There are high-risk babies at home. What should parents do? High-risk babies are brain injuries caused by fetal growth. So if they have a high-risk baby at home, what should they pay attention to during their postpartum development? What should we do as parents? The following is about what parents should do if there are high-risk children at home!
What if parents have high-risk children? 1 What is a high-risk baby?
High-risk infants refer to infants who have risk factors for growth and development (especially brain development) in fetal period, delivery period and neonatal period. According to statistics, high-risk infants account for 10% ~ 20% of the total number of newborns. High-risk infants have the potential risk of brain injury, which will lead to cerebral palsy, mental retardation, epilepsy and abnormal emotional behavior, which is the main cause of infant disability.
Common high-risk factors are:
1, prenatal: intrauterine hypoxia, intrauterine growth retardation or intrauterine infection, twins or multiple births, maternal pregnancy-induced hypertension, diabetes, infection, severe anemia, etc.
2. Delivery time: hypoxia during delivery, premature delivery, overdue delivery, low birth weight (-2.5 kg) or too large (-4 kg), abnormal fetal position, too short umbilical cord, around neck, prolapse, etc. , placental abruption, calcification, infarction, polyhydramnios, too little pollution, too long labor process, birth injury, fetus.
3. Postpartum: hypoxic-ischemic encephalopathy, intracranial hemorrhage, infection, pathological jaundice, hypoglycemia, convulsions, encephalitis, epilepsy caused by various reasons, abnormal neonatal screening, and backward DDST screening.
In addition to premature delivery and low birth weight, frail children also include moderate and severe anemia, moderate and severe malnutrition (growth retardation, low weight and emaciation), active rickets, simple obesity, congenital heart disease and repeated infections.
Can high-risk babies have brain damage?
The answer is obviously no, although there are various unfavorable factors during pregnancy or perinatal period, most high-risk infants will not suffer from brain injury during normal development, but 5- 10% of high-risk infants will suffer from brain injury, leaving more or less sequelae, including developmental disorders such as motor, language, cognitive, social and behavioral disorders or epilepsy, which will bring great pain and burden to families, society and individuals.
Why do high-risk babies need early intervention?
Scientific research has proved that the younger the baby, the stronger the plasticity of the brain and the better the compensation ability for brain injury. Especially the first year after birth, especially 0-6 months, is a critical period for brain development. During this period, it is very important for infants to receive professional systematic guidance and early comprehensive intervention from rehabilitation therapists. Comprehensive intervention methods include audio-visual tactile training, motor function training, cognitive ability training, listening integration and language training, social adaptability training, sensory integration training, hydrotherapy, physical therapy and so on.
Which high-risk babies must be followed up strictly?
Anyone who meets the definition of high-risk baby should be examined and monitored by children's systematic health care. However, if the child has the following indications, systematic follow-up and early intervention training must be strictly carried out.
1, premature infants, especially those with birth weight below 1500g, multiple premature births and encephalopathy.
2. Congenital heart disease and pulmonary dysfunction, such as: 0-3 points within 5 minutes, continuous hypoxemia for 2 hours.
3, perinatal hypoxemia or acidosis, neonatal hypoglycemia, or repeated apnea.
4. People who have used mechanical ventilation for more than 48 hours within 28 days after birth or have used extracorporeal membrane oxygenation at any time.
5. Any factors that may lead to brain injury, such as intracranial hemorrhage above level 2 and cerebral infarction.
6. Other potential nervous system problems, such as central nervous system infection, septicemia and hyperbilirubinemia reaching the exchange index. All kinds of congenital malformations.
How to conduct follow-up and early intervention training for high-risk infants?
No backward high-risk children were found to go to the outpatient system of high-risk children in the child care center for evaluation 1 time and receive intervention training and family guidance 1 time; From June to 1 year, every 2 months 1 time; 1 ~ 3 years old every 3 ~ 6 months 1 time. If backwardness is found, according to the degree of backwardness, doctors and rehabilitation therapists make intervention plans, and therapists conduct intervention training and give corresponding family intervention guidance. Follow-up includes routine physical examination, neuromotor test, intelligence development monitoring, nutritional status evaluation, feeding guidance and disease prevention. In addition, development milestones should be evaluated. Results Abnormal patients should go to the children's physical and mental development center for systematic intervention and treatment as soon as possible, so as to promote functional recovery to the maximum extent, and never let themselves go and miss the best recovery opportunity.
Special reminder
Early education and early intervention are completely different concepts!
Early education-mainly organized and purposeful educational activities for normal children to enrich the environment, usually completed in early education institutions.
Early intervention is organized, targeted and planned treatment activities for children with developmental abnormalities, so as to promote these children to improve their sports ability and intelligence level or catch up with the development milestones of normal children. It must be led by medical institutions, with the participation of family and society.
