Congenital deformity of the chest in children. Pathologies in children: chest deformity

After the birth of the baby, neonatologists carefully examine and measure, and before discharge, an orthopedist or surgeon. But the observation of the musculoskeletal system of the baby does not end there: in the first year of life, you have to go through several commissions, on which the baby will be examined again and again. Such control is necessary in order to identify pathologies in time and proceed with immediate treatment baby. The sooner you and the specialists begin to correct the deformities, the less harm they will cause to the baby.

Doctors pay special attention to the shape and size chest. Which arrangement of its components is the norm, and which one indicates congenital or acquired deformity?

Norm

1. At birth, in a healthy child, the circumference of the chest is less than the circumference of the head by 3 cm.
2. The shape of the breast at birth should be barrel-shaped.
3. The ribs must be horizontal and strictly symmetrical.
4. Only the lower part of the chest is involved in the child's breathing.

Deviations from the norm

By origin, deviations from normal form chest can be of two types.

1. Acquired. Occur due to wrong position baby When he lies mainly on one side, a pillow is placed under his head and shoulders, and he is also planted early. Acquired deformity can also be the one that arose with a calcium deficiency in the body - the effect of rickets on the bones can change the shape of the chest.
2. Congenital. Occur due to pathology prenatal development fetus or hereditary factors.

According to the form of congenital deformities, the following types of chest are distinguished: funnel-shaped type, keeled and other complex cases, which are much less common.

Funnel-shaped chest

This deformity is also called the "shoemaker's chest", it is characterized by the indentation of the sternum inward. This pathology is congenital, and actively develops while the child grows. If the baby is not treated, the degree of retraction of the sternum will increase and adversely affect the location of the internal organs.

The funnel-shaped chest has a gradation of degrees of retraction of the sternum:

1. Grade 1 - the sternum is recessed inward for a short distance - up to 2 cm.
2. Grade 2 - the chest is pressed deeper - up to 4 cm.
3. Grade 3 - the indentation deepens to 6 cm. Such a colossal deformation is already very noticeable, and brings the child not only moral discomfort, but also greatly affects his health. Compressed lungs are not able to fully ventilate - the baby will often get sick.

Keel-shaped chest

With such a deformation, the sternum, like a keel, protrudes forward. This pathology is often congenital and is diagnosed in the first months of a baby's life. Very rarely, cases of acquired deformity of this type are noted. The growth of the sternum in the womb is due to active cell division cartilage tissue. Its growth and subsequent bulging leads to a change in the position of the ribs - they are not horizontal, but converge at the sternum at an angle. Because of this, the shape of the chest is not round and barrel-shaped, but angular. Pathology affects not only the bone and cartilage components of the chest, but also the muscle: in children, part of the diaphragm is missing in front, and its lateral sections are attached to 7-8 ribs and are overdeveloped.

If not treated, keeled deformity can lead to displacement and dysfunction of the internal organs.

Rare forms of deformation

• Another type of deformation, which is characterized by a uniform decrease in the volume of the sternum, is a flat shape;
• sometimes the chest can be arched;
• in rare cases, babies are diagnosed with congenital cleft sternum;
• Poland's syndrome is also a rare deformity of the chest in children.

Why are congenital deformities dangerous?

Congenital deformities of the chest are quite common. They occur in 14% of infants, more often pathologies are diagnosed in boys.

1. Any deformation of the chest in a child affects the position of the internal organs and their work. The lungs and heart surrounded by ribs are especially affected.
2. Noticeable irregular shape will cause psychological discomfort to the grown child. This will interfere with the child's harmonious development and communication with peers.
3. The child will often get sick due to insufficient ventilation of the lungs. Violations at work cardiovascular systems s will lead to rapid fatigue, pain in the heart and the development of VVD.

Reasons for the appearance of deformation

1. Heredity. If the family has or had chest deformities, the child may be born with a pathology.
2. Pathology can occur at the stage of intrauterine development of the fetus, when
the cartilaginous elements that make up the sternum, as well as the muscles of the diaphragm, are laid down and developed.
3. A number of diseases in the first year can deform the chest: this occurs with rickets, tuberculosis, scoliosis, etc. Can change its shape purulent inflammation, tumors, injuries, burns and operations associated with opening the chest.

Diagnostics

Congenital deformities of the chest in newborns and infants are quite difficult to diagnose. At an early stage, the irregularity of its shape can be determined by the “behavior” of the bone-cartilaginous complex during inhalation and crying: the ribs and directly the sternum sink strongly.

If you suspect an irregular shape of the chest in an infant, you will be assigned a number diagnostic procedures to determine the size and location of bones and cartilage.

Treatment

Based on the degree of deformity, the orthopedic surgeon will prescribe an adequate complex treatment. With complex and deep congenital changes in the shape of the chest, an operation may be indicated for the child.

The first and second degrees are amenable to correction by conservative methods. The child will be helped:

• physiotherapy;
• massotherapy;
• physiotherapy;
• breathing exercises.

Conservative treatment will also help with acquired deformities, but only after eliminating the root cause of the change in the shape of the chest. If the pathology is rachitic in nature, that is, it has arisen due to vitamin D deficiency, you need to stop the process with the help of drug therapy, and then eliminate the consequences of the disease.

Prevention

1. The only way to avoid congenital pathology is to eat right during the laying and development of the skeletal system, take multivitamins and avoid diseases at important stages of fetal formation.
2. A pathology diagnosed in time is corrected faster, so visit the commission with the baby and, if you suspect any irregularity in shape, contact narrow specialists.
3. To avoid the appearance of an acquired deformity, follow the pediatrician's recommendations for taking a vitamin D solution and strictly observe the dosage of the drug.
4. Do not hesitate to talk to the pediatrician about changes in the behavior and well-being of the crumbs, which may signal the development of dangerous diseases in him.

Chest deformities in children

Chest deformities in children are congenital or early acquired curvature of the sternum and the ribs that articulate with it. Chest deformities in children are manifested by a visible cosmetic defect, disorders of the respiratory and cardiovascular systems (shortness of breath, frequent respiratory diseases, fatigue). Diagnosis of chest deformity in children involves thoracometry, radiography (CT, MRI) of the chest, spine, sternum, ribs; functional studies (RF, EchoCG, ECG). Treatment of chest deformity in children can be conservative (exercise therapy, massage, wearing an external corset) or surgical.

Symptoms of chest deformities in children

The clinical manifestations of pectus excavatum vary with the age of the child. In infants, the depression of the sternum is usually hardly noticeable, however, there is a "paradox of inspiration" - the sternum and ribs sink down when inhaling, when the child screams and cries. In children younger age the funnel becomes more visible; there is a tendency to frequent respiratory infections(tracheitis, bronchitis, recurrent pneumonia), fast fatiguability in games with peers.

Funnel chest deformity reaches its greatest severity in children. school age. On examination, a flattened chest with raised edges of the ribs, lowered shoulder girdle, protruding abdomen, thoracic kyphosis, and lateral curvature of the spine are determined. The "paradox of inhalation" is noticeable with deep breathing. Children with pectus excavatum have low body weight and pale skin. Characterized by low physical endurance, shortness of breath, sweating, tachycardia, pain in the heart, arterial hypertension. Due to frequent bronchitis, children often develop bronchiectasis.

Keeled deformity of the chest in children is usually not accompanied by serious functional disorders, so the main manifestation of the pathology is a cosmetic defect - protrusion of the sternum forward. The degree of chest deformity in children may progress with age. When the position and shape of the heart changes, complaints of fatigue, palpitations and shortness of breath may occur.

Schoolchildren with chest deformity are aware of their physical handicap, try to hide it, which can lead to secondary mental layers and require help from a child psychologist.

Poland's syndrome or rib-muscular defect includes a complex of defects, including the absence of pectoral muscles, brachydactyly, syndactyly, amastia or atelius, deformity of the ribs, lack of axillary hair growth, and a decrease in the subcutaneous fat layer.

The cleft of the sternum is characterized by its partial (in the area of ​​the handle, body, xiphoid process) or total splitting; at the same time, the pericardium and the skin covering the sternum are intact.

Causes

Most often, this pathology is congenital, scientists have the following theories of its appearance:

1. When bone and cartilage formations grow unevenly in the chest area, because the embryo lacks certain substances in the womb. At the same time, the chest begins to form unevenly, its circumference, shape, size change, it is quite flattened.

2. Funnel-shaped deformity is associated with a congenital pathology of the diaphragm - the thoracic part lags behind in development and is shortened. The ribs are strongly inclined, because of this, the muscles of the chest change their position, the anterior part of the diaphragm is attached to the arches of the ribs.

