Postpartum Crack Treatment

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What causes crack after pregnancy?
Pregnancy is a special period in which there are many physical changes with an intense hormonal activity. In this process, skin changes and various rashes are frequently encountered. Striae, also known as striae, is one of the paintings we see as common in pregnancy and cosmetically disturbing. More than 50 percent of pregnant women are seen. It usually occurs on the belly, on the hips, on the legs and on the breast.
The exact cause of cracks is not known, but it is thought to be related to genetic factors, hormones and mechanical stress. Strias are initially in the form of bands ranging from pink to purple. In this area, there is a decrease in the attenuation of the connective tissue, elastin and collagen fibers. They become increasingly faint and less visible. They continue after birth and often do not fully regress.

Consult your doctor when your cracks look pink-purple!
When the cracks reach white, ivory color, it is more difficult to reach the result. Therefore, it is recommended to intervene at the stage where pink-purple appearance is present. There are many moisturizing and nourishing cream with a high concentration of herbal ingredients. However, there is no definitive data on their effectiveness. Although successful results are reported with creams containing vitamin A derivative or retinoic acid locally, it is not appropriate to use such creams during breastfeeding. Various creams containing ascorbic acid (vitamin C), hyliulonic acid and glycolic acid (fruit acids) can also be useful in the early period.
The most effective treatment of cracks after pregnancy: Laser

The most effective method for the removal of cracks after pregnancy is laser treatments. Successful results are obtained in newly formed pink-purple lesions with pulse dye lasers (dye laser). Fractional lasers are used in both new and old strias. With laser energy, small microscopic damages are created in the upper and lower layers of the skin, and regeneration by secreted growth factors is achieved during healing.
Again in the microneaching method, the skin can be damaged by small needles, and the appearance of regeneration and striae can be reduced. It is aimed to increase the synthesis of collagen and elastin by giving simultaneous radiofrequency energy with needling in needle radiofrequency devices used in recent years.
Applications are performed in sessions. PRP, hydrolytic acid and mesotherapy can be used to increase efficacy. Since early initiation of treatment increases the chances of success, it will be an appropriate approach to start right postpartum in the strias developing during pregnancy without delay.
This article Prepared by Banu Taşkın.
You can contact our dermatology department for more information.

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Fear of School: Alas, my child does not want to go to school!

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In the early period of schooling, especially in the first year of the child’s meeting with the school, fear of school is frequently encountered. In primary school first grade students, fear of school is short term (not exceeding one month), decreasing in quality and in a level which does not cause serious problems. The family must take the child to school in a determined manner and this familiarization period must be carried out in cooperation with the school guidance service and teacher.
Fear of school may require psychiatric support in some cases.
At which stage should parents apply for psychiatric support?
If your child has a fear of a school that lasts more than a month and does not decrease over time, you may need support from experts. These school-feared children may complain of physical ailments such as headache, abdominal pain, nausea and vomiting when school time comes. Therefore, there may be multiple doctor applications. These symptoms may be accompanied by anger outbursts, intolerance, fear of separation, or family behavior.
Most of the time, children do not want to leave their parents who come to school, they like to go out and go home during classes. Complaints of the child sent home usually disappear at home, and complaints appear again the next morning. Sometimes children may refuse to leave the house.

Why do children fear a school?
Moving, change in family dynamics and such stressful events may have triggered school fear. The underlying causes may be something that happens to parents when they are in school, fearing another student, bullying, or fear of failure. Transition periods (starting school for the first time, changing schools, starting with secondary school or high school, etc.) can trigger school fear.
In cases where the fear of school is not resolved and concerns are kept away from school for a long time, serious educational or social problems may arise in the child. Treatment of fear requires the cooperation of health personnel, school staff, guidance teacher and the whole family.
What can the family do to overcome school fear?

1. Seek help from child mental health workers (child psychiatrist, specialist child psychologist, etc.).
The most important step to overcome the fear of school is to understand the cause of fear. The reasons underlying the reluctance of your child to school are tried to be understood by using various techniques and the most appropriate treatment method is provided to the child. It may also be comfortable for your child to know that it is always a safe place to go and talk.
2. Talk to your child.
Your child needs to share his feelings and concerns with you. Don’t show that you don’t take the child’s fear seriously by saying in over time “. Talk about her fears and show that you understand her and you’re willing to help.
3. Talk to school staff.
Teach teachers, guidance counselors, infirmaries and the school head. Together we collaborate in a solution-oriented manner.
4. Get your child to school gradually (eg by increasing school hours each week).

