When your baby is still in the womb (still in the form of a fetus), then the task of removing bilirubin from the blood of fetuses carried by the placenta. Heart / liver of the fetus does not have to waste bilirubin.

When your baby is born, the task is immediately taken over by a liver / her liver. Because his liver is not used to it, then do not be surprised if it turns out it can take weeks for adjustments.
During your baby’s liver to work hard to eliminate bilirubin from the blood, of course, the remaining amount of bilirubin will continue to accumulate in the body. Since bilirubin is yellow, so if there are huge numbers, he can “stain” the skin and other body tissues which is owned by your baby.

When will hyperbilirubinemia Become Dangerous?
For low or medium levels of bilirubin, a result that happens is your baby’s skin color change to yellow. While high levels of bilirubin can be dangerous, because he could get into the baby’s brain cells and cause damage.

To prevent this from happening, it is wise to continue to control the baby’s bilirubin level is affected by hyperbilirubinemia.

What Can You Do?
At the level of accumulation of bilirubin is low, you can simply give more water intake for your baby and give phototherapy (or usually by soaking in the hot sun in the morning).
On the accumulation of bilirubin level was very high, it may take a blood transfusion, to “swap” the baby’s blood containing high bilirubin with the blood of adults with low levels of bilirubin.
Usually this condition hyperbilirubinemia were more common in premature babies, but usually can be overcome only by increasing water intake and phototherapy.

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Rule 4 Day Wait Period

This rule is particularly important if you or your family have allergies to certain foods. “Rule 4 Day Wait Period” is an easy way to check for food allergies. How do I? Basically, you should introduce one new food at a time and wait until 4 days before introducing the next new food.

For example, if you want to introduce your baby to an avocado on Monday, then you should you wait until Thursday to introduce the next new food.

With this sepert way, you can know better whether your baby has an allergic reaction to certain foods or not. In addition, if it turns out negative reaction from your baby, this way will be able to distinguish whether it is an allergic reaction or problems in pencernaanya. Usually an allergic reaction will occur in the first 24 hours, while the digestive problems arising from the new food will look after more than 1 day 1 night.

Well, once you introduce some type of food with “Rule 4 Day Wait Period”, you can just try menkombinasikan some food for your baby recipe. Once again, these preventive measures such as good run if you or your family has a “history” of food allergies.

Know also the difference between food allergies with the body’s reaction to food.

8 Foods That Cause 90% of Cases Incidence of Food Allergies

1. Milk

2. Eggs

3. Peanuts

4. Tree nut (walnut, cashew, etc.)

5. Fish

6. Scallop

7. Soybean

8. Wheat

For milk, eggs, soy and wheat, there could be more adult baby, allergic reactions to food will be lost.

Symptoms of Food Allergies

To find out whether your baby has allergies to certain foods, so here are some symptoms that you should be aware:

- Diarrhea that occurs suddenly
- Vomiting which occurred suddenly
- Skin rash issue
- Runny nose
- It’s hard to breathe after eating a new food
- Dizziness
- Face, lips or tongue swells
- Throat feels narrows

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However, the risk manifests itself only when we heat the bottle. Climbing the temperature of polycarbonate, the particles of Bisphenol A follows, adhering to food and going, therefore, the baby’s body. There are bottles and pacifiers market that do not contain BPA, so do not worry. One of the best alternatives is the crystal, the most reliable material. However many times we reject the obvious risk of breakage. Currently you can find in specialty stores around the plastic protectors without chemicals. They are very useful because they prevent the glass from breaking, are removable and can be washed in the dishwasher.

Protective glass bottles

Returning to bisphenol in Spain have already begun to undertake studies to begin to launch hypotheses about the effects and risks of this chemical component. In an article published in the journal XLSemanal recording the statements of the expert Angel Nadal, director of the Unit of Cellular Physiology and Nutrition of the Institute of Bioengineering, University Miguel Hernández de Elche (Alicante). Nadal has more than ten years experimenting with the effects of bisphenol on animals and now expands the range of hypotheses to humans. Among the risks observed in rats and mice blunts the imbalance evident in the endocrine system.

But there’s more. Nadal aims to BPA affects development hormones, can stimulate precocious puberty. On the other hand, there are adverse effects related to fertility, the adipocytes or fat cells … and even precancerous changes in cells or behavioral changes. These studies are still being tested, but better safe than sorry, your child away from any chemical that can lead to health risks. And it may be appropriate for us adults, we should be careful with the BPA in plastics and cans.

