child care

HOW TO PLAY THE GAME WHEN CHILD

2012-03-08T23:21:00.000-08:00

Dr. Myrtha Chokler - Translation Dr. Luis Stoppiello
CONCEPT OF GAME. ROOTS DELL'ATIVITA 'LUDICA

      The game is in principle a right of the child (1), essential to a pleasant activity that contributes to the subjective construction.

      In the process of identity formation, one of the key tools is the game and, at an early age, particularly the game body, sensorimotor and symbolic, which allow different levels of performance, the motor domain of the structuring of space, knowledge and understanding of the progressive reality at the same time that self-expression together with the elaboration and symbolization of desires, fears, fantasies and unconscious potential.

      This step is essential for the child self-games, put in a first level: their axis, the sensorimotor, the pleasure of movement, the pleasure of discovery and appropriation of the body and from there, affect the organization, structuring the dismantling and restructuring of the body schema and body image and self.

      All healthy children play, they do it constantly. Play is a vital function like breathing, centered in the principle of pleasure, enjoyment and pleasure from the discovery by the progressive domination of the world and himself. The healthy child then, plays, wants and knows how to play at his level and with its own tools. Indispensably is the adult who can guarantee the conditions of the child's emotional security, materials, space and time enough for him to fully express its playful impulse, which stands as its motivation, its internal strength, for his drive epistemic linked to an essential need to adapt and understand the surrounding world.

      The infant's early interactions with adults are the primary sources of pleasure possible. Reassured by the adult emotionally through the quality of the attachment bond, the child will put in place in a semiotic process, ie, creating and assigning meanings of signs, a series of actions sensorimotor, cognitive and symbolic underpinning of his leisure activities.

      The child can play in action - can be played in the action - from its relative safety compared to everything integrated in itself. He can play to lose themselves and others what they already have or know intimately that certainly can recover. He can play the equilibrium and disequilibrium in terms of inner security. Play either fall or jump when he firmly established an image of his body, before that the fantasies of loss, insecurity, breaking the unity of the body and the loss of spatial references is usually the cause distress. The most common expression is the restlessness, anxiety, excitement, boundless, impulsivity, disorganization or inhibition. This also leaves its traces blocking attention, disturbing the arrangement for learning and stimulate outbursts and aggression.

THE FUNCTIONS OF THE GAME IN VARIOUS STAGES OF THE CHILD

      The child is not only to establish the existence of things, to learn and actively adapt to reality, but basically to understand and to recreate it.

      The game is essential for intellectual development, motor and affective child is his natural way of expression, despite playing just because you play to become his main value. The engine and the result is the pleasure of playing.

      Through play, the child incorporates the basics about himself, about others and the world learns to master and learn the parts of the body and its functions, to orient themselves in space and time, to manipulate and build, to establish relationships with others, to communicate and talk. All these learnings needed to non-conscious level.

      The game becomes such only as through him are expressed and provide the complex processes of consolidation of self and identity. It is not an exercise for a workout ... or ... or for preparation for future tasks, but a way of being in the world today, here and now. Although the adult games, however, the game for him does not have the same meaning as the game in the child: for an adult also means pleasure and at the same time is linked to leisure, relaxation, distraction, relief from with daily tasks, to his concerns, for the child instead, the game is the life in spite of all life is not a game.

      From experience, exploration, experimentation with simple objects, the emotional resonance and pleasure shared later with other children or the adult world, children will pose questions, beginning nonverbal, build their knowledge, compare results , questionano and ask others to create their own paths to learning, along with their global potential, their skills and interests.

      We consider three stages in the child's game:

      The first two years of life are essentially sensorimotor period.

      Initially we would find three types of activity pre-games:

    * During the maternal care (feeding, rocking, support), there are games in mortgages interactions.
    * After the child's own body, the discovery of his hands as an object of sucking and brightened push him to repeat and sensations.
    * Later, as an indicator of a stage of maturation of the attachment bond, appears a privileged object that can partially substitute for a little adult time significantly in its function of accompanying or consolation: it is the "transitional object" (2).

BY HAND KNOWLEDGE OF HOW TO OBJECT TO THE HAND AS A TOOL TO LEARN AND PLAY (3).

      The discovery of the first and then using its own hands as an object of the game is a crucial step in child development. It starts with a random appearance of the hand, as any object within the visual field that did not previously attracted his attention for anything but that now captures his interest. When using the movements are not willing, that is, reflexes, hand out of sight, the little boy trying to retrieve it again. At that moment, the hand becomes a subject of "relevant" for exploration, learning and playing.

      The success of being able to put before his eyes either hand or both hands and the posterior domain of that coordination, visual-proprioceptive integration implies that the circuit: attractive object, visual perception, kinesthetic and voluntary motor activity. And 'the circularity of the body schema and integrative unity of self-image.

      You may think that at first the child "does not move his hand", but looking closely at the hand that moves. This conduct is rapidly evolving with more complex gestures. Ready to begin "to move" his hands before his eyes. The leaves, the approach generally makes one at a time, opens and closes his eyes, takes a hand or hang with the other, the trips, he discovered and perfected movements of his hands, then repeat with the objects.

      Early in the second quarter of the child, in the meantime holding her hand, collects information on the feelings that cause the objects in them, their possible movements in contact with the types, weights and warp object. The focus is particularly in this stage in his hand as an object of knowledge, in a process of discovery, acquisition, exercise and progressive domain. This then allows it, shifting the focus of interest from the hand towards the object, transforming it into a tool that is increasingly skilled exploration, experimentation and the use of the elements that are accessed.

