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Type 1 diabetes in children Type 1 diabetes in children is a condition in which your child’s body no longer produces an important hormone (insulin). Your child needs insulin to survive, so you’ll have to replace the missing insulin. Type 1 diabetes in children used to be known as juvenile diabetes or insulin-dependent diabetes. The diagnosis of type 1 diabetes in children can be overwhelming at first. Suddenly you and your child depending on his or her age must learn how to give injections, count carbohydrates and monitor blood sugar. Type 1 diabetes in children requires consistent care. But advances in blood sugar monitoring and insulin delivery have improved the daily management of the condition. Causes of Type 1 diabetes in children The exact cause of type 1 diabetes is unknown. But in most people with type 1 diabetes, the body’s immune system which normally fights harmful bacteria and viruses mistakenly destroys insulinproducing (islet) cells in the pancreas. Genetics and environmental factors appear to play a role in this process. Insulin performs the critical job of moving sugar (glucose) from the bloodstream to the body’s cells. Sugar enters the bloodstream when food is digested. Once the islet cells of the pancreas are destroyed, your child produces little or no insulin. As a result, glucose builds up in your child’s bloodstream, where it can cause life-threatening complications. Symptoms of Type 1 diabetes in children The signs and symptoms of type 1 diabetes in children usually develop quickly, over a period of weeks. These signs and symptoms include: Increased thirst and frequent urination.  Excess sugar building up in your child’s bloodstream pulls fluid from tissues. As a result your child might be thirsty and drink and urinate more than usual. A young, toilet-trained child might suddenly experience bed-wetting. Extreme hunger.  Without enough insulin to move sugar into your child’s cells, your child’s muscles and organs lack energy. This triggers intense hunger. Weight loss.  Despite eating more than usual to relieve hunger, your child may lose weight sometimes rapidly. Without the energy sugar supplies, muscle tissues and fat stores simply shrink. Unexplained weight loss is often the first sign of type 1 diabetes to be noticed in children. Fatigue.  Lack of sugar in your child’s cells might make him or her tired and lethargic. Irritability or behavior changes.  In addition to mood problems, your child might suddenly have a decline in performance at school. Fruity-smelling breath.  Burning fat instead of sugar produces certain substances (ketones) that can cause a fruity breath odor. Blurred vision.  If your child’s blood sugar is too high, fluid may be pulled from the lenses of your child’s eyes. Your child might be unable to focus clearly. Yeast infection.  Girls with type 1 diabetes may have a genital yeast infections. Babies can develop diaper rashes caused by yeast. When to see a doctor See your child’s doctor if you notice any of the signs or symptoms of type 1 diabetes. Risk factors Risk factors for type 1 diabetes in children include: Family history.  Anyone with a parent or siblings with type 1 diabetes has a slightly increased risk of developing the condition. Genetic susceptibility.  The presence of certain genes indicates an increased risk of developing type 1 diabetes. Race.  In the United States, type 1 diabetes is more common among non-Hispanic white children than among other races also European countries. Environmental risk factors might include: Certain viruses.  Exposure to various viruses may trigger the autoimmune destruction of the islet cells. Diet.  No specific dietary factor or nutrient in infancy has been shown to play a role in the development of type 1 diabetes. However, early intake of cow’s milk has been linked to an increased risk of type 1 diabetes, while breast-feeding might lower the risk. The timing of the introduction of cereal into a baby’s diet also may affect a child’s risk of type 1 diabetes. Complications Complications of type 1 diabetes develop gradually. If blood sugar levels aren’t well-controlled over a prolonged period of time, diabetes complications can eventually be disabling or even life-threatening. Complications can include: Heart and blood vessel disease.  Diabetes dramatically increases your child’s risk of developing conditions such as coronary artery disease with chest pain (angina), heart attack, stroke, narrowing of the arteries (atherosclerosis) and high blood pressure later in life. Nerve damage.  Excess sugar can injure the walls of the tiny blood vessels that nourish your child’s nerves, especially in the legs. This can cause tingling, numbness, burning or pain. Nerve damage usually happens gradually over a long period of time. Kidney damage.  