Many problems in babies are associated with their immaturity and adjustment to a new environment. Premature babies are at particular risk of life-threatening conditions, but medical advances have greatly increased the number of babies that survive.
The first article in this section covers problems experienced by premature babies, those born more than 3 weeks before their expected birth date, who may have special problems as a result of their immaturity. The next article discusses congenital infections, which are transmitted from the mother to the fetus either during pregnancy or at birth as the baby passes through the birth canal. Although these infections are rare, they may have serious effects. Neonatal jaundice, which is discussed next, occurs in many newborn babies. In most cases, the jaundice is normal, but rarely there is a serious cause, such as the underdevelopment of the bile ducts in the baby’s liver. Problems experienced with sleeping, feeding, crying, colic, and teething are also covered. These minor problems can be stressful for parents but rarely require medical treatment. The section ends with an article on sudden infant death syndrome (SIDS), also known as cot death, and advice on how to reduce the risk of it occurring. The cause of SIDS is not known, but its incidence has decreased since parents were advised to position babies on their backs to sleep. Other conditions that affect babies from birth are discussed in chromosome and gene disorders and endocrine and metabolic disorders.
The 46 chromosomes (22 pairs plus two sex chromosomes) in human body cells contain about 20,000 to 25,000 pairs of genes, and several thousand disorders are directly the result of a defect in a gene or a chromosomal abnormality. Such genetic defects or chromosomal abnormalities vary enormously in their effects, from unnoticeably minor to severe physical and/or mental problems.
This section covers a few examples of chromosome and gene disorders that affect many body systems and become apparent during childhood. Some of these conditions are caused by an extra or absent chromosome or an abnormality in a chromosome. For example, Down’s syndrome is due to an extra chromosome, and Turner’s syndrome is due to an absent chromosome. Other conditions in this section are caused by defective genes. These include cystic fibrosis, muscular dystrophy, and neurofibromatosis.
Genetic disorders that mainly affect one part of the body are covered in the relevant sections of the guide. The principles of chromosome and gene disorders, including how and why they occur and patterns of inheritance, are discussed elsewhere (see Genetic disorders).
For information on the structure and function of chromosomes and genes, see Genes and Inheritance.
Young skin is sensitive and particularly susceptible to irritation or allergies. Most skin disorders in children are minor, affect only a small area of skin, and disappear as the child grows older. Many skin and hair disorders that affect children can be treated successfully at home with over-the-counter preparations.
Skin and hair disorders that mainly or exclusively affect children include a number of rashes and viral infections. The section begins with disorders that may affect young babies: birthmarks, which are present at birth or develop soon afterwards, and two skin rashes, cradle cap and nappy rash. The next article discusses eczema, which is sometimes caused by an allergy and may persist for many years. Viral infections that cause a rash and affect only young children are also covered. The section concludes with an article on infestation with head lice. Children are especially vulnerable to this problem due to close contact with other children at school.
For more information on the structure and function of the skin and hair, see Skin, Hair, and Nails.
In addition to everyday injuries and fractures, most bone, muscle, and joint problems in children fall into two broad categories: problems that are present at birth and those associated with the changes that occur during the growth spurt of puberty. Early treatment of most of these conditions improves the likelihood of recovery and reduces the risk of complications.
This section begins with articles on three conditions that may be present at birth: developmental dysplasia of the hip, clubfoot, and achondroplasia, which is caused by an abnormal gene. These are followed by musculoskeletal conditions that may develop later in childhood and around puberty. These conditions include two that affect the femur (thighbone), Perthes’ disease and slipped femoral epiphysis, as well as Osgood–Schlatter disease, which causes inflammation of the tibia (shinbone). Minor foot and leg problems, such as flat feet and bow legs, which are often part of normal development, are also covered. The final article discusses the joint disorder juvenile chronic arthritis. Musculoskeletal disorders that affect adults in addition to children are included in the main section on the musculoskeletal system.
For more information on the structure and function of the musculoskeletal system, see Musculoskeletal System.
Disorders of the heart and lungs are relatively common in children. The heart is affected by birth defects more than any other organ, and all children have recurrent bacterial and viral infections of the throat and lungs. Usually these infections are mild and play a role in developing a healthy immune system.
The first articles in this section cover disorders of the cardiovascular system, such as congenital heart disease. Many heart abnormalities correct themselves without medical intervention as a child grows. Many of the more serious heart defects can now be treated successfully because of recent advances in surgical techniques. A rarer disorder that can affect the heart in children is Kawasaki disease, which damages the heart and blood vessels. In Henoch–Schönlein purpura, which is due to an abnormal response by the immune system, small blood vessels are damaged. In some cases, Henoch–Schönlein purpura can eventually cause kidney failure.
The final articles address respiratory disorders, of which asthma is the most common, affecting about 1 in 11 of all children in the UK. Respiratory tract infections, such as bronchiolitis and croup, are common in young children. The inflammatory disorder epiglottitis can be dangerous but is now rare in developed countries because of routine immunization of infants against Haemophilus influenzae type B, the bacterium responsible for causing the condition.Haemophilus influenzae type B, the bacterium responsible for causing the condition.
The nervous system consists of the brain, the spinal cord, and the network of nerves that extends throughout the body. Serious disorders of this system are uncommon in children, although disabling conditions may be present from birth due to defects that occur during pregnancy. The nervous system is sometimes affected by minor disorders and, rarely, by infections and cancers.