5. Highlight the beautiful aspects of the school.
Emphasize that your child can play with friends at school, make new friends, have fun at recess and learn new things at school.
6. Remove all fun activities at home during school hours.
If your child refuses to go to school, avoid access to all televisions, tablets and toys in the house. When the child is at home, he / she should not have a more enjoyable time at school.
7. Tell your child that he / she can reach you at certain times (during breaks, lunch breaks).

8. Knowing that your child can reach you or another adult during school hours makes him feel safe and secure.
9. Tell your child that his family will be safe when he / she is at school.
Patiently repeat that there will be nothing happening to you when you go to school, hugging your child, saying nice and positive words.
10. Guide your child to hobby and interests.
Entertainment means relaxation. With hobbies, your child may be headed for other things and help them think less of school-related concerns. Hobbies also increase self-confidence.
This article Prepared by Tuba Mutluer.
For more information, please contact our Child and Adolescent Mental Health (Psychiatry) department.

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Things to consider when preparing a lunch box

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This period is the period between pre-school and adolescence and it is the first period in which children feel the most distinctive being away from home in the majority of the day. Again, mostly children are away from home, so individuals outside their families are also influential in their food choices. In this process, children may want to make their own food choices.
The 6-12 age range is the period of growth for children. Each year an average of 5 cm length is extended, 2 kg weight increase is observed. For girls, the fastest growth and development age is 10-14 and 12-16 in males.
Do not compare between children!

It is not correct to compare energy needs among children. For each child, height, weight, age, physical activity level vary. The basal metabolic rate varies accordingly. There is no special food source for their growth. Most of the calories taken are; cereals, fruit and vegetables, dairy products and legumes, meat products, such as protein-rich foods should be provided. Oil, salt and sugar content is not with packed foods!
According to the 2010 Diet Guidelines, calcium, potassium, vitamin D and fiber intake in children have been observed. Up to 2-3 cups of milk per day significantly meet the calcium requirement of children.
You can choose your milk preference from those enriched with vitamin D. If your child has enough time in the sun and the intake of their resources is sufficient, vitamin D supplementation is not needed. By increasing the amount of fruits and vegetables can be removed fiber needs. In order to prevent potassium deficiency, the consumption of fruits, vegetables and dried legumes should be taken into consideration.
What should be the breakfast habit?

Breakfast in school-age children is an important factor affecting success and growth. Therefore the content should be of high quality. Milk or freshly squeezed juice can be an option for children who cannot have breakfast or have a habit.
Practical breakfast options:

Toast made with cheese, freshly squeezed juice,
Cereal, milk and banana,
Homemade jam, cheese, pancakes,
Fruits, dried raisins, milk, oatmeal.

How will my child meet his daily energy needs?
Children should take 25-35% of their daily energy needs from fats. Fish, oilseeds, vegetable oils containing more polyunsaturated and monounsaturated fatty acids should be preferred.

How do I prepare the right lunchbox for my child?
In order to prepare the right snack and the right lunch box for the school, you should first ask and learn about the alternatives that your child will consume and will consume in every food group.
In the kitchen, you should spend time with your child and teach them the places in the kitchen. Fresh fruits and vegetables can be seen in the process of being at home where the places can be washed, ready to eat ready to eat will be useful in terms of habit.
Recommendations for the feeding bag
(If your child is attending school for half a day or if he / she is going to school for a full day and having lunch at the school, it is enough for him / her to have snacks at school)

At home, there are cakes, cookies, etc. with sugar and low-fat, plenty of nuts / almonds / walnuts. next to milk
Fruit, milk and nuts / almonds / walnuts
Whole-grain bread with homemade jam, marmalade, peanut / hazelnut paste and milk
Home-prepared low-fat plenty of cheese pie and fruit

(If the child is in full-time education and not lunch at school)

Whole-wheat bread with egg / chicken / tuna sandwich, one fruit and milk / buttermilk
Cereal flakes, milk, fruits and oil seeds
Cheese sandwich or toast with whole grain bread, fruit and milk / ayran
Pasta with vegetables, cheese, oilseeds, fruit / juice

If your child refuses to eat some food Ç

Playing games for children will be very attractive and can forget to eat. In addition, children may not like some of the nutrients, forcing them to create a feeling of disgust, rejection against the food. In this case, the child should not go over it, should be tried to eat again later. If the child refuses to eat the food every time he tries to eat as a side dish with other dishes.
The lack of food, the lack of a table setting, not to sit on the table, to consume a single type of food in the future to choose food, to reduce the ability to eat and unbalanced food. Children should have regular meal times, not including nutrients that are not nutritious, such as chocolate, sugar and acidic beverages.
This article has been prepared by Dietician Aslıhan Yağcıoğlu.
For more information please contact our Nutrition and Diet Department.

