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Child Health Issues - Health is Easy to Reach

Vaccination as Primary Prevention

Qualtiy of a nation or welfare of a nation is related to its productivity. Health of society will impact the productivity. One of the indicators of society health is child death ratio. With the demographic transition that caused lower amount of child in family, then the productive ages population is increasing.
From the research, we can see that there is an inverese correlation between amount of livebirth and life expectancy, that the lower birth incidence the higher live expectancy of a nation.

Prevention of infection is important task in oder to create conducive situation for child growth and development. Besides that, prevention of infection far more effective and cheaper than treatment of infection.

Primary prevention of disease is all the efforts in order to prevent or avoid the disease before it occurs. Such as, exercise regularly, having a healthy diet, and having vaccination. Secondary prevention is early treatment of disease in order to prevent the complication of the disease. Tertiary prevention is aimed to minimize the complication and improving the quality of life.

Vaccination or immunization is the most precious technology that been developed in medicine field. Katz in 1999 said that vaccination is the best contribution by scientist for human life. Vaccine is the most effective and efficient health efforts compare to others.

With aggressive WHO program of immunization, child death is decreasing significantly, escpecially in disease that can be prevented by vaccination.

Immunity from infection is an aim of the immunization. Basically, immunity can be achieve passively and actively. Passive immunity can be achieve naturally, during intrauterine growth in third semester since there is transplacental transfer of immunoglobulin from maternal to fetal.

While active immunity can be achieved if someone get infection and achieve cure. This mechanism is adopted in vaccine induction of immunity.

Vaccination is giving vaccine (antigen) in order to stimulate immunity (antibody) from immune system. Antigen from pathogenic microorganism that have been modified, that doesn't cause the disease but its enough to stimulate our immune system in order to achieve immune response to specifiv infection.

Vaccination give several benefits:
a. Long life immunity
b. cost-effective
c. not harmful, serious adverse reaction is very rare, far more rare than the complication of the infection.

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January 19th 2011 @ 15:45

Posted By: yulius hermanto - Category: General Health Issues, Child Health Issues

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Kangaroo Mother Care

Introduction
Nowadays, with the advanced in medical science and technology especially in perinatalogy. The amount of infant death rate is being reduced significantly. But, we are facing a more complicated newborn e.g. low-birthweight and premature baby. Since most infant deaths occurs in neonatal period about 2/3 total of infant death. And low-birthweight infants have higher risk of death since its related to its immaturity.

Eventhough, better management in hospital can prevent infant mortality especially in developed countries. But the cost in hospital care is high and not applicable in developing nations, so the new method is needed, that is simple, practical and cheap.

Kangaroo Mother Care is introduced by WHO for management of low-birthweight infant, that improved survival of low-birthweight infant.

Definition
Kangaroo Mother care is a special way of caring of low birth weight babies. It fosters their health and well being by promoting effective thermal control, breastfeeding, infection prevention and bonding.

With Kangaroo Mother Care, the baby and the mother is continuously kept in skin-to-skin contact and breastfed exclusively to the utmost extent, KMC is
initiated in the hospital and continued at home.

Two components of KMC:
Skin-to-skin contact
Early, continuous and prolonged skin-to-skin contact between the mother and her baby is the basic component of KMC. The infant is placed on her mother's chest between the breasts.

Exclusive breastfeeding
The baby on KMC is breastfed exclusively. Skin-to-skin contact promotes lactation and facilitates the feeding interaction.

Benefits of KMC
Breastfeeding: Studies have revealed that KMC results in increased breastfeeding rates as well as increased duration of breastfeeding. Even when initiated late and for a limited time during day and night, KMC has been shown to exert a beneficial effect on breastfeeding.

Thermal control: Prolonged skin-to-skin contact between the mother and her preterm/ LBW infant provides effective thermal control with a reduced risk of hypothermia. For stable babies, KMC is at least equivalent to conventional care with incubators in terms of safety and thermal protection.

Early discharge: Studies have shown that KMC cared LBW infants could be discharged from the hospital earlier than the conventionally managed babies. The babies gained more weight on KMC than on conventional care.

Less morbidity: Babies receiving KMC have more regular breathing and less predisposition to apnea. KMC protects against nosocomial infections. Even after discharge from the hospital, the morbidity amongst babies managed by KMC is less. KMC is associated with reduced incidence of severe illness
including pneumonia during infancy.

Other effects: KMC helps both infants and parents. Mothers are less stressed during kangaroo care as compared with a baby kept in incubator. Mothers prefer skin-to-skin contact to conventional care. They report a stronger bonding with the baby, increased confidence, and a deep satisfaction that theywere able to do something special for their babies. Fathers felt more relaxed, comfortable and better bonded while providing kangaroo care.