Damage to the nervous system, either before birth or in early childhood, can result in varying degrees of physical disability. The first articles in this section describe defects that occur during the development of the spinal cord and brain, causing disorders such as spina bifida and cerebral palsy.
Children are commonly affected by minor disorders of the nervous system, such as headache and migraine, which are described next. Migraine may be more difficult to recognize in young children than in adults because the main symptom is often abdominal pain or vomiting rather than headache. Further articles discuss serious disorders of great concern to parents, including meningitis, which is a dangerous infection of the coverings of the brain and spinal cord, and Reye’s syndrome, an inflammation of the brain and liver. The final articles describe tumours of the brain and of the spinal cord, both of which are rare in children.
Epilepsy, which usually develops in childhood, is discussed in general nervous system disorders.
For further information on the structure and function of the nervous system, see Pain Relief Using TENS.
A child’s development is a continuous process, marked by identifiable advances in skills and behaviour. The rate at which an individual develops is influenced by many factors, including the family environment and physical health. In some children, psychological disorders may cause developmental delays.
The first two articles in this section cover sleeping and eating problems, which can be very disruptive to the whole family but which can often be overcome with simple self-help measures. The following article covers childhood obesity, a problem that is becoming increasingly common in developed countries and one that could have long-term health consequences. Soiling (encopresis) is dealt with next, followed by an article that covers the more serious problems that may be caused by autism spectrum disorders, which result in failure to develop normal communication and social skills. Autism, which may be linked to brain abnormalities, is a life long condition, but its effects can usually be reduced by appropriate education and therapy.
The next articles describe disorders that may delay children’s achievement of certain developmental milestones. These range from generalized learning disabilities, which can affect all areas of development, to specific learning disabilities and speech difficulties in an otherwise normal child.
Attention deficit hyperactivity disorder and conduct disorder, covered in the last two articles, are behavioural disorders that tend to have underlying medical, psychiatric, or social causes. Affected children usually respond to skilled guidance and therapy.
Vision and hearing are important to a child’s development because the eyes and ears collect information about the environment and play a key role in the acquisition of speech and language. Eye and ear disorders are often diagnosed during routine examinations in childhood.
The first article covers congenital blindness, in which a child is born with impaired vision. The following articles discuss conditions such as strabismus, in which vision is affected due to misalignment of the gaze of the eyes, and amblyopia, in which a child’s vision fails to develop normally. The remaining articles cover ear disorders that affect children, beginning with congenital deafness. A common cause of earache in children is acute otitis media. Chronic secretory otitis media is covered in the following article. Eye and ear disorders that can affect people of any age are covered in other sections of the guide (see Eyes and vision, and Ears, hearing, and balance).
Throughout early childhood, attacks of diarrhoea and vomiting system are common, and many children have episodes of constipation. Such disorders can often be treated successfully at home with self-help measures. Other rarer disorders may be due to a physical defect present at birth, and these disorders may require surgery.
The first two articles in this section cover problems with the mouth that affect babies: the physical defects of cleft lip and palate, which require surgery, and oral thrush, a common fungal infection. Two other digestive disorders that may affect babies, gastro-oesophageal reflux disease and pyloric stenosis, are covered next. Both can be treated successfully, but pyloric stenosis requires surgery.
A general article follows on vomiting and diarrhoea, including self-help measures for avoiding dehydration. There is also an article on cows’ milk protein allergy. The section ends with articles on intussusception, a rare obstruction of the intestines, and constipation. Digestive disorders that affect adults only or affect adults and children are covered in the section on the digestive system.
For further information on the structure and function of the digestive tract, see Digestive System.
Some endocrine and most metabolic disorders in children are present from birth and are caused by an abnormal gene that is inherited from one or both parents. Most of these disorders are rare, but, when they do occur, they can adversely affect normal growth and development unless diagnosed and treated early.
Most of the disorders discussed in this section are caused by abnormalities in the production of enzymes that are vital for the metabolic (chemical) processes of the body. The first disorder covered is congenital adrenal hyperplasia, in which deficiency of an enzyme affects production of one or more hormones by the adrenal glands. As a result, important metabolic processes are disrupted and excessive production of male sex hormones may affect the formation of a female baby’s genitals. The second article introduces a group of rare inherited metabolic disorders, known as inborn errors of metabolism. The articles that follow cover five of these disorders: phenylketonuria, MCADD, galactosaemia, Tay–Sachs disease, and albinism. The section concludes with a general article on growth disorders. Endocrine and metabolic conditions such as diabetes mellitus that affect adults only or adults in addition to children are discussed in hormones and metabolism or in the section that covers the particular body system affected.
For more information on hormones and metabolism, see Hormones and Metabolism.
The two main causes of reproductive and urinary disorders in children are abnormal development of the affected systems in the fetus and infection. Prompt treatment of urinary tract infections is important because of the risk of kidney damage.
The first articles in this section cover two disorders of the male reproductive and urinary systems, hypospadias and undescended testis, which are present at birth. In hypospadias, the opening of the urethra (the passage that carries urine from the bladder to the outside of the body) is on the underside of the penis rather than the tip. Undescended testis is a condition in which one testis (or rarely both) fails to descend into the scrotum before birth. Urinary tract infections, which are more common in girls, are discussed next. All children who have these infections need prompt medical treatment because the kidneys can be damaged if the infection persists. An article follows on bedwetting, a common urinary problem in childhood. The section ends with an article on Wilms’ tumour, a rare cancer of the kidney that can often be treated successfully. Circumcision is discussed elsewhere.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.