Description

Child Health and Diseases (Pediatrics)

In the Department of Child Health and Diseases, the necessary examinations, laboratory and
radiological examinations are carried out by making use of all the
opportunities and innovations offered by science and technology.

In our department, children’s growth and development follow-up, Ministry of Health routine
vaccinations and all special vaccines are applied in accordance with the
calendar. Childhood nutrition services are provided while childhood
diseases and all infectious diseases are diagnosed and treated.

Routine Child Control for 0-16 Years Old

A child should be monitored at regular intervals, starting from the period in the mother’s womb to the end of the adolescence period when it completes its development.

Systemic examination of the child is made at every examination, growth and development and
vaccinations are evaluated. Hearing, vision and dental problems are
investigated. Behavior problems are discussed by talking to the family and
observing the child.

The most important aim is to protect and support health, to prevent preventable diseases and to recognize and treat diseases early.

How Often Should Children Follow-up?

It should not be forgotten that there may be differences in the follow-up of each child. The
pediatrician welcomes the newborn baby at the moment of
birth. Examination, screening tests are performed during the stay in the
hospital, and nutrition training is also started.

Discharged newborns should be checked again in the first week and then on the 15th
day. Monthly follow-up of the baby is recommended until the age of one.

After the age of one, follow-up continues with three-month intervals at the latest. It is
important to be brought to the pediatrician’s routine check-up every six months
until the preschool period and at least once a year thereafter.
Preschool period includes children between the ages of 5 – 6, which is also
called middle childhood. With the health checks to be made during this
period, it is aimed to prevent the health problems and learning difficulties
that the child may encounter during his school years.

For the child to be ready for school and to have a successful school life, the child’s
chronological age, as well as physical, social and mental health, including
sight and hearing, should be appropriate.

Ministry of Health and Administration of Special Vaccines

Vaccines are very effective methods of preventing infectious diseases. In our department, in
addition to all vaccines administered by the Ministry of Health, ‘special’
vaccines, which are not currently included in this list, are also recommended
and applied.  

Breast Milk and Breastfeeding

Breast milk is the most natural and healthiest nutrient for the baby. The milk of every
living thing has a composition suitable for the needs of its own child.

Unless there is a medical problem, babies should be fed exclusively breast milk for the first 6
months, without any supplementary food, including water.

The World Health Organization recommends breastfeeding for at least one year.

Benefits of Breast Milk:

• Breast milk contains all the protein, fat, sugar and minerals necessary for the baby, as well as protective substances and growth factors against some diseases and infections.
• Breast milk is easy to digest.
• Breast milk does not need to be prepared, it is practical and economical.
• Breastfeeding provides physical contact and intimacy, babies are more peaceful.
• Breastfeeding mothers return to their prenatal state more quickly due to the effect of hormones related to breastfeeding.
• Infections, allergies, obesity, diabetes, etc. in breastfed babies. such diseases are less
  common.
• Women who are breastfeeding are less likely to have osteoporosis, breast and ovarian cancer.
• After the dark and high energy colostrum secreted in the first days, 3-6. On the days the
  transition milk starts to come, and then the mature milk, which looks more
  watery.
• The milk of mothers of preterm or term babies is naturally arranged according to the needs of each baby and is different.
• Milk content also changes at the beginning and end of breastfeeding; While milk rich in glucose is secreted at the beginning, milk rich in fat is secreted, which provides a
  feeling of satiety towards the end of breastfeeding.

For Successful Breastfeeding;

• Although breastfeeding seems to be a natural and simple event, mothers need to be informed, have self-confidence and support from those around them.
• Attaching the baby to the breast as early as possible after birth, breastfeeding at the desired frequency and time including at night, keeping the breast in an appropriate position and ensuring that enough breast tissue is taken into the mouth will result in
  plenty of milk.

In an effective breastfeeding;

• The whole body of the baby is facing and very close to the mother.
• Its mouth is wide open with its lips outward and it grasps a part of the areola (brown ring) with the nipple.
• It is observed that the baby sucks in deep and slow intervals.
• A pacifier or bottle should not be given in order to avoid sucking confusion in the baby.

Expressing Breast Milk:

• In cases where the mother is unable to breastfeed her baby, it is sometimes necessary to discharge the breast milk by hand or with a tool in order to prevent the cessation of milk
  and to avoid tension in the breasts.

Storage of breast milk:

• Breast milk can be stored at room temperature for 3 hours, in the refrigerator for 3 days, in the deep freezer for 3 months.

Visual Screening in Children

Newborns and all children attending routine health examination should be evaluated in terms of eye and vision problems with anamnesis, age-appropriate physical examination
and tests.

All children should be examined by an ophthalmologist before starting school, around the age of 3, for conditions that may cause lazy eye, strabismus or visual acuity.

Hearing Screening in Children

Today, with the increase in preventive medicine practices, hearing tests in the neonatal period
are becoming more common.

Hearing Scans

When hearing loss is moderate or severe, it causes speech and language problems in the child, and school and behavioral problems, even if it is mild. It is important to
detect hearing loss with neonatal screenings and to evaluate the hearing in
each child’s examination in order to prevent or reduce negative consequences.

Ideally, congenital hearing loss should be diagnosed in the first 3 months and treatment started in the first 6 months.

Risk factors for hearing loss:

In some cases, hearing loss is more likely. These situations to be careful about are
listed below.

In the first 1 month:

• Congenital, neural type hearing loss in the family
• Infections of the mother during pregnancy (TORCH group)
• Head, face and ear anomalies, cleft lip-palate
• Syndromes where hearing loss can be expected (e.g. Down’s syndrome)
• Jaundice levels requiring exchange transfusion
• Birth weight less than 1500 grams
• Apgar score being 0-3 at the 5th minute and 0-6 at the 10th minute
• Breathing problems (e.g. delivery with meconium)
• Mechanical ventilation for more than 10 days
• Use of ototoxic drugs (eg gentamicin) for more than 5 days or use of these drugs in combination with diuretics
• Having meningitis

In 1–24 months:

• If the family or caregiver thinks that the child has a delay in hearing, speech or development
• Serous otitis that recurs or persists for at least 3 months
• Head trauma with temporal bone fracture
• Childhood diseases (meningitis, mumps, measles) that can lead to hearing loss
• Diseases involving the nervous system

However, it is reported that only 50% of children with significant hearing loss can be
detected by screening hearing only in the high-risk group.

Therefore, OAE hearing test should be performed on every newborn baby.

Newborn Screening Tests

When is the test done?

To avoid false negative results, blood should be drawn at least 24 hours after the baby starts
eating protein foods. Generally, it is preferred to take blood at 48-72
hours, this period should not exceed 7 days. If blood had to be drawn in
the first 24 hours, a repeat test should be recommended in the 1st-2nd week.

The test should be taken on the 7th day regardless of the treatment in premature babies.

It is recommended to repeat the tests after a while in babies who take antibiotics, corticosteroids, dopamine and have iodine contamination.

How are the test results found?
If the results of the metabolic disease screening in the newborn are normal,
usually there is no return to the family. If there is any doubt as to the
result of the test, the family is called again and information is given about
further tests and the necessary tests are applied to confirm the diagnosis.

Inpatient Follow-up and Treatment

Care is taken that inpatient children are not separated from their parents. The services and
rooms where children are treated have been arranged with all security measures
in the foreground. For all kinds of interventions, the patient’s family is
informed and approval is obtained. All consultations required for
treatment can be provided.