All stable LBW babies are eligible for KMC. However, very sick babies needing special care should be cared under radiant warmer initially. KMC should be started after the baby is hemo -dynamically stable.

The KMC procedure
• The baby should be placed between the mother's breasts in an upright position.
• The head should be turned to one side and in a slightly extended position. This slightly extended head position keeps the airway open and allows eye
to eye contact between the mother and her baby.
• The hips should be flexed and abducted in a "frog" position; the arms should also be flexed.
• Baby's abdomen should be at the level of the mother's epigastrium. Mother's breathing stimulates the baby, thus reducing the occurrence of apnea.
• Support the baby’s bottom with a sling/binder.

Duration of KMC
Skin-to-skin contact should start gradually in the nursery, with a smooth transition from conventional care to continuous KMC.
Sessions that last less than one hour should be avoided because frequent handling may be stressful for the baby.
The length of skin-to-skin contacts should be gradually increased up to 24 hours a day, interrupted only for changing diapers.
When the baby does not require intensive care, she should be transferred to the post-natal ward where KMC should be continued.

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January 14th 2011 @ 16:06

Posted By: yulius hermanto - Category: General Health Issues, Child Health Issues, Women Health Isuues

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Breastfeeding: An Ideal food for your Baby

Breast Milk is the ideal food for normal full-term babies, but unfortunately in many Western societies its advantages are not fully utilized. The advantages of breastfeeding can be considered as those for the baby and those for the mother, although these are of course interrelated.

Advantages to the baby
Breastfeeding brings many benefits to the baby:
1. Nutritional. It provides the baby with source of nutrition that changes with the baby's changing metabolic needs.
2. It confers an advantage in intellectual attainment
3. Breastfeeding is anti-infective
4. Antiallergic. The avoidance of foreign proteins in formula feeds reduces risk of asthma and eczema in infants predisposed to these conditions.
5. Protection various illness (e.g. gastroenteritis), atlhough apparent protection against SIDS (sudden infant death syndrome) probably related to maternal education, socioeconomic status and birthweight, rather than to breastfeeding.
6. Reduced likelihood and severity of cow's milk protein allergy.
7. Decreased incidence of infant obesity and subsequently type II diabetes, hypertension and hyperlipidemia.

Advantages to the mother
The mother also gains from breastfeeding in several ways:
1. Succesful breastfeeding brings sense of personal pride and achievement
2.Promotion of a close mother baby relationship which provides security, warmth and comfort to baby.
3. Lactation helps the mother lose weight acquired in pregnancy.
4. Convenience - there is no preparation of formula. It also can be simply expressed, stored, and given to baby by others.
5. Lactational amenorrhea remains the world's most important contraceptive by delaying the return of ovulation.
6. Oxytocin release during breastfeeding contracts the womb and helps its involution
7. Financial benefit, as breastfeeding is free.
8. Breastfeeding confers some health advantages on the mother, as there appears to be some protection against ovarian and premenopausal breast cancer and osteoporosis.

Nutritional aspects
Human milk is uniquely adapted to the requirement of babies, with low levels of protein and minerals compared with the milks of others species. The energy content of human milk (67 kcal/100 ml) is provided by fat (54%), carbohydrate (40%) and protein (6%). Human milk has a very low protein content of only 0.9 g/dl, with a whey-casein ratio of 0.7.

Human milk contains twice the amount of lactalbumin as cow's milk (and is immunologically different), but no lactoglobulin, which is a significant component of the protein constitution of cow's milk. The levels of amino acids such as taurine, aspartic acid, glutamic acid and asparagine are especially high. Human milk fat also better absorbed than cow's milk.

Human milk contains more vitamins A, C and E and nicotinic acid than does cow's milk but less vitamin B and K. The low mineral level in human milk results in a low renal solute load for immature kidney. Although calcium and phosphate levels in cow's milk are higher than in human milk, their absorption form cow's milk is much lower.

Techniques of breastfeeding
Preparation for breastfeeding should begin in the antenatal period. Antenatal expression of colostrum may result in an increase in the duration of breastfeeding and a reduction in milk engorgement but may induce labour.

The infant should be put to the breast as soon as possible after delivery, and the timing and duration of feeds should be responsive to the needs of the baby. Breastfeeding at night should be encouraged. Supplementing breast milk with water or glucose reduces the duration of breastfeeding with no compensating benefit, and should be strongly discouraged.

The baby should never be pulled off the breast. The jaw should be released by depressing with the finger at the corner of the baby's mouth. Feeds should be started on alternate breasts. Nipple creams and sprays are unnecessary, application of breast milk to nipples post-feed accelerates healing.

Human milk For Human
Cow's Milk for Cow

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January 10th 2011 @ 13:59

Posted By: yulius hermanto - Category: General Health Issues, Child Health Issues, Women Health Isuues

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