Urinary tract infection (bladder, Kidneys) is a very common issue in children and sometimes not the easiest to diagnose. The symptoms depend on the age and sex of the child, and the location of the infection and these symptoms can vary across the board. Urinary tract infections (UTI) are more common in females as a rule but during the first year of life, when it is most difficult to diagnose, the incidence is just about the same in males and females.
Sometimes there is an anatomical problem with abnormalities in the kidney or bladder or both that children can be born with, but most of the time these infections occur de novo. An infection is defined as bacterial growth in the urine in the presence of appropriate symptoms. If there are no symptoms, the presence of bacteria might only mean colonization, eg: there are bacteria in the urine but have not caused a body reaction yet. Under certain circumstances even colonization needs to be treated.
During the first year of life, one might only see a very irritable, cranky baby with or without fever and the source of those symptoms is “hidden” sometimes even to the best and most experienced physician. Therefore, during the first year of life the suspicion for a UTI is very high and the urine might be checked more often than it would in an older child with the same symptoms. As you can imagine, obtaining a “clean” urine specimen is very difficult so a variety of methods have been devised. If one merely “catches” the urine as it is produced externally this stands a significant chance of being contaminated by bacteria living on the skin. The best ways of obtaining a reliable urine specimen is somewhat invasive but at least your doctor can rely on the results of the evaluation. These consist of either a bladder catheterization, where a small tube is passed up into the bladder and a urine specimen is obtained or a supra pubic needle aspiration where a needle on a syringe is passed through the lower abdominal wall and a urine sample is obtained. The urine sample is obtained by a reliable lab or sometimes in the Doctor’s office by means of a urinalysis and a culture of the urine to be sure there are bacteria in it and what kind it may be so as to choose the correct treatment. This culture can take 2- 3 days to complete.
This is a very large and important subject so I will stop here and take on the topic of treatment of UTIs and possible further diagnostic procedures in my next entry.
If you’re pregnant with more than one baby, a healthy diet and lifestyle will help you cope with your pregnancy and give your babies the best start in life.
The advice for keeping healthy in pregnancy is similar whether you’re expecting twins, triplets or just one baby. Eat well, take gentle exercise, drink lots of fluid and, if you feel stressed, get support from friends and family, or talk to your midwife. It’s also important to attend all your antenatal (*prenatal) appointments so your maternity team can keep a close eye on you and your babies.
Healthy eating with a twin pregnancy
Expecting two babies doesn’t mean you have to eat significantly more than during a single pregnancy. However, it’s normal to put on more weight than a woman who is only carrying one baby.
Aim to eat a healthy, balanced diet that includes plenty of fruit, vegetables and wholegrains. These will help you avoid constipation and provide a range of vitamins and minerals.
You also need some protein foods, such as lean red meat, well-cooked eggs, and nuts and seeds. Dairy foods such as milk, cheese and yoghurt are important for calcium.
If you feel peckish, it’s best to fill up on healthy snacks, such as fresh fruit, low-fat yoghurt or sandwiches filled with grated cheese, lean ham or mashed tuna. Try to avoid foods with empty calories, such as sugary snacks, crisps and fizzy drinks.
You’re more at risk from anaemia during a twin pregnancy. You’ll be offered extra blood tests and may be offered iron supplements. Good sources of iron include lean red meat, leafy green vegetables, beans and fortified breakfast cereals.
Read more about healthy eating in pregnancy and foods to avoid in pregnancy.
Staying active with a twin pregnancy
Gentle exercise will help you tone your muscles and protect you from aches and pains. Exercises that won’t overstress your joints are recommended, such as swimming, walking, antenatal yoga, pilates and tai chi.
Doing pelvic floor exercises regularly will help your pelvic floor get back to normal after your babies are born. Even if you’ve had a caesarean birth, you pelvic muscles can still be weak from your pregnancy.
Read more on how to keep active in pregnancy.
Common pregnancy health worries with twins
- It’s not necessarily true that you will have more morning sickness if you’re expecting twins.
- Although some women expecting twins or more report lots of morning sickness, others don’t experience any.
- If you do experience morning sickness, you may find it helps to eat little and often, and to avoid getting hungry.
- You’re more likely to experience piles and varicose veins during a multiple pregnancy, because of the weight of your babies pressing on the blood vessels of the pelvic area.