      The child extends his hand toward the object, pushes him, look how he moves, it passes from hand to hand, touch him with both hands, throws him, the leaves, the door to her face and mouth.

      The exploration and manipulation from the fourth month already an autonomous complex. According to an internal incentive, strong and persistent, just the child, appears spontaneously when they are placed into the conditions of comfort, space, toys or objects lighter, safer and understandable in its scope because the child can manipulate. Objects are not too small for it to take them in your mouth and suck without risk, to throw, hit, etc.. The sensation caused by these objects in his hands and his mouth seems to be the primary objective.

      Starting the second half of the child's actions become more complex because it shifts its focus so prevalent on the search for effects of its manipulation on the objects, toward understanding the physical and topological relations, instead of exploring the sensations they cause in this his hands.

      At the age between 18 and 24 months, the manipulation is no longer an independent and passes them to integrate in a more organized and more complex game. The child grew from an exploration tactile-motor, which prevailed in the organization and interelazione perceptual-tactile, kinesthetic and multisensory but particularly visual, sensorimotor activity towards the base of which continues to be handling, however, its purpose, interest and significance in cognitive development is more complex and differentiated, given to reports of the objects themselves and each other or the object as an intermediary in social relations.

      The extreme development of manual dexterity (due to the maturation of the cerebral cortex and pathways of association) and the mental representations they sustain each other, thus ensuring the gradual adjustment of the experiences of manipulation aimed at a goal autoproposta, whose project , planning and anticipation are related to the growing powers of observation and selective attention and persistent.

      During the second quarter, from 3 to 6 months, the child manipulates an object, takes it, looks at him, turns, moves, palpeggia him, takes him into his mouth, him away, clings to it. The intention is to appropriate the object, holding it, turn from all his party know it and recognize it, whatever the causes were notables of joy.

      The presentation of the different forms of manipulating differ between them. Have been described more than 100 forms in the first year of the child. The most frequent at the beginning are: support-look, knock the object against something, tighten and then leave in a repetitive way, pass an object from hand to hand, drop-back, turn and move with one hand , touch-feel.

From the seventh or eighth month until the end of the year, the child is interested only in an object that has a hand in, but to play him away and rub against the floor, or pass it from hand to hand and pursues him with his eyes. It 'a first step in risk to leave it and then retrieve it later. Shortly after leaving resume and become deliberate repeated every time a game more often. He is interested in, then two objects simultaneously, causing them to enter into a relationship, banging against each other, both supported in each hand, or throws an object that supports a hand, with another that is farther away. Puts an object in the other, and experience as shake, turn it, turn it over and repeating again and again these actions. There are countless variations of this game.

      The mime and gestural expressiveness realizes perceptions, images and sequences of thought, appeared by the infinite variety and subtlety of the game manual included and available in his psyche. The visual exploration and manipulation, while soil testing and how to express the emotional experience of the child, are sources of a mutual feedback process during which complex systems of representation and semiotisation.

      In the same way that an adult in the child, the retraction of the language is an important and significant sign of suffering in the face of a loss or a severe separation, particularly the amount and quality of the game manual is greatly reduced when the child needs to support life changes that disorganize him. In this sense the manual tasks are more sensitive to postural activities. The most fragile are naturally forms most recently acquired, except to leave and take that instead of diminishing in these cases show a significant growth of up to stereo.

FIRST toys

      What types of items affecting more children at this early stage?:

      The first is undoubtedly the face, hands, body and clothes of the significant people who try to take the child, clinging and explore. And 'the attitude of the adult, enjoyment or the laughter, the challenge that makes this activity "in play". What is more important then the child's hand. Precisely for this reason it is convenient that it can investigate it with comfort from a posture that ensures the total sense of balance (4).

      After two or three months of age, are recommended all those objects that can be taken easily: a cotton handkerchief, then rings or other small items of fabric, soft, light and with which there is no risk of harming yourself.

      In summary, the game at this stage is to explore, experiment and repeat business of motor, which initially have a fine adaptation, but that pass to become an activity that goes on the purpose of the pure joy of discovery, the exercise functional and serve to consolidate everything learned. Many activities sensorimotor become this way in the game: multiple shifts, rolls, turns, rocking, stretching, climbing, balance and imbalance self-promoted, so it takes a broad and secure space.

      When the child begins to wander in all possible ways (rolling, crawling, or standing in knee) he likes to reach, rub with your fingertips, drag, push toys, throw away, collect, etc..

      The symbolism in children's thinking is still absent, though it is present in the bud through primerissime imitations of actions, ecoprassie and echolalia (5). Experiencing the physical properties of objects, relate them to each other, and then fill empty containers, disperse and then collect, enter and pull out of objects inside other objects, are all essential activities from the point of view of the constitution of the self, of 'organization of motor coordination, notions of space and time, the body schema, emotional relationships and the integration of social rules.

From two to six years.

      This is a long period of multiple and heterogeneous psychic transformations during which the child adds to the exploration and testing each time more varied and complex of the surrounding world, the use of an incipient and then abundant symbolism. The beginnings of the games can be found in the early game to appear and disappear: "Where? ... Is here!", In ecoprassie, and then in ecomimie imitation. Later the child plays snippets of scenes from real life, modifying them along to their needs.

     The symbols acquire their meaning in an object of metamorphosis and in response through the recognition of certain attributes of the objects of reality, as defined by its parameters and its shift to other objects: the feature is "acting as if ... "a small piece of wood becomes a spoon against a flying object that" pretends to be a plate ", a cardboard box becomes a truck, a circle becomes the wheel of a car, a stick is a horse, a container is a pot, a boat, a bed, etc.. The child recreates the objects, plays the roles of individuals and social activities that they develop, the father, mother, teacher, doctor and all that enables him to understand and process the imaginary conflict.

