Friday, July 26, 2013

AIDS in children

Infection with human immunodeficiency virus is a viral disease that progressively destroys white blood cells and causes acquired immunodeficiency syndrome (AIDS, according to Eng: Acquired Immunodeficiency Syndrome). 



Infection with human immunodeficiency virus (HIV, according to Eng.: Human immunodeficiency virus) which progressive deterioration of the immune system, which opens the door to opportunistic infections, especially in adults, certain types of cancer. 



AIDS (AIDS) is the late stage of HIV infection and for the time being is lethal. HIV infection and AIDS primarily affects young adults. Only about 2% of people infected with HIV in the United States as children or adolescents. However, the number of young adults who have acquired the infection in adolescents is growing rapidly. In 1995. year in the United States were more than 3,000 children with AIDS and at least 1200 with covert infection. Each year, new cases recorded 800-1000. Approximately 90% of children infected before, during or shortly after birth; 61% blacks, 23% Hispanics, and 15% white. 



Causes 

HIV infection is caused by viruses HIV-1, or, rarely, HIV-2. Young children almost always get the infection from their mothers before or during birth, although it is more than 2/3 of children of mothers with HIV will become infected. Infection can also be obtained after birth because the virus can be excreted breast milk. 



Transmission from mother to child is not the only way children can become infected. Although rare, the second transmission of infection is sexual contact with child abuse. The child could be infected blood transfusion before in 1985. year. Boys with hemophilia who received clotting factor preparations before the mid-1980s could be infected if they were blood products contaminated with HIV. Since 1985. The collected blood is controlled by the presence of antibodies to HIV. Made significant steps towards the safety of clotting factor concentrates. Today in the United States seldom that a person infected with HIV through blood transfusion by blood products. 



In the same way as the infected adolescents and adults: sexual contact, by sharing infected needles by drug abuse, and although now rarely before in 1985. The blood transfusion. 



The virus can be transmitted through homosexual and heterosexual activity. Male homosexual activity is responsible for 33% of new HIV infections in adolescent males, and heterosexual activity is responsible for 54% of cases among ado-lescenticama. Sharing of infected needles is responsible for 11% of new cases among adolescents of both sexes. 



The virus is not transmitted through food, water, household items, or social communication at home, at work, or at school. In very rare cases, HIV is transmitted through infected blood skin. In almost all such cases, the skin has been damaged by scratches or open wounds, or anything else. Although saliva may contain a virus, never confirmed the transfer of a kiss or bite. 



Symptoms and Complications 

Infection before, during, or shortly after birth is not immediately obvious. In 10% - 20% of children problems begin during the first or second year of life, the other 80% - 90% of the problems begin until years later. In about half of children infected with HIV-AIDS diagnosis is set to the third birthday. 



If the disease starts after infancy, changeable intervals illness with periods of relatively normal health.Infections acquired in adolescence often remains hidden or causes scant symptoms for months or years, it looks like the infection acquired in adulthood. 



Different symptoms and complications occur in the child's immune system deteriorates. Approximately 1/3 gets pneumonia (lymphocytic interstitial pneumonitis), usually in the first few years of life. As a result, the occurrence of cough and batićasti fingers, depending on the severity of lung involvement. 



Pneumonia caused by the microorganism Pneumocystis carinii seriously endangers a child with AIDS.Children born with HIV usually have at least one episode of pneumonia penumocistis in the first 15 months of life. More than half of the infected children before or after get pneumonia. Pneumocystis pneumonia is a significant cause of death among children and adults with AIDS. 



In a significant number of infected children progressive brain damage prevents or slows the normal mastery of psychomotor functions 



Diagnosis 

On HIV infection is suspected in children of mothers with known infection or in children with symptomatic HIV infection or immune problems. In newborns, the standard test for antibodies against HIV has no diagnostic value because of their blood antibodies are almost always the mother who is infected with HIV (even if the child does not have to be infected). The majority of infants these antibodies retain 12-15 months or more, but finally lost from the blood if the child is not infected. To definitively diagnose HIV in children younger than 18 months must be used in specific blood tests (growing HIV or polymerase chain reaction). By repeating these tests in most, if not all, of the infected infants can be diagnosed for HIV before the age of 6 months. 



