– Fedor, you have two daughters. Don’t you worry at all?
– In the health of children, own peace of mind and lack of panic are most important. Situations in which it makes sense to worry, are extremely rare, and they are pretty obvious.
Even if mom starts to panic, it is advisable to ask dad. After all, when you deal with your own children, the mind is eclipsed.
And I have one.
– When should you start to panic? Signs of …
– Lack of breathing is a fairly distinct sign. Pulses … Obvious situations related to injuries: falls from a great height, serious injuries, especially those accompanied by bleeding, burns, poisonings.
It is necessary to react quickly and call an ambulance.
If we talk about banal diseases – these are mainly viral infections: respiratory, intestinal, urinary, then most of all parents are concerned about when to start worrying during this infection. Here it flows quietly, and suddenly something happens.
This may be primarily a difficulty in breathing, the appearance of an incomprehensible rash, especially in combination with temperature. Excessive inadequate lethargy of the child, drowsiness, up to loss of consciousness. Inadequate response to stimuli.
Discoloration of the skin: when the child is blue or pale, this is not a good sign. That is, these are the signs that will make any person frightened. Just raising the temperature to 39, even if it badly gets off, is not a reason for panic, but a reason to understand.
Notify the doctor is necessary, and then he will decide whether to do something about it.
– Doctors are different. For example, I am very grateful to my pediatrician when, in response to another cry, he says: “We are not doing anything, we are watching.”
My favorite phrase. But not everyone was lucky.
How to find your doctor?
– A pediatrician with a patient should form a partnership. Therefore, in the first place, I would run from those doctors who practice the paternalistic approach, do not listen to the patient, and issue recommendations in the form of an order.
Parents have the right to ask why this or that examination is necessary, this or that vaccination, and in general any intervention in the child’s health, and the doctor should explain this to him in detail.
Otherwise, you can leave the office with a pile of prescriptions that are not used in modern medicine in developed countries. This is such a marker is not very competent doctor.
– For example, what drugs?
– Immunomodulators, antiviral, homeopathy, antitussive and expectorant drugs in children. A good pediatrician is one that does not treat ARVI.
– What to do with ARVI?
– My favorite recommendation: to water and to love. You can wash your nose.
In some rare cases bury the vasoconstrictor. But mostly otpaivanie, fever depressing and caring.
Of course, in different situations a child can be helped, but not in order to cure him, but in order, for example, to improve the quality of life. When a mosquito bites a child, I say you don’t need to do anything about it.
But on the other hand, I understand that itching can interfere with sleep. And it would be good to anoint the bites with ointment.
And in some cases, the reaction is so pronounced that blisters blow, bruises remain. And then a short course of hormone cream will not interfere in order to relieve this inflammation and reduce the undesirable effect. But this is not a cure for mosquito bites.
And, if nothing is done with them, they will pass by themselves.
– What is wrong with homeopathy? She, of course, does not cure, but there is no harm.
– Homeopathy is considered no more effective than placebo. I do not support the practice of prescribing a placebo, it makes a fool of people, forms the habit of medicines for the child, the idea that all problems must be treated.
A lot of problems do not need to touch at all. Need to calm down.
– Another option: go to an osteopath …
– Osteopathy – quackery. This is indicated by two things.
First, the theoretical basis on which osteopathy is built does not stand up for any scientific criticism. It is a fantasy.
The second: according to the results of research, osteopathy does not work. In addition to individual situations, which, in particular, include back pain.
But while the same results show manual therapy and nonsteroidal anti-inflammatory drugs.
It turns out the same placebo. A person is engaged in something, walks somewhere, something rubs him. But it would be much more effective to do physical exercise.
Plus, osteopathy does not have sufficient control and safety criteria.
– Let’s now kick antiviral. What are they bad?
– Antiviral drugs exist in a very limited set for specific viruses: HIV, hepatitis, herpes, influenza. Against viruses that cause SARS (except flu), there are no drugs.
And all that is called deception.
– What other diseases do not exist?
– If the child has problems with the skin or with the stomach and the pediatrician asks you to give a stool for dysbacteriosis, it is better to find another.
Parents consider the diagnosis of biliary dyskinesia. And it is usually based only on the fact that they have found some kind of bend of the gallbladder on an ultrasound, which should not have been done.
This is not a disease.
Very often, when the child is ill, it is not known what (most likely, a prolonged acute respiratory viral infection), pediatricians tend to look for all sorts of herpes infections. They can be found in almost everyone and blame everything on them. And to prescribe some alleged antiviral treatment.
Firming. Similarly, with frequent bronchitis they like to look for mycoplasma and chlamydia.
The beauty of it is the diagnosis of perinatal encephalopathy from neurologists with the appointment of nootropics. The conclusion is made by a small expansion of the ventricles of the brain, which is found on ultrasound, which should not be done.
Ultrasound is generally a subjective method. Therefore, whether there is an extension or not is also a big question.
Harmless, but completely meaningless appointment – baby massage. Children supposedly begin to develop. For some reason, no one takes into account that they are already developing.
On their own.
– How many times a year from the moment of birth do you need to visit a pediatrician?
– If everything is in order, five to six visits are enough, and almost all of them are timed to vaccination. Premature, poorly added and underweight babies require closer monitoring.
– What should not be done from what is offered in clinics without fail?
– In the first year of life there is no need to visit such a large number of specialists. In particular, if the ultrasound examination of the hip joints is okay, then I see no need to consult an orthopedist.
It is useful to do more ultrasound of the heart. But I consider the internal organs, kidneys, abdomen, head (neurosonography) unnecessary.
This often leads to more anxiety than to a useful diagnosis.