3. The funnel-shaped chest is deformed due to the fact that the sternum is incompletely formed in utero, then dysplasia appears in the connective tissues, this affects the cardiovascular, respiratory system, the metabolic process is disturbed. The additional features are:

• violations in the cuts of the eyes, they have a Mongoloid appearance;
• the child's sky is high;
• the skin is hyperelastic;
• scoliosis, umbilical hernia, ear dysplasia develop;
• weakened sphincter.

4. genetic predisposition child to this deformity.

Modern scientists believe that the disease is provoked by an early embryonic developmental deficiency - in the first eight weeks, when the cartilaginous rib cells and the sternum do not fully develop, because of this, the child has a congenital pathology, the cartilage that was still in the embryo is preserved, it is fragile, soft tissue.

Treatment of chest deformities in children

Conservative treatment is prescribed for sunken chest. In this case, treatment depends on the degree of retraction of the sternum. At 1 and 2 degrees, therapeutic exercises are prescribed. The main emphasis should be placed on the chest - push-ups, pull-ups, spread dumbbells in the prone position, etc. The child can go in for swimming, volleyball, rowing. These sports allow you to delay the deepening process. In addition, therapeutic massage will be effective.

In a complicated case, surgical intervention is performed. The operation is performed on the child only after 6-7 years. It is at this age that the defect ceases to form. In other cases, the operation is done on early dates.

An incision is made in the child's chest, where a magnetic plate is inserted. A belt with a magnetic plate is put on the chest area. Magnets are attracted to each other, so sunken breasts can be corrected in 1-2 years.

If the changes are acquired, then the child is first examined for diseases that could cause deformity, and only then conservative treatment or, if necessary, surgery is performed.

Treatment of keeled chest deformity in children begins with conservative measures: exercise therapy, massage, therapeutic swimming, wearing special compression systems and children's orthoses.

Surgical correction of the keeled chest is indicated for a pronounced cosmetic defect and progression of the degree of deformity in children older than 5 years. Various methods of thoracoplasty include subperichondral resection of the parasternal parts of the ribs, transverse sternotomy, repositioning of the xiphoid process, and subsequent fixation of the sternum in its normal position by suturing it to the perichondrium and ends of the ribs.

With a funnel chest, conservative measures are indicated only for the I degree of deformation; at II and III degree, surgical treatment is necessary. The optimal period for surgical correction of the funnel chest is considered to be the age of children from 12 to 15 years. In this case, the fixation of the corrected position of the anterior chest can be carried out using external sutures made of metal or synthetic threads; metal clamps; bone auto- or allografts left in chest cavity, or without their use.

Special thoracoplasty techniques have been proposed for the surgical correction of cleft sternum and costo-muscular defects.

The results of chest reconstruction in children with her congenital deformity good in 80-95% of cases. Relapses are observed with inadequate fixation of the sternum, more often in children with dysplastic syndromes.

Chest deformity is a change in the shape of the musculoskeletal skeleton of the upper body. There are two main types of chest deformity in children: funnel-shaped and keeled. What is the cause of chest deformity in children, and what should parents do in case of such a diagnosis?

Types of chest deformities in children and health hazards

The health consequences associated with chest deformity in children depend on the type of deformity and its degree.

funnel deformity chest in children manifests itself in the sinking of the costal cartilages, resulting in the formation of a "funnel", or depression, in the center of the chest.

There are 4 degrees of funnel chest deformity in children, depending on the depth of the "funnel". With I degree of deformation (deepening no more than 2 cm), the child may not feel any symptoms of the disease at all. With more high degrees deformation, the child may experience difficulty breathing, shortness of breath, and some disruption of the internal organs due to their compression.

At keeled chest deformity in children, the sternum protrudes forward in the form of a keel, to which the ribs are attached at a right angle. This deformity is often only a cosmetic defect. If the keeled deformity is pronounced, this can lead to problems in the functioning of the lungs, heart and other internal organs due to a violation of their relative position. In this case, it is necessary to conduct an examination and find out the features of the location and functioning of the internal organs of the child.

What can cause chest deformity in children?

Chest deformity in children most often it is a congenital disease and is formed even in the prenatal period, when the child is in the mother's womb. Scientists have not yet found the exact answer why the baby's chest is deformed. It is only known that the probability of the manifestation of this defect increases with:

• negative heredity (the presence of this disease in the anamnesis of the mother or father of the child or their immediate family);
• exposure to teratogenic factors ( negative factors that affect the pregnant woman and the fetus and cause developmental disorders without affecting hereditary structures). These factors include transfer future mother infectious diseases taking antibiotics and other chemicals, contact with radiation, etc.

That is, expectant mothers need to follow the standard recommendations: take care of yourself, do not contact with patients, use medications with caution, etc.

As for the acquired, it can be caused by serious illnesses suffered by the child (rickets, scoliosis, pulmonary diseases, etc.) and injuries to the upper part of the body.

How is chest deformity corrected in children?

At chest deformities in children in mild degree carry out conservative treatment, without surgical intervention. It consists in carrying out physiotherapeutic procedures, massage, therapeutic exercises and, if necessary, in wearing a special squeezing device - orthoses and dynamic compression systems.

In more serious cases, children are prescribed surgery to correct the shape of the chest. Previously, it was believed that the younger the operated child, the better, since the ability of children's tissues to regenerate is much higher than that of a teenager or an adult. Therefore, operations to correct the shape of the chest were performed on babies as early as preschool age. However, now most doctors agree that early correction of the shape of the chest surgically can lead to abnormal growth of the ribs, recurrence of the disease and the need reoperation. Therefore, surgeons recommend performing the operation no earlier than 10-12 years for boys and 12-13 years for girls.

Respiratory gymnastics and physiotherapy exercises for chest deformity in children

The first thing to do if a chest deformity is found in a child is to consult a doctor (orthopedic surgeon or a narrower specialist). If the specialist confirms that the defect does not pose a risk to the health of the child, parents can deal with the deformity of the child’s chest on their own, namely, to deal with the child breathing exercises and physical therapy. These methods cannot completely correct the defect, but they can slow down its development.

Breathing exercises for chest deformities in children helps to correct the shape of the musculoskeletal frame, in addition, normalizes the work of the heart and lungs. Before practicing breathing exercises with a child, you should check with the doctor - are there any contraindications to these exercises?

Breathing exercises

1. Holding your breath. Stand straight, feet shoulder-width apart. Do deep breath and hold your breath for as long as possible. Then exhale sharply through the mouth. Repeat 5-10 times.

2. Upper breathing. Can be performed both standing and sitting. Inhale slowly and deeply, making sure that the stomach remains still and the chest rises. Exhale sharply through the mouth, repeat 5-10 times.

3. Expansion of the chest. Stand up straight, take a deep breath, clench your fists and extend your arms in front of you at shoulder level. With a quick movement, take your hands back and smoothly return to the starting position. Repeat several times and exhale sharply through your mouth. During the exercise, the muscles of the hands should be very tense.

In addition to breathing exercises, it is very useful for children with chest deformity to perform exercises for the development of pectoral muscles: push-ups, pull-ups, exercises with dumbbells and an elastic gymnastic tape. Strong muscles of the chest will help slow down the deformation and even stop it, in addition, the developed muscular frame will visually correct the cosmetic defect, “close” the deformed chest.

Swimming is very useful for children with a deformed chest - this sport helps the development of the pectoral muscles and lungs and at the same time has very few contraindications. Volleyball, basketball and rowing are also often recommended for this disease, especially if the child shows interest in them.

Mild chest deformity in children usually does not affect their health, especially if parents take measures to correct the defect: they do breathing exercises with the child, teach him to play sports. And even if the degree of deformation is high, medicine offers effective ways to completely eliminate the defect, ranging from high-tech compression devices to modern operations with minimal intervention. We wish your children good health and good mood!

Curvature of the chest is a relatively rare defect - it occurs in two children out of a hundred. Most often, the diagnosis is made shortly after or at infancy. Particularly pronounced, even parents are able to suspect. The danger of a curvature of the chest in a child is a violation of the functions of the respiratory and cardiac systems, as well as psycho-emotional disorders due to a pronounced defect in appearance.

Brief description and classification

This deviation in the structure of the chest can be congenital (diagnosed in 1-2% of babies) or acquired pathology (noted in 14% of adults and adults), characterized by changes in the structure, volume and proportions of the chest. They negatively affect the location, condition and operation of many organs and systems.

There are three main types of curvature:

1. Funnel-shaped. It visually looks like a depressed or sunken chest, which is why it is often called the "shoemaker's chest." The only effective treatment for pectus excavatum in children is surgery, as the disease tends to progress during adolescence.
2. Keeled ("chicken breast"). The causes of pathology include some defects,. In 20% of cases, keeled curvature is diagnosed along with scoliosis, with age the defect becomes much more pronounced. discover this pathology can be at an early age - at 3-4 years.
3. Flat chest. With this pathology, there is a decrease in the volume of the chest, the child is characterized by an asthenic physique: high growth, low body weight and long limbs. With this defect, the child is more prone to colds.