For the diagnosis of HIV infection in children older than 18 months and adolescents using the standard search for antibodies against HIV. 



Treatment and prognosis 

An increasing number of drugs used to treat HIV infection in adults and adolescents. Many of these drugs, but not all are tested in children and have proved to be useful. Many experts believe that the combination may be more useful than individual drugs. 



Drugs that are given to children as zidovudine (AZT), didanosine (ddl), stavudine (d4T), lamivudine (3TC) and zalcitabine (ddC). Some of the drugs that are already applied to adults just take aim at children - are sakinavir, ritonavir and indinavir. Some drugs, such as nevirapine and delavirdine, and tested on adults and children. 



To prevent pneumocystis pneumonia infants older than 1 month of mothers who have HIV infection, and children with significant impairment of immunity, antibiotics are given. In general, given trimethoprim-sulfamethoxazole, but some children treated with pentamidine or dapsone. 



With modern therapy, 75% of children with HIV infection experience 5 years and 50% 8. The average age of death is still about 10 years for children infected with HIV, although more and more children to survive into adolescence. 



Occasionally Intravenous immunoglobulin to enhance your child's immunity. Routine vaccines are given to most children infected with HIV, regardless of whether they have symptoms or not. Generally do not give live virus and bacterial vaccines. However, the vaccine against measles, mumps and rubella (which contains live virus) is given nonetheless, since measles in children can be infected to a HJV cause a serious or fatal disease, and the vaccine has not been reported unwanted side effects. 



For children in need of residential care, kindergarten or school doctor evaluate the risk of exposure to infectious diseases. In general, the transmission of infections, for example. chickenpox in children infected with HIV (or any child with a weakened immune system), the higher the risk of transmission of HIV from the child to the other. A small child with HIV infection, which has open sores on the skin or is prone to potentially dangerous behavior such as biting others, will not be eligible for kindergarten. However, in general, there is no need for anyone other than the parents, doctors and school can be a doctor, be aware of the HIV status of the child. 



Children infected with HIV should be closely monitored for their medical condition is getting worse, treatment is best applied to the least restrictive conditions. If there is a system of care in the home along with social services, children may spend more time at home than in the hospital. 



Prevention 

Prevention depends on the knowledge of the transmission of HIV and to apply that knowledge. Pointing out the importance of refraining from sexual intercourse or practice safe sexual intercourse, it is important to stop the spread of AIDS among adolescents and adults. 



The most effective way to prevent infection in the infant to infected mothers avoid pregnancy. Some studies show that caesarean section delivery reduces the risk of infecting the child, but this is not standard procedure. 



One of the most important achievements is to prevent, in many cases, transmission of HIV from mother to child by anti-HIV drugs. Pregnant women who are infected with HIV, given zidovudine (AZT) in the mouth during the second and third trimester (last 6 months) of pregnancy with intravenous zidovudine during labor and delivery. Zidovudine continues to give the newborn for 6 weeks. These measures threefold reduced transmission of the virus from mother to child (from 25% to 8%). 



In the course of further research to see if others drugs to further reduce the rate of transmission of the virus. Therefore, all the pregnant women had to think twice to get tested for HIV early in pregnancy to zidovudine, if necessary, could be applied at a time. 



Although the risk of HIV transmission by breast milk rather low, infected mothers should avoid breast feeding fetus, especially in the U.S. where there is no problem of good industrial milk and water. In countries where the risk of malnutrition or infectious diarrhea caused by contaminated water large, natural nutrition benefits far outweigh the risks of HIV transmission. 



Since it does not need to know the HIV status of the child, all schools and kindergartens should adopt special measures of treatment in case of accidents, such as bleeding from the nose, and cleaning and disinfecting surfaces stained with blood. The staff is advised to avoid contact of bare skin with blood.Gloves must be readily accessible and hands after removing gloves must be washed. Contaminated surfaces should be cleaned and disinfected freshly prepared solution of household bleach at a concentration of 1 bleach: 10-100 parts water. 

