Rus Articles Journal

The premature child - at all not a sentence for a family! Part 2

the Beginning

the Condition of nervous system of the premature child deserves special attention as correct functioning of nervous system defines development of the kid in general, his mental capacities and an athletic ability.

Possible defeats of nervous system of the premature child

Everything that can be with nervous system of the premature child, can be divided into 2 big and inadequate groups conditionally. In - the first even if nothing bad happened to nervous cages and a brain blood-groove, all the same cages of nervous system are very unripe and sometimes not “capable“ to carry out the correct regulation of all bodies and systems. Adjustment of this relationship requires time. So, in the first days the kid is not able to suck independently because the nervous impulse is not transferred correctly to muscles which participate in sucking. The child is long fed through a probe until the sosatelny reflex is created. Very often such children, having already learned to suck, badly swallow. The child long keeps food in a mouth in small volume and only then swallow it. Feeding takes a lot of time, usually parents adapt to raise the kid from a pipette, small portions. Besides, such child it is necessary long, sometimes till 2 - 3 years, to feed with liquid food from - for the fact that chewing muscles badly develop. From - for immaturity of nervous system of a stomach and intestines such children usually plentifully belch, intestinal gripes proceed sometimes to 5 - 6 monthly age. Often there are locks because nervous regulation of intestines is very imperfect.

Children whom doctors were compelled it is long to raise through a probe, and long being on artificial ventilation, usually late begin to speak, mispronounce sounds because the reflexes regulating a tone of muscles, participating in a pronunciation of sounds are very long formed. Therefore practically all deeply premature children need the help of the logopedist. And logopedic occupations are necessary still before the child begins to speak to normalize a tone of muscles of language, to create the correct development of speech muscles.

because of deep immaturity premature children are late in motive development, they late begin to hold a head, to take a toy, to turn over. After six months immaturity is already not so expressed, and the child develops quicker. Often at the premature kid motive abilities “are confused“: the child starts anew to rise, then to sit down, can late learn to creep, perhaps, he will long tiptoe. Remedies for immaturity two - time and your patience.

If to your kid was lucky

less, then besides deep immaturity of a cage of nervous system can suffer from a lack of oxygen which is tested by the premature child at the heavy course of pregnancy and childbirth. If oxygen starvation of a brain was not too heavy and long, then the changes which happened in cages will be reversible and will not lead further to serious consequences. In the first months such children can be more excitable, have sleep disorders. Further they well develop and by 1,5 - 2 do not differ on a level of development from the full-term peers. But if nevertheless damage of cages did not manage to be avoided, then “ruptures“ of vessels of a brain and hemorrhage in brain ventricles can be result of it. In 1 - 2 month of life the condition of such children usually happens heavy, and they need medical care and long nursing.

At hemorrhages of easy degree walls of small vessels “burst“, it can lead to increase of intra cranial pressure. Intra cranial pressure increases from - for superfluous formations of liquid in brain ventricles which presses on surrounding fabrics. At small hemorrhages the state in most cases is quickly compensated, outflow of liquid from ventricles is normalized, and hemorrhages completely resolve. In other words, hemorrhages can pass 1 and 2 degrees completely for the child, however, it does not mean that life should not observe and treat him on 1 - 2.

Heavy hemorrhages when large vessels “are torn“, blood fills with

all brain ventricles, cause much more serious consequences, lead to hydrocephaly, spasms, an arrest of development, motive violations. Such children need the constant help of a neonatolog, the neuropathologist and other experts, in particular control of neurotouch bodies (hearing and sight) as these zones of a brain can be damaged. If the kid strongly is late in the development, it is necessary to observe attentively whether it has spasms. Attacks happen very different and sometimes do not remind a spasm at all. The child can take eyes aside and fade for several seconds, put out tongue, do the unusual elaborate movements by hands and legs. Especially has to guard you if the child is strongly bent or unbent as far as a time in a row a series. At any suspicion on convulsive attacks consultation of the neuropathologist, carrying out the electroencephalogram is necessary for the kid. Whenever possible make video that the neuropathologist could see the attacks which guarded you.

the premature children who transferred a heavy lack of oxygen can have an irreversible death of nervous cages directly in brain fabric. It is the heaviest type of defeat, and it is called a periventrikulyarny leykomalyation. At a periventrikulyarny leykomalyation cages white, and sometimes collapse and gray substance of a brain, and on their place cysts are formed. This injury of a brain is established by means of ultrasonic research of a brain. Over time these cysts “are closed“, and after 6 - 8 their monthly age it is not visible on ultrasound any more. Such children can have various outcome: from the minimum motive violations with motor awkwardness and normal development of mentality, before formation of paresis, paralyzes with a delay of psychomotor development.

the Diagnosis of intra cranial hemorrhage and a periventrikulyarny leykomalyation is very serious

, however is not a final sentence. What will be an outcome in this case in the first months of life nobody knows. Cells of a brain of the premature child continue to develop vneutrobno, fabric is very plastic and it can partially undertake function of the damaged cages. More and more time we want to tell: do not lose hope, you treat the child, try to help him, to develop him, to carry out appointments of the attending physician. And you will be able even to receive rather good result at very serious situation. Especially as the science goes forward, and every day new knowledge and methods of assistance appear.

of the Problem of digestion at the premature child

the Main care of parents of the premature child is problems of increase of body weight and, really, it has paramount value as the main indicator of physical wellbeing of the kid. It is necessary to consider that rates of a gain of physical indicators (body weight, length, a circle of the head and a breast) at the premature child will significantly differ from those at his full-term peers. At least till 6 - 9 months your kid will be “smaller“, and major importance gets obligatory control of weight at this time: in the first weeks and months of life daily (at the same time it is necessary to consider correctness of daily weighing of the child which needs to be seen off at the same time, it is preferable before the first morning feeding or in the evening, before bathing), and then monthly. That this falling of body weight or lack of its increase has to guard you first of all, so (the kid “costs“ in weight). The reasons can be as rather serious, and the feedings caused by errors, insufficient amount of breast milk at mother. It is natural that anyway you need to consult with the pediatrician to specify the reasons and to eliminate them.