Did you know?In 19th century America it was popular to give as an analgesic"pain-relieving syrup" (eng. Mrs. Winslow's Soothing Syrup). However, as it turned out later, it contained dangerous chemicals and even strong drugs: morphine, codeine, heroin, chloroform. For many children, this "treatment" ended tragically.

• mild degree - depression up to 2 cm;
• medium degree - depression from 2 to 4 cm;
• severe degree - depression up to 6 cm.

1. Arched chest (Currarino-Silverman syndrome). An extremely rare pathology.
2. Poland syndrome.
3. Cleft of the sternum.

Why does

There are two main versions of occurrence:

1. genetic predisposition. If the disease occurs in distant and close relatives, then with a high probability it will manifest itself in the child.
2. The negative impact of external and internal factors on a woman and during the first trimester, when the laying and formation of bone and cartilage tissues of the chest occurs. Among negative impacts alcohol consumption is noted infectious diseases, strong psycho-emotional shocks.

• chronic diseases respiratory system;
• rickets;
• kyphosis;
• bones;
• or Turner;
• severe chest injury.

How does it manifest

Most often, parents can suspect the presence of a defect by visual signs: the chest becomes disproportionate, sunken or concave, protruding like the keel of a ship. In this case, the curvature of the spine occurs. Breast curvature is also accompanied by other symptoms:

• paradoxical breathing, in which the ribs sink down at the time of inspiration, which leads to respiratory failure;
• limitation of motor activity;
• developmental delay;
• shortness of breath, vegetative;
• rapid fatigue during physical exertion;
• weakness;
• frequent respiratory illnesses.

Which doctor should be consulted

Breast curvature requires the participation of many specialists who will not only eliminate the pathology, but also, if necessary, normalize the psychological state of the child. If a pathology is detected, the help of such doctors may be required:

• thoracic surgeons, in whose competence are the organs of the chest;
• orthopedists, if the pathology affects the functioning of the limbs and spine;
• traumatologists;
• cardiologists, if the curvature disrupts the work of the heart;
• pulmonologists, if the curvature disrupts the functioning of the respiratory system;
• geneticists;
• child psychologists if the curvature affected the emotional state.

How is the diagnosis

As a rule, the diagnosis of curvature of the chest does not cause difficulties. Diagnosis is made using physical and functional methods, less often instrumental and laboratory studies. Initially, the pediatrician examines the child to identify:

• size, shape of the chest;
• degree of curvature;
• noise and other disorders of the heart;
• respiratory and work disorders.

1. The exact shape and degree of curvature can be determined using x-rays. It is done in two projections: front and side.
2. CT can detect compression of the lungs, displacement of the heart.
3. MRI is rarely done. The study gives an extensive picture of the state of bone and soft tissues.

Fundamentals of effective treatment

If the pathology is congenital, it is an independent diagnosis, however, in the case of acquired curvature, every effort must be made to combat the underlying pathology, which led to breast deformity. Treatment is more successful in children, as their bone and cartilage tissue is more pliable and flexible. Therefore, if the pathology is seen on initial stage and is expressed slightly, it makes sense to try to eliminate it by traditional methods.

Important! Parents whose children are diagnosed with this pathology should clearly understand that conservative methods (exercise therapy, massage, corsets, exercises, etc.) are in no way able to eliminate a pronounced pathology. However, they must be performed for the normal functioning of the respiratory and cardiac systems. A curvature that disrupts the functioning of the lungs and heart is treated only surgically!

conservative methods

Conservative methods of treatment are used in the following cases:

1. If the deformation delivers only (!) aesthetic discomfort and does not affect the operation and location of the internal organs.
2. After surgery to remove residual effects deformations.
3. To normalize and maintain the functioning of the lungs, heart, musculoskeletal system.

Important! When performing breathing exercises, it is extremely important to monitor inhalation and exhalation: inhalation occurs through the nose, exhalation through the mouth. Breathing is also important during physical activity- at the moment of effort, you must always exhale.

Surgical correction

The following criteria are considered indications for surgical correction:

1. The curvature negatively affects the functioning of the internal organs, leads to their displacement, and is the cause of labored breathing and heartbeat.
2. The curvature gives a person such a strong psychological discomfort that it interferes with normal interaction in society.
3. The curvature significantly affects the spine and. This is dangerous due to the formation, pinching and inflammation of the nerves, severe pain syndrome, protrusion.

1. With the use of implants.
2. With the use of internal / external fixators.
3. Flip of the sternum by 180°.
4. Operations without the use of clamps.

Did you know? Since ancient times, doctors have used dangerous and harmful substances: opiates, marijuana, cocaine, alcohol and even strong blows on the head to stun a person. In the 19th century, there were attempts to use nitrous oxide - the substance caused inadequate fits of laughter, and at the same time was an anesthetic. And only a little later they began to use medical ether.

Possible Complications

The development of complications and relapses after surgical correction depends on many factors - the age of the patient, the type of operation, the severity of the deformity, the presence of an initial or concomitant. Most often, a relapse occurs - the re-formation of a defect, and the more complex the initial pathology, the higher the chances of a relapse after surgery.
In the first hours after the operation, the body of the operated patient adapts to new conditions. At this time, respiratory failure is possible. Its causes are liquid and air in pleural cavity, and sputum in the respiratory tract, retraction of the tongue. To alleviate the condition and eliminate the lack of air, the patient is shown oxygen and mixtures after the operation. Among other complications, in addition to relapse, the following are possible:

• allergic reaction to implants, retainers and metal plates;
• twisting of the plate, if the operation was performed without clamps;
• inflammation of the pericardium;
• the occurrence of a keeled curvature.

Preventive measures

As exact reasons Since the occurrence of chest deformity has not been established, then the methods of prevention in order to avoid treatment are rather subjective.
Most experts give the following recommendations:

1. During the period, especially in the early stages, exclude alcohol and any drugs, minimize stressful situations, if possible, avoid taking . During the height of epidemics, expectant mothers should not visit crowded unventilated places so as not to catch the infection.
2. Also, during the gestation period, it should be correctly drawn up. The same applies to the baby when he stops eating mother's milk.
3. At an early age, the child should be systematically examined for the purpose of prevention and early detection defect.
4. From an early age, the baby needs to instill a love for sports and exercise, encourage active image life. This will have a positive effect on posture and the entire musculoskeletal system.
5. It is necessary to treat all acute and chronic diseases, especially those affecting the respiratory tract, in time.
6. Avoid injury, burns.

Types of deformation

1. funnel-shaped(depressed), these changes are due to the fact that the sternum (the bone in the center of the chest) goes deep, it is also called the "shoemaker's chest".
2. keeled(rachitic) when the sternum strongly protrudes forward. It is compared to the keel of a ship. This condition is otherwise referred to as "chicken breast";
3. dysplastic chest(flat), with it a decrease in the volume of the sternum is noticed.

Causes of the appearance of pathology

Congenital include:

• genetic factors;

• rickets;
• tuberculosis;
• scoliotic disease;
• kyphosis;
• osteomalacia;
• Turner syndrome;
• Down's disease;
• chest injury.

Symptoms

• up to 2 cm - the first degree;

• up to two cm - the first degree;

Diagnostics

• chest x-ray;

• breathing exercises;
• massotherapy;

When diagnosing more severe forms of deformity, surgical intervention is used. Experienced orthopedic surgeons perform operations to change the deformity of the child's chest. In 90-95 percent of cases, a positive outcome of the operation is achieved.

Diagnostics

Doctor Komarovsky about rickets

Rickets is a diagnosis that scares parents of babies even more than the flu. From childhood, grandmothers' frightening stories have firmly settled in the minds of moms and dads that if you eat badly, then terrible rickets will definitely happen.

• Doctor Komarovsky about rickets
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• Types of pathology
• Etiological factors
• Acquired deformity
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• Keeled shape
• Diagnosis and treatment
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Girls and boys have grown up, become parents themselves and already know that rickets has nothing to do with the amount of food eaten, but this does not make it any less of a problem, especially if the local pediatrician sighs sadly at the next examination of the baby and says that the baby has a condition close to rickets or even some degree of rickets. Evgeny Komarovsky, a well-known pediatrician, tells about what it is and whether it is necessary to be afraid of it.

