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1.
2. HEALTH PROBLEMS DURING
INFANCY AND THEIR
Bandana Yadav
M.Sc. Nursing,1st Year (B-2023)
B. P. Koirala Institute of Health
Sciences, Dharan
3. INTRODUCTION
Accidents are the main cause of injury and even
death in children. People only relate accidents to
outdoor activities. However, as a matter of fact,
the place where people regard as the safest place
that is "home" hides many "hazards". Bandana Yadav
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5. DEFINITION
An accident is an event, independent of
human will caused by outside force
acting rapidly and resulting in physical
or mental injury.
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6. DEFINITION (CONTD…)
Accident is defined an unexpected, unplanned
occurrence which may involve injury.
Unpremeditated event resulting in recognizable
damage
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7. TYPES OF ACCIDENTS
1.According to location:
a. occurring outside home
b. Occurring inside home
2. According to severity
a. Major b . Minor
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9. TYPES OF ACCIDENT
Burns
Extremity fractures
Choking
Head injuries
Motor vehicle accident
Drowning
Toxic ingestions
Bicycle injuries
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10. PREVENTION
Keep floor dry.
Always ensure bed-rails of cot are raised when
the baby is in the cot.
Windows and doors must be locked to avoid
misadventure by children.
Avoid placing "step-stones" such as a chair
next to a window. Take extra care to avoid side
turning of a baby chair.
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11. PREVENTION( CONTD…)
Keep floors free of toys and obstructions.
Exercise close supervision when toddler learns to
walk.
Never leave babies unattended on raised surfaces.
Check constantly floor surface for wear and tear.
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12. CHOKING
Accidental swallowing of foreign body,
strangulation, covering of head by
blankets, accidental suffocation by pillow
while baby sleeps in a prone position.
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13. PREVENTION
Choose toys appropriate to the age of
children. Avoid toys with detachable
small parts.
Ensure small objects are kept out of
reach of children.
Pull cords on curtains and blinds should
be kept short and out of reach of children.
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15. PREVENTION (CONTD…)
Foldable furniture should be properly placed
and locked. Instruct children not to play with
them.
Instruct children not to play while eating.
Never let children use milk bottle by
themselves without adult's supervision.
Never use pillow for baby under one year of
age.
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16. PREVENTION (CONTD…)
Do not use large and heavy blanket. Never let
the blanket cover the face of children during
sleep.
Never leave children alone in a bath tub or
basin filled with water.
Bucket filled with water must be covered
and keep children away from it. Bandana Yadav
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18. PREVENTION (CONTD…)
For adults, never hold a hot drink/food and a child at
the same time.
Ensure proper fence or door is installed at the entrance
of kitchen. That must be closed at all times.
While cooking, pay extra attention to the stove fire and
the cooking utensil.
When bathing a child, always test temperature of water
beforehand. Bandana Yadav
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19. PREVENTION (CONTD…)
All hot objects including an iron or
containers with hot matter must not be placed
near the margin of a table.
Match boxes and lighters should be placed
out of reach of children.
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20. PREVENTION (CONTD…)
Never allow children to wander around
when preparing a meal.
Install proper cover to sockets.
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21. SUDDEN INFANT DEATH
SYNDROME (SIDS)
Sudden infant death syndrome (SIDS)
is the sudden, unexplained death of an
infant younger than one year old.
Some people call SIDS "crib death"
because many babies who die of SIDS
are found in their cribs.
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22. SIDS (CONTD…)
SIDS is the leading cause of death in children
between one month and one year old.
Most SIDS deaths occur when babies are
between two months and four months old
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23. SIDS (CONTD…)
A leading hypothesis is that SIDS may reflect a delay or
abnormality in the development of nerve cells within the brain
that are critical to normal heart and lung function.
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24. SIDS (CONTD…)
Research examinations of the brainstems of infants who
died with a diagnosis of SIDS have revealed a
developmental delay in the formation and function of
several serotonin-binding nerve cell pathways within the
brain system Bandana Yadav
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25. PREVENTION
Don't let your baby get too hot or too cold.
Keep your baby's head uncovered. Their blanket should
be tucked in no higher than their shoulders.
Place your baby in the "feet to foot" position (with their
feet touching the end of the cot or pram).
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26. PREVENTION (CONTD…)
If possible, breastfeed your baby Feet to foot position
Place your baby with their feet to the foot of the cot, with the
bedclothes firmly tucked in and no higher than their shoulders,
so they can't wriggle down under the covers. Don't worry if
they wriggle up and get uncovered.
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27. Studies in SIDS
Alcohol as a risk factor for sudden infant death syndrome
(SIDS)
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28. PREVENTION (CONTD…)
6000-7000 babies die of SIDS every year in the US
Sleeping on a soft surface.
Draping a blanket over a baby's head also is risky.
Sleeping with parents. While the risk of SIDS is lowered if an
infant sleeps in the same room as his or her parents, the risk
increases if the baby sleeps in the same bed - partly because
there are more soft surfaces to impair breathing.