the Main problems from a gastrointestinal tract at the premature kid which practically all parents face are intestinal gripes. The word comes from the Greek “kolikos“ that means “pain in a thick gut“. Colic - the pristupoobrazny belly-aches which are followed by the expressed concern of the child. The attack, as a rule, begins suddenly, the child loudly and more or less for a long time shouts, face reddening or pallor of a nosogubny triangle can be noted. The stomach is blown up and intense, legs are tightened to a stomach (can instantly become straight), feet often cold to the touch, hands are pressed to a trunk. The attack sometimes comes to an end only after the child is completely exhausted. Often noticeable simplification comes after an otkhozhdeniye a calla and gases.

Premature children are especially predisposed with

to gripes, at the same time at some babies frequent and intensive attacks which on force of manifestation can be compared to patrimonial pain, and by all means demanding medicamentous intervention are noted. Apparently, immaturity nervously - the muscular device and enzymatic system of intestines can be the main reason for these sufferings of the kid. And owing to this fact tendency to the increased gas generation therefore pressure upon a wall of a gut amplifies and arises a muscular spasm.

the Reason of discomfort and an abdominal distension. Some products, especially with the high content of carbohydrates, can promote excessive fermentation in intestines. The intestinal allergy also causes the crying of the child caused by feeling of discomfort in a stomach. But the reasons of gripes are not limited to these states. It is important to diagnose in due time the diseases demanding surgical intervention. Therefore in the absence of effect of the usual actions directed to elimination of colic (special carminative herbal teas, preparations of a simetikon, a cleaning enema, application of an exhaust tubule, massage of a stomach, dry heat on area of a stomach), the child has to be carefully examined in medical institution.

of Dyspepsia (ponosa, locks) at the premature child - the phenomenon frequent and concerning parents and pediatricians. When breastfeeding the child can have a chair after each feeding together with gases (foamy) and rather liquid. At the children receiving mixes, a chair more rare - 3 - 4 times a day. Lack of a chair at the kid can be considered more than 1 days as a lock. Immaturity nervously - the muscular device of intestines, violation of formation of a biocenosis of intestines, the postponed bacterial infections, long antibacterial therapy, treatment is iron preparations, anticonvulsive preparations the reason of dyspepsia (what was appointed to your child according to vital indications), can lead to violation of an innervation of intestines, inflammations of his mucous membrane result from change traffic of a mucous membrane of a thick gut.

the digestion Violation caused by the increased fat content of breast milk or its substitutes; immaturity of enzymatic function. In all these cases there are special corrective mixes - the medical substitutes of breast milk, preventive preparations capable to help your child, but it is very important to coordinate their application with your pediatrician.

the Syndrome of vomiting can also disturb parents of the premature child. Immaturity and the temporary (passing) hypotonia of smooth muscles of a stomach - so-called “duodeno - a tour reflux“ is the most frequent reason of it. Most often it arises at the premature children eating a long time through a probe. The aerofagiya can be also possible cause of vomiting (when the baby with greed swallows of air together with food). Masses when vomiting looks plentiful due to their linkng with air and usually does not change health of the kid in any way. In that case it is necessary to have patience and to wait when the stomach of the kid ripens“, observing at the same time recommendations about the correct feeding, keeping of the child after feeding vertically within 10 - 15 minutes. Quickly enough improvement comes also at introduction to food of mixes - thickeners (Frisovom, Nutrilon - an anti-reflux). It is better to give medicines to the child before feeding. However there are situations at which urgent consultation of the expert is necessary. If at the belched masses there are blood streaks if vomiting is so plentiful that the child badly puts on weight if when vomiting the health of the kid is broken - do not hesitate, see a doctor!

the Condition of bone system and joints

of the Phenomenon of a morph - functional immaturity at the premature child often extend also on oporno - the motive device. Imperfection nervously - muscular regulation, weakness of sheaves, excess mobility of joints can lead to changes of the correct position of extremities, the head and child`s backbone.

Often the baby holds the head in the fixed situation on one party. Congenital shortening of a muscle of a neck from one of the parties, traumatic damage of a backbone or cervical muscles at removal of a head in labor or only “habitual“ position of the head can be the cause of it, that is the child in this situation “lay“ the most part of time in a uterus. The correct diagnosis is always established by the doctor, and the earlier it will occur, the treatment will be more effective.

Prematurity, especially in a combination to the wrong pre-natal provision of a fruit, as a rule, is followed by an underdevelopment of coxofemoral joints or “dysplasia“. The heaviest option of this pathology is dislocation of a coxofemoral joint. The diagnosis is established soon after the birth of the child and demands the early initiation of treatment based on assignment of legs in a coxofemoral joint. Now an effective method in identification of deviations of development of joints is ultrasonic scanning which is surely carried out by everything to children in 1 and 3 months of life or a thicket if the disease is revealed.

Considering

that the described problems occur at premature children especially often, each kid has to look round repeatedly on the first year of life the orthopedist. As a rule, children get the first advice in 1 month of life, then in 3 and in 12 months. At detection of pathology of consultations can be more. Timely identification of deviations will help to begin quickly treatment and to grow up the child healthy.

We tried to tell

in an available form of the most often found problems of 1 year of life of the premature child. All of them require attention, supervision and timely treatment. We persistently recommend to you to address experts who purposefully deal with problems of health and development of such children - it will help to avoid mistakes and excess disorders.

We wish good luck and health to you and your kids!