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7 reasons to have a communication problem with your child

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Pay attention to the parents who live in the child communication problem!
We have mentioned the points you should pay attention to when spending time with your child in our previous article.
Do we want to start by making a mistake on parenting?
Most of the time, parents trust their parenting instincts and do not try to get help with problems with their children. Unfortunately, as a parent, we may often not be able to correctly understand how to behave in situations we face, and sometimes make mistakes in communicating with our children.
In the following, we can overcome the most common 7 common mistakes in parenting and provide more effective family communication.
Not trying to solve problems

Thinking that some problems cannot be solved or accepting them easily can cause parents to be disappointed with these problems for years. These can often occur as wake-up nights, sleep-time discussions, tantrums, and behavior disorders in older children.
For some problems you may encounter as parents, you can get help, work on these problems and change them. Your child may not be born with a manual, but it may be helpful to consult a specialist for ongoing and difficult-to-solve problems.
Grow or underestimate problems

Before attempting to solve the problems, the problem should be determined very well and what is the problem and how big the problem is. If it is a big problem, the following questions should be asked:

Does your child suffer from anger at times?

If your child is a teenager, is he testing his limits?

Does he spend a lot of time away from his family or is he trying to be more independent?

To have unrealistic expectations

If you have unrealistic expectations about what your child should do, it can actually lead to various problems.
These are examples of waiting for your 2.5-year-old child to complete toilet training. Remember that your expectations may not match what your child may develop or do. In such cases, what age your child can do, what kind of psychological changes can be consulted a specialist should be consulted and expectations should be adjusted, should not be treated hastily.
Not being consistent
As a parent, approaching your child with inconsistent behavior may cause you to experience many problems with your child. Sometimes it seems very strict not to care what your child is doing, but at other times, it may cause your child not to distinguish what is right and what is expected, and not to understand what is expected of him / her or how to behave.
No rules and no limits

You can think that your child is doing your child good by doing whatever you want. However, most children may experience problems with living without borders.
Having rules, setting limits, consistent routines and offering limited options to your child allow your child to learn what to expect and what to expect throughout the day.
Pass against the counter
Passing against an attack is not only about physically fighting with your child, but observing them in many ways, such as getting angry with them, shouting, repeating yourself over and over again.
Fighting or discussing with your child may give them the message that they have the power to trigger these harsh reactions. Responding with such behaviors instead of trying to terminate the problems means that you reward the wrong behavior that you are trying to terminate without realizing it.
It would be a better option to end these power discussions and learn more effective disciplinary methods rather than counter-attack.

Not changing the methods that don’t work
Failure to identify or change methods that you do not use in parenting can create problems at the first stage in solving problems.
For example, the method you use to adjust your sleep routine does not work, and if your child is tired all day long when you wake up the next day, this is an indication that you need a new method of sending your child to sleep.
If you are having problems with family communication on these 7 issues and similar issues, it is useful to consult a child and adolescent psychiatrist.
For more information please contact our Child and Adolescent Mental Health (Psychiatry) department.

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What is epilepsy? What you need to know about epilepsy

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What is epilepsy?
Everyone has an electrical activity in his brain. In the region that leads to epileptic seizures in the brain, this electrical activity increases abnormally, and this increase causes a seizure.
Our brain is composed of indentations. All these indentations have a function of overhangs. In the speech center, the patient cannot speak, and bright lights, shapes and objects can be seen in the visual field, and nothing is completely visible. It is called ”seizure bet and eli epilepsy bul if the seizures are recurring, which are sudden, temporary and short-term and often have the same clinical findings.