Worms in children

Infection little kid worm is a condition in which small children Enterobius vermicularis worms grow and multiply within the intestines. Mala baby worms or white worm is the most common parasite of children in temperate climates. At least 20% of all children and up to 90% of children placed in institutions have a small baby worms.





The causes of infection usually runs in two steps. The eggs are first transferred from the area around the anus (back passage) to clothing, bedding and toys. The eggs are then transferred, often fingers into the mouth of another child who swallowed them. The eggs can also be inhaled from the air and then swallow.Children can re-infect (reinficirati) by transferring eggs from the skin around the anus of his own mouth.worms Male children are growing up in the final part of the small intestine during 2-6 weeks. Female then moved into the area around the anus, usually at night, to be deposited eggs in skin folds. The eggs are deposited in a sticky, gelatinous substance. This material, as well as moving the females, itchy condition.eggs can survive up to 3 weeks at normal room temperature. However, the eggs in the skin folds can quickly sprawl and small worm back into the colon and final part of the small intestine.













Symptoms 

Most children infected young kid worm causes no symptoms. Some, however, itching around the anus and is constantly scratching and the skin may become rough. The girl may be itching and irritation of the vagina. Abdominal pain, insomnia, seizures and other unproven effects were unjustifiably blaming the kid's small worm infection. In rare cases of appendicitis may be due to blockade of a small baby worms.



Diagnosis 

Diagnosis is made ​​by finding the worm. Search is the best spend reviewing children's anus about 1-2 hours after a litter to sleep. Worms are white and thin as hairs, but are moving and are visible to the naked eye.Samples of eggs or worms may be taken from the skin around the anus of the transparent adhesive tape early in the morning while the child is still asleep. Scotch tape can be folded and take the doctor. The eggs and worms on adhesive can be seen under a microscope. Prognosis and Treatment Treatment is usually not necessary. Parasite rarely causes damage, even it is very common. However, most of the patients upset knowing that there are worms and often they are to be solved. A single dose of the drug mebendazole or pirantela cure about 90% of cases. All family members must be treated for the infection is transmitted from one member to another. Cream or ointment itching (anti-pruritic preparations) were applied directly to the skin around the anus to reduce itching. despite treatment often leads to re-infection (reinfection) because it has seven days to live eggs are excreted in stools (because after 7 days should be more single dose).Clothing, bedding and toys should be cleaned often to remove the eggs.

Gastroenteritis in children

Infectious gastroenteritis is an infection of the gastrointestinal (GI) tract that cause vomiting and diarrhea.



Gastroenteritis can cause a number of diverse bacteria. Some bacteria cause symptoms exuding toxins, others grow in the intestinal wall. If you are growing inside the wall, can penetrate into the bloodstream.Viruses and parasites, for example. Giardia, can also cause gastroenteritis. In fact, one virus (rotavirus) is responsible for almost half of all cases of severe diarrhea hospitalizations ending in the U.S. and developing countries. Bacteria and parasites are somewhat less important in the U.S. than in developing countries, but they also cause outbreaks of food poisoning and diarrhea.



The consequences of severe diarrhea are quite different in developed countries than in developing countries, for example. in the United States, despite the millions of cases of diarrhea in children each year, all of them ending fatally hundreds, while the proljevne disease, killing more than 3 million children under 5 years in developing countries.



Symptoms and diagnosis

Gastroenteritis is usually manifested by vomiting and diarrhea. To determine the cause, the doctor takes into account whether the child may have been exposed to a source of infection (eg, a particular food, animal or sick person), how long had the symptoms and what are the symptoms and how often the child vomits or has shed chairs . One must also take into account the child's age.



Within 24 hours of the occurrence of gastroenteritis in infants under 6 months can fall into dehydration, the loss of too much water and salt (electrolyte). However, each child may run into dehydration within 24 hours if they are severe vomiting and diarrhea and fluid intake is insufficient.