- Pressure from your womb (uterus) pushing on your stomach may make you more prone to heartburn and indigestion as well.
- You may also find you have backache and pelvic pain, particularly later in your pregnancy. Speak to your midwife, who may refer you to an obstetric physiotherapist.
- If you register with Tamba** on their website, you can download their Healthy Multiple Pregnancy Guide for free.
For more information on how to have a healthy pregnancy, feel free to read:
Editor’s Note: * Clarification Provided for our U.S. Readers
**Resources Available Outside the UK
- Marvelous Multiples: provides links to support organizations throughout the world for expecting parents and families of multiple births.
From www.nhs.uk
>
Cradle cap is the greasy, yellow scaly patches that sometimes appear on the scalps of young babies.
It is common, harmless and doesn’t usually itch or cause discomfort. Do not pick at the scales as this can cause an infection.
Cradle cap is not contagious and is not caused by poor hygiene or an allergy.
It usually appears in babies in the first two months and clears up without treatment within weeks to a few months.
What does cradle cap look like?
Cradle cap is easy to recognise by the large, greasy, yellow or brown scales on your baby’s scalp.
The scales flake and may make the affected skin look red. Sometimes the hair will come away with the flakes, but it will grow back.
It usually occurs on the scalp but can also affect the face, ears, neck, nappy area and armpits, and behind the knees.
Treatment for cradle cap
Most cases of cradle cap clear up on their own without the need for treatment within weeks to a few months.
Tips to help reduce the build-up of scales on the scalp:
- regular washing of the scalp with a baby shampoo, followed by gentle brushing with a soft brush to loosen scales.
- soften the scales with baby oil first, followed by gentle brushing, and then wash off with baby shampoo.
- soak the crusts overnight with white petroleum jelly, or vegetable or olive oil, and shampoo in the morning.
If these methods don’t work, speak to your pharmacist about using a greasy emollient or soap substitute, such as emulsifying ointment.
There is usually no need to see your GP (*pediatrician) if your baby has cradle cap. However, you may want to ask them for advice if there is swelling to the scalp or if the cradle cap spreads to other parts of the body.
Special shampoos
You can buy special shampoo for cradle cap from a pharmacy. Always read the instruction leaflet to check it’s safe to use on your child.
Avoid getting the shampoo in your baby’s eyes. If you’re unsure about using it, speak to a pharmacist for advice.
Treating an infection
If these home treatments don’t lead to any improvement, your doctor may recommend an antifungal cream.
A mild steroid cream may also be recommended in some cases where the baby has a nappy rash.
When to see your GP (*Pediatrician)
Speak to your GP if your baby’s cradle cap:
- itches
- swells
- bleeds
- spreads to the face or body
What causes cradle cap?
It’s not clear what causes cradle cap, although it may be linked to:
- high levels of an oily substance called sebum on affected areas
- a reaction to a yeast called malassezia on the skin
Cradle cap is a type of seborrhoeic dermatitis, a common irritation that affects oily skin in children and adults.
Editor’s Note: * Clarification Provided for our U.S. Readers
From www.nhs.uk
>
Ways to get your baby moving
Lay your baby down on their back so they can kick their legs.- Pulling, pushing, grasping and playing with other people are great ways to practise different kinds of movements.
- Once your baby has started crawling, let them crawl around the floor, but make sure it’s safe first – see our crawling safety checklist.
- Playing outdoors helps your baby learn about their surroundings.
- You can take your baby swimming from a very young age – there’s no need to wait until they’ve been vaccinated.
See Start4Life for more activity tips for babies.
Why tummy time is important
Tummy time helps to build the muscles your baby needs for sitting and crawling. You can start doing tummy time from birth by lying your baby on your chest – but only do this when you’re wide awake and unlikely to fall asleep.
Little and often is best to begin with. Gradually increase the amount of time you do this day by day. Then, when your baby is ready, try doing tummy time on the floor. If your baby has difficulty lifting their head, you can roll up a towel and put it under their armpits. Put some toys nearby for them to reach out to.
Only do tummy time when your baby is awake and alert, and you’re there to keep an eye on them.