About the disease

Rickets is a typical childhood disease. It is associated with insufficient mineralization of bones, with improper formation of the bones of the skeleton. This condition occurs when the baby is actively growing, and his body is pathologically lacking in vitamin D. Rickets can be associated with a lack of calcium, phosphorus, and sometimes it occurs when completely normal these substances in the blood test. The disease can be acute, subacute and recurrent, and also has three degrees of severity.

Rickets begins, gains momentum, and then goes down on its own, leaving doctors to study only signs of the disease. Secondarily, the disease develops quite rarely, mainly against the background of severe kidney disease, serious metabolic disorders, as well as in children who have been given anticonvulsants for a long time.

It is believed that rickets is most often found in children born in winter or late autumn, as well as living in regions climatic conditions which are not often allowed to be in the sun, or in regions with unfavorable environmental conditions (smoke, air pollution, a small number of sunny days a year).

Artificial workers get rickets more often than children who eat breast milk, since the former absorb only 30% of calcium, and the latter - up to 70%. Vitamin D deficiency impairs calcium absorption.

The main source of this important vitamin- the sun's rays that fall on the skin of the child.

Medicine considers the classic signs of rickets to be sleep disturbance in an infant, tearfulness, poor appetite, shyness (when the baby starts from loud sounds), sweating, especially at night, baldness of the back of the head, with which the baby rubs against a diaper or pillow due to itching of the scalp. The smell of the patient's sweat has a sour specific smell. All these symptoms are characteristic of the initial stage of the disease, which can last about a month.

In the active stage of the disease, various disorders of the skeletal system, softening of the bones, deformation start, the child may experience a lag in mental and physical development. Typical signs are rachitic "rosary", "bracelets" and "strings of pearls". With such beautiful names, medicine denotes not very beautiful manifestations of thickening of the transition of cartilage tissue to bone. "Bracelets" - on the handles, "rosary" - on the ribs, "strings of pearls" - on the fingers. Another visual sign is also called quite poetically - "Olympic forehead". It manifests itself in a noticeable protrusion frontal bone forward.

Then the disease declines, leaving the child with the consequences of rickets for the rest of his life - a violation of posture, deformity of the chest, changes in the bones of the legs. The disease in girls is considered especially dangerous, since the narrowing of the pelvic bones, which may remain after suffering rickets, can cause difficulties in natural childbirth in the future. For such girls and women, a caesarean section is recommended.

Doctor Komarovsky about rickets

Modern pediatricians are very fond of this diagnosis. Firstly, because he relieves the doctor of all responsibility for possible problems in the development of the baby (anything can happen, but they warned you - rickets!), And, secondly, it is as difficult to refute it as it is to prove it. In this case, the doctor makes a diagnosis that does not exist, for example, rickets of 0-1 degree. There is no such disease, says Komarovsky. And rickets of the 1st degree, if desired, can be found in nine out of ten babies early age. In 99% of these guys, the signs of rickets will go away on their own.

If the doctor told you that the child has rickets and did not prescribe additional research, you can not worry - there is no rickets.

If the doctor has reason to assume real rickets (and this happens very infrequently), then he will definitely give a referral to x-ray examination bones of the lower extremities and forearm, will recommend donating blood for the content of vitamin D, calcium, phosphorus.

Nowhere in the world is rickets diagnosed by signs such as chest deformity, sweating or loss of appetite. And baldness of the back of the head is not at all considered a sign of rickets, according to Komarovsky, just Thin hair a newborn, when he starts to turn his head (by 3-4 months), are mechanically “wiped” on the diaper, and no pathological causes you don't have to look for it.

In 90% of cases, the baby's sweating is due to the wrong temperature regime in the apartment where he lives, as well as the fact that his parents do not know how to dress him reasonably and, as a result, they simply wrap him up.

Crooked chest in general can be hereditary, just take a closer look at the sternum of dad, grandfather, great-grandfather. If there is no family pattern, then again there is no reason to worry, because when the need for calcium becomes less, when bone growth slows down somewhat, all the imperfections and curvature will go away by themselves.

But the majority of pediatricians stubbornly do not want to notice the modern world standards for diagnosing this disease, they continue to use the information published by medical textbooks 50 years ago, and therefore the number of children who, due to sweaty legs and a bald head alone, were given the verdict "rickets", in Russia today is approaching 70% of the total number of newborns and infants, while only 1 has a real problem % of children.

Treatment according to Komarovsky

Most often, doctors who diagnosed a child with rickets prescribe him shock doses of vitamin D and coniferous-salt baths. Such water procedures are very useful for children's health, but they have nothing to do with the treatment of real rickets, says Komarovsky. The appointment of shock doses of a vitamin is generally a medical crime. Maximum amount, which is due to the child - no more than 500 units per day or 1 drop of the Aquadetrim aqueous solution. An overdose in a baby can cause severe vomiting, diarrhea, urinary dysfunction, increased pressure up to the development of cardiopathy and cardioneurosis.

If you don’t want to expose your child to such a risk, you don’t have to rush to follow the recommendations to take the vitamin in lethal doses, moreover, in the summer, when walking on the street makes up for the deficiency of the substance in the body quite well. The dosage should be treated more than reasonably.

Walks and Fresh air for a child with rickets (or suspicion of it) are very useful. In the baby's diet, be sure to introduce the intake of cereals or mixtures with a vitamin content. It will not hurt to consult a good children's opropedist, who, on the basis of x-rays long bones legs (shins) and forearms, will dispel or confirm fears. In the second case, he will certainly give his recommendations.

If rickets is associated with a lack of phosphorus, calcium, and vitamin D deficiency, and this is confirmed by laboratory tests, newborns are treated with cholecalciferol. Depending on the test results, calcitriol may be prescribed. This is not enough for premature babies, they are definitely recommended to take calcium gluconate and potassium phosphate.

The prognosis for most children with real, and not fictional, rickets is quite favorable. But what parents should definitely make sure of is the absence of calcium deficiency, it is more common in children than rickets, both with it and separately. If blood tests have shown this deficiency, then it is worth starting to give the child calcium supplements in strictly defined age dosages.

Prevention

Prevention of rickets is not something expensive, complicated and difficult. And therefore, says Komarovsky, it must be dealt with in without fail. If the baby is breastfed, vitamin D should be taken by a nursing mother, the child will receive his dose with milk.

For artificers, especially those born in winter, the vitamin can be given from almost birth (from the second or third week), but if he eats an adapted mixture, then it already contains this substance. As soon as complementary foods make up about a third of the daily ration for a breastfed baby, he should be given vitamin D if he is prepared with regular milk.

If baby porridge already has it in its composition (and most of these modern instant cereals do) or is prepared on an adapted mixture that also contains this vitamin, then there is no need to take the drug separately.

Half an hour in the sun a day covers the daily requirement for vitamin D. If there is little sun (from October to March in most regions of Russia), then vitamin preparations should be taken strictly in age dosage. An overdose of this vitamin is worse than its lack.

You can learn more about rickets from the next broadcast of Dr. Komarovsky.

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Source: chest deformities in children, treatment with massage, exercises

Pathologies of the skeletal system are quite common. Chest deformity in children can be congenital or acquired. In this case, the position of internal organs, in particular, the heart and lungs, may change.

The chest is part of the child's torso. It is formed by the following structures: ribs, sternum, spine and muscles. This bone frame limits the chest cavity, in which the vital organs are located. important organs(heart, lungs, esophagus, trachea, thymus). Normally, the chest is slightly compressed in the anterior-posterior direction. Its main purpose is to protect internal organs.

Types of pathology

Chest deformity in a child pathological condition, characterized by a change in the shape, size and volume of the chest due to congenital or acquired malformations.

This condition not only poses a threat to the health of the baby, but is also a serious cosmetic defect. With such an ailment, the distance between the spinal column and the sternum decreases, which can contribute to squeezing the organs. This pathology is diagnosed most often in boys. There are 2 types of chest deformity in children: congenital and acquired. The latter develops against the background of exposure to the body of various harmful external and internal factors.

Most often this occurs during active bone growth. Concerning birth defect, then it may not manifest itself for a long time. Progression is observed during the period of intensive growth of bones (ribs). The incidence of chest deformity in children varies from 0.6 to 2.3%. Today, the following types of chest deformity are distinguished:

• keeled (chicken);
• funnel-shaped (chest shoemaker);
• flat;
• curved;
• Poland syndrome;
• split chest.

The last three types are diagnosed very rarely.

Etiological factors

Deformation of the chest in children occurs for certain reasons. The acquired form of pathology is formed against the background of the following predisposing factors:

• violation of the posture of the child;
• scoliosis;
• rickets;
• bone tuberculosis;
• chronic lung diseases;
• neoplasms (chondromas, osteomas);
• traumatic injuries;
• severe burns;
• diseases connective tissue.