Dehydrated infant has poor appetite, dry mouth, fever and scantily urine production and thirst shows and weight loss. More severe dehydration gives eye inflammation and dry appearance, and the soft part between the bones of the scalp (fontanelle) is also inflamed. A child may be sleepy.In older infants and children fat symptoms may occur before dehydration becomes critical. Such children may seem very weak, with hot, dry skin and inflammation, dry eyes.



Treatment

First, given fluids and electrolytes, usually the mouth, but if dehydration is severe, intravenous, to compensate for the loss of vomiting and diarrhea. Older otherwise healthy infants and children are given antibiotics for certain bacteria and parasites, for example. 
Those that cause bloody diarrhea or cholera.Infants under 6 months and those with impaired immune systems are treated with antibiotics, even when there are no signs of infection beyond the intestines. Antibiotics are ineffective when the gastroenteritis is caused by a virus. Antibiotics are often given to people who are traveling befalls diarrhea and when heavy or persistent diarrhea.

Feeding your baby

Hey baby has mature sucking reflex and searching lips and can begin feeding immediately after birth. If the child is placed on the mother's chest in the delivery room, meals usually starts within four hours of birth.



The first day of life is normal puking and vomiting mucus. If it takes longer, the doctor or nurse may gently rinse the rest of mucus by introducing the probe through the nose to the stomach.



In neonates who were fed some milk substitutes (artificial food, "formula"), vomiting may be due to a milk allergy. Then you can apply some milk that does not produce allergies. If that does not help, the doctor still looking for the causes vomiting. In infants fed breast cause vomiting should seek the roadblock that prevents gastric emptying. On human milk allergy does not occur.



Newborn wet diaper six to eight times a day. In addition, a chair every day for the first few weeks, nourishing crying skin nucleus has a strong sucking reflex. These are all signs that your child gets enough food, or breast milk substitutes, and this is supported by the increase of body weight. Prolonged sleep between meals usually indicates a sufficient amount of food, even in the children fed breast is not always the case. Therefore, infants breast doctor regularly to monitor perceived food you enough.



ARTIFICIAL NUTRITION

(Bottle feeding)



In the newborn to be bottle fed for the first meal given sterile water, to test the reflexes of sucking and swallowing, because the water will not harm the child with a feeding disorder. If the child does not return water to the next meal can give milk substitutes. The maternity ward is considered sufficient feeding babies every four hours.



Formula is adequate caloric and vitamin content is available in sterile bottles of 120 ml. The mother should not try to kid each meal drink a whole bottle, but as much as you want. The amount of food should be gradually increased during the first week of 30 ml or 60 ml to 90 ml or 120 ml six times a day.



In the first year of life are more suitable preparations adapted milk (commercial formula) than cow's milk.Although cow's milk is bad food for infants, poor in iron, which is important for the development of red blood cells. You give daily multivitamin drops containing vitamins A, C and D infants on artificial or natural diet during the first year of life and during the second winter in cold areas where children are little exposed to the sun, and the activation of vitamin D is limited. In areas where tap water is not fluoridated, feeds can be added fluoride.



Children on artificial diet in warm weather or when in a hot, dry environment between meals should be offered water. Sometimes the child is inappropriate foods must dohraniti intravenously. In this case, the doctor searches for the causes of malnutrition.



NATURAL NUTRITION

(Breastfeeding)



Breast milk is the ideal food for a baby. In addition to providing essential nutrients in the most appropriate form for digestion and absorption, breast milk contains antibodies and white blood cells (leukocytes), which protect the baby from infection. Breast milk is best regulated by acidity and intestinal flora, thus protecting the baby from bacterial diarrhea. Because of this protective role, children who are breastfed less frequently suffer from infectious diseases than children on artificial diet.



Meals on the chest has benefits for the mother, for example. provides intimate contact with the mother, her child, what can not be done with bottle feeding. First of mature breast milk is secreted rare yellow liquid called colostrum. Colostrum is rich in calories, proteins and antibodies. These antibodies are particularly valuable as they successfully absorbed from the stomach. The child gets protection from infection against which his mother has developed antibodies.