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29. Risk factors
Low birth weight
Respiratory infection
Sleep environmental factors
Sleeping on the stomach or side. Babies who are placed
on their stomachs or sides to sleep may have more
difficulty breathing than those placed on their backs.
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30. Risk factors (Contd…)
Although sudden infant death syndrome can strike any infant,
researchers have identified several factors that may increase
a baby's risk. They include:
Sex..
Age.
o Race.
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31. Risk factors (Contd…)
Family history
Secondhand smoke.
Being premature..
Maternal factors
During pregnancy, the risk of SIDS is also affected by
the
mother, especially if she:
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32. Risk factors
Almost all SIDS deaths happen without any warning or
symptoms
To Death occurs when the infant is thought to be
sleeping.
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33. Causes of SIDS
A combination of physical and sleep environmental
factors can make an infant more vulnerable to SIDS.
These factors may vary from child to child.
Brain abnormalities
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34. Causes of SIDS
Is younger than 20
Smokes cigarettes
Uses drugs or alcohol
Has inadequate prenatal care
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35. PREVENTION
There's no guaranteed way to prevent
SIDS, but you can help your baby sleep
more safely by following these tips:
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36. PREVENTION (CONTD…)
Place your baby on their back to sleep, in a cot in the
room with you.
Don't smoke during pregnancy or let anyone smoke
in
the same room as your baby. 。 Don't share a bed with
your baby if you or your partner smoke or take drugs,
or if you have been drinking alcohol.
Never sleep with your baby on a sofa or armchair
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37. PREVENTION (CONTD…)
To test whether alcohol is a risk factor for sudden infant death
syndrome (SIDS)
Participant: All SIDS cases (n = 129,090) and other infant
deaths (n = 295,151) from 1973-2006; all persons involved in
late-night alcohol-related crashes (n= 135,946) from 1994-
2008.
Measurement: Three measures were used
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38. PREVENTION (CONTD…)
the expected number of deaths on New Year versus
the observed number (expected values were
determined using a locally weighted scatterplot
smoothing polynomial)
the average number of weekend deaths versus the
average number of weekday deaths and the SIDS
death rate for children of alcohol-consuming
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39. PREVENTION (CONTD…)
versanon-alcohol-consuming mothers Result
These measures indicate that
the largest spikes in alcohol consumption and in SIDS
(33%) occur on New Year alcohol consumption and
SIDS increase significantly on weekends
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40. PREVENTION (CONTD…)
children of alcohol-consuming mothers are much more likely
to die from SIDS than are children of non- alcohol-consuming
mothers.
Sleep environment risk factors for sudden infant death
syndrome: the German Sudden Infant Death Syndrome Study.
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41. OBJECTIVE:
Our goal was to investigate the risk factors for sudden Infant
death syndrome in the infants' sleep environment for a
population in which few infants sleep prone as a result of
education campaigns
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42. Method
This was a population-based sudden infant death syndrome
case-control study over 3 years (1998-2001) in German
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43. Result
There were 333 sudden infant death syndrome cases and 998
matched control o Although only 4.1% of the infants were
placed prone to sleep, those infants were at a high risk of
sudden infant death
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44. RESULT
Those who were unaccustomed to sleeping prone were at very
high risk, as were those who turned to prone. Bed sharing
(especially for infants younger than 13 weeks); sleeping prone
on a sheepskin; sleeping in the house of a friend or a relative
(compared with sleeping in the parental home)
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45. RESULT
sleeping in the living room (compared with sleeping in the
parental bedroom) increased the risk for sudden infant deatH
syndrome; pacifier use during the last sleep was associated
with
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46. RESULT
a significantly reduced risk of sudden infant death
syndrome
Breastfeeding and reduced risk of sudden infant death
syndrome: a meta-analysis
(Department of Family Medicine, University of Virginia
School of Medicine, 2011)
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47. OBJECTIVE:
To perform a meta-analysis to measure the association
between breastfeeding and SIDS.
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48. METHODS:
We identified 288 studies with data on breastfeeding and SIDS
through a Medline search (1966-2009), review articles, and meta-
analyses. Twenty-four original case-control studies were identified
that provided data on the relationship between breastfeeding and
SIDS risk. Two teams of 2 reviewers evaluated study quality
according to preset criteria; 6 studies were excluded, which resulted
in 18 studies for analysis. Univariable and multivariable odds ratios
were extracted. A summary odds ratio (SOR) was calculated for the
odds ratios by using the fixed- effect and random-effect inverse-
variance methods of meta- analysis/The Breslow-Day test for
heterogeneity was performed
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49. Separation Anxiety/Stranger Anxiety
Infant demonstrate attachment to one
person they exhibit less friendliness to
others.
After the age of six month infants shows
increasingly interest on parents especially
mother and starts to show fear of stranger.