     In this second level of reality in the game he submits to his desires and needs. The games become more complex and body are improved: balance and imbalance, climbing, jumping, falling, strokes, combined with a character, a mimicry, their symbolic of the game, his narrative, pointing to the affirmation of self and its differentiation on the other.

     They are typical of this stage:

    * The games of destruction, construction and reconstruction of the other related to the symbolic relationship with adults and peers,
    * The play of presence and absence (appearing-disappearing, hiding), linked to the establishment of permanent self, other and object,
    * The games of persecution (catch and be caught, eat and be eaten, the wolf, the crocodile), linked to primitive anxieties and fantasies,
    * The games of omnipotence and identification with the ego ideal,
    * The play of identification with the aggressor and changes in roles.

     The construction of houses and shelters as an extension and projection of self-image, sexual identity and the integration of social roles often present with different characteristics in males and females:

    * In females usually prevail, but not necessarily so exclusive, games centripetal approximation to the body, gestural fallback, the hugs, body envelope, games body care and repair, coordination and manual dexterity, games with dolls and elaborate disguises.
    * In males usually prevail games expansion, competition motor, power and strength, acrobatics, speed, aggression de fusili, swords, opening and extension of the body, the disguises are generally less developed and only need an element that represents symbolically attributes.

     In symbolic play, just as in structures: towers, anchors, puzzles, cut, paint, glue, children's songs, stories and fables, becomes of paramount importance. (?). They are essential precursors of a thought more elaborate, with power handling and operation symbols, required for the learning of language, reading, writing, mathematics, urban signage, as well as for the understanding and integration of values , rules and laws of society and its symbolic expression.

From 6 years to puberty.

      The evolution of the game, the interests and social experience, in addition to the expansion of games of exploration, research and production of objects, introduces the dominance in this new stage of the game rules. We must emphasize that the characteristics of exploration and pleasure sensorimotor, imitation, symbolism or social roles that emerge in subsequent stages, the first months of life, to integrate new games, perfected or restructure, but do not disappear. Indeed, even in games of adults can observe the presence of peculiar features of a previous game-playing. The third level of play, which is organized after the 6, 7 or 8 years, is regulated by fun activities that require greater structuring of the ego, less current decentralization emotional or affective unconscious projections ie: ability to put in place the other, for the integration of law and for the understanding of rules developed each time more and more symbolically effective socialization.

      The physiological maturity and mental capacity of attention in this age allows just be careful, fully understand and integrate deliveries not come only for his own reasons, that does not arise from their own initiative and therefore can actively adapt to other proposals of equal or adults. So it is from this age, some children may supplement the law and thus, produce and accept the rules that all players must follow. This returns the necessary communication, cooperation, tolerance to frustration, the ability to wait, because without the work and the understanding of all the pedals. This helps to coordinate the different points of view, very important for social development and overcoming self.

      This does not mean they can not, at times, surrender, adapt passively to obey without understanding, everything in order to feel accepted by the other, than to imagine the emotion that shares inclusive of other's enjoyment, but if you do not have the maturity to attention focused on the possibility of supporting a time putting in place of the other, it becomes virtually impossible to imagine what the other has in mind, that what is proposed in playing or learning. This clearly has to do with the decentralization process of which they speak both Piaget and other researchers present.

      These games like hide, la mancha, its variants, games and games of skill ingenio global motor regulated in a complex way as running, climbing, jumping, manipulation, memory and strategy of the figures, balls, games, construction, Meccano, a table, competitions, ludo, goose, cards, chess, etc.., require, and also reinforce the psychological maturity, emotional, cognitive and social.

TIPS ON GAMES AND APPROPRIATE FOR ALL AGE Toys'

      Children can play many things without toys but require space and generally objects, especially when young. Within the game, toys play a supporting role, particularly those that allow the variability and multiplicity of meanings. Some reproduce reality in a very precise way. These are not shown.

      The toys are also already constructed objects with a symbolic value for use in the game but made specifically for that use, and in general with specific functions already integrated in the design.

      Children need simple materials to play with them will always have the opportunity to explore and do something in every stage of their development. They do not need expensive toys but they are safe and that its use involves no risk or precautions that will not be ready for the child, must be managed in an autonomous and non-toxic.

      In certain age water, sand, boxes, containers, leaves, objects of different colors, balls of fabric, are more suitable to buy toys too attractive. The important thing is creativity, change, transformation, construction, construction that provides the child with objects.

      The toys too sophisticated, requiring simple and repetitive movements (after a pulse, the rest is all over the toy and not the child) are those that contribute less to the development, due to his creative work with this type of objects is very small. If we put in the hands of a small child in a car remote control, almost all its activity is reduced to pushing a button and follow him, because he can not control the movement of the machine in that space, this is very little in the new possibilities that have some pieces of wood with which the child "factory" a car, a garage, a track that organizes his desire and that can represent many different classes of machines and much more. "The essential thing is that the child plays with toys and not toys with the child" (Tardos, A.).

      And 'then give the child involved material that allows him to experiment, to recreate in his will and when he wants, by itself produce some symbolic activities that enrich its action.

      In a safe environment on their own children take their own decisions. They learn best from their own initiatives, concerns and questions that lead them to seek their own paths, to find solutions for themselves and prosecute their obstacles or mistakes.

      Children also need to play alone. The game with adults is an important form of communication but the alternation with the play only, allows the child to give free run to his own imagination without relying on gaze, expectations and / or opinions of adults.