Mother's nipples do not require special preparation before breast-feeding. Hand express breast milk before birth can lead to a breast infection (mastitis) or even premature birth. Area nipple and areola are naturally prepared to suck secretion podmazujućeg protective layer. This protection does not need to be removed.



For a woman who planned to breast feed the baby may be useful to talk to a woman who has successfully breastfed her baby. Observation of nursing mothers and pressing the apprentice confessed can be very instructive and encouraging.



For a successful breastfeeding mother is comfortably placed in a relaxed position, and can be quite lie flat and rotate it from side to side giving the child both breasts. The child sat opposite her mother that holds her breast with your thumb and index finger from above, and other fingers below the nipple and gently touches the baby's lower lip. This encourages the child to open his mouth and latch. Mother helps child put in his mouth the entire nipple and areola which prevents damage to the nipples. When you want to stop breastfeeding mother finger gently pressed the baby's chin, and so break the suction.



At first the child was fed on each breast for a few minutes. While sucking the mother's milk is helping to create, from scratch to be avoided too suck. Sore nipples caused by improper position of the nipple in the mouth of a child during suckling and it is easier to prevent than to treat. On the other hand, the milk depends on the total duration of breastfeeding. Breastfeeding gradually extended until it reached sufficient milk production. It is considered appropriate to ten minutes on the first breast and then the other until the child is satisfied.



For the first child to create a full milk supply is expected within 72-96 hours. For the next Children should be shorter. If the mother after delivery of the first night exhausted, a meal at 2am it can be replaced with water. Yet the distance between the first day of meals must not be longer than 6 hours. Breastfeeding is better to implement the child's wishes but according to the calendar. Similarly, the duration of each feeding should be adapted to the child's needs.



Mother to her child, especially if the first, for 7-10 days after birth should take a doctor to assess whether breastfeeding successfully and mother needed advised.



The frequent occurrence of the first days of breastfeeding is breast tumescence (become clogged). This can be avoided by frequent feedings. The pain can be reduced by wearing a comfortable bra 24 hours a day.Pumping under a warm shower can also reduce tension. Before feeding mother sometimes has to manually express milk a small amount of milk to enable the child to cover his mouth swollen areola. However, over-pumping in between meals can cause painful constant overcrowding and mother to express milk when her only that overcrowding creates considerable discomfort.



Inappropriate position of the child in the chest causing damage to the nipples. Child nipple sometimes catches lower lip and sucking it, is irritating. In this case the mother of the thumb releases the lower lip of a child. After feeding nipples should be kept dry and should not be deleted or rinse. Mother can optionally nipples dry hair dryer on a low heat. In a very dry environment warts can be spread hypoallergenic lanolin cream or neutral. We should not avoid nipple shields in my bra.



Mother in lactation need special diets, particularly rich in calcium. Dairy products are an excellent source of calcium, but if the mother can not stand, can successfully replace the nuts and green leafy vegetables.Optionally calcium can be taken in the form of a peroral preparation. Vitamin is not necessary if the diet is well balanced, and is particularly important enough vitamins C and B6, and B12. It should be noted that the average American diet is low in vitamin B6, and vitamin B12 vegetarian diet.



The separation of the child from the breast depends on the needs and desires of both mother and child.Breastfeeding is considered desirable at least six months. The gradual separation from the breast for a few weeks or months, it is easier for the mother and for the child, rather than abrupt cessation of breastfeeding.



The separation usually means introducing stiffer food, so instead of 8-10 feedings a day, stiffer food given to three times a day, and the number of feedings gradually decreased. At the age of seven months, a bottle or a glass of fruit juice, milk or expressed breast milk substitutes, we should replace one breastfeed a day.Drinking from a cup is an important developmental range, and can be completely overcome by the age of 10 months. Some children are tied to one or two meals a chest until the age of 18-24 months. The child has to eat solid foods and drink from a cup, and when it feeds on the chest.



