Treatment of Child and Adolescent Problems
Thyroid Problems Treatment
Thyroid Disorder Treatment
Paediatric Critical Care
Treatment of Childhood Infections
Child Nutrition Management
Growth And Development Including General Paediatri
Management of New Born Care
Preimplantation Genetic Diagnosis (Pgd)
Congenital Ear Problem Treatment
Treatment of Polycystic Ovary Syndrome In Adolesce
Treatment of Thyroid Disease in Children
Cleft Lip Treatment
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What You Need to Know About Clubfoot?
Clubfoot most often presents at birth.
Clubfoot is caused by a shortened Achilles tendon, which causes the foot to turn in and under.
Clubfoot is twice as common in boys.
Treatment is necessary to correct clubfoot and is usually done in two phases — casting and bracing.
Children with clubfoot should be able to take part in regular daily activities once the condition is treated.
What is clubfoot?
Clubfoot is a foot deformity classified into three different types: idiopathic (unknown cause), neurogenic (caused by condition of the nervous system) and syndromic (related to an underlying syndrome).
Also known as talipes equinovarus, idiopathic clubfoot is the most common type of clubfoot and is present at birth. This congenital anomaly is seen in one out of every 1,000 babies, with half of the cases of club foot involving only one foot. There is currently no known cause of idiopathic clubfoot, but baby boys are twice as likely to have clubfoot compared to baby girls.
Neurogenic clubfoot is caused by an underlying neurologic condition. For instance, a child born with spina bifida A clubfoot may also develop later in childhood due to cerebral palsy or a spinal cord compression.
Syndromic clubfoot is found along with a number of other clinical conditions, which relate to an underlying syndrome. Examples of syndromes where a clubfoot can occur include arthrogryposis, constriction band syndrome, tibial hemimelia and diastrophic dwarfism.
What are the signs and symptoms of clubfoot?
In a clubfoot, the Achilles tendon is too short, causing the foot to stay pointed — also known as “fixing the foot in equinus.” The foot is also turned in and under. The bones of the foot and ankle are all present but are misaligned due to differences in the muscles and tendons acting on the foot.
What are the risk factors of clubfoot?
Foot imbalance due to clubfoot may be noticed during a fetal screening ultrasound as early as 12 weeks gestation, but the diagnosis of clubfoot is confirmed by physical exam at birth.
The treatment for clubfoot consists of two phases: Ponseti serial casting and bracing. Treatment is always necessary, because the condition does not get better with growth.
Ponseti Serial Casting
The Ponseti technique of serial casting is a treatment method that involves careful stretching and manipulation of the foot and holding with a cast. The first cast is applied one to two weeks after the baby is born. The cast is then changed in the office every seven to 10 days. With the fourth or fifth cast, a small in-office procedure is also needed to lengthen the Achilles tendon. This is done using a local numbing medicine and small blade. Afterward, the baby is placed into one last cast, which remains on for two to three weeks.
Bracing for Clubfoot
While the casting corrects the foot deformity, bracing maintains the correction. Without bracing, the clubfoot would redevelop. The day the last cast is removed, the baby is fit in a supramalleolar orthosis with a bar. These braces are worn 23 hours a day for two months, then 12 hours a day (naps plus nighttime) until kindergarten age.
Life after Treatment of Clubfoot
A well-corrected clubfoot looks no different than a normal foot. Sports, dance and normal daytime footwear are the expectations for a child born with a clubfoot. This condition will not hold a child back from normal activities.
My son is 3 months 20 days old. He has given 3dose of pentavalent vaccine on scheduled time. I missed his 1st dose of ipv before so He got 1st dose of IPV (0.1 ml subcutaneous) with 3rd dose of pentavalent vaccine. So when should I give 2nd dose of IPV? How many doses are needed? His weight is 6.6 kg now. Which other vaccines are mandatory?
My son age was 3 years 11 months. Which type of diet will give him. How to increase his body weight. Please suggested me diet.
Hello. .my nephew is 40 days old and he is often crying badly due to etching on anus caused by pinworm.. Suggest some medicine for him. I repeat he is only 40 days old.
My baby is 7 months old. Which type of foods are good for him? Weight is little low at the time of birth. What are the weight gain food.
Health considerations when bottle-feeding
If you decide not to breastfeed, or are unable to breastfeed, commercial iron-fortified formulas can give your baby the nutrition he or she needs. Infant formulas have the right amounts of protein, calories, fat, vitamins, and minerals for growth. However, formula does not contain the immune factors that are in breastmilk. The immune factors in breastmilk help prevent infections and other health conditions throughout a baby's life.
Infants who take enough iron-fortified infant formula usually don’t need vitamin and mineral supplements. However, the American Academy of Pediatrics recommends vitamin D supplementation for all babies drinking formula until they are drinking at least 32 ounces a day. Fluoride supplements are recommended for babies whose primary water supply is not fluoridated. Check with your baby's healthcare provider about vitamin D and fluoride supplements.