Baby bouncers, walkers and seats
It’s important that your baby doesn’t spend too much time in:
- baby walkers or bouncers – these encourage babies to stand on their tiptoes and can delay walking if your baby uses them a lot
- baby carriers and seats – long periods in reclining carriers or seats, or seats that prop your baby in a sitting position, can delay your baby’s ability to sit up on their own
If you do use a baby walker, bouncer or seat, it’s best to use them for no more than 20 minutes at a time.
Physical activity for toddlers
Once your child is walking, they should be physically active for at least 180 minutes (three hours) a day, spread throughout the day.
- Let your toddler walk with you rather than always using the buggy.
- Toddlers and young children love going to the park, where they can climb and swing or just run around.
- Toys your child can pick up and move around will help improve their co-ordination and develop the muscles in their arms and hands.
- Involve your toddler in household tasks like unpacking shopping, tidying or sorting washing.
- Teach your child songs with actions and encourage them to dance to music.
Watching TV or using a tablet for long periods – or being strapped into a buggy, car seat or highchair – isn’t good for young children.
If you need to make a long car journey, consider taking a break and getting your child out of their seat for a bit.
See physical activity guidelines for children under five.
Enjoy being active together
It’s good to join in with your child’s active play when you can. Have fun showing them how to do new things like running and hopping. Being active together shows your child that activity is enjoyable.
You’re a role model for your child so stay active yourself and try to meet the physical activity guidelines for adults.
There may be activities for parents and children at your local leisure centre or Sure Start Children’s Centre.
Activity for young children with a disability
All babies and young children need to be active, including children with a long-term condition or disability, unless their health professionals give you different advice.
Just like other children, they will enjoy being active and it will help their development. You may need to adapt some activities to suit your child.
Scope has ideas for games all children can play, and the Contact a Family advice service** offers information on caring for a disabled child (in the UK).
Coping with a very active toddler
It can be exhausting keeping up with a toddler who is always on the go. It may help if you:
- keep to a daily routine – routine can help if your child is restless or difficult; it can also help you stay calm and cope with the strain
- dedicate time to your child – make sure there are times each day when you give them your full attention
- avoid difficult situations – for example, keep shopping trips short
- try to go out every day – go to a park, playground or other safe, open space where your child can run around and use up energy
- set small goals – help your child to sit still and concentrate for a very short time, perhaps on a book or new toy, then gradually build it up
Does my child have attention deficit and hyperactivity disorder (ADHD)?
At times you may wonder if your non-stop toddler has ADHD. But only about 2% of children in the UK have ADHD**. It’s more likely that your child is just a healthy, energetic toddler.
If you’re worried about how active your child is, talk to your health visitor (*nurse specialist/midwife) or GP (*physician).
Learn more about ADHD or visit ADDISS: National Attention Deficit Disorder Information and Support Service.
Editor’s Note:
* Clarification Provided for our U.S. Readers
** US Reference Information:
- The American Psychiatric Association (APA) says that 5 percent of American children have ADHD. But the Centers for Disease Control and Prevention (CDC) puts the number at more than double that. The CDC says that 11 percent of American children, ages 4 to 17, had the attention disorder as of 2011.
- UNICEF-USA is a charity that helps to protect US children and support children with disabilities
From www.nhs.uk
>
On average, twins are about six months behind single babies in their language development.
Twins may be slower to pick up speech and language skills because:
twins tend to receive less attention in shorter bursts than single babies- parents often speak to one twin while looking at the other, but children need eye contact to help their language development
- twins tend to spend more time with each other, so they pick up each other’s speech rather than that of adults and older children around them
- twins have less time to practise speech as they compete to get themselves heard
- sometimes one twin may answer for the other
Don’t worry if your twins seem to be slow to speak. Just try to make sure they have plenty of time to talk and express themselves.
Talking to twin babies
Nappy changes can be a good opportunity to give twins one-on-one attention. You could bathe each baby separately to give you time to chat with them individually.
You can also:
- turn off the TV and radio for at least 30 minutes each day, so your babies can listen to the noises around them with no distractions
- listen to your babies and respond to them as they experiment with different sounds
- try to play and read books with your babies individually; make time to talk to your babies individually each day, using their name and making eye contact
- encourage older siblings, friends and family to talk to your babies one to one
Read more about how to encourage language skills in children.
Twins & Multiple Births Association (Tamba) has information about twins and language. Tamba also has a free (in the UK) telephone helpline. Twinline** is open every day from 10am to 1pm and 7pm to 10pm on 0800 138 0509.
