Pediatrics as the science of healthy and sick children.

Medical care for children. Feeding and nutrition of children.

Definitions• Pediatrics (also spelled paediatrics or pædiatrics) is the branch

of medicine that deals with the medical care of infants, children, and adolescents, and the age limit usually ranges from birth up to 18 (in some places until completion of secondary education).

• A medical practitioner who specializes in this area is known as a pediatrician, or paediatrician.

• The word pediatrics and its cognates mean healer of children; they derive from two Greek words: παῖς (pais = child) and ἰατρός (iatros = doctor or healer).

• In the United States, a pediatrician is often a primary care physician who specializes in children, whilst in the Commonwealth a paediatrician (or pediatrician) specialises in paediatrics but generally not as a primary general practitioner.

Child Development• Definition:

– Change in the child that occurs over time. Changes follow an orderly pattern that moves toward greater complexity and enhances survival.

Periods of development:– Prenatal period: from

conception to birth– Infancy and toddlerhood: birth

to 2 years– Early childhood: 2-6 years old– Middle childhood: 6-12 years

old– Adolescence: 12-19 years old

Domains of DevelopmentDevelopment is described in three domains, but growth

in one domain influences the other domains.• Physical Domain:

– body size, body proportions, appearance, brain development, motor development, perception capacities, physical health.

Domains of Development• Cognitive Domain:

– thought processes and intellectual abilities including attention, memory, problem solving, imagination, creativity, academic and everyday knowledge, metacognition, and language.

Domains of Development

• Social/Emotional Domain:– self-knowledge (self-esteem, metacognition, sexual

identity, ethnic identity), moral reasoning, understanding and expression of emotions, self-regulation, temperament, understanding others, interpersonal skills, and friendships.

Prenatal period:

• it lasts from conception to birth. • Prenatal period is divided into • embryonic (trimester 1) and • fetal or placental periods (trimesters 2 and 3)

Factors which can influence the development of the embryo:

• Condition of the parents health, pathology of pregnancy, effects of environmental factors

Infancy period:• it lasts from birth to 12 months. • Infancy is divided into neonatal and infancy.

• The infancy period is one of rapid motor, cognitive, and social development. Through mutuality with the caregiver (mother), the infant establishes a basic trust in the world and the foundation for future interpersonal relationships.

Health indices

Demographically indices (birth rate, mortality rate, neonatal mortality rate , early neonatal mortality rate , still birth rate, infant mortality rate ).

• Morbidity indices (primary, general, according to preventive services, hospital morbidity, morbidity with temporary disability ).

• Invalidity indices (primary, general).• Indices of physical development.

Neonatal period• it begins from birth of the baby and lasts

by 28 days.

Infancy lasts from 1 to 12 months

• The infancy period is one of rapid motor, cognitive, and social development. Through mutuality with the caregiver (mother), the infant establishes a basic trust in the world and the foundation for future interpersonal relationships.

Early childhood includes the children in age from1-6 years (deciduous

dentition)

Toddler period (pre-pre school) lasts from 1-3 years

• The functions of the thymus, hypophysis and epiphysis dominate in the endocrine system within this period.

Preschool period

• Begins from3 years -6 years

Middle childhood: it lasts from 6 to 12 years.

Middle childhood includes prepubertal period:

it begins from 10 years and completes at 12 years.

Frequently referred to as the "school age," this period of development is one in which the child is directed away from the family group and is centered around the wider world of peer relationships. There is steady advancement in physical, mental, and social development with emphasis on developing skill competencies.

Social cooperation and early moral development take on more importance with relevance for later life stages. This is a critical period in the development of a self-concept.

Later childhood (adolescence period): it lasts from 12 to 18 years.

• The tumultuous period of rapid maturation and change known as adolescence has been described in various ways.

• It is considered to be a transitional period that begins at the onset of puberty and extends to the point of entry into the adult world - usually high school graduation. Biologic and personality maturation are accompanied by physical and emotional turmoil, and there is redefining of the self-concept. In the late adolescent period the child begins to internalize all the previously learned values and to focus on an individual, rather than a group, identity.

Dentist importance in child’s health care.

• Tooth decay is the most common chronic childhood disease.

• 5 times more common than asthma.• 7 times more common than hayfever.• 52 million school hours missed annually

because of oral problems

• 50% of decay in low income children goes untreated.

“What amounts to a silent epidemic of dental and oral diseases is affecting some population groups. This burden of disease restricts activities in schools, work and home and often significantly diminishes the quality of life.”

Surgeon General David Satcher, PH.D, M.D

• Poor oral health and untreated infections can have a significant impact on school aged children.

• Children have trouble eating and sleeping, and can experience speech impairments, trouble focusing and low self esteem

• Dental disease can greatly reduce a child’s capacity to succeed in the educational environment.

• Children who are missing teeth have to limit their food choices because of chewing problems, which may result in nutritionally inadequate diets

• Inadequate nutrition during childhood can have a detrimental effect on children’s cognitive development and productivity in adulthood

What are the Consequences?

• Pain & infection

• Hospitalization, surgical intervention, death

• Missed work/school

• Distraction from normal activities

• Speech and eating dysfunction

• Growth delay

• Oral health is part of overall health!• Patients are seen more regularly at the medical offices• Part of oral health prevention strategies

Role of the Primary Care Physicians

• Screen for disease and risk • Monitor oral-systemic health

interactions• Initially manage oral

emergencies• Referral for dental care• Provide anticipatory

guidance• Apply fluoride varnish• Preventive Dental Care is linked

to Good Overall Health!

• Preventive Dental Care is linked to Good Overall Health!

Children health.• Child's health includes physical, mental and social well-being too.• Each year more than 10 million children under the age of five die. • At least 6.6 million child deaths can be prevented each year if

affordable health interventions are made available to the mothers and children who need them.

Child Health Child Health

Antenatal Care

Delivery Care

Postnatal Care

Childhood Vaccinations

Childhood Illnesses

Access to Health Care

Source of Antenatal CareSource of Antenatal Care

17

11

11

3

6

1

Doctor

Nurse/auxiliary nurse midwife

Health assistant/ auxiliary health

worker

Maternal child health worker

Village health worker

Traditional birth attendant/other

Percent

Key FindingsKey Findings One in two pregnant women received

antenatal care. 45% received two or more doses on tetanus toxoid injection.

Less than one in ten births occurred in a health facility. 13% of births were attended by a health professional.

60 percent of children 12-23 months are fully immunized by age 1.

Use of a health facility to treat symptoms of ARI, fever and diarrhea is low.

Medical care for children.