Finally, remind parents that compared with healthy children, high-risk children have potential risks of developmental disorders and need more health care. Parents with high-risk children must take their children to the high-risk children's outpatient department of the Child Care Center as soon as possible to establish project management, regularly monitor their physical and intellectual development, find problems in time, and intervene in time to minimize the impact of high-risk factors on their children. The first 1000 days of life is an important stage of children's early development. For high-risk children, half a year ago is the prime time of this 1000 day. In this period, it is essential to carry out scientific comprehensive intervention activities to promote the all-round development of high-risk children's physiological, psychological and social development potential.
What should parents do if they have a high-risk baby? 2 1: If it is premature, don't rush to recover.
A premature baby is a fetus that is less than 37 weeks old. Generally, the age of premature infants will be calculated according to the revised age. Simply put, the calculation method is based on the date of the original expected date of delivery, and those before the expected date of delivery are not counted as months. For example, the expected delivery date is February 1, and the result is June 1. It's March 1, so the actual birth of the baby is 2. The reason why they are called premature babies is precisely because they were born early for various reasons and their developmental integrity is not as good as that of normal-month-old babies. Therefore, the calculation of the baby's development, intelligence and behavior should be calculated according to the corrected month age. No matter how long the period before the expected date of delivery is, it is only equivalent to the growth in the uterus and belongs to the catch-up growth period. Therefore, I hope that the parents of premature babies will realize this problem first, and then communicate with the doctor, otherwise it is likely to overtreatment the baby.
Due to time, the development of internal organs and nervous system of premature infants may not be perfect after birth, and a lot of quiet and warm environment is needed to catch up with their growth. This time should be to simulate the baby's feelings in the womb and give the greatest love, protection and care, which is not only good for development, but also plays a vital role in the baby's mental health. And some mothers I have consulted have postpartum anxiety because they are too nervous, or because doctors talk too seriously about their children's future. They must give the baby all kinds of preventive treatment in advance, and even use neuroleptics such as hyperbaric oxygen chamber and ganglioside. Mothers who have used these should understand that before doing hyperbaric oxygen, they need to give their children anesthetics. Injecting drugs requires scalp injection, screaming and crying again and again, waiting for a period of treatment in pain, and glistening money flows. And have you ever thought that at this time, for children of the same age, the baby is lying in the comfortable and safe uterus of his mother and growing up rapidly, where there is no crying and pain, and everything is so safe and enjoyable. For premature infants who have not given birth to term, the most important thing is not to intervene immediately, but to provide an ideal environment for the baby to grow and develop rapidly and achieve catch-up growth. That's all that matters. (Of course, unless there are pathological problems that need treatment, such as aspiration pneumonia, infants still have a large range of bleeding spots and continue to spread. )
2. For children, it is more important to reduce a certain amount of rehabilitation and strengthen nutrition to catch up with weight.
A sample book refers to a child weighing less than 5 kg. If it is premature, most of them are small samples. After all, I came out early and didn't catch up with my weight. The most troublesome thing is actually the full-term baby. Don't think that full-term babies are better than premature babies. Actually, it is not. The full-term baby has been in the mother's body for a long time, but it is certain that due to various intrauterine conditions, the child's growth retardation is far more harmful to the body than the premature baby. Especially in the late feeding period, because it is full-term, unlike premature babies, there is no catch-up time for the expected date of delivery, so many small full-term babies always lag behind the development of normal children and can't catch up. When some abnormalities are found, some mothers are anxious to do a lot of rehabilitation training for their babies because they are afraid of sequelae such as cerebral palsy. No matter how the baby cries, some mothers insist on biting their teeth. However, we should remind everyone that because the baby is naturally weak and thin, giving a lot of massage on the basis of high-intensity rehabilitation in physical fitness and other aspects will not have a good effect, but will cause more harm. For example, some parents feedback that their children's height and weight are almost no longer after rehabilitation, and some parents feedback that their babies are too thin to train in many projects. After practicing for a while, they find that muscle tension is higher. Therefore, it is suggested that parents of children should not be too eager to give a lot of training, and proper training within the acceptable ability of children is the key to solving the problem.
3. Don't be afraid of cerebral palsy. Don't label your child with cerebral palsy just because you read some cases and articles.
The definition of cerebral palsy is actually very strict, and its diagnosis is also a process. We can't rush to define cerebral palsy according to an abnormality or a relatively backward factor in a certain period. I wrote a lot of questions about abnormality in this blog "Summary of Cathy's Feeding Experience (III)-Abnormal Discovery", but I also reminded parents many times that abnormal performance is only a warning function, reminding parents that the baby may have some different changes or problems. Please go to the hospital as soon as possible to find a professional doctor to evaluate the diagnosis, instead of telling you if you see anything abnormal. This is cerebral palsy. Only at this point, there are not a few parents who call me or leave messages for consultation. I can understand their psychology. I am also anxious and helpless, but impatience does not mean losing my mind. Please parents must read the article, and don't apply it to the baby out of context, which will eventually harm themselves and the baby.