Types of infant formula
Cow's milk-based formula. Most infants should be able to tolerate a standard cow's milk formula. Cow's milk formulas are modified to be closer to human milk. These formulas have lactose as the carbohydrate (sugar) source. They are available in ready-to-feed cans, liquid concentrate, and powder. Regular cow's milk is not an appropriate source of nutrition for a human baby.
Soy-based or lactose-free formulas. These formulas are used if an infant can’t tolerate lactose, which is rarely a significant problem in babies. They don’t contain lactose as the sugar source. As many as 50% of all infants who are allergic to cow's milk formula will also be allergic to soy-based formulas. Talk with your baby's healthcare provider before changing formulas. Vegetarian parents may prefer soy-based formulas. But they should be aware that breastfeeding is still the best option.
Specialized formulas. There are special formulas for babies who are premature or who have certain rare disorders or diseases. These formulas may have special directions for use. They are prescribed by the baby's healthcare provider.
Hydrolyzed formulas. Hydrolyzed formulas are easier to digest. They may be used in babies at risk for allergies. They are more expensive than regular formulas. Talk with your baby's healthcare provider before using these formulas.
Low iron formulas. These formulas are not recommended.
Helpful hints for feeding your baby
Breastmilk only is the ideal feeding for at least 6 months. This means no water, sugar water, or formula.
Wait until breastfeeding is well established before giving your baby breastmilk in a bottle.
Working mothers can use a breast pump on break time and refrigerate or freeze the milk for later use as a bottle-feeding. Refrigerated breastmilk should be used within 24 hours after pumping. Frozen breastmilk is good for several months in the freezer. Fathers and other family members can be involved in feeding time if breastmilk is offered from a bottle occasionally.
Offer cow's milk-based formula with iron as first choice of formula if not breastfeeding.
Keep your baby on breastmilk or baby formula until he or she is 1 year old. After this time, you may switch to whole milk. Children under 2 years old should not drink skim or low-fat milk.
It’s important to follow the formula preparation directions exactly as directed on the packaging. Using too much water can result in poor weight gain. It's also important to discuss your water supply with your child's healthcare provider. In some areas, water must be boiled first, or bottled water should be used.
Bottles should never be propped up.
Babies should never be put to sleep with a bottle. This can cause cavities to develop.
All babies, whether breast or bottle fed, should be offered a feeding whenever they show signs of hunger.
Birthmarks in Infants
A baby's skin coloring can vary greatly, depending on the baby's age, race or ethnic group, temperature, and whether or not the baby is crying. Skin color in babies often changes with both the environment and health. Some of these differences are just temporary. Others, such as certain birthmarks, may be permanent.
What are birthmarks?
Birthmarks are areas of discolored and/or raised skin that are present at birth or within a few weeks of birth. Birthmarks are made up of abnormal pigment cells or blood vessels.
Although the cause of birthmarks is not known, most of them are harmless and do not require treatment. Babies with birthmarks should be examined by your child's health care provider, especially if they are:
- Located in the middle of the back, along the spine (may be related to spinal cord problems)
- Large birthmarks on the face, head or neck
- Interfering with movement of activity, for example a birthmark on the eyelid that may interfere with vision
Some common birthmarks include:
- Stork bites
- Angel kisses
- Salmon patches
These are small pink or red patches often found on a baby's eyelids, between the eyes, upper lip, and back of the neck. The "stork bite" name comes from the marks on the back of the neck where, as the myth goes, a stork may have picked up the baby. They are caused by a concentration of immature blood vessels and may be the most visible when the baby is crying. Most of these fade and disappear completely.
Congenital dermal melanocytosis (also known as Mongolian spots)
Congenital dermal melanocytosis refers to areas of blue or purple-colored, typically on the baby's lower back and buttocks. These can occur in darker-skinned babies of all races. The spots are caused by a concentration of pigmented cells. They usually disappear in the first 4 years of life.
This is a bright or dark red, raised or swollen, bumpy area that looks like a strawberry. Hemangiomas are formed by a concentration of tiny, immature blood vessels. Most of these occur on the head. They may not appear at birth, but often develop in the first 2 months. Strawberry hemangiomas are more common in premature babies and in girls. These birthmarks often grow in size for several months, and then gradually begin to fade. They may bleed or get infected in rare cases. Nearly all strawberry hemangiomas completely disappear by 9 years of age.
A port-wine stain is a flat, pink, red, or purple colored birthmark. These are caused by a concentration of dilated tiny blood vessels called capillaries. They usually occur on the head or neck. They may be small, or they may cover large areas of the body. Port-wine stains do not change color when gently pressed and do not disappear over time. They may become darker and thicker when the child is older or as an adult. Port-wine stains on the face may be associated with more serious problems. Skin-colored cosmetics may be used to cover small port-wine stains. The most effective way of treating port-wine stains is with a special type of laser. This is done when the baby is older by a plastic surgery specialist.
These common moles (less than 3 inches in diameter) occur in about 1 out of every 100 newborns. They increase in size as the child grows, but usually don't cause any problems. Your child's health care provider will watch them closely as rarely they can develop into a cancerous mole.