Is there any treatment for epilepsy?
Drug treatment is started before epilepsy. If the seizures do not stop as a result of testing of at least two drugs in the treatment of the drug, the patient will receive different treatment recommendations, especially surgical treatment. These may include a special diet (ketogenic diet), batteries attached to the neck and brain, and other alternatives.
What is the process of epilepsy treatment?
In the treatment of epilepsy for children 2-3 years and for adults 3-4 years if the drug is provided with inaction, very slowly start to stop drugs. It is not possible to understand that epilepsy is over without undermining or decreasing the medication. Electroencephalography (EEG) showing brain waves helps us in this time.

What are the symptoms of epilepsy?
What we do with all brain functions for symptoms of epilepsy, we look at the loss of that function, or sometimes we see that the function has increased. If there is a seizure caused by the region that manages the arm-leg area and allows us to make voluntary movements, rhythmic pulses and contractions begin on the fingers of the patient’s right or left arm / leg. Sometimes these contractions may spread to the leg or face on the same side. It can find hours, hours, hours.
Some seizures may start with a leading symptom. Most often, a feeling comes from the stomach, butterflies fly in the stomach, they say. The person who feels this leading symptom understands that the seizure will begin and sits in a safe place. It tries to avoid the dangers. In some seizures, there are no leading symptoms. In particular, a group of focal epilepsy and all generalized epilepsy without any indication may start the seizure. Generalized tonic-clonic seizures, seizures, convulsive seizures in the whole body, or seizures, can be a seizure of the seizures. Flashing lights, sudden unexpected touch and call, lead to seizure.

Are children’s epilepsy symptoms the same as adults?
Neonatal seizures may be difficult to recognize with low clinical findings. Some types of seizures are seen only in childhood; infantile spasm The majority of other seizures show similar clinical findings.
What are the types of epilepsy?
Epilepsy is roughly divided into two; generalized and focal.
Generalized epilepsies begin suddenly without leading symptoms. In the case of tonic seizures, the patient suddenly falls down like a tree falling to the ground. During the atonic seizure, the patient suddenly falls down like an empty sack. During the diving seizure, the patient cannot continue his / her speech, look empty, chewing and correcting his head in the arms. In the body, there is a sudden splash of the arm or both arms once. In the large generalized seizure, arms and legs are observed to be contractile and jump movements. In these seizures, the tongue becomes biting and / or urinary incontinence.

Some of the focal seizures are pioneering and some do not. In focal seizures, the patients may stop at the seizure of diving, stop the speech and chew as if there is something in their mouth. Sometimes there are motions like cycling or floating.
If you’re wondering what we should do when we see a person with epileptic seizures, check out our article.
This article Dr. Prepared by Candan Gürses.
You can contact our Neurology department for more information.

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How should we treat someone who has epileptic seizures?

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What should we do when we see a person with epileptic seizures?
Patients with precursor symptoms should remove themselves from dangers. (window edge, ladder head, piercing cutting tools, etc.). People who have a seizure without a forerunner sign should take away the person from these hazardous areas in case of any seizure.
Generalized contraction, called a large seizure, jumps on the watch, people who have a seizure while falling to the floor while pushing the head to the ground by pushing the head or by supporting the head to be able to fall to the ground softly. It is necessary to turn the patient’s head aside on the floor. Turning the head sideways prevents the vomiting of the lungs if the person vomits.
If the teeth are not yet closed, they are placed in the upper part of a soft body. This soft object should never be finger. The soft body is the edge of the blanket, the edge of your jacket and so on. can. The goal is to break the gap between the teeth and to prevent the bite of the tongue. Never attempt to open if the teeth are closed. Never try to stop the contractions in the arms and legs, or you may cause fractures and dislocations. The only thing to do is to determine the duration of contractions.

After the seizure, the person usually wakes up, is confused, does not understand what is said, but he tends to sleep around and sleep. If the seizure lasted for more than five minutes, if the person had no known epilepsy, was hit by a head while crashing, but could not be aroused despite a seizure, he should be taken to the hospital urgently.
What should we do when we see a person with epileptic seizures?

Onion smelly is the most performed and non-beneficial application.
Never put your finger between your teeth during seizure. He can bite your finger.
Never try to open if the mouth-teeth are closed during the seizure. Even if the tongue is bleeding, bleeding will stop within one minute. However, the broken teeth will not replace a new one.
Do not try to stop the contractions in your body. You can cause bone fractures and dislocations.
Never try to eat and drink water to the person who has seizures.

This article Dr. Prepared by Candan Gürses.
You can contact our Neurology department for more information.