Introducing solids



Time of introduction of solid foods is determined by the child's needs and willingness to accept it. In general, babies do not need solid food before six months of age, although it can smooth swallow of 3 or 4months. Ingestion of solid food may be earlier, if you put a bite on the back of the tongue, but the babies are usually rejected. Some parents give their infants large amounts of solid food to sleeping over night. It sometimes does this desired effect, forcing solid foods too early can lead to problems later in the diet. Many babies take solid food after a meal or bottle feeding, making them quickly solve hunger, while it is not denied the satisfaction of feeding.



From solid food is first applied jednovrsne grains (avoids mixed), and then introduces the fruit and it also one by one species, and then the vegetables. Hypersensitivity to food will be easier to define if the infant gives some new food over a few days. Solids is given a spoon to master a new technique of infant nutrition.



Many commercial preparations of baby food, especially baby food and soup mixture containing much starch. Starch does not contain any vitamins or minerals, is highly caloric and infant difficult to digest.Some finished preparations of baby food with a high content of sodium, more than 200 milligrams per serving. The composition of each mixture was highlighted in a box. Fragmented food prepared at home is cheaper and more comprehensive source of quality nutrition.



The meat should be introduced later, after 7 months of age, then he should be given priority over food rich in sugars, because babies need a lot of protein. However, many infants refuses meat, so it should be introduced with great care. How many children are allergic to wheat, eggs and chocolate, should be avoided to a year. Honey should also be avoided until the age of one year, because it can contain spores of Clostridium botulinum in infants can cause botulism, while in older children and adults safe. 

Juvenile rheumatoid arthritis

Juvenile rheumatoid arthritis is a long-term joint inflammation (arthritis) is similar to rheumatoid of arthritis in adults, but it starts before the age of 16 year.

The cause of the disease is unknown. Hereditary factors may increase the risk of disease.



Symptoms

In about 40% of children disease affects only a few joints, and another 40% is affecting many joints. The remaining 20% ​​of patients develop a systemic disease that affects the entire body, not just the joints, and can also be seen with fever, a condition called Still's disease.



Inflammation that affects only a few joints usually occurs before the age of four years (usually girls) or after eight (usually boys). The affected joint is painful, swollen (edematous), and stiff, and usually hit his knee, ankle and elbow. Sometimes, they may be more affected by two other joints such as the big toe, wrist, or TMJ, which are stiff and swollen. Symptoms resulting from the joint may not last long, or you can go back and pull.



Girls have more inflammation of the iris (iris) and ciliary body in the anterior chamber (chronic iridocyclitis), which does not always cause symptoms and are discovered only target search. Inflammation of the ciliary body can cause blindness, because the children have to specifically browse the circumstances of this possibility in the case of irodociklitisa treated immediately.



Inflammation of multiple joints can occur at any age and affects equally boys and girls. Pain, swelling and stiffness may begin gradually or suddenly. The joints that are usually affected are the knee, ankle, wrist and elbow. Later joint inflammation occurs both hands, neck, temporomandibular joint, and may be affected hips. The inflammation is usually symmetrical, and affects some joints on both sides of the body, for example. both knees and both hips.



Systemic juvenile rheumatoid arthritis affects boys and girls equally. The temperature is variable (intermittent), usually higher in the evening (often 39.5 ° C or higher), and then rapidly returned to normal.During fever, the child has a sense of serious illness. Surface, sitnotačkasti pink rash mainly on the trunk and upper parts of the arms and legs, there is a short time (often at night), migrate (occurring in different places), disappears and can occur. The spleen and some lymph nodes may be increased. Pain, swelling and stiffness occurs last.



Every juvenile rheumatoid type of arthritis can hinder growth. When the disease interferes with the growth tempromandibularnog joint may be poorly developed chin (micrognathia).



Rheumatoid factor, an antibody that is often found in the serum of adults with rheumatoid arthritis, is rarely found in children with juvenile rheumatoid arthritis. Rheumatoid factor is most commonly found in girls where the disease spread to multiple joints (polyarticular form).