It seems that there must be different discussions about the definition time of cerebral palsy at home and abroad. Some suggest that cerebral palsy should not be defined within 1 year, while others say that it should not be defined within 2 or even 3 years, but in general, all the suggestions have the same bottom line: children under 1 year should not be diagnosed with cerebral palsy. Unfortunately, many doctors like to diagnose cerebral palsy immediately after finding the problem, even within half a year. I've seen funnier ones. A 28-week-old premature baby diagnosed his baby's cerebral palsy before the expected date of delivery, gave his parents a lot of hyperbaric oxygen, rat nerves and other treatments, and finally made his family close to collapse. In this regard, I really want to say to these doctors who gave the diagnosis: Is this how the country trained you for so long? Do you have any moral conscience? If you are short of money, please take a bowl and squat at the gate of the shopping mall to beg for food. Don't make fun of those poor children and parents. You don't make that much money!
Seeing this, look at the parents whose children were diagnosed with cerebral palsy before they were one year old. Do you understand?
4. Early intervention is very important.
Once the child is confirmed to have high-risk factors, or has shown some problems, such as abnormal muscle tone, abnormal posture, abnormal reflexes at various time periods, backward movement and so on. , it is necessary to intervene in time, try to grab the intervention or professional rehabilitation training within the time window of 6 months (6 months for premature babies), because the brain nervous system developed very rapidly before 6 months, and the brain compensation function is the best time. Timely intervention techniques can be used.
There are many contents of early intervention, and it is also very complicated according to each baby's situation, so there are not many items that can be safely done for parents who have not received professional guidance at home. For example, it is enough to touch the baby once a day during the full moon. After the baby is full moon, on the basis of good development, you can train twice a day. A lot of touching, especially touching the head, face, limbs and joints, can make the corresponding brain tissues better connected.
After waiting for the baby for 2 months, parents are no longer afraid of the baby. After they are familiar with the baby's limbs by touching them, they can intervene in the form of passive exercises. For some areas with abnormal muscle tone, you can strengthen training (preferably under the guidance of a professional doctor). In addition, the training of big sports is also essential, such as standing up, turning over and sitting up. After 4 months, the baby should also pay attention to separation training, and parents with early education knowledge background.
5. Pay attention to cognitive training
Some mothers constantly improve their training intensity because they are worried about the influence of muscle tension on their children's future. Paying too much attention to physical training may often neglect cognitive function. Infant's early cognition is developed from audio-visual function. Through the information they see and hear, their brains can quickly adapt to various external environments and realize simple social interaction, such as understanding what their mothers say and knowing their relatives around them. Paying attention to cognitive training can also promote the improvement of the baby's large amount of exercise, and let the baby dominate his limbs with an internal driving force through game interaction, thus fundamentally solving the abnormality.
Therefore, cognition cannot be broken. There are many common early cognitive contents, and there are also many parents who can rarely operate them. My suggestion is that there is no more content, but whether you can continue to train several times. This is the most important thing, such as telling stories to your baby, no matter how old you are. By telling parents' stories, you can not only improve your baby's intelligence, but also enhance your feelings and interaction with your parents. More importantly, it will form a very important language in the future. For example, playing with the baby's building blocks every day can promote the child's hand-eye coordination and fine finger movements, and has unexpected effects in terms of color, shape and space. For later growth, playing with building blocks can also make children more creative.
At the same time of these games, the early music stimulation is also good. For example, children can play Bandari's light music piano music in training, children can get relatively stable mood through Bandari's natural and fresh music, and children can play some rhythmic music when they are happy, even nursery rhymes and nursery rhymes. This can also make children get a sense of rhythm from music, and make their physical and musical behaviors become a spontaneous movement mode, which can better promote rehabilitation.
6. Parents should have a good attitude and be prepared for long-term training.
I often get some phone calls telling me how serious my child is and how poor the rehabilitation training is. Some mothers are crying: "We have been doing it for a month, why not?" Is this mentality for the sake of children or hurting children?
My training for Xiao Hao is uninterrupted. It was eight months from when we found out that she had muscle tone problems to when the alarm of abnormal muscle tone was lifted. Eight months, firm training every day, about 3-5 hours of training every day. The whole training didn't end because of abnormal muscle tension. Our training has been done for Xiao Hao for 14 months. How many mothers have done it?
If so, will it have no effect on the baby? Rehabilitation training, natural green, pollution-free, no injections, no medicine, how can we expect immediate results in a few days? Moreover, the improvement of nervous system needs a long process, just like parroting, it is unrealistic to rush for success. Parents are requested to put down their anxiety. Only when the mentality is stable will the child be better.
7. Finally, send a word to the parents of all high-risk children:
Persistence is the basis of solving problems.
Learning is the guarantee of mental stability.
Come on, mom and dad, I wish all the babies in the world healthy, lively and lovely.