Less common causes of acquired chest deformity in children are purulent diseases(osteomyelitis, phlegmon), mediastinal tumors, emphysema. Sometimes the cause may be surgical operations (thoracoplasty or sternotomy). Congenital curvature may be due to heredity or exposure to the fetus of various teratogenic factors. Violation of the formation of the chest frame is one of the manifestations of Marfan's syndrome.

Acquired deformity

In children and adolescents, the shape of the chest can change with various diseases. Most often it is associated with pathology of the lungs. In medical practice, there is often a paralytic form of the chest, barrel-shaped, kyphoscoliotic and navicular. The paralytic form of the chest is formed against the background of pulmonary fibrosis. At the same time, the volume of lung tissue decreases. The size of the chest is reduced. In such patients, the shoulder blades stand out sharply. If the chest becomes like a barrel, this indicates the development of emphysema. In this case, the ribs are located more horizontally, and the gaps between them increase.

A kyphoscoliotic type of chest can form if a person has a tuberculosis infection, rheumatoid arthritis. The cause may be a curvature of the spine. With a boat-shaped chest, there is a recess. It is formed in the middle or upper part of the sternum. The main cause of this disease is syringomyelia. Acquired deformity of the chest in most cases occurs between the ages of 5 to 8 and 11 to 15 years.

Funnel chest

Funnel chest deformity is associated with a congenital malformation. Its main feature is the retraction of the ribs and costal cartilages. In this case, the depth of depression can be different. Depending on this, 3 degrees of severity of pathology are distinguished. Light degree characterized by a funnel depth of up to 2 cm. Treatment can be conservative (massage, exercises). At the second degree, the size of the funnel is 3-4 cm. At the same time, a displacement of the heart by 2-3 cm is observed. At the 3rd degree, the heart changes position by 3 cm, and the depression is more than 4 cm. Funnel chest deformity is diagnosed in 1 baby out of 300. In most cases, this defect is gradually corrected and by the age of three the deformity disappears. In more severe cases, the child subsequently becomes disabled.

In the general structure of congenital malformations, the funnel chest is about 90%. Along with a change in the shape and volume of the chest, such children experience rotation of the heart and curvature of the spine. The main cause of this disease is a violation of the formation of hyaline cartilage tissue during fetal development. Funnel chest is dangerous because against the background of a decrease in the volume of the chest cavity, the following complications may develop:

• increased blood pressure in the pulmonary circulation;
• insufficient saturation of blood with oxygen;
• dysfunction of organs;
• violation of acid-base balance;
• amyotrophy;
• respiratory failure.

In such children, there is a risk of squeezing the bronchi and changes in the location of large vessels. The symptoms of this pathology depend on the age of the child. If the child is less than 1 year old, the ribs and sternum may retract during inhalation. At preschool age, the defect contributes to frequent respiratory diseases(bronchitis, pneumonia). In this case, laryngotracheitis develops very often. Quite often at such children stridorny breath comes to light. It differs in that there is difficulty in breathing. In addition, muscle tension, retraction of the abdomen is determined.

Almost always after 3 years, the funnel chest leads to a curvature of the spine. Thoracic kyphosis becomes more pronounced. Some children develop lateral curvature of the spine. Symptoms are most pronounced in older children. During this period, the following symptoms may appear:

• protrusion of the abdomen;
• drooping shoulders;
• pale skin;
• weight loss;
• dyspnea;
• fast fatiguability;
• increased blood pressure;
• signs of bronchiectasis.

Keeled shape

A little less often, keeled breasts are diagnosed in children after birth. Boys suffer from this disease about 3 times more often than girls. In girls, this pathology progresses at a younger age. The keeled chest is dangerous because it can lead to emphysema. All this contributes to the violation of gas exchange. Very often, the keeled chest is combined with scoliosis.

The main cause of this pathology is the excessive growth of cartilage tissue in the area of ​​the ribs. Most often, such a violation is detected in the region of 5-7 ribs. If in the previous case there was a recess (funnel) in the chest, then in this situation the opposite is true: the sternum protrudes forward. The main manifestations on the part of the body will be: tachycardia, a change in the configuration of the heart (it takes the form of a drop), shortness of breath and low endurance. With age, the defect becomes more noticeable. The main method of treatment is surgical.

Diagnosis and treatment

Any experienced doctor, including the well-known pediatrician Komarovsky, can visually detect chest deformity. Nevertheless, the diagnosis must be comprehensive. It includes a visual examination, a questioning of the child or his parents, a physical examination (listening to lung and heart murmurs), an examination of the oral cavity and the entire skeleton of the child. For more accurate information, an X-ray examination is performed. The depth of the funnel is also measured (with a funnel cell). Additional diagnostic methods include ECG, EchoCG, MRI of the heart, determination of lung capacity.

Treatment of this pathology can be conservative and surgical.

Conservative therapy is carried out with mild deformity and includes exercises, massage, swimming, wearing special corsets.

If there is a congenital pectus excavatum, conservative therapy is indicated only at grade 1. Exercises, massage and other methods in this situation are carried out in order to prevent the progression of pathology, strengthen muscles and ligaments, prevent spinal curvature and increase lung capacity.

If exercise (exercise therapy), massage and other therapies are ineffective, surgical intervention is performed. With a funnel-shaped chest, surgical treatment (plastic surgery) is preferably carried out at an age. Absolute indications for surgery are: severe degrees funnel-shaped chest, deformities that caused a mental disorder in a child, the presence of congenital cleft chest, Poland syndrome. Contraindications for surgery include mental retardation and severe accompanying illnesses CNS, heart and respiratory system. With congenital deformity, the effect of thoracoplasty is very good. Thus, chest deformity requires close attention of doctors and timely treatment.

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Source: there are mothers whose children have chest deformity

Redness and itching in a child

Magne B6 - what is it for?

Comments

Hello, and today we were at the surgeon with the elder (we are undergoing a medical examination for the kindergarten), she said that He had a deformity of the chest. Insignificant, but in order to avoid future risks of pathology for the heart and spine, exercise therapy and special massage are needed. I ask: why would that be? Says rickets. There was never rickets and did not set. The orthopedist said that swimming from the age of 4 and playing sports. We take vitamin D regularly. I don't know if I'm afraid or not

I have the same problem, not a big deformation, they also say you need to go swimming

I have a friend. from the point of view of medicine, I can’t say anything, I don’t know))) Love and praise more, my friend never had a complex about this, she calmly put on swimsuits, tops, that’s how I say I’m unusual!))))))))) Plus On top of everything, she says, if you look from above, my one-girl looks like 2+))))))))))) Now she has a wonderful husband and her son is 3 years old. I wish you health, but I actually wrote to the fact that if we cannot change something, we can change our attitude towards this))). And if you also go in for sports, it will be just fine!) By the way, one problem is all- she still has it, with fluorography every time she draws attention to this, because in the picture the deformation gives a shadow

Did you take vitamin D?

Gave didn't help

no, let's go tomorrow

This is odin iz priznakov rahita. From vitamin D i dependent

My son has a deformity. We have a keeled form of deformation. While it is not pronounced, the ribs from below seem to be upright. If you look closely, and feel it, you can feel it. The surgeons don't say anything either. Everything, as usual, like all children, needs physical education, swimming, massages. And so, they said that it will not be fixed. It is necessary to correct the situation surgically already when there is really compression of the internal organs, or it looks very bad aesthetically, and many people live with this all their lives. I also read a lot about it.

didn't go to an osteopath

Pochemu imenno k osteopatu?

nuya heard they work wonders right

I should also go. We, too, according to several rehabilitators, have problems. I really don't see them..

Well, every doctor has his own opinion.

My son categorically does not let anyone near him. Tried to go to a very good massage therapist. As a result, I barely survived one session. Masseur for children, the best in town. He said that so far the massage would not bring any benefit. In a psychological sense. So for now we are waiting. Let's try again in a year

I called the physiotherapist and they told me that it is possible to fix it

I don’t know how much I understood from all my consultations and the Internet that you can only strengthen the pectoral muscles so that it is not very noticeable. And the only way to fix it is by surgery.

well, yes, basically everyone writes like that, but some mothers on the forums wrote that after physiotherapy or some other measures, mainly gynastics, sports, that there was an improvement. now I read in general that this is one of the symptoms of connective tissue dysplasia. there is still a lot of side effects, not only such a cell can be. Here is fear this and have us genetic. then such children often get sick with bronchitis, they various diseases the heart of the lungs, unless of course the degree of deformation of the cell is quite large and interferes with the internal organs

We have genetics, my husband, and his father has this. Not very pronounced. But still (

Do they have other signs of connective tissue dysplasia?

well. there are a lot of signs of connective tissue dysplasia. In general, I think that every person can find at least one of the signs in himself.