Diabetes can damage the numerous tiny blood vessel clusters that filter waste from your child’s blood. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, requiring dialysis or a kidney transplant. Eye damage.  Diabetes can damage the blood vessels of the retina, which may lead to poor vision and even possibly causing blindness. Diabetes can also lead to cataracts and a greater risk of glaucoma. Skin conditions.  Diabetes may leave your child more prone to skin problems, including bacterial infections, fungal infections and itching. Osteoporosis.  Diabetes may lead to lower than normal bone mineral density, increasing your child’s risk of osteoporosis as an adult. Prevention There’s currently no known way to prevent type 1 diabetes. Children who have a high risk of developing type 1 diabetes can be tested for antibodies associated with the disorder. But the presence of these antibodies doesn’t make diabetes inevitable. And there’s currently no known way to prevent type 1 diabetes if the antibodies are found. Researchers are working on preventing type 1 diabetes in people who have a high risk of developing the disease. Other research focuses on preventing further destruction of the islet cells in people who are newly diagnosed. While there’s nothing you could have done to prevent your child’s type 1 diabetes, you can help your child prevent its complications by: Diagnosis There are several blood tests for type 1 diabetes in children: Random blood sugar

Meningitis Meningitis is an inflammation of the membranes (meninges) surrounding your brain and spinal cord. The swelling from meningitis typically triggers symptoms such as headache, fever and a stiff neck. Most cases of meningitis in the World are caused by a viral infection, but bacterial, parasitic and fungal infections are other causes. Some cases of meningitis improve without treatment in a few weeks. Others can be life-threatening and require emergency antibiotic treatment. Seek immediate medical care if you suspect that someone has meningitis. Early treatment of bacterial meningitis can prevent serious complications. Causes of Meningitis Viral infections are the most common cause of meningitis, followed by bacterial infections and, rarely, fungal infections. Because bacterial infections can be life-threatening, identifying the cause is essential. Bacterial meningitis Bacteria that enter the bloodstream and travel to the brain and spinal cord cause acute bacterial meningitis. But it can also occur when bacteria directly invade the meninges. This may be caused by an ear or sinus infection, a skull fracture, or, rarely, after some surgeries. Several strains of bacteria can cause acute bacterial meningitis, most commonly: Streptococcus pneumoniae (pneumococcus).  This bacterium is the most common cause of bacterial meningitis in infants, young children and adults in the World. It more commonly causes pneumonia or ear or sinus infections. A vaccine can help prevent this infection. Neisseria meningitidis (meningococcus).  This bacterium is another leading cause of bacterial meningitis. These bacteria commonly cause an upper respiratory infection but can cause meningococcal meningitis when they enter the bloodstream. This is a highly contagious infection that affects mainly teenagers and young adults. It may cause local epidemics in college dormitories, boarding schools and military bases. A vaccine can help prevent infection. Haemophilus influenzae (haemophilus).  Haemophilus influenzae type b (Hib) bacterium was once the leading cause of bacterial meningitis in children. But new Hib vaccines have greatly reduced the number of cases of this type of meningitis. Listeria monocytogenes (listeria).  These bacteria can be found in unpasteurized cheeses, hot dogs and lunchmeats. Pregnant women, newborns, older adults and people with weakened immune systems are most susceptible. Listeria can cross the placental barrier, and infections in late pregnancy may be fatal to the baby. Viral meningitis Viral meningitis is usually mild and often clears on its own. Most cases in Zimbabwe it is caused by a group of viruses known as enteroviruses, which are most common in late summer and early fall. Viruses such as herpes simplex virus, HIV, mumps, West Nile virus and others also can cause viral meningitis. Chronic meningitis Slow-growing organisms (such as fungi and Mycobacterium tuberculosis) that invade the membranes and fluid surrounding your brain cause chronic meningitis. Chronic meningitis develops over two weeks or more. The signs and symptoms of chronic meningitis headaches, fever, vomiting and mental cloudiness  are similar to those of acute meningitis. Fungal meningitis Fungal meningitis is relatively uncommon and causes chronic meningitis. It may mimic acute bacterial meningitis. Fungal