CHILDREN AND TELEVISION

      Although the TV keeps the children, you must remember that the choice of programs is the responsibility of adults. In early age, up to 2 or 3 years, the television image is fascinating (and in the worst sense), imprisons the subject without a choice, to separate from the stimulus and unable to think. Television is particularly insufficient in those age groups: subjects the child, whose key requirement is movement, action and report to a situation of massive liabilities and reception of stimuli, without being able to analyze, understand, compare, or use those images in a creative way. Many products of children's television, only stimulate the adhesion indiscriminate emotional, excitement or fear and panic for the child meaningful image.

      In this sense it is convenient to think about television programs, models and social values that are transmitted and evaluated, sometimes subliminally and influence which it exercises that audio-visual medium in the complete education of the child.

      The television can be used well, of course, school-age, an interesting tool of information, access to knowledge, learning and identification.

   1. See the International Declaration of the Rights of the Child.
   2. D. Winnicott, Realidad y Juego. Buenos Aires, Gedisa, 1972.
   3. This paragraph is taken verbatim from the Doctoral Thesis in Speech Therapy by Dr. Myrtha Chokler, supported nell'Universidad the Argentine Social Museum in 1999 and whose title is Subjectivity and Communication.
   4. Comfortable posture, lying on the mouth, without clothes or objects that impede his movements or distracting him.
   5. The ecoprassie are imitations of facial expressions or gestures that young children do by observation or incitement of adults (How does the bunny? As the baby cries? How does farewell with his hand?), So the imitations sounds onomatopietici constitute the echolalia of this period.
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Child treatment without fiat both parents may

2012-03-06T23:15:00.000-08:00

Publication Nr. 24 to 8 June 2011
Year 2011
New Reflex Category
Author KNMG, Simone Paauw

The importance of the minor child is always paramount, even if a doctor for treatment is not required dual consent of both parents of the child.

image: Stock image Think: Think Stock

This has the Central Disciplinary Tribunal ruled in two cases that occurred on May 24. Both complaints were unfounded. The disciplinary tribunal under this breaks the KNMG with previous rulings. If a parent accompanies the child and there is no question of a substantial, unnecessary or unusual treatment, the doctor there, what the disciplinary tribunal concerned, in principle, assume that there is consent from both parents.

The required permission has double what the disciplinary tribunal are two exceptions. The first exception is to prevent serious harm to the child. In one of the cases involved a 13-year-old boy with divorced parents, whose mother wanted him to be vaccinated, while the father, the complainant, was against it. It would not be vaccinated for the boy may cause serious harm if he would have become infected.

The second exception concerns the desire of the minor patient. The 13-year-old boy himself during interviews and in a written statement to the doctor indicated to be vaccinated, even though he knew that his father was against it.

In the other case was also divorced parents. The father, the complainant, his son without the consent of the parent registered with another GP. He also had the old doctor specifically asked his son not to treat. The mother visited it three times and the old doctor also gave no permission for the child to be treated by the new GP. Also in this case the Central Disciplinary Tribunal ruled that the father the importance of the child did not prevail.

The disciplinary committee also maintains that authoritative parents have to turn to the (child) court if it fails to work the choice of a doctor to come in who both have confidence.

The statements for the practice of health care is very important, reports the KNMG on its website. The organization believes that the disciplinary tribunal practice a useful handle empowering and that the care is more workable for doctors.

Simone Paauw

Hormones in baby fingernails to show stress in the womb

2012-03-05T22:49:00.000-08:00

When mothers were exposed to severe stress during pregnancy, this can be detected by fetal stress hormones in the fingernails of infants. This is a study that researchers at the University of Basel with colleagues from France in the journal "Biological Psychology" have published.

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May affect that stress during pregnancy, fetal development is well known. But how maternal stress affects really affect the fetal stress response? Blood tests on unborn children or amniocentesis, which can answer these questions require an invasive procedure and are therefore difficult to perform.

A research group led by Dr. Gunther and Dr. Marion Meinlschmidt Tegethoff at the Department of Psychology at the University of Basel has now developed a method such as the fetal stress physiology can be detected without pinholes.

Together with colleagues at the University of Strasbourg, the researchers, the concentration of stress hormones in babies' fingernails are measured. The fingernails begin in the 8th To grow week of pregnancy, and previous studies indicate that stress hormones can accumulate in such a horny substances.

The researchers found that the fingernails of infants whose mothers during pregnancy, high levels of stress were exposed to a higher concentration of the major fetal stress hormone dehydroepiandrosterone (DHEA) than the fingernails of infants ungestresster mothers.

It is still unclear whether the stress-related increased DHEA levels adversely affect the short or long term health of the children involved. Another possibility would be that it protects the fetus from the negative consequences of stress. The findings help, the researchers, in order to deepen the knowledge of the phenomenon of stress during pregnancy and the resulting fetal stress processes, and give clues for further research. Above all, these findings show for the first time out that is the analysis of fetal stress hormones in the finger nail, a new, noninvasive method for detecting retrospectively physiological stress processes in the fetus objectively.

