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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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Bedwetting or nocturnal enuresis, refers to the unintentional passage of urine during sleep. Enuresis is the medical term for wetting, whether in the clothing during the day or in bed at night. Another name for enuresis is urinary incontinence. For infants and young children, urination is involuntary. Wetting is normal for them. Most children achieve some degree of bladder control by 4 years of age. Daytime control is usually achieved first, while nighttime control comes later.
The age at which bladder control is expected varies considerably. Some parents expect dryness at a very early age, while others not until much later. Such a time line may reflect the culture and attitudes of the parents and caregivers.
Factors that affect the age at which wetting is considered a problem include the following:
- The child's gender: Bedwetting is more common in boys.
- The child's development and maturity
- The child's overall physical and emotional health. Chronic illness and/or emotional and physical abuse may predispose to bedwetting.
No one knows for sure what causes bed-wetting, but various factors may play a role:
- A small bladder: Your child's bladder may not be developed enough to hold urine produced during the night.
- Inability to recognize a full bladder: If the nerves that control the bladder are slow to mature, a full bladder may not wake your child, especially if your child is a deep sleeper.
- A hormone imbalance: During childhood, some kids don't produce enough anti-diuretic hormone (ADH) to slow nighttime urine production.
- Stress: Stressful events, such as becoming a big brother or sister, starting a new school, or sleeping away from home, may trigger bed-wetting.
- Urinary tract infection: This infection can make it difficult for your child to control urination.
- Sleep apnea: Sometimes bed-wetting is a sign of obstructive sleep apnea, a condition in which the child's breathing is interrupted during sleep.
- Diabetes: For a child who's usually dry at night, bed-wetting may be the first sign of diabetes.
A structural problem in the urinary tract or nervous system. Rarely, bed-wetting is related to a defect in the child's neurological system or urinary system.
- Wetting during the day
- Frequency, urgency, or burning on urination
- Straining, dribbling, or other unusual symptoms with urination
- Cloudy or pinkish urine, or blood stains on underpants or pajamas
- Soiling, being unable to control bowel movements
Most kids are fully toilet trained by age 5, but there's really no target date for developing complete bladder control. Between the ages of 5 and 7, bed-wetting remains a problem for some children. After 7 years of age, a small number of children still wet the bed.
When to see a doctor: Most children outgrow bed-wetting on their own, but some need a little help. In other cases, bed-wetting may be a sign of an underlying condition that needs medical attention.
Consult your child's doctor if:
- Your child still wets the bed after age 7
- Your child starts to wet the bed after a few months or more of being dry at night
- Bed-wetting is accompanied by painful urination, unusual thirst, pink or red urine, hard stools, or snoring
- Self-Care at Home
Here are some tips for helping your child stop wetting the bed. These are techniques that are most often successful
- Reduce evening fluid intake.
- The child should urinate in the toilet before bedtime.
- A system of sticker charts and rewards works for some children.
- Make sure the child has safe and easy access to the toilet.
Some believe that you should avoid using diapers or pull-ups at home because they can interfere with the motivation to wake up and use the toilet. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
Cleft lip and cleft palate are the two most common birth defects affecting children all over the world. What happens in the cleft lip is that the upper lip is incompletely formed and in cleft palate abnormalities, we see babies with an incompletely formed roof of the mouth. Both these can be found individually or can occur together. These conditions can be severe or mild and affect one or both sides of the face.
The fEtus undergoes the separation of the upper lip and the roof of the mouth pretty early. In certain cases, this separation does not happen or happens incompletely and certain parts of the upper lip and roof of the mouth fail to form properly leading to cleft lip and palate.
Repair through surgery
- Plastic surgery is the only way to repair a cleft lip and/or palate. Both of these impair vital functions like speaking, eating, breathing, and hearing properly.
- Surgery is done to restore function and to make the affected child look more normal.
- Most cleft lip and palate surgeries are done on very young children usually 3 months to a year old.
- Before the actual surgery, a team of specialist define a course of treatment, including repair of the cleft using surgery, which means plugging the hole in the lip or the palate; speech rehabilitation and dental restoration, as the child usually has no teeth in the affected parts of the upper palate.
The specialists required are:
What happens during surgery?
Usually, cleft lip surgery happens in children as young as 3-6 months old. It has to be carried out under general anaesthesia. If the condition is severe, and the cleft lip is wide, special procedures like lip adhesion or a moulding plate are used to bring the two parts of the lip closer and it is fully repaired.
Cleft palate repair surgery is done at the age of 9-12 months only.
What happens here is that plastic surgeons bring together the muscles of the upper soft palate and rearrange them to cover the gaping hole in the roof of the mouth. The surgery is usually done under general anaesthesia and requires a short hospital stay.
- Without a normal palate, the child can’t speak properly. So, surgery helps to improve and normalise speech.
- And that’s not all. The child may require more surgeries as he grows older to treat these two problems.
- This is because the child’s facial structure changes and he or she may require advanced surgeries like pharyngoplasty, which helps improve speech, or alveolar bone grafts to provide stability for permanent teeth.
- A bone graft is usually done when the child is 6-10 years old and it closes gaps in the bone or gums near the front teeth. If you wish to discuss about any specific problem, you can consult a pediatrician.