If everything is good according to the audio test (it is done in the maternity hospital), then you should not visit Laura.
I consider it obligatory to visit an oculist. A neurologist can be consulted later.
Not in the month of life, as is done, but in the region of four.
– And why is this all prescribed, meaning?
– These are non-invasive, harmless, methods. I believe that doctors want to take on as little responsibility as possible, they want to carry out a complete examination as much as possible, so that this responsibility can be shared with all specialists and functional diagnosticians.
In countries where medicine is adequately paid, this is too expensive and unjustified. The examination should always follow the clinical picture, that is, the visible symptoms.
– We turn to the mandatory procedures. What is the logic for creating a vaccination calendar?
– It takes into account the age at which a disease can be dangerous or not. The structure of the pathogens that cause diseases varies with age.
For example, for teenagers, meningococcal meningitis is more likely to get sick, and for a three-year-old child, pneumococcal. Therefore, vaccinations are made in certain periods: when they are most relevant.
Rotavirus can get sick in adulthood, but we only vaccinate babies, because the first two years of life is the most dangerous and potentially fatal disease.
Whooping cough began to make pregnant women to protect newborns. Because while we vaccinate the child himself, he has been living for several months, the most dangerous, when whooping cough can kill him.
When creating a calendar, the territorial epidemiological situation is taken into account. There is no point in inculcating encephalitis in Sochi or in typhoid fever in Karelia. The calendar is based on the known efficacy of vaccines, the frequency of their introduction depends on when we get an adequate response.
For some, this is a one-time vaccination, others need to be done three times. This is not fantasy, it is the properties of the vaccine itself.
Economic factors also affect. All vaccines included in the national calendar, the state must provide.
Therefore, it lacks a lot of vaccinations.
– Meningococcus, chickenpox, hepatitis A, rotavirus, hemophilic infection, pneumococcus. They need to buy.
“I wonder why mommies chase after children with chickenpox and try to infect theirs from them if there is a vaccine.”
– Many simply do not know about its existence. Vaccination against chickenpox is different from the chickenpox itself in that the second is a disease and it is unpredictable.
It can flow hard, give complications – encephalitis, pneumonia, cause unpleasant consequences. Probably need to say that chickenpox is a deadly disease.
And although the chance at preschool age to die is rather low, it is in infants and adults. The disease adversely affects the immune system. After blisters, pockpots can remain for life.
A varicella virus, remaining in the body, can subsequently cause herpes zoster. And the virus, which is contained in the vaccine, makes it less likely.
In addition, it is just unpleasant. Look at the child who is suffering, lies with the heat.
Turns from side to side and can not get rid of the itch.
Chickenpox vaccine is well tolerated. Done twice and for life.
– Tell us about meningococcus and how to escape from it.
– Meningococcus is an unpleasant bacterium, a relative of the bacteria that causes gonorrhea. It can provoke various diseases: from a simple cold to purulent meningitis and the fulminant form of meningococcemia, blood poisoning by meningococcus, which leads to death within 24 hours.
The child dies quickly, unpredictably, little can be done.
There are five main types of meningococci. Four of them are saved by the modern Menactra vaccine. Fifth, meningococcus B, is vaccinated separately with Bexsero vaccine, which is not yet available in Russia.
I recommend to do this vaccination in other countries. In America, it is practiced only as a teenager, and in England it is made from two months.
– What are two months? We are afraid to do vaccinations if the child has snot.
– There are several clear contraindications, they are written in any instructions for vaccines, neither snot nor cough do not apply to them. Temperatures above 38 are contraindicated.
Although in some countries – above 38.5. But it, most likely, will not affect the development of undesirable reactions, but will reduce the effectiveness.
Therefore, we are waiting.
– Let’s talk about one more scary story – “the diet of a nursing mother.”
– It does not exist. The reasons for this mythical diet may be two.
The first is to lose weight after pregnancy. It is quite selfish, can affect lactation. The second is the fear of allergies.
And this is an absolutely unjustified story! By default, the child has no allergies. They evolve over time.
And the later a person is faced with some products, the more likely it is that he will develop an allergy.
Therefore, it is now practiced throughout the world earlier introduction of a variety of complementary foods. As for mom, she should limit herself if she sees a direct connection between what she ate and some kind of problem in a child.
It is unreasonable to conduct an experiment and eat again.
– And when is the correct feeding?
– Between 4 and 6 months. After six months, milk becomes insufficient for its nutritional value.
For a variety of nutrients and microelements. And in children without complementary foods, deficiency can develop, leading, for example, to anemia, to a decrease in hemoglobin.
Reduced hemoglobin leads to a lack of oxygen. And this may already provoke a delay in development, a decrease in immunity.
Timely introduction of complementary foods is necessary in order to develop the brain. With the help of different tastes, paths are formed in the brain, new connections between neurons.
And this is good for the brain. To accustom the child to new tastes well, while he has not yet learned how to actively refuse.
There are situations when at 9–10 months the child rejects everything, and it is much more difficult to accustom him to eating. But it is necessary that he get his puree food on time and move on to more solid food in time.
Solid food and chewing stimulate including speech.
– Your approach to the profession is somewhat different from the generally accepted.
– The system in which I work is focused exclusively on Western studies. And most importantly, what teaches: you can help everyone, regardless of the situation. And this is the correct goal setting in medicine.
Unfortunately, it often looks like a formality. The hospital gives extracts, and no one thinks about whether it is possible to fulfill what is written there. If anything – we will report to the prosecutor, and that’s all.
The goal is to fulfill all required points and not to make mistakes. A goal to help the patient in front of these doctors is not worth it.