Original Post
Tegethoff Marion, Jean-Sébastien Raul, Carole Jamey, Mehdi Ben Khelil, Bertrand Ludes, and Gunther Meinlschmidt
Dehydroepiandrosterone in the nails of infants: A potential biomarker of maternal responses to intrauterine stress
Biological Psychology Article in Press | doi: 10.1016/j.biopsycho.2011.05.007

For more information

• Dr. Marion Tegethoff, University of Basel, Faculty of Psychology, Department of Clinical Psychology and Psychiatry, Tel: +41 (0) 61 267 02 61, E-mail: @ unibas.ch marion.tegethoff

• Dr. Gunther Meinlschmidt, University of Basel, Faculty of Psychology, Department of Clinical Psychology and Epidemiology, Tel: +41 (0) 61 267 02 75, E-mail: @ unibas.ch gunther.meinlschmidt

Reto Caluori | Source: EurekAlert
For more information: www.unibas.ch
www.sciencedirect.com/science/article/pii/S0301051111001426

Names make people

2012-03-04T21:57:00.000-08:00

Wednesday, 08.25.2010, 06:18 · FOCUS-Online-author Ruth Wallner

colourbox because of smoke and mirrors: the names affect personality
Kevin and Max, Marie Chantal, or - the name says a lot about its wearer. He is not emotional stress, parents should consider the good choice.
Everyone has one, some two and some even have very many, as the German Defence Minister Karl-Theodor Maria Nikolaus Johann Jacob Philipp Franz Joseph Sylvester. Others have unusual: Lola, Rocco and Ava - that have Liefers Jan Josef, Heino Ferch and Oliver goats ever called one of her children. Whether out of even a courtesan Lola, is a diva from Ava and Rocco from a Latin lover, is pure speculation - or not, if you believe the name researchers like Joachim Schaffer Suchomel.

You are what your name is
Schaffer Suchomel is convinced that name affect our personality. His theory: The name says - the names have a character and say something about the life of the wearer. Studies by U.S. scientists who deal with "implicit egotism" support his assumption. Simply put, it involves giving that we are and everything that has to do with us are good.

Sounds logical, but has surprising consequences: The scientists' findings suggest that there is probably no coincidence that when a woman named Louise relatively common in Louisiana settle and draw men named Philip to Philadelphia. And not only that, statistically more likely to be decided by a Marsha for a Mars bar than a Snickers bar, Corinna more for a Coke, Pepsi, however, Peter. Psychologists and marketing experts call this phenomenon as "Name Letter Branding ': Similar to a brand name to our name, we resort to very much.
...
Psychology: names make people - read on to FOCUS Online: http://www.focus.de/gesundheit/baby/tid-18563/psychologie-namen-machen-leute_aid_517473.html

Abdominal hernia in children

2012-03-03T21:54:00.000-08:00

Priv.-Doz. Dr. Hans Albert Beiler 76275 Ettlingen
Specialist pediatric surgery for technical articles index
Priv.-Doz. Dr. Hans Albert Beiler [This member is a doctor]

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Abdominal hernias, hernias also called, are innate in children in general and with the abdominal wall fractures in adults usually not comparable. The mechanism is different and has nothing to do with childhood or with an overload of the muscle connective tissue. So be different treatment and prognosis of abdominal hernias in childhood differ significantly from the approach adulthood. Mesh implants made of artificial materials are used in children only when extensive abdominal wall fractures (eg gastroschisis and omphalocele) or congenital diaphragmatic hernia, if it can not be covered with autologous material. Artificial networks grow and not be reluctant implanted foreign material to remain for decades in the body of the child.

As a frequent cause of abdominal hernias in childhood is usually a lack of closure of abdominal wall during pregnancy necessary gaps, such as the navel of physiological or projections of the peritoneum, such as the testicular capsule in boys. Boys are therefore also affected more frequently than girls. In preterm births abdominal hernias also occur more frequently than children born at term. Most abdominal hernias in children initially do not cause acute symptoms. Often, the parents have only a visible bulge in the abdominal wall, the navel or groin area without the child be in pain. The umbilical hernias are generally harmless. Not so the hernia, which can be trapped. The epigastric hernia make more diffuse complaints. Special shapes such as diaphragmatic hernia, gastroschisis Omphalocelen and are usually detected before birth by ultrasound and supplies immediately after birth.

The typical fracture types are:
Hernias
Umbilical hernia
Epigastric hernia

Rare fracture types are:
Diaphragmatic hernia
Omphalocelen
Gastroschisis

The congenital childhood hernias, the processus vaginalis peritonei, a protrusion of the peritoneum into the inguinal canal has not closed spontaneously. As the boys of the testicle through the inguinal canal walk and part of the peritoneum as the shell does with it, boys are affected more frequently than girls, in which only the master tape, a thin connective tissue located in the inguinal canal. The fracture origin has nothing to do with stress. However, hernias get in first with infection with severe cough. Hazard exists only if a hernia clamps. This pushes a piece of intestine into the breach and jammed in the narrow inguinal canal. There is acute pain and there is the risk that the jammed intestine is not properly supplied with blood and dies. Why should children's hernias are surgically repaired promptly after their discovery.

Umbilical hernias are congenital abdominal wall openings through which nourishes the baby during its development in the womb through the umbilical cord vessels and is supplied with oxygen. In general, these abdominal hernias close shortly after birth and the umbilical cord falls off. In some children, this process takes longer. Since umbilical hernias do not squeeze, until the end of the second year of life may be delayed. Has the umbilical hernia is not closed by this time, a spontaneous closure is no longer expected.

Epigastric hernias may already be present at birth or occur during the course of life. There are small openings in the abdominal wall fascia between the rectus abdominis muscles. They are found between the navel and the lower end of the sternum. They can cause diffuse abdominal pain, as bulges through the small abdominal hernias präperitoneales fat.

When the diaphragm breaks there is a gap in the diaphragm muscle that separates the abdominal cavity from the chest cavity. For large abdominal wall fractures, the displaced and the lungs breathing in the newborn disabled.