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50. Separation Anxiety/Stranger Anxiety
Separation anxiety symptoms usually
peak between 9 and 13 months of age.
It decreases usually after two years of
age, with increasing levels of autonomy
by the age of three. Bandana Yadav
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51. Separation Anxiety/Stranger Anxiety
Signs and Symptoms
Crying
Clinging
Complaining upon separation.
Searching or calling for the parent after
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52. Parental guidance
Parents should be prepared for the type and duration of
separation anxiety
Parents are encouraged to have close friends or relatives visit
often.
Parent can help the child to develop the ability to form
relationship with other caretaker and parents.
Parents should stay with new caretaker for few days 5-7 days
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53. Thumb Sucking
Thumb sucking is a normal behavior in infant and toddlers.
It reaches its peak at age 18-20 months where it may begin as
early as 3 months of age and most children spontaneously drop
the habit by 4 years of age. Infants may suck his/her thumbs for
satisfaction as it is one of the chief pleasure activities of infants.
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54. Causes
It is most prevalent when the child is hungry or
tired, bored, frustrated or at bed and want to
sleep but is lonely.
It is a habit disorder in older children due to
feeling of insecurities and tension reducing
activities.
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55. Causes
Sucking is the infant's chief pleasure and may
not be satisfied by breastfeeding. However, it
may be due to inadequate oral satisfaction as a
result of poor breastfeeding
Early introduction of pacifier to calm the child,
early termination of breast feeding, decreased
exclusive breast feeding and early weaning.
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56. Parental Guidance
Reassure parents, there is no need to
restrain non- nutritive sucking of the
fingers during infancy and early
childhood. Bandana Yadav
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57. Parental Guidance
Reassure parents not to worry too much and advice not
to become irritable, anxious and tensed.
Most children will resolve the problem spontaneously as
they grow up.
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58. Parental Guidance
To decrease dependence on non nutritive sucking in
young infants, instruct mother to increase sucking
pleasure by prolonging feeding time Aware the parents
that persistent thumb sucking in listless apathetic child
may indicate emotional problem between parent and child
or boredom, isolation and lack of stimulation.
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59. Parental Guidance
Educate mother that breast-fed infants tend to wake up more
often than formula fed infants because breast milk is easily
digested thus, infants fed in breast milk gets hungry sooner.
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60. Parental Guidance
Educate mother that night waking can be
eliminated by delaying bed time for 1
hour, shortening the afternoon sleep
period, not responding immediately to
infants so that they can have time to sleep
on their own.
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61. Parental Guidance
Teach them to provide soft toys and music to allow infant
to play quietly alone.
Teach them to divert thumb-sucking with other activities
consider distracting substitute activity. keeping the hand
busy, such as a rubber ball to squeeze or finger puppets
to play with.
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62. Parental Guidance
The parent's should be discouraged excessive use of the
pacifier to calm the child.
Hygiene measures should be followed to prevent infections.
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63. HEAD BANGING
As odd as it may seem, head banging among babies and
toddlers is actually a normal behavior.
Some children do this around nap time or bedtime, almost as a
self-soothing technique.
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64. HEAD BANGING
But despite being a common habit, it’s no less upsetting or
frightening for you. It’s only natural to think the worst. Can
head banging cause brain damage? Is it a sign of something
serious? Can it cause other injury?
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65. HEAD BANGING
Head banging can take different forms. Some
children only bang their head when lying face down
in the bed, and then repeatedly bang their head
against the pillow or mattress.
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66. HEAD BANGING
Other times, though, babies or toddlers head bang while in
an upright position.
In this case, they might bang their head against a wall, crib
railing, or the back of a chair.
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67. HEAD BANGING
Some children rock their body while banging their
head, and others moan or make other noise.
The important thing to know, though, is that head
banging isn’t usually anything to worry about,
especially if it only occurs during nap time or
bedtime.
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68. HEAD BANGING
The habit can start around the ages of 6 to 9
months, with many children getting over the
habit by ages 3 to 5.
Head banging episodes are relatively brief,
lasting up to 15 minutes, although they might
seem longer if you’re worried.
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69. CAUSES
Head banging is usually a way for your child to comfort
himself.
As many as 2 in 10 healthy children between the ages of 6
months and 4 years of age will bang their head at some time
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70. PARENTAL GUIDANCE
Tell they're banging their head to get your attention,
Try not to make a big deal out of it.
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71. PARENTAL GUIDANCE
Strong reaction could reinforce the behavior and make them
more likely to keep doing it.
Avoid yelling at them or harshly scolding them.
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72. REFERENCES
Kliegman M Robert. Nelsons essentials of Pediatrics. 5th
edition. Elsevier publication; 2007
Acharya S. Comprehensive Text book of C hild Health
Nuring(pediatric Nursing) Samiksha Publication.Pvt. LTD.
Datta, P. Pediatric Nursing.Jaypee Brothers Medical Publisher’
(p) LTD
6/2/2023
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