovsky, in his videos on this topic, says that pediatricians themselves often unjustifiably make this diagnosis. It is impossible to detect high intracranial pressure in a baby purely by external examination of the child. Bright wreaths on the head of a newborn, hyperactivity and increased excitability of the child are not symptoms of this disease. These signs may indicate the presence of many diseases, and treatment of an incorrect diagnosis is lost time and an opportunity for the child to maintain health.

In video presentations, the doctor urges parents not to trust doctors who recklessly diagnose ICP without an appropriate examination.