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Clearly, going to the dentist commands respect to almost all kids, but as long as is necessary to diagnose potential problems at an early stage of growth and avoid greater problems when she’s older. Although your child’s teeth from being correct and beautiful, the orthodontist can detect complications not seen with the naked eye, such as overbite or jaw problems. Your doctor may recommend one or another type of device, depending on each particular case. Roughly, we can establish two different devices, the detachable (removable) and braces or brackets.

As in the case of removable appliances is used when the child is in a growth phase to correct bone defects progressively. For example, when you have a problem of narrow palate. They are usually used at night and the time the child is at home. He thinks that the longer you use, the faster it will solve the problem. The price of a device of this type is usually around 1500 euros, regardless of previous treatment or after the appliance.

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Breast milk has several mechanisms of protection:

• The composition of milk contains substances that hinder the development of viruses and bacteria such as lysozyme, lactoferrin, immunoglobulins, factor bifidófilo.
• Being a natural substance, produced especially for the baby, does not irritate the intestine, so that the infant mucosal barrier remains intact, thus not allowing the entry of foreign substances.
• If the mother has an acute, produces antibodies that pass into breast milk, protecting the baby. This is true for diarrhea, etc..
Care to diseases of infants:

The baby’s immune system has been consolidated during the first moments of life. From birth it is necessary to monitor the baby for any signs of illness early. It is also essential to continue the vaccination schedule for prevention of diseases in infants, which could be fatal.

The procedure for diagnosis of diseases is to identify specific clinical symptoms during the first week of life, as a way of recognizing them.

There are a number of measures to prevent diseases of infants:

Dehydration, for example, can be seen because the baby cries and drink any liquid eagerly offered.

As dehydration progresses, the fontanelles may appear swollen and sunken eyes. Also the mouth and tongue become dry and rough. And may have a fever.

When the baby is otitis (inflammation in any area of the ear) which can be caused by an infection or not. dangerous accumulation of fluid in the inner ear.

The causes of otitis can be simple, such as bath water entering the ear canal, irritating the skin. You can also become infected root hairs in the area. Colds are the cause of otitis media, because the mucous membranes become inflamed, blocking the Eustachian tube.
If the baby gets used to taking a bottle very bed, milk passes to the Eustachian tube, causing inflammation.

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The Health Ministry said MPB’s disease may be caused by intestinal viruses, with the EV71 and the Coxsackievirus (Cox A16) were the most common.

MPB’s disease usually starts with a slight fever followed by blisters and ulcers in the mouth and rashes on hands and feet. Those with EV71 often show serious signs. It can also cause meningitis, encephalitis, pneumonia, and edema and paralysis in some children. So far no vaccine for the disease.

The Health Department has sent expert teams to Heze to implement emergency treatments and control measures and prevention of disease.

Some groups came to Heze tonight to begin research on the disease and disinfection operations, technical training and medical education among people.

They were also sent medical teams to Heze to help in combating the disease.

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AIDS poses a significant threat to both the mother and her child. It is advisable to carry out testing for HIV. It is increasingly common for the gynecologist ordering this test to pregnant women on their first visit although neither it nor its partner belonging to a risk group.

Rubella, or: can be very harmful to the fetus and cause serious malformations. They can also increase the risk of abortion and cause premature birth. If you have already passed or have been vaccinated, the risk that the contract and they affect your baby does not exist. If not and you contract the infection during pregnancy, sometimes there are treatments to prevent your child sick, but the best thing is to get vaccinated against these diseases before pregnancy if possible.

Toxoplasmosis: Caused by a parasite that can be contracted in the feces of cats in the land of plants and in raw or undercooked meat. The parasite can cause brain damage to the developing baby if you become infected during pregnancy. The risk of transmission is higher in the last trimester of pregnancy, but is most severe in the first three months.If pregnant once you have no choice to live every day with pets, simply follow a series of recommendations. Avoid cleaning your stools or at least wear gloves. The same if you make gardens. It is best to feed your cat or dog with canned meat. It is very important to wash hands thoroughly after contact with soil, cats, raw meat and vegetables. And as for your diet avoid eating raw, undercooked or cured meats and vegetables make sure that this well-washed fresh.

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Most of these defects are inherited in an autosomal recessive or X-linked, so there is not always a history of disease in parents, only a few are inherited in dominant form.

Early detection of such conditions allows appropriate treatment early and this improves the prognosis of these patients to stop the progression of the disease and its complications and sequelae.

How are inborn errors of metabolism (IEM)?

Currently about 500 known inborn errors of metabolism (IEM) which are classified according to the metabolic pathway is altered, the role of the enzyme concerned, of substances related to it or involved in cell body the metabolic pathway affected.