meningitis isn’t contagious from person to person. Cryptococcal meningitis is a common fungal form of the disease that affects people with immune deficiencies, such as AIDS. It’s lifethreatening if not treated with an antifungal medication. Other meningitis causes Meningitis can also result from noninfectious causes, such as chemical reactions, drug allergies, some types of cancer and inflammatory diseases such as sarcoidosis. Symptoms of Meningitis Early meningitis symptoms may mimic the flu (influenza). Symptoms may develop over several hours or over a few days. Possible signs and symptoms in anyone older than the age of 2 include: Signs in newborns Newborns and infants may show these signs: N.B – Infants with meningitis may be difficult to comfort, and may even cry harder when held. When to see a doctor Seek immediate medical care if you or someone in your family has meningitis symptoms, such as: N.B – Bacterial meningitis is serious, and can be fatal within days without prompt antibiotic treatment. Delayed treatment increases the risk of permanent brain damage or death. It’s also important to talk to your doctor if a family member or someone you work with has meningitis. You may need to take medications to prevent getting the infection. Risk factors Risk factors for meningitis include: Skipping vaccinations.  Risk rises for anyone who hasn’t completed the recommended childhood or adult vaccination schedule. Age.  Most cases of viral meningitis occur in children younger than age 5. Bacterial meningitis is common in those under age 20. Living in a community setting.  College students living in dormitories, personnel on military bases, and children in boarding schools and child care facilities are at greater risk of meningococcal meningitis. This is probably because the bacterium is spread by the respiratory route, and spreads quickly through large groups. Pregnancy.  Pregnancy increases the risk of listeriosis an infection caused by listeria bacteria, which may also cause meningitis. Listeriosis increases the risk of miscarriage, stillbirth and premature delivery. Compromised immune system.  AIDS, alcoholism, diabetes, use of immunosuppressant drugs and other factors that affect your immune system also make you more susceptible to meningitis. Having your spleen removed also increases your risk, and anyone without a spleen should get vaccinated to minimize that risk. Complications Meningitis complications can be severe. The longer you or your child has the disease without treatment, the greater the risk of seizures and permanent neurological damage, including: N.B – With prompt treatment, even patients with severe meningitis can have good recovery. Prevention Common bacteria or viruses that can cause meningitis can spread through coughing, sneezing, kissing, or sharing eating utensils, a toothbrush or a cigarette. These steps can help prevent meningitis: Wash your hands.  Careful hand-washing helps prevent the spread of germs. Teach children to wash their hands often, especially before eating and after using the toilet, spending time in a crowded public place or petting animals. Show them how to vigorously and thoroughly wash and rinse their hands. Practice good hygiene. Don’t share drinks, foods, straws, eating utensils, lip balms or toothbrushes with anyone else. Teach children and teens to avoid sharing

Infant jaundice Infant jaundice is yellow discoloration of a newborn baby’s skin and eyes. Infant jaundice occurs because the baby’s blood contains an excess of bilirubin, a yellow pigment of red blood cells. Infant jaundice is a common condition, particularly in babies born before 38 weeks’ gestation (preterm babies) and some breast-fed babies. Infant jaundice usually occurs because a baby’s liver isn’t mature enough to get rid of bilirubin in the bloodstream. In some babies, an underlying disease may cause infant jaundice. Most infants born between 35 weeks’ gestation and full term need no treatment for jaundice. Rarely, an unusually high blood level of bilirubin can place a newborn at risk of brain damage, particularly in the presence of certain risk factors for severe jaundice. Causes of Infant jaundice Excess bilirubin (hyperbilirubinemia) is the main cause of jaundice. Bilirubin, which is responsible for the yellow color of jaundice, is a normal part of the pigment released from the breakdown of “used” red blood cells. Newborns produce more bilirubin than adults do because of greater production and faster breakdown of red blood cells in the first few days of life. Normally, the liver filters bilirubin from the bloodstream and releases it into the intestinal tract. A newborn’s immature liver often can’t remove bilirubin quickly enough, causing an excess of bilirubin. Jaundice due to these normal newborn conditions is called physiologic jaundice, and it typically appears on the second or third day of life. Other causes An underlying disorder may cause infant jaundice. In these cases, jaundice often appears much earlier or much later than does the more common form of infant jaundice. Diseases or conditions that can cause jaundice include: Risk factors Major risk factors for jaundice, particularly severe jaundice that can cause complications, include: Premature birth.  