Talk to your GP (*doctor) or health visitor if you’re concerned about your children’s language skills.
Editor’s Note:
* Clarification Provided for our U.S. Readers
** Resources Outside the UK:
- Multiples of America: US non-profit providing information, research studies and clubs throughout the U.S. for multiple birth families (and families-to-be)
From www.nhs.uk
>
Atopic eczema (atopic dermatitis) is the most common form of eczema, a condition that causes the skin to become itchy, red, dry and cracked.
Atopic eczema is more common in children, often developing before their first birthday.
However, it may also develop for the first time in adults. It’s usually a long-term (chronic) condition, although it can improve significantly, or even clear completely, in some children as they get older.
Symptoms of atopic eczema
Atopic eczema causes the skin to become itchy, dry, cracked, sore and red. Some people only have small patches of dry skin, but others may experience widespread red, inflamed skin all over the body.
Although atopic eczema can affect any part of the body, it most often affects the hands, insides of the elbows, backs of the knees and the face and scalp in children.
People with atopic eczema usually have periods when symptoms are less noticeable, as well as periods when symptoms become more severe (flare-ups).
Read about the symptoms of atopic eczema
When to seek medical advice
See your GP (*physician) if you have symptoms of atopic eczema. They’ll usually be able to diagnose atopic eczema by looking at your skin and asking questions such as:
- whether the rash is itchy and where it appears
- when the symptoms first began
- whether it comes and goes over time
- whether there’s a history of atopic eczema in your family
- whether you have any other conditions, such as allergies or asthma
- whether something in your diet or lifestyle may be contributing to your symptoms
Typically, to be diagnosed with atopic eczema you should have had an itchy skin condition in the last 12 months and three or more of the following:
- visibly irritated red skin in the creases of your skin – such as the insides of your elbows or behind your knees (or on the cheeks, outsides of elbows, or fronts of the knees in children aged 18 months or under) at the time of examination by a health professional
- a history of skin irritation occurring in the same areas mentioned above
- generally dry skin in the last 12 months
- a history of asthma or hay fever – children under four must have an immediate relative, such as a parent, brother or sister, who has one of these conditions
- the condition started before the age of two (this does not apply to children under the age of four)
Causes of atopic eczema
The exact cause of atopic eczema is unknown, but it’s clear it is not down to one single thing. Atopic eczema often occurs in people who get allergies – “atopic” means sensitivity to allergens.
It can run in families, and often develops alongside other conditions, such as asthma and hay fever.
The symptoms of atopic eczema often have certain triggers, such as soaps, detergents, stress and the weather. Sometimes food allergies can play a part, especially in young children with severe eczema.
You may be asked to keep a food diary to try to determine whether a specific food makes your symptoms worse. Allergy tests aren’t usually needed, although they’re sometimes helpful in identifying whether a food allergy may be triggering symptoms.
Read about the causes of atopic eczema.
Treating atopic eczema
Treatment for atopic eczema can help to relieve the symptoms and many cases improve over time.
However, there’s currently no cure and severe eczema often has a significant impact on daily life, which may be difficult to cope with physically and mentally. There’s also an increased risk of skin infections.
Many different treatments can be used to control symptoms and manage eczema, including:
- self care techniques, such as reducing scratching and avoiding triggers
- emollients (moisturising treatments) – used on a daily basis for dry skin
- topical corticosteroids – used to reduce swelling, redness and itching during flare-ups
Read about treating atopic eczema and complications of atopic eczema.
Other types of eczema
Eczema is the name for a group of skin conditions that cause dry, irritated skin. Other types of eczema include:
- discoid eczema – a type of eczema that occurs in circular or oval patches on the skin
- contact dermatitis – a type of eczema that occurs when the body comes into contact with a particular substance
- varicose eczema – a type of eczema that most often affects the lower legs and is caused by problems with the flow of blood through the leg veins
- seborrhoeic eczema – a type of eczema where red, scaly patches develop on the sides of the nose, eyebrows, ears and scalp
- dyshidrotic eczema (pompholyx) – a type of eczema that causes tiny blisters to erupt across the palms of the hands
Editor’s Note:
* Clarification Provided for our U.S. Readers
From www.nhs.uk
>
« Previous Page — Next Page »