There are three main groups:

1. By the accumulation of large or complex molecules.
2. For toxicity caused by small molecules
3. By defects in the production or use of energy

GROUP I: at-large complex molecules

These include diseases that affect the production or degradation of complex molecules such as would all the components of cell membranes or tissues. The symptoms will be permanent, progressive, independent of other diseases and are NOT related to food. This group of diseases lysosomes or peroxisomes which are basic components of the cell.

GROUP II: small molecules for toxicity

EIM includes leading to acute or progressive intoxication due to the accumulation of toxic compounds. To this group belong

* Disorders in the metabolism of some amino acids phenylketonuria, urine disease maple syrup smell
* Disturbances in carbohydrate metabolism: galactosemia, hereditary fructose intolerance.
* Disruption of the urea cycle.

The diseases in this group have clinical similarities, including symptom-free intervals alternate with signs of intoxication may be acute. Imbalances are often accompanied by systemic or widespread:

* Acidosis (a condition characterized by excess acid in body fluids).
* Ketosis (a state of acidosis is characterized by the presence of high concentrations of acetone in blood and urine.
* Hyperammonemia (metabolic disorder characterized by high levels of ammonia in the blood)
* Hypoglycemia (low blood glucose)

The diagnosis is usually simple and is based on the study of blood and urine amino and organic acids

GROUP III: defects in production or use of energy

In these cases the body does not include the energy needed for normal operation, since an overall multi-organ failure, being the organs most commonly affected:

* Liver
* Myocardial (heart muscle)
* Striated muscle
* Central nervous system (brain)

Are common diseases?

IEM are rare genetic conditions individually but collectively numerous. The number of metabolic diseases is steadily increasing to the extent that we have new concepts and techniques for the identification of biochemical phenotypes (phenotype is any detectable characteristic of an organism (eg, structural, biochemical.

on physiological and behavioral) determined by an interaction between genetic information and its environment).

The incidence varies between different races, for example, CF has an incidence of 1 in 1600 newborns of European descent, sickle cell anemia occurs in 1 in every 600 live births of African parents and Tay Sachs disease is 1 in 3,500 live births Ashkenazi Jews.

What are the main symptoms of inborn errors of metabolism?

The EIM can affect any organ or system and sometimes several of them simultaneously. The manifestations depend on the affected pathway and the intensity of default. They tend to progress rapidly and impair the patient’s condition within hours or it may manifest as episodic decompensation and lapses with asymptomatic (without signs or symptoms) or have an evolution that will take decades to manifest clinically. The age at which symptoms begin to appear, depends on the metabolic error.

There is great diversity of signs and symptoms that guide the physician to the diagnosis of EIM and we will be separated into five basic groups according to age of presentation and form of presentation of them:

1. Acute symptoms in the neonatal period
2. Late-onset symptoms
3. General symptoms and progressive chronic
4. Characteristic symptoms and permanent
5. Congenital malformations

1) Acute symptoms in the neonatal period

This is usually a term infant, apparently healthy in their first hours of life, which after a few hours or days of power begins to deteriorate for no apparent reason and does not respond to symptomatic treatment, but all these symptoms can begin in pregnancy or presented in the immediate neonatal period (forms of energy deficit and inborn errors of metabolism of complex molecules).

There are no specific symptoms of a metabolic disorder in this period of life. The clinical manifestations of the newborn are limited and nonspecific and often attributed to other common processes such as sepsis (generalized infection) or respiratory distress syndrome (also often accompany metabolic diseases). However, there are some common forms of presentation of the EIA in this age:

* Neurological or neuromuscular symptoms: is the most common in the newborn. Disorders of sucking and swallowing, vomiting, hypotonia (low muscle tone), respiratory distress, lethargy or fatigue, convulsions, coma, and CNS malformations.
* Symptoms Liver: hepatic failure (liver failure) in neonatal fulminant is usually due to an inborn error of intermediary metabolism (which is made or occurs in a middle stage).
* Symptoms Cardiac rhythm disorders mainly or progressive cardiomyopathy.
* Other signs: progressive failure of all systems (multi-system failure), dysmorphic syndromes, blood disorders, kidney, skin, etc., Can be just an expression of neonatal EIM.