A baby born before 38 weeks of gestation may not be able to process bilirubin as quickly as full-term babies do. Premature babies also may feed less and have fewer bowel movements, resulting in less bilirubin eliminated through stool. Significant bruising during birth.  Newborns who become bruised during delivery gets bruises from the delivery may have higher levels of bilirubin from the breakdown of more red blood cells. Blood type.  If the mother’s blood type is different from her baby’s, the baby may have received antibodies through the placenta that cause abnormally rapid breakdown of red blood cells. Breast-feeding.  Breast-fed babies, particularly those who have difficulty nursing or getting enough nutrition from breast-feeding, are at higher risk of jaundice. Dehydration or a low caloric intake may contribute to the onset of jaundice. However, because of the benefits of breast-feeding, experts still recommend it. It’s important to make sure your baby gets enough to eat and is adequately hydrated. Symptoms of Infant jaundice Yellowing of the skin and the whites of the eyes the main sign of infant jaundice usually appears between the second and fourth day after birth. To check for infant jaundice, press gently on your baby’s forehead or nose. If the skin looks yellow where you pressed, it’s likely your baby has mild jaundice. If your baby doesn’t have jaundice, the skin color should simply look slightly lighter than its normal color for a moment. Examine your baby in good lighting conditions, preferably in natural daylight. When to see a doctor Most hospitals have a policy of examining babies for jaundice before discharge. Pediatrics recommends that newborns be examined for jaundice during routine medical checks and at least every eight to 12 hours while in the hospital. Your baby should be examined for jaundice between the third and seventh day after birth, when bilirubin levels usually peak. If your baby is discharged earlier than 72 hours after birth, make a followup appointment to look for jaundice within two days of discharge. The following signs or symptoms may indicate severe jaundice or complications from excess bilirubin. Call your doctor if: Complications High levels of bilirubin that cause severe jaundice can result in serious complications if not treated. Acute bilirubin encephalopathy Bilirubin is toxic to cells of the brain. If a baby has severe jaundice, there’s a risk of bilirubin passing into the brain, a condition called acute bilirubin encephalopathy. Prompt treatment may prevent significant lasting damage. Signs of acute bilirubin encephalopathy in a baby with jaundice include: N.B – Kernicterus is the syndrome that occurs if acute bilirubin encephalopathy causes permanent damage to the brain.  Kernicterus may result in: Prevention The best preventive of infant jaundice is adequate feeding. Breast-fed infants should have eight to 12 feedings a day for the first several days of life. Formula-fed infants usually should have 1 to 2 ounces (about 30 to 60 milliliters) of formula every two to three hours for the first week. Diagnosis Your doctor will likely diagnose infant jaundice on the basis of your baby’s appearance. However, it’s still necessary to measure the level of bilirubin in your baby’s blood. The level of bilirubin (severity of jaundice) will determine the course of treatment. Tests to detect jaundice and measure bilirubin include: Treatment Mild infant jaundice often disappears on its own within two or three weeks. For moderate or severe jaundice, your baby may need to stay longer in the newborn nursery or be readmitted to the hospital. Treatments to lower the level of bilirubin in your baby’s blood may include: Light therapy (phototherapy).  Your baby may be placed under a special lamp that emits light in the blue-green spectrum. The light changes the shape and structure of bilirubin molecules in such a way that they can be excreted in both the urine and stool. During treatment, your baby will wear only a diaper and protective eye patches. Light therapy may be supplemented with the use of a light-emitting pad or mattress. Intravenous immunoglobulin (IVIg).  Jaundice may be related to blood type differences between mother and baby. This condition results in the baby carrying antibodies from the mother that contribute to the rapid breakdown of the baby’s red blood cells. Intravenous transfusion of