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Are you in seasonal depression?

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What is seasonal depression?
Seasonal depression is the name given to periods of seizure and recurrent periods of depression. In order for this diagnosis to be made, it is important that depressive periods start and end in certain seasons of the year, and it is important to show that the seasonal periods do not depend on environmental stress factors such as change of work, school period.
In the vast majority of people who show these symptoms, symptoms begin in autumn or winter, and end in spring. Therefore, these periods of depression are defined as dil seasonal depression ”in medical language. Rarely, there may be people who start depressive periods that begin in the summer and end in the fall.
Seasonal depression is frequently seen in autumn and winter months, with a decrease in energy, increased desire to sleep, and increased desire to eat, increase in weight and the desire to eat foods containing carbohydrates. In addition, complaints such as increased irritability and more frequent crying can be observed. On the other hand, in people who have seasonal depression periods in summer, there are signs of drowsiness and loss of appetite.

Who is observed in seasonal depression?
It is more common in people living in high altitude, women and young people. In some cases, a mood disorder called bipolar disorder can be observed as part of eating disorders or alcohol use disorders, and its diagnosis becomes difficult.
Causes seasonal depression?

The causes of seasonal depression have not yet been fully elucidated, but there are some findings that have been studied and have high evidence. From a biological point of view, in the periods of seasonal depression, the brain has been shown to have decreased metabolic activity in the so-called orbitofrontal cortex and the left inferior parietal lobe. In addition, people with seasonal depression have been suggested to have mood disorders regulating the regulation of serotonin.
In these individuals, the varying amount of daylight in seasonal transitions affects the operation and the number of serotonin carriers in the brain. In addition, melatonin, known as the sleep regulating molecule, may cause symptoms such as fatigue and lack of energy, which is higher than expected with the arrival of winter months. As a result, an inappropriate adaptation to the changing biological rhythm with seasonal transition may cause seasonal depression. Environmental factors, especially the changes in daylight time and meteorological changes are considered to be responsible.

How is seasonal depression diagnosed?
Diagnosis must be made by a professional. In autumn or winter, antidepressant treatments, light therapy, deficiency in the use of Vitamin D and cognitive behavioral therapy methods are used in the treatment. In addition, carbohydrate-poor, protein-rich, untreated diet, alcohol, smoking and caffeine to reduce the use of, plenty of fluid, yoga and meditation, regular exercise, attention to sleep-wake hours, as much as possible to receive daylight and short travel to sunny regions with seasonal depression recommended methods for coping.

This article Prepared by Hale Yapıcı Eser.
For further information, please contact our Psychiatry department.

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My child has a tiki, what should I do?

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What is Tik? Why?
Tics are involuntary movements occurring in certain muscle groups, occurring suddenly, repetitive, stereotyped and non-rhythmic, as motor movement or noise extraction. Teak usually begins in boys and at an early age and occurs for spiritual reasons. Ticks are usually not seen before 3-4 years of age. The most common is 6-7 years of age and the first adolescence (11-13 years) period. Tics are not considered to be just learned behaviors as they were before.
Tics are caused by neurobiological structural defects, but they can worsen and heal as a result of environmental stimuli. In other words, environmental impacts by the behavioral techniques or the effects of the individual on the environment can be modified. Since each individual’s interaction with his environment and environment is different, it is necessary to understand in detail the interaction of the individual with the environment. This understanding will strengthen the hand of both the individual and the doctor in dealing with tics.

How should families treat their children with tics?
– The families of children should be careful about the following issues.
Both medical (drug) and behavioral therapy methods should be followed closely. The support of the family is important for your child to use their medicines regularly and to continue their regular therapy at home regularly.
– Factors that increase and decrease the levels should be determined by family observation and support. These situations should be talked about, the cases considered to increase tics should be reduced as much as possible;
-The parents must learn exactly what the parents are and help the child to learn. The more knowledgeable the child is, the easier it can handle their tics. In this case, it is also useful to exercise the competing response determined with the therapist.
Conflicts and tensions in the home should be reduced as much as possible and the child should feel safe.
-Those attitudes should be avoided, since all the individuals in the family can emphasize this behavior and often feel that they are annoyed by increasing the anxiety due to tike.
– As the teak response increases in the face of stress and tension, there should not be a strong reaction to the issue.
-The child should be made to feel loved and a positive self-perception and self-confidence should be developed.
-Prompting the child constantly by parents and leaving him to do is put him under emotional and physical strain, which may lead to tics or new tics. Be careful about this.
It should be noted that even if the child stops tics for a while, these tics are not under his control. Parents’ approach should be in this direction.
– Threats threaten the child’s self-confidence and impair social cohesion. Children with tics often find it difficult to socialize and make friends. The child can be helped to create a play environment with his friends for socialization and to develop positive social relations with the support of other adults he is associated with.
– Apart from these, multi-faceted approach to tick intervention is required. Family counseling, child psychotherapy, and drug therapy can also be applied along with behavioral therapy.
This article Prepared by Tuba Mutluer.
For more information please contact our Child and Adolescent Mental Health (Psychiatry) department.