Omphalocelen are very large abdominal hernias in the navel area with additional prolapse of organs, often the liver in the sac. This is usually the abdominal cavity itself is too small and there are often accompanying malformations.

In gastroschisis, the abdominal wall of the womb has not closed and the intestines are exposed at birth. These children are the ultrasound examinations during pregnancy, usually before birth and known to undergo surgical treatment in specialized clinics, emergency room immediately after birth.

First Treat hernia

A child's hernia is always an indication for surgery dar. A spontaneous recovery is unlikely. Usually, the child's hernias are closed through a small incision in the groin. Abdominal hernias, the operation is in otherwise healthy children aged 6 months-patient basis. Mesh implants as an adult are not required. Recurrences are extremely rare. In addition to the proven standard method, there are some centers that provide the child's hernias and laparoscopy. Which method is suitable for your child, you should discuss with the surgeon the best of your trust.

Second Treatment of umbilical hernia

In principle, the first two years of life are awaited. In approximately 80% of children closes spontaneously during this period of mostly small abdominal hernia. The surgery is recommended for lasting umbilical hernia in girls, as the hernia may later cause problems in pregnancy. In boys, it is more of cosmetic reasons. The surgery is performed through a small semicircular incision in the lower margin of the umbilicus, which is barely visible later. Again, the procedure on an outpatient basis, unless there are serious underlying diseases of the heart and lungs.

Third Epigastric hernia treatment of

In the epigastric hernia can wait until symptoms occur. A spontaneous closure is unlikely, however. The surgery is performed through a small incision. The gap in the muscular layer is exposed, and closed the abdominal wall rupture with a double row of sutures. The surgery is an outpatient setting.

4th Treatment of diaphragmatic hernia, omphalocele and gastroschisis

The supply of abdominal hernias in specialty hospitals performed immediately after birth. The children are usually after a long period in hospital. The prognosis depends largely on the particular malformations. These large abdominal hernias in childhood are at with modern surgical techniques and intensive care follow-up usually well controlled.

Overall, the treatment of abdominal hernias in a large percentage of all operations in childhood. Through the careful and tissue-sparing surgical techniques and modern methods of anesthesia, most interventions in the meantime be done as an outpatient. Children can recover after the surgery in their familiar surroundings much faster and less stressful. The post-operative risks are generally low and well controlled. Most are simply a short-term pain for 2-3 days. Which surgical techniques of abdominal wall openings for your child to come into question whether the interference can be inpatient or outpatient, will give a detailed history and examination of your child in a pediatric surgical specialists.

Author:
Priv.-Doz. Dr. Hans Albert Beiler
Specialist in Pediatric Surgery
On Lindscharren 4-6 76275 Ettlingen

Hernia

2012-03-02T21:49:00.000-08:00

Hernia, and other hernias - As the hernia is referred to as Skrotalhernie, we go first to the term "hernia" field. A hernia is colloquially referred to as "broken". Meant by the prolapse of the peritoneum through a hole in the abdominal wall (outer fraction) or in the diaphragm (the inner break). The peritoneum is the hernia sac and can parts of the intestine or the large network that covers the intestine outside, contain, or be filled with liquid. Rarely the bowel is trapped in a pocket within the peritoneum of the abdominal cavity. About four percent of the population suffer in their lives to a hernia. Fractures are also among the most common diseases in surgery, hernia operations are in accordance with the most common surgical procedures. They occur mainly in children and between 40 and 50 years of age. Almost exclusively boys and men are affected.

What hernias be distinguished?
After the place where they appear, we distinguish several hernias:

    Hernia:
    He holds a stake of 70 percent in men and 60 percent for women the most common type of hernia.

    Hernia (Skrotalhernie):
    The hernia sac travels along the spermatic cord and may continue to go down into the scrotum. The testicle will then greatly enlarged, possibly intestinal parts in it are palpable.

    Umbilical hernia:
    Congenital hernias result from weaknesses in the abdominal wall at the navel. They are the second most common type of hernia, affecting mainly infants and very obese people.

    Diaphragmatic hernia:
    The hernial sac is pushed through a hole in the diaphragm into the chest between the ribs and pleura.

    Femoral hernia:
    Occurs mainly in women. Hernial opening leg of the channel is between the inguinal ligament and pelvic bones.
    Less common forms are broken pelvis and lumbar hernia Epigastric hernia called.

Various methods of treatment of hernias

2012-03-01T21:46:00.000-08:00

As mentioned above, are prone to self-healing umbilical hernias, regardless of their Größe.Es is recommended that a number of activities on the conservative character of the existing pathology-mail address. With the proper treatment of a hernia may already have arranged to six months. What are some methods of conservative treatment of umbilical hernia?

The most effective measure for prevention of umbilical hernia, and the treatment of an already existing state sets some baby in her belly.

It is recommended to spread child 10-15 minutes before feeding 2-3 times a day on a flat hard Oberfläche.Dies a changing table or a table can be covered with a diaper. Necessarily in the vicinity of the child, do not leave it for a second, even if your baby does not roll into the situation.

During a reupload would be useful to have a gentle massage of the back, legs and behavior takes care of your crumbs, just stroking the tips of the fingers upward from the buttocks to the shoulders.

The second method of conservative treatment of umbilical hernia as well as the prevention of this condition is to massage the abdomen. Massage in the outpatient appointment by the observation of the pediatrician is usually performed after the child reaches two Monate.Allerdings you immediately after the massage, healing the navel befragen.Die smallest crumbs enough to just three or four mild stroke in the stomach clockwise, starting from the right iliac region on the left side, on the right lower quadrant on the lower left Bereich.Streichmassage relaxes the muscles and therefore the motion should be very soft and comfortable for the child. This reception is volar surface of the brush instead.