There is a bit more specific elements, like the smell of the newborn, which can be very characteristic. The most characteristic odor of burnt sugar is maple syrup, typical of the second most common metabolic disease, the disease-smelling urine maple syrup. The smell of sweaty feet seen in isovaleric acidemia (disorder where people can not fully break down proteins) and glutaric aciduria type 2 (is an inborn error of metabolism of the essential amino acids lysine and tryptophan), the smell of cat urine in multiple carboxylase deficiency (defects of the intermediary metabolism of carbohydrates associated with lactic acidosis.; tyrosinemia (caused by the deficiency of the enzyme terminal degradation pathway of tyrosine) is characterized by the smell of cooked cauliflower, and phenylketonuria, smells of damp and mouse.

Given the clinical suspicion of an EIM physicians should initiate a study of additional tests to confirm that suspicion and guide the baby’s diagnosis.

The interval between birth and the onset of symptoms can vary from hours to weeks depending on the degree of metabolic block, environmental conditions and feeding the baby is receiving. In general, all studies of routine that makes them normal (chest radiograph, cerebrospinal fluid analysis, bacterial cultures and cerebral ultrasound).

THIS UNEXPECTED AND MYSTERIOUS DETERIORATION AFTER A NORMAL PERIOD IS THE MOST IMPORTANT KEY TO SUSPECT THE PRESENCE OF AN EIM.

How is an energy deficit type box?

In the EIM energy production, both production and energy use are affected. T he symptoms come on quickly after childbirth or after a few hours of birth and the property is a serious commitment to life and if nothing is done giving energy, death ensues.

The clinical presentation is diverse and their severity but there is no period without symptoms.

The most common symptoms are:

* Loss of strength or muscle tone widespread
* Growth of abnormal heart
Rapidly progressive neurological deterioration *
* Congenital malformations

They are also frequent low blood sugar and lactic acid elevation in plasma.

2) Late submission

In almost one third of babies with IEM, the appearance of symptoms is delayed. The interval without symptoms may be a year or more or appear in adolescence and adulthood. The disease can occur when there is a crisis, either by presenting a minor viral infection, fever, severe constipation or excessive intake of protein.

The clinical data of late onset may be acute and recurrent these are:

* Ataxia or loss of balance
* Vomit
* Metabolic acidosis

3) chronic and progressive clinical manifestations

Usually produce digestive and neurological manifestations. Digestive diseases such as anorexia or loss of appetite, vomiting, chronic diarrhea and growth arrest are frequently attributed to other conditions and are misdiagnosed as intolerance to milk protein, celiac disease, gastrointestinal infections and pyloric stenosis among others. There are a number of neurological symptoms at the same time also often confused with other illnesses or are misdiagnosed, which include mental retardation, dystonia or torsion of a limb, stiffness, Parkinson’s, dementia, epilepsy, or intellectual impairment

4) Clinical features and permanent:

There are a number of signs and symptoms that may alert the physician to make the diagnosis of EIA. For example, the dislocation of the lens of the eye and thromboembolic events that occur in homocystinuria (amino acid metabolism disorder of methionine), dark urine that occurs in alkaptonuria (disorder of the metabolism of tyrosine) and cherry-red spot at the bottom eye is typical of gangliosidosis (group of inherited diseases caused by an accumulation of gangliosides, a type of chemical found in nerve tissue, especially in neurons) and Tay Sachs disease common in Jews.

5) Congenital malformations associated with inborn errors of metabolism

The vast majority of EIM not occur with birth defects, which explains that the organ damage is later because in the perinatal period often maternal metabolism fetal overcome their deficiencies. Many babies with accumulation of complex molecules show changes at birth as congenital cataracts in galactosemia. The dysmorphic facial features or rare conditions are shown in energy deficit and are frequently: the middle of the face as well as small and malformed kidney cysts, small head, fingers, more so. as in the Smith Lemli Opitz Syndrome.

What is the importance of diagnosis for EIM?

In all cases, because they are genetic diseases, accurate diagnosis is essential for proper genetic counseling to the family. For parents of the patient is up to 25% risk of recurrence. EIM For those with specific treatment, accurate diagnosis is essential for the couple to offer prenatal diagnosis in subsequent pregnancies.

Do they treat these diseases?

For some forms of acute onset (newborn and intermittent acute forms more later), emergency treatment is aimed at reducing the production of toxic metabolites proximal to freezing point and at the same time stimulating anabolism (one of the two parts of metabolism responsible for the synthesis or formation of more complex molecules from simpler ones) with a high energy intake.

On the other hand, depending on the severity of symptoms, can be used exogenous detoxification measures such as exchange transfusion, peritoneal dialysis, hemodialysis, and in some cases, increase the elimination of toxic product. Liver transplantation, the contribution of diet and enzyme permanent restraining are other treatments that may apply. Finally, there is a group of IEM that does not have specific treatment.

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