Prognosis and treatment

Symptoms of juvenile rheumatoid arthritis completely disappear under the influence of drugs in about 75% of children. The prognosis is worse in those who have the disease spread to more joints which are found in rheumatoid factor.



High doses of acetylsalicylic acid (aspirin) can usually reduce the pain and inflammation of the joints. Other non-steroidal anti-inflammatory drugs, eg. tolmetin and naproxen, are often used instead of aspirin because of the risk of Reye's syndrome.

Children may be given corticosteroids by mouth if the disease is severe and if it affected the whole body, but steroids inhibit the growth of the child and the need to avoid use if possible. Corticosteroids may be administered directly to affected joints to reduce inflammation locally. A child who does not respond to aspirin or other anti-inflammatory drugs can be injected with the preparation of gold. Penicillamine, methotrexate and hidroksihlorokin can be applied when the gold salts no effect or cause side effects.



Exercises keep your joints movable and protect them from development stiffness. The splint can prevent joint remains fixed in position unsuitable.



Eyes are reviewed every six months to rule out inflammation of the iris (iris) and ciliary body in the anterior chamber. Inflammation is treated with corticosteroid eye drops or eye ointment that open wide (dilate) the pupil. Sometimes it is necessary to conduct eye surgery. 

Games that develop motor skills in children

At the age of 3 to 5 year old children are too busy developing physical and motor skills-learning how to use the muscles of the legs, arms and torso to running, jumping, throwing, grabbing and kicking. You are working on the development of fine motor skills, but they develop later as opposed to rough. Obviously you want to allow your toddler plenty of time so that he can develop all the muscles, both large and small.



Try the following actions:

- Dance - child bouncing, moving every part of the body, activates almost all the muscles ...
- Walking - let the child around the house, walking around the neighborhood, park. You can include running, fast walking, skipping low barriers, all that comes to mind, and it seems a good child development.
- Swimming or any other games and water activities.
- Keeping the balance - let the child walk on low beam. If the park is no beam, you can make one at home and is fully adapted to the needs of their child.
- Play games that require your child imagination, imagine and pretend - enhancing children develop gross motor abilities when imitating a duck, a horse running, a robot-plane or anything that comes into their heads.
- Riding a tricycle, bicycle, children's motor - heavy-truck-toys will help if the trucks pull trailers.
- Construction of houses and other buildings - the house will be used as the material pillows, blankets, boxes, pieces of furniture, and outdoor stones, wood, sand and equipment on the playground.
- Playing with a ball - throwing, catching a ball, throwing the same as the rolling of large and light ball.
- Play with peers.
- Swinging, going down the slide, climbing on the playground or at home if you have a space for play.

My child bites?

To be honest, it's not fun when near a child who bites. Although it is not abnormal behavior is not acceptable at another child, especially with other parents. This concern typically occurs when the child starts preschool and when very few.



What parents can do to reduce and eradicate this problem?


1) firmly say, "No bite!" And remove it from the child who was bitten.
2) Take away a toy or punish him by being only a few minutes.
3) Enough Pay close attention to the person you bit me.
4) Have fun and watch the kids play. Avoid inserting the game children who bite.
5) Resist the temptation to you and baby through the bite of an effort to pointing out an error. Instead, use a positive approach. You do not want a child says teacher to bite as do his parents.
6) Be uvijjek in the shade because it is the only way to be present when the child is wanted again to bite and prevent it.
7) Tell him that it hurts. As small children it is their perception of pain worse and do not understand that violates others. It's a slow process, but be persistent. Anything less will want to bite.
8) You need to know when a child bites in self-defense, and when attacking. This procedure can not be justified, but it is certainly easier to know that a child bites in defense, and it does not work in any other case. Talk to your child but it will soon discover just other ways by which will defend themselves if attacked.
9) Only talk can solve the problem. The more you talk about how biting is wrong and what the consequences may be, it will decrease the child's desire for the same. You need to be strong, tough and tenacious, but it will pay off.