Does the Prevalence of Reflux in Children Increase?

Attention if you have weight loss and unrest!
Does the frequency of reflux in children increase?
The reflux problem, which is thought to be an adult problem, can occur even in infants. Research shows that around 15 percent of all children have reflux. Yeditepe University Hospital Pediatric Health and Diseases, Child Gastroenterology Specialist Assoc. Dr. Meltem Uğraş points out that children with discomfort, nausea and especially weight loss should also be evaluated for reflux.
Reflux is the result of the loss of stomach contents to the esophagus due to the slackness in the valve between the esophagus and the stomach. Recently, the increase in signs of reflux in children of all age groups is important. This problem can reduce the quality of life of children and parents, as well as treatment of asthma, esophageal damage, recurrent otitis media and pneumonia can prepare for different diseases such as. Allergies and food allergies in particular can damage the esophagus and cause reflux symptoms. As the development process of infants continues, reflux is more common.
Reflux of children due to difficulty in gaining weight Yeditepe University Hospital Child Health and Diseases, Child Gastroenterologist Specialist Assoc. Dr. Meltem Uğraş states, however, that the development of children can also be affected. In addition, the acid escaping from the stomach to the esophagus, tissue damage and small wounds can lead to the risk of developing anemia.
Symptoms can be mixed
Complaints related to reflux can vary in infants and children. For example, nausea, vomiting and weight loss are observed in infants, but vomiting does not occur in children, but chest burning, hoarseness and slowing in development occur. In general, many of the symptoms are similar to different diseases, Assoc. Dr. Meltem Uğraş speaks: Ta Unless the underlying cause is found in the upper respiratory tract infections that develop with reflux, the child may be exposed to long and recurrent antibiotic treatments. In addition, complaints such as chest pain or compression can also be confused with heart-related diseases. Therefore, it is important to be vigilant about the symptoms of reflux and to consult a physician immediately. Dolayısıyla

Patient history is important in diagnosis
Asserting that the most important factor in the diagnosis of the disease is taking the child’s detailed history. Dr. Meltem Uğraş said, den We use various methods developed for the diagnosis of reflux and we do not approach each child with the same method. Some children only listen to complaints, while the clinical situation of some of them, depending on the severity of the complaint we use endoscopic or radiological methods.
Treatment begins with lifestyle change
In the treatment of reflux disease, first of all, some changes in life style need to be done. In dairy children, changing the contents of the food (intensification) is often one of the measures to be taken when feeding a small amount and raising the head while lying. In older children, orange juice, chocolate, mint-like foods that may cause reflux, and after the dinner need to reduce the intake of fluid. In addition, problems such as constipation, obesity, which leads to increased intraabdominal pressure, not to wear too tight clothes, to sit at the table while eating, eat frequently and a small amount of food, to eat 1.5-2 hours before bedtime and to raise the head while lying other measures that can be taken. Child Health and Diseases Specialist Assoc. Dr. Meltem Uğraş said, çık In accordance with the child, drugs can be used to regulate the movement of the digestive system and to decrease the stomach acid and to strengthen the valve functions. This treatment can last for about 4-6 months. However, surgery can be an option in very rare cases, which cannot improve despite long-term treatment. Ancak
Symptoms indicating reflex
• Frequent nausea, vomiting • Rejection of feeding (bottle) • Grouching • Restlessness • Frequent crying spells • Recurrent cough • Recurrent otitis media • Slow development
• Burning in the chest • Pain in the mouth • Loss of dental brightness • hoarseness • Slowening in development • Common upper respiratory tract infection • Common ear diseases • Common pneumonia / pneumonia