Friday, November 13, 2009

Bedwetting



Bedwetting or nocturnal enuresis is involuntary passage of urine while the child is asleep at an age beyond which the sphincter control is normally developed. An occasional lapse by child should not cause concern. Bedwetting is of two types - Persistent (or primary) type and the Regressive type. In persistent type child has never been dry at night and in regressive type, the sphincter control is developed at normal age and child remains dry for several months after which child again starts wetting bed at night.

Prevalence of nocturnal enuresis at 5 yrs of age is 7% for males and 3% for females. At 10 yrs of age it is 3% for males and 2% for females and at 18 yr of age it is 1% for males and rarely present in females. There is a marked familial pattern.

Persistent Type

Persistent type of bed wetting is due to delay in maturation of neurological control of sphincters. Persistent type of nocturnal enuresis may also be due to inadequate or inappropriate toilet training. Parents who demand rapid toilet training may generate an angry response, the child unconsciously defy them by wetting the bed. But on the other hand parents who do not understand the timely need of toilet training may undermine childs effort to control the bladder.

One hypothesis also suggests that these children sleep deeply hence signal from distended bladder indicating the need to empty the bladder does not reach the conscious level of their brain during sleep.

Treatment for Persistent type of Nocturnal Enuresis

(a) Children should not be given liquids after dinner
(b) Child should void before going to sleep
(c) No punishment or humilation of child
(d) Reward therapy - Reward the child for being dry at night
(e) Conditional devices (alarm that rings when child wets the sheet) is reserved for persistent and refractory cases and is successful in more than 90% cases.
(f) Bladder stretching exercises
(g) Drug treatment is effective only briefly and there is exacerbation of symptoms once drug is discontinued.

Regressive type
This type of bedwetting is precipitated by stressful environmental events such as birth of a sibling, death in family, marital conflict and moving to a new home.

Treatment for Regressive type of Nocturnal Enuresis

This type of bedwetting is transitory. Prognosis is better and management is easier than persistent type.

In both types of bedwetting organic pathology is found only in small number of cases. Organic causes such, as anomalies of urinary tract, juvenile diabetes; nephropathies and neurologic illnesses should be excluded by physical examination and investigations.
Posted by sri sultan hamengkubuwono[

BABY FOOD RECIPES

BABY FOOD RECIPES - CHICKEN HEARTS APPLE
Baby food recipes

Material:
250 grams of chicken liver
2 apples, peeled, seeded, chopped
1 carrot, peeled and cut into pieces
3 pieces potatoes, peeled and cut into pieces
2 stalks celery, chopped
3 tablespoons green peas

Directions:
1. Cook all ingredients until cooked.
2. Drain and puree (or chopped finely for children ages 8 months and up)

BABY FOOD RECIPES - FISH APPLE
Baby food recipes

Material:
2 pieces of fish fillets
2 apples, peeled, cut into pieces

Directions:
1. Boil the ingredients until cooked. Drain and puree.

Note:
For children 8 months, the food should not be crushed but only finely chopped. It is good to stimulate the growth of teeth and to train the muscles of the mouth and gums to bite.

BABY FOOD RECIPES - CARAPPEAR
Baby food recipes

Material:
2 stalks carrots, peeled, cut into pieces
2 apples, peeled, cut into pieces
2 pieces of pear, peeled and cut into pieces

Directions:
1. Kl Boil carrots for 10 minutes, then amsukkan apple and pear. Cook until soft.
2. Drain and puree (or chopped finely for children ages 8 months and up)

BABY FOOD RECIPES - steamed fish
Baby food recipes

Material:
1 snapper fillet (or other fish species, according to taste)

Directions:
1. Steam the fish until cooked and then mashed.
2. Can be mixed with pureed vegetables (carrots, broccoli, etc.).

BABY FOOD RECIPES - Broccoli POTATO
Baby food recipes

Material:
7 broccoli florets, discarding the stem
2 potatoes, peeled, cut into pieces
Chicken broth / meat taste (only boiled water chicken / meat, without salt or other seasonings)

Directions:
1. Steam the broccoli and potatoes until cooked.
2. Blend the two ingredients with the processor / blender.
3. Give the broth to taste.

BABY FOOD RECIPES - VEGETABLE INTERFERENCE
Baby food recipes

Material:
1 carrot, peeled, cut into pieces
1 piece of potato, peeled, cut into pieces
2 tablespoons green peas (can be replaced other green vegetables, eg broccoli,
zuchini, celery, etc.)
Chicken broth / meat taste (only boiled water chicken / meat, without garammaupun other seasonings)

Directions:
1. Boiled / steamed until cooked all the ingredients and puree.
2. Give the chicken broth / meat taste.

BABY FOOD RECIPES - CHICKEN SOUP
Baby food recipes

Material:
1 piece of chicken thighs, remove skin, cut meat into pieces (bones were not removed)
1 stalk celery, chopped
2 potatoes, peeled, cut into pieces
1 stick carrot, peeled, cut into pieces
2 tablespoons green peas
500 ml water

Directions:
1. Cook all ingredients until cooked.
2. Discard the chicken bones, then puree all ingredients

BABY FOOD RECIPES - puree CARROT
Baby food recipes

Material:
2 medium carrots, peeled
Boiled water to taste

Directions:
1. Steam the carrots until tender then puree. Add water as needed.
2. Presentation: Give the carrot puree as single or mixed foods
with pulp POTATO / SWEET POTATOES porridge.

BABY FOOD RECIPES - pea puree
Baby food recipes

Material:
250 grams of fresh or frozen peas

Directions:
1. Boil peas until cooked and then mashed.
2. Strain the rough skin so do not take part inedible.
3. Presentation: Give peas puree as a single food or
mixed with porridge POTATO / SWEET POTATOES porridge.