Massage older children can use the method of "I Love U" performed werden.Diese massage helps with flatulence (bloating belly), with colic and with an umbilical hernia. Also present on the surface of your child's belly inverted U, and just looks Darm.Setzen on your hands to massage a little oil and knead your belly baby lying down with your fingers in a circular motion. First, go the left side of the belly child the letter "I" write (for you, it would be right). This movement, which you move the gas, forcing them out of the descending part of the Dickdarms.Dann draw an inverted "L" promoting peristalsis and gas over the cross section of the colon, then back down into the descending part of the colon (upper abdomen) and then - again on the left side of the abdomen of Kindes.Dann plot the inverted "U" went to the increasing proportion of large intestine, then the cross and so on up to a top-down, that is, right from bottom to top, then the upper abdomen, and then - on the left side of the abdomen baby.

Particular attention should be paid umbilical region, since they constituted the weakness of the recti enlarged umbilical ring and hence umbilical hernia is. Rectus abdominis muscle on the right and left of the navel and cover almost the entire front you Bauchwand.Legen the thumb and index finger on the right and left side of the navel of the child at a distance of about 1-2 cm from the center of the navel and fine point movements made ten clicks. The same key steps above and below the navel. The movements must be gentle and not deliver the child at the same distance from Unbehagen.Dann navel index and middle fingers held ten circular motion clockwise. And in the end push the hernia sac protruding slightly into the stomach. The intensity of this process should be comfortable for your massage Baby.Tagsüber the navel desirable to have two or three. Duration is not longer than 5 minutes, and preferably keep them up to their child ernähren.Manche babies prefer to have massaged his belly to swim, others prefer to receive procedures after a bath. This question is solved each time mentioned individually depending on the condition of the above Kindes.Wie are children with omphalocele sensitive to changes in weather, and if the child is naughty, then a massage is better to postpone until an opportune time.

The third method of conservative treatment is the introduction of Gipsverband.Die establishment of such association as a method of treatment of umbilical hernia is just a pediatrician or a surgeon is recommended. There are several ways of applying the patch. The patches for the treatment of umbilical hernia produce different companies (Chicco, Hartmann); such patches in pharmacies and baby stores sold. Emplastic medical bandage for 10 days, a broad band (preferably 4 cm), one of the lumbar region to another, that is, a bandage will be introduced to reduce the abdominal hernia werden.Gleichzeitig edge of a finger, and the rectus abdominis muscle of the umbilical ring are connected by two longitudinal folds. With proper application of those wrinkles under the plaster should be left (not punish) sein.Wenn after removing the bandages revealed that the umbilical ring is not closed and remains a hernia, the association may be imposed for a further 10 days. The implementation of the course three times dressing (3 times for 10 days) is enough to heilen.Diese modern version of the patch application pediatricians are rarely used, because the adhesive can irritate the delicate skin of the child.

There is also a method of applying plaster directly bathed in the navel in a few weeks without Faltenbildung.Das patch needs to be changed every two to three days, and the baby every day, without the association. This method is easy, and the parents themselves can change the patch without the help of a Arztes.Bei the application of this method is recommended, hypoallergenic adhesive "Cosmopor E" 5? 7.5 cm Hartmann, who has to shoot it while swimming verwenden.Wenn to a question on the application emplastic dressings as a treatment for an umbilical hernia, the tactics and methods determined by the association, a doctor, when viewed from a child with an umbilical hernia. Children were asked on the pavement, we recommend gentle massage abdomen as described above, and some sit on the Bauch.Der whole complex of conservative measures (mean sit on the abdomen, abdominal massage, application of plaster) should be performed only , after complete healing of the wound umbilical cord and in the absence of skin lesions, including inflammatory and allergic reactions in the navel.

If the entire spectrum of activities of the conservative treatment was ineffective and a hernia in a child remains at 1 year, then surgery is performed to correct a cosmetic error. This problem is solved together a pediatrician and a surgeon who observed the child

Hernia in babies recognize

2012-02-29T21:44:00.000-08:00

Hernia in babies recognize

Normally, it closes the inguinal canal of a fetus until the eighth month of pregnancy. Failing this, it is called a hernia or a hernia. How parents can see this in infants, a pediatrician explained in this article.
Dr. Ulrich Fegeler

A soft bulge in the groin area indicated, even if it is not always visible, indicative of a hernia or a so-called hernia. "Normally, the inguinal canal closes before birth. But in some children remains open a small gap may protrude through the colon, or liquid. Often shows the bulge only when the baby cries or makes an effort and disappears when lying relaxed, "explains Dr. Ulrich Fegeler, children and youth as well as federal medical spokesman for the Professional Association of Child and Adolescent Physicians (BVKJ). Boys are from a hernia in childhood affects approximately four to eight times more frequently than girls. An increased risk of inguinal hernias have babies with low birth weight or premature babies, babies with urological problems, such as a non-down gewanderter testicles, or children with relatives who also had a hernia as a baby.

A hernia is usually not painful, but they should be provided - usually surgery - before complications occur. "In the sac of inguinal hernias in young girls very often an ovary is present. Here, the surgical indication be more liberally, "recommends Dr. Fegeler. "The danger is then put hernias when the hernial orifice is narrow and pre-lesional gut stuck and will not bleed through. This can die intestinal and testicular tissues. In girls, the ovaries may also be deprived of its blood supply. These situations require immediate treatment or surgery then, "warns Dr. Fegeler. In the first six months of life, the risk of entrapment at a fraction is especially large.