Source: chest in a child Komarovsky

As I found out, I was shocked, because there are no pathologies anywhere in the family at all. and here it is. I cried for several days in a row.

Then she pulled herself together and began to study literature on an Internet.

We have already had one massage course, we will repeat it in 1.5 months. I am engaged with the kid in the bathroom - he loves to swim. We constantly do exercises aimed specifically at the chest.

Of course, it's easy to say - it's not their child.

Is it possible to cure without surgery.

Was at other doctors, the degree is also not given.

We have already gone to the Kozyavkin center for treatment twice - they also said that the muscles should grow and then the defect will disappear.

How old is your child, months or years old? and how are you doing?

I started to deal with the child right away, I'm afraid of the consequences, and so as not to make fun of it. In the summer, even without a T-shirt, they wouldn’t let me into the country. Only my husband and mother know about me, but we hide it from everyone.

And how is the result in 1.5 years? very visible?

With regard to such deformations, they must be observed in dynamics, if there are no deviations in the heart and lungs, as well as an increase in the defect, then it is not very scary. If you have a girl, then later the breasts will grow, and the lower protruding ribs will not be very conspicuous. What if it's a boy. Just look at bodybuilders - a mountain of muscles and not a single bone is visible. Then choose a sport.

The main thing is not to complex yourself. Your child and you love him most of all, and this is the main thing.

The complex is that I think about his future, so that later he himself did not complex, and so that his peers would not.

We also thought about sports. The doctors said that it does not affect the organs.

I understand that you have a boy? Do you go to kindergarten? And does he notice it himself .. although he is small, he should not.

People, of course, are evil (those who themselves are not all right), nurture the child's self-confidence and do not complex yourself.

What sport did you decide to send your daughter to?

In general, my husband dreams of football!

My daughter is 2 years old. Since 3 months we have been diagnosed with funnel chest. I was also worried, I couldn’t find a place for myself, especially when I read all the consequences of this pathology on the Internet, my hair stood on end. but you get used to everything. got used to this situation. I don’t want to upset you, but massages and gymnastics are not very effective in this case! the disease reaches its maximum by the 3rd year of life and only then it will be seen what degree of deformation you have.

so for now I live with it, I love my child and inspire him that he is the best and most beautiful, and of course I hope that the deformation will remain of the first degree.

we are already 9 months old, and thank God there is no deterioration .. everything remains the same. The only thing I noticed is that the baby is growing very actively, and against the background of the breast, this pathology has become smaller.

you see, it means that some people have a result!

And I'm wondering if they have this hereditary thing that two children showed up?

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Source: chest deformities in a child: what to do and how to fix?

Chest deformity in children is a congenital or acquired change in the physiological shape, volume and size of the sternum. And there can be many reasons for this pathology. What to do and how to treat the disease? Let's consider everything in order ...

The chest is a kind of musculoskeletal frame of the infant organism and adolescents. Due to the deformation of the sternum, children may experience various functional failures in the body, for example, the respiratory system, cardiovascular, and mental. Psychological disorders can be caused by the child's complexes due to their external flaw.

Types of deformation

Exist the following types this pathology:

1. funnel-shaped (depressed), these changes are due to the fact that the sternum (the bone in the center of the chest) goes deep, it is also called the "shoemaker's chest".
2. keeled (rachitic), when the sternum strongly protrudes forward. It is compared to the keel of a ship. This condition is otherwise referred to as "chicken breast";
3. dysplastic chest (flat), with it there is a decrease in the volume of the sternum.

Causes of the appearance of pathology

There are two causes of deformation of the sternum in children - congenital and acquired.

Congenital include:

• genetic factors;
• violation of the formation of the skeleton (sternum, ribs, spine, shoulder blades) at the time of an increase in the volume of cartilage and bone tissue of the breast of a child in the womb.

Acquired causes of deformity include various chronic diseases:

• rickets;
• tuberculosis;
• scoliotic disease;
• kyphosis;
• osteomalacia;
• chronic lung diseases;
• Turner syndrome;
• Down's disease;
• chest injury.

Symptoms

The transformation of the chest manifests itself in different ways, it is affected by the type of deformation and the age of the child.

Funnel chest deformity in children (sunken chest)

This type of pathology is observed in children much more often. The reason is the insufficient development of the costal cartilages in the chest area (central or lower parts), a depression appears.

There are three degrees of funnel deformity:

• up to 2 cm - the first degree;
• from two to four cm - the second degree;
• more than four cm - the third degree.

Deformations can be very different from each other: depressions are narrow and deep, and vice versa, they can be wide and shallow. One-sided retraction of the sternum is often observed.

In children under the age of 3 years, it is very difficult to identify the symptoms of the disease. These manifestations are most often associated with prolonged, often recurring viral diseases that can progress to pneumonia.

Children 7-10 years of age and older experience breathing difficulties during and after physical activity, often experience overwork, pain in the chest. They are much more likely to get viral infections than their peers.

In 20% of children, lateral curvature of the spine is observed. In severe cases, organs such as the heart and left lung may be affected.

Keeled deformity of the chest in children (protruding chest)

It is much less common in children. The main reason is the excessive growth of the cartilage of the 5th and 7th ribs. It also has three degrees of severity:

• up to two cm - the first degree;
• from two to four cm - the second degree;
• from four cm - the third degree.

To a greater extent, the keeled deformity of the chest in a child has a cosmetic defect - a strong protrusion of the sternum forward. In addition, the child has difficulty performing exercise, chest pain.

Diagnostics

In order to determine accurate diagnosis, the severity of the disease and what to do next - you need to go through full examination at a pediatric orthopedic doctor with all clinical and instrumental methods.

Diagnosis of chest deformity can be done by two studies:

• chest x-ray;
• magnetic resonance and computed tomography;

Also, an orthopedic doctor prescribes diagnostics of the respiratory system, heart and blood vessels to identify the presence or absence of pathology.

How to fix the situation that has developed with the child? The famous doctor Komarovsky advises parents not to panic. Treatment of deformity depends on the type and severity of the disease. With a slight deformity of the chest in a child, conservative methods of treatment are used. For example, such as physiotherapy measures, wearing individual medical corsets, massage techniques, physiotherapy exercises.

Activities to be performed in the postoperative period:

• breathing exercises;
• massotherapy;
• a set of physical exercises;
• taking analgesics medicines for the purpose of anesthesia;
• regular clinical trials.

When diagnosing more severe forms of deformity, surgical intervention is used. Experienced orthopedic surgeons perform operations to change the deformity of the child's chest. In a percentage of cases, a positive outcome of the operation is achieved.

The rehabilitation period should be as productive as possible, since his future future of the baby depends on it. Therefore, it must be carried out with great benefit for the child's body.

Source: chest ribs!

Urine according to Sulkovich handed over?

It’s amazing, only here I found out about this analysis: ((. We were prescribed only blood and it turned out to be normal.

we are seven months old, we have the same problem, our pediatrician said to drink kidifarmaton and drink vitamin D, and said that in our city all babies with primary rickets, this answer does not suit me, I want to go to another doctor, but he is still on vacation .

Oh, I don't even know what to suggest. my rickets was diagnosed at 3 months, but also uncertainly, but at 1.5 feet X-m steel. and the ribs are slightly twisted, but it is almost imperceptible and seems to pass. And us on feet emphasis in treatment. But coniferous-salt baths will not interfere with you either. Practice with your child every day. They showed me like a masseur how to smooth the ribs so that they fit into place. So we drink calcium in courses, vitamin D 2-3 drops (but right now I give in the summer).

And look we can you have any Institute of Orthopedics. In St. Petersburg, for example, the Turner Institute, they treat severe children there and you can come for a consultation for a fee. And panic strongly, everything is fixable, right now every 2nd person is given rickets and all deformations grow over time. Nobody scared us that 2 years would come and pipets, then everything is useless. For example, then you can do exercise therapy with them, this is after 3 years, until it turns out.

I had the same situation when I was a year old (but the child has lactose intolerance, so calcium was not absorbed from milk in the right amount) now my son is 4 years old and it’s okay to do massage and strengthen the muscles of the back, arms, do extension exercises and monitor posture. There is no question of any surgical intervention, now this is such a feature of the structure of the chest!

Tell me how did you solve the problem?

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Source: Komarovsky funnel deformity

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but they say that it does not fall into the same funnel 2 times. SP: get-togethers

just tin, 10 years ago, my eldest before NG stuck a cucumber into her nose, I didn’t think that after 10 years I would stand pieces of drying their nostrils younger. Well, that's why children are so interested in sticking something up their noses. no, I don't understand.

Apparently for prevention 🙂

I read Dr. Komarovsky. A child from birth to one year

His famous book "The Health of the Child and the Common Sense of His Relatives". When my daughter was a baby, I, reading this book, choked with indignation (especially when it comes to carrying and feeding). Now, probably, I'm not such a quivering mother anymore, because I read this author with pleasure :) True, in some places I still smile. Tell me, is it true that there are children who sleep on the balcony from 7 am to 10 pm with breaks only for food? True, there are those who after gymnastics.

Then I relaxed)) From the third life experience saves me)))

Chest deformity. Children's medicine

My daughter has a deformity of the chest (keeled chest) 1 tbsp. The doctors we show ourselves to don't consider it serious illness, because “There is no harm to the body, but the appearance - well. » Of course, this does not suit me, but I do not know what to do. Maybe you can suggest something? Just please do not write that “breasts will grow and nothing will be noticeable” - this is true, but I would rather do something now. We regularly do massages, and that's all for now.

Diving on Komarovsky. A child from birth to one year

Moms, who has experience teaching babies to dive in a big tub? I understand that our third time does not mean anything, but so far there is no progress. The child swallows water, then screams, a minute comes to his senses - it's a pity for him! He probably thinks: “here are the fools of my parents” :) Although today I held my breath twice. Share your experience in this area and impressions, it is very necessary!

Meso and biorevitalization?. Fashion and beauty

Girls, let's share our experience. Rto that pricked, what impressions and recommendations? My experience: 1) meso cocktails (with hyaluronic acid, vitamin C, etc.) - the complexion has refreshed for the duration of the course, I think it's just a reaction to an injury and that's it. didn't notice anything else. 2) Princess Rich - nothing at all, money thrown away. Now I'm in a frenzy. after winter earthy complexion, dehydration, forehead wrinkled a little. You definitely need something to poke. but here's what. Hyalreper and Hyaluform are advised by a cosmetologist well.

What can I say. hits the pocket very hard. The effect is incomparable with the cost, well, it happened to me personally :)

More details about each type:

Meso is a waste of money if you are not 25 years old. I'm 37 and the effect was zero. Then I went and read it on the internet, it turns out that everyone has known this for a long time, except for me: (In the reviews, they write without exception not to even spend money. Whoever has the effect - it goes away in a week.

Bio - I did not specifically see any improvement (there was a task to moisturize my very dehydrated skin). I did 3 procedures in a row (first 1 IAL, then a stronger one - three Hydrate procedures).

My impressions - for a week (up to 10 days) after each procedure, I went “beautiful”, the marks from the injections became inflamed in places, because I had to use a toner for masking, I constantly looked like I had acne. Only the pain-less everything went away and the face was cleared - and it's already time for a new procedure and so on in a circle :(

Either my case is running, or I don't know what.

Funnel specialists. deformations?. Children's medicine.

Where in Moscow good specialists funnel chest deformity in a child?

Komarovsky about the situation. Society

stole on a friend *** The topic was moved from the conference "SP: gatherings"

Maybe I don't know, I'll be grateful for the links

Tell me about sumamed (((. Children's medicine

Please, dear moderators, do not delete. Girls, tell me about sumamed. why the doctor prescribed it with suprastin. and now in order. my boy has had a high fever since Thursday, snot, and a sore throat, today the doctor visited and prescribed to take sumamed 1 tb. per day after meals, and suprasin 0.5 tb. 2 times a day. I can not understand why not some kind of gastric? (linex, bactisubtil, bifidum bacterin, amoxiclav) and, in principle, why is sumamed dangerous? Thanks a lot, everyone)

who treated giardiasis?. Child 1 to 3

Girls, help, who treated lamblia? Share your experience. To us 2 years the doctor has appointed or nominated makmiror-an antibiotic. I know that Trikhapol is still being prescribed. And we already suffer from constipation, I'm afraid of antibiotics, then another dysbacteriosis will have to be treated. Maybe there is another way? and then these lamblia everywhere: WATER, SAND, DIRTY HANDS. Let's heal now, but for how long? And what again then an antibiotic?

In principle, Macmirror is not an antibiotic, but I have long vowed to stuff my children with drugs in such dubious cases, with their (children's) health being clearly good.

prevenar or pneumo who knows about them? vaccine opponents.

before the kindergarten, I decided to do prevenar 13, already recorded on the 1st of August in pediatrics. recommended there, with the wording - protects well from colds. my friends’ daughter was very ill in the garden, stayed at home, got vaccinated, and for half a year, small snot calmly departed once. other acquaintances are served in the medical center and today their pediatrician was asked if she recommends pneumatic 23, which is more suitable for kindergarten. I put myself in the description in the prevenar of 7 serotypes, in the pneumatic 23 serotypes, as I understand how.

Pulmicort?. Children's medicine

The child was seen by two doctors (one yesterday, the other today). diagnosis of acute obstructive bronchitis. One of the Filatovskaya hospitals says: “get rid of berodual and pulmicort, these are hormones, you don’t need them.” The second (main, pediatrician from paid polyclinic) on the contrary, he says: “leave pulmicort, I insist directly, because it removes replenishment well.” The rest of the appointments are almost the same. I don't know what to lean towards. I was in the hospital two months ago obstructive bronchitis and starting.

How many doctors, so many opinions, and the child is yours, and only you are responsible for his health.

How to beat clubfoot. Orthopedic problems in children

As a rule, in the presence of clubfoot, the muscles develop incorrectly, asymmetrically, unevenly. Some muscles are overstressed and tight, they need to be relaxed (by the way, as a result, a lot of problems can go away: headaches, poor sleep, etc.), and poorly developed muscles need to be pumped up, trained, made to work correctly. At the age of 7-15, the body continues to grow, the backbone and joints are formed, and deformations and curvatures occur where there is no muscle resistance or they contract unevenly. Club-footed children often, when walking, not only place the foot incorrectly, but also make the wrong sending of the leg from the hip. As a result, the knee “looks” to the inside, and it seems that when walking, the legs “kick”. Remember that clubfoot, flat feet, scoliosis are all links in the same chain. What to do? You saw the problem and understood.

Convert dry cough to wet. Children's medicine

Girls, advise a remedy that helps to turn a dry, tedious cough into a wet one. Just do not send to the doctor, There were two today. STUPID. One put ARVI, the other flu. Both gave completely different drugs. The child coughs very dry frequent cough. What to do? On Thursday, take the child to the sanatorium.

1. Plentiful drinking - MANDATORY, frequent fractional.

2. irritants - sour, sweet, salty, every half an hour or an hour. maybe a drop of lemon, a small candy, a lick of pickled cucumber.

after 3-4 days everything is normal and the cough gets better.

School of Dr. Komarovsky. Early development. 03/11/2012

Where to find a good orthopedist. Children's medicine

My daughter has problems with walking and posture. Where to apply? Orthopedist, sports dispensary? slender, young, and walks like a bear. Soon 16. I'm worried. *** The topic was moved from the conference "SP: gatherings"

The child often sighs and yawns - what is it ?. Children's medicine

Good afternoon! About a couple of months ago, I noticed that the child (8 years old) began to sigh deeply and often, about once every minute or two, and yawns too often, although he gets enough sleep. He himself explained to me that it was as if he could not breathe completely, as if there was some kind of barrier. This is not shortness of breath and not shortness of breath, that is, clearly not of a respiratory nature - when he sleeps - everything is perfect. Very active, two hourly training (taekwondo, football) in a row withstands perfectly. Appetite, everything else - c.

Urgently! Alternating antipyretic?. Child 1 to 3

What is alternated with high temperature? Paracetamol doesn't work. Should I try Nurofen?

About rubbing with vodka. I am not a supporter of such methods. And just in case, keep in mind that with cold limbs this cannot be done categorically.

And what is the temperature?

If under 40 and does not go astray, then you can add no-shpu + suprastin (or another antihistamine) to Nurofen and wrap the legs.

Why are there clear snot when teething?

Dr. Komarovsky in his daily five minutes in the morning program answered another question about snot during teething. Here is what he said: Indeed, when teething, local immunity decreases and the risk of catching viral infection increases, given the decrease in the influence of mother's milk after 6 months of age, as a supplier of antibodies. But there is a transparent snot and other explanation - the fact is that the aorta passing through oral cavity also passes through the nose.

At the appointment with a neurologist: a few words about the norm and pathology.

Examination of a child by a neurologist at 1 month

About crooked legs

Another well-known manifestation of rickets is the X-shaped or O-shaped curvature of the legs. Less known, but much more dangerous deformations pelvic bones in girls, which can later cause serious problems at the time of delivery. Vitamin D deficiency in a child's body occurs as a result of insufficient intake of this vitamin from food, or due to insufficient insolation of the baby's skin, and most often as a combination of these two reasons. deficit sun rays ultraviolet spectrum for such, in about.