Diaphragmatic hernia (hernia or diaphragmatic CDH - Congenital diaphragmatic hernia)

2012-02-28T21:43:00.000-08:00

The Perinatal Center of the Danube Hospital specializes in this malformation. Congenital defects of the diaphragm are referred to as so-called diaphragmatic hernia. They are located at "weak points" of the diaphragm, namely in lumbocostalen and sternocostalen area.
A distinction is thus the following two types of hernias:
Types of congenital diaphragmatic hernia seen from the abdomen of
Types of congenital diaphragmatic hernia seen from the abdominal cavity. The blue box corresponds to the point of penetration of the vena cava, the yellow box of the esophagus and the red of the aorta.

    The sternocostale hernia (Morgagni hernia so-called):
    It is usually small and located just next to the sternum on the front wall of the chest. They can extend through portions of the liver (hump) in the chest. Often the hernia is asymptomatic and is diagnosed as an incidental finding. The surgical correction consists of a diaphragm seal the gap medium seam. The "liver hump" is shifted into the abdominal cavity and diminishes over time.

    The lumbocostale hernia (CDH):
    It is of various sizes and can be found on the exterior rear wall of the chest. The typical form is in the form of a gap, so that organs in the abdominal cavity slide (stomach, spleen, small intestine and colon, left. Portion of the liver) in the chest, hampering growth as the lungs. The mediastinum (mediastinal) is re-click the. Side down. The gap is greater than that of the sternocostalen hernia.

The big problem of the typical diaphragmatic hernia is that the lungs do not develop sufficiently. I.e. the bronchial tree is small, the number of alveoli is lower, the number of pulmonary arteries is low, the vessels are thick-walled (muscles) and an increased sensitivity with spasms (vascular spasms). The underdeveloped lungs can flow through the blood decreased only have problems with the blood of enough oxygen to accumulate and thus supply the body after birth is sufficient. Critical are the "big" hernias, where portions of the liver are present in the chest.

In any case, a baby with a diaphragmatic hernia in a neonatal unit (obstetrics, neonatology, pediatric intensive care medicine, Child and Adolescent Surgery) brought to the world. It may be necessary for the child to be artificially ventilated immediately after birth. The ventilation strategies, which should include helping the small lungs, for example, the high-frequency ventilation (special ventilator) and the NO - admixture to reduce pulmonary vascular resistance. In rare and severe cases, we perform in a so-called Danube Hospital ECMO (extracorporeal membrane oxygenation) by complementary therapy. Here are the lungs and heart of a "machine" for some time taken (to about 1 week). Once the child is medically stabilized after delivery (24 - 48h, drop in blood pressure in the pulmonary circulation; suspend the persistent fetal circulation "PFC") has carried out the pediatric surgical closure of the diaphragmatic defect. This must be done at times as so-called diaphragm plastic with an artificial material (patch).
Temporary (1 week) ECMO therapy
Temporary (1 week) ECMO therapy (OA Dr. Ch disc plow; christian.scheibenpflug @ wienkav.at) with a baby in the Danube Hospital, taking support of the circulation and lung function of a "machine" incorporated. The "small lung" can grow and heal. Even at this highest level of intensive care, parents should as often as possible have the opportunity to be with her child!

An alternative to surgical treatment of the child after birth, treatment in the womb before birth. Here, between the 24th and 26 Weeks of gestation, the trachea of ??a child (this is not required) endoscopically over a period of 2 weeks sealed with a balloon. In the airways, rises through the secretion of the pressure in the lung fluid at 2 mm Hg. This minimal increase in pressure is sufficient that the lungs increase in size and the institutions that have happened in the chest a little push back into the abdominal cavity. This therapy should be discussed, especially in those cases that have a poor prognosis (left portion of the liver also in the chest; unfavorable head: lungs - ratio (Lung Head Ratio) at 1 - from 1.4 significantly better opportunities; polyhydramnios - ie much too much amniotic fluid). In the Danube Hospital is jan.deprest for these complicated cases, an international collaboration with Prof. Dr. Jan Deprest (gynecology and obstetrics / fetal surgery TO Gasthuisberg Herestraat 49 B-3000 Leuven zu.kuleuven.ac.be @, or eurofoetus@eurofoetus.org )

Basic procedure in prenatally diagnosed
Diaphragmatic hernia:

    Confirmation from several ultrasound examinations
    Contact with a perinatal center
    Supplement the diagnosis by magnetic resonance imaging (MRI)
    Determining the size of the defect, the lungs and the exclusion of additional malformations.
    Meeting with the gynecologist and the pediatric surgeon and determine further procedure. You may consider an intrauterine Trachealokklusion (Balloon closure for 14 days).
    Delivery of an experienced perinatal (stage IV) in the presence of neonatologists and pediatric surgeons.

Hernia (inguinal hernia) at Baby & Child

2012-02-27T11:04:00.000-08:00

Hernia (inguinal hernia) at Baby & Child
Dr. Toepfer Carolina, Specialist in Pediatrics
description

When a hernia in the groin area caused gaps in skin or muscle tissue, which are normally closed. Through these gaps, parts of intestines - for example, intestines, rarely, other abdominal organs - pass. In general, these gaps are present at birth.

Hernias occur when the peritoneum of the fetus during pregnancy in the inguinal canal closes properly. During the fetal development of the inguinal canal is lined by the peritoneum, the forms back to the birth and access all locks.

The hernia is for baby and toddlers a very common disorder. He often shows itself in the first year of life. It occurs in boys four to five times more often than girls. The hernia occurs most often on the right side.