And the relentless promotion of exclusive breastfeeding of children (if it is effective, of course 🙂 leads to the fact that our pediatricians will increasingly encounter cases of "terry" rickets. Unless, of course, the same pediatricians take active steps to prevent rickets in children By the way, colleagues of our children's doctors from the US and Britain have already encountered this problem.The fact is that human milk contains very little vitamin D - only IU (international units) in 1 liter. daily requirement the child in this vitamin is about 400 IU. As studies show, in large cities of northern latitudes, due to atmospheric pollution, the earth's surface reaches minimal amount solar

I am now 23 years old.

I have chicken breasts.

And I am ashamed of it.

Whether it is possible to recover?

And isn't this disease dangerous, why is it dangerous to me now?

Our guest is Evgeny Olegovich Komarovsky.

I never allow myself to criticize my colleagues, I try to treat any child the way I would treat my own, but I have to cancel some previously prescribed drugs, make other diagnoses (mostly correct). If this is done by a certain professor, this is understandable, but if not by a professor. And if a certain doctor unsuccessfully treats with hormones bronchial asthma, and then at a reception with Komarovsky it turns out that it is not asthma, but whooping cough, then the doctor does not at all feel joy that someone turned out to be more attentive and more professional. Moreover, this causes not a desire to improve one's own qualifications, but negativism in relation to the opposite "very smart" Komarovsky. Nothing can be done about it. Yes, I'm not trying to do anything. I’m not bored, there are enough patients, the results of treatment seem to be quite good, what can I complain about. We respect only real power, real.

Pacifier and breastfeeding: my pros and cons

Some pediatricians advised the use of a pacifier in order to eliminate such a bad habit as sucking fingers and clothes, while others, on the contrary, warned that sucking a pacifier could lead to malocclusion and decreased lactation in the mother. By the time my first son was born, I still hadn’t decided which “school” I should follow, and just in case, I stocked up on a few pacifiers different firms(cherry, teardrop, and beveled orthodontic). The baby was born, and even in the hospital, I noticed how strong the intrauterine habit of thumb sucking is. Auxiliary

My mother gave pacifiers to a child for the first time, because. I was afraid to be alone with him without this “weapon”, when I simply needed to take care of my health after childbirth. It is ALWAYS GOOD if a child takes a pacifier, the main thing is that he knows how to take it - you never know when it will come in handy. And to give or not to give is your right.

I was more fortunate, I primarily used the seventh tip of intuition.

Children's heart. Childhood diseases

Treatment of mother's love. Psychology and education.

Psychotherapist B.Z. Drapkin offers a unique method of treating neurosis, enuresis, stuttering, vegetative dystonia and other ailments in children.

Hydrocephalus: do not miss the time! Child health up to a year

Signs of hydrocephalus in newborns, treatment of a child with hydrocephalus

Scary doctor. Why are children afraid of doctors? Children's health

Help the doctor to be good!

“The doctor is simply obliged to examine the oral cavity for any illness, and he will do this regardless of whether Masha wants to open her mouth or not. In the latter case, it will be painful and unpleasant. I completely agree with Ptichka - this is SADISM. A good doctor will be able to make Masha open her mouth herself, and examine it so that Masha does not want to leave the office .. There are even sisters who manage to take blood from children like this ( light hand+ jokes-jokes) that kids don't cry (I know cases).

Grandmother: a social phenomenon through the eyes of a pediatrician.

To deny the huge role of grandmothers in the upbringing of the younger generation is simply pointless.

Cephalhematoma: everything is fixable! Newborn

In this case, a certain amount of bilirubin (the breakdown product of hemoglobin in tissues) will enter the bloodstream and the child may develop jaundice that will last longer than physiological (transient neonatal jaundice) and will not disappear by the 10th day of life. In these cases, the periosteum in the region of the cephalohematoma thickens, the hematoma ossifies, that is, it ossifies, followed by bone growth, which leads to deformation or asymmetry of the skull. Under the cephalohematoma, a bone fracture is sometimes found, through which communication with the epidural hematoma is possible. Diagnosis of cephalohematoma is usually not difficult. Ultrasound examination can help in clarifying the prevalence of cephalohematoma, as well as in excluding the presence of a bone defect and cerebral herniation.

Doctor, I have it. About diseases

Finally, he releases the half-strangled victim, shaking his head in concern. - Yes, my dear, the case is serious! - and turns to the assistant, - Andryusha, an injection of "magnesia". To the head. In life you often hear: a doctor is rude, inattentive, never listens to the end, interrupts, pretends to be God knows what. We have to admit: yes, in our medical universities they don’t teach good manners, where would they fit into the program. However, firstly, good manners are not yet a guarantee against conflicts: politeness without attention to the patient is even more antagonistic to the doctor. And secondly, according to some observations, the source of conflicts between the doctor and the patient is very often.

Notes from a young mother. Part I. Shopping for a newborn

Having little experience(my daughter is 3 years old) and after reading magazines and all kinds of books, I made a rough list of what might come in handy, and took up a survey of recently born friends about what they really needed and what they can do without.

Heart secrets. Heart defects in children. First visit to the doctor

To be sure of the health of the baby, parents can do this study without a referral, for a fee at the medical center. What can alert the doctor and parents? Noise in the heart. It is detected by the doctor when listening to the baby's heart. Echocardiography in this case is mandatory. Noises are organic, which are associated with heart disease, and inorganic, or functional. Functional noises in children are normal. As a rule, they are associated with the growth of the chambers and vessels of the heart, as well as with the presence of an additional chord or trabeculae in the cavity of the left ventricle (heart chamber). A chord or trabecula is a strand that stretches from one wall of the ventricle to another, around it a turbulent blood flow is created, traces.

no teeth at 11 months. Children's medicine

This is fine? At birth, the child was diagnosed with hydrocephalus, but the child develops normally. Sits, stands, tries to speak. But no teeth yet. Or is it worth it to sound the alarm? P.S. The child is not mine, but a very close friend.

Syndrome of movement disorders. Other children

Hello, I'm not from this conference, but I have a question about the cat. somehow there is no answer. Syndrome of movement disorders in a child. The child is 2 months old. What is it in general and what does it threaten in the most extreme cases? Thanks in advance for your replies!

The syndrome of movement disorders in children under one year old is the collective name for muscle tone disorders. Varieties are possible: syndrome of muscular hypotension - weak tone, muscular hypertension - increased, muscular dystonia - different tone in different limbs (where it is increased, where it is lowered).

The syndrome of muscular dystonia is now being put on EVERYONE without exception, forgive me. There is even such a joke - “if there is no SMD in your child’s card in the first year, then you just forgot to visit a neurologist” 🙂

So if the neurologist does not sound the alarm, but simply prescribes a planned course of general massage, then this is the NORM. Violations of tone by a year and a half will pass.

To mothers of restless children: PEP - myths and reality.

Girls, we were given para-whooping cough. Cough. Other children

Girls, we were given para-whooping cough. We've been coughing for 2 weeks now. But now - even and vomiting has gone. Started taking antibiotics. Help in any way you can. Who was sick. With our neurology, we only lacked whooping cough. And so he could vomit if he choked.

Now your task is to reduce the number of paroxysms to a minimum, notice what causes seizures in you and avoid these situations. Limit all types of activity (if possible), avoid bright lights, loud sounds. The room in which the child should be quiet, even during the day you can curtain the windows, disturb the child less, prevent outbursts of anger in him, you can even give up educational principles for this time and go completely on about the child, if only he was less nervous. Feed, drink very small portions, but more often, no irritating food.

I don’t want to upset you, but complications occur mainly in the respiratory system and in the brain. But I want to please you, most complications occur in infants (up to a year). I don’t want to scare anyone, personally, I haven’t vaccinated my child against whooping cough yet (we had contraindications and we got it after a year), I didn’t go anywhere with the child. There is no vaccination against parapertussis, but after a year it is no longer so dangerous.

Each paroxysm is brain hypoxia (to one degree or another), even in children “without neurology”, convulsions can develop - often in infants, rarely in older ones. I ask again, do not be afraid, you are already older, these complications occur mainly in the chest, but after severe paroxysms, hemorrhage in the brain, eyes, skin and mucous membranes can develop. I will not describe further all the horrors and what are the complications of the respiratory tract, but you must clearly understand what your efforts should be aimed at - to reduce the frequency of paroxysms. In my opinion, all the appointments were made correctly for you, but you still need to consult with the treating neurologist, maybe they will tell you something.

Hold on and get well soon, your recovery stage will begin soon and it will be easier, the paroxysms will still remain, but they will no longer end with vomiting. Get well!

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