Nephrotic Syndrome is an illness where the kidney loses protein in the urine. This causes protein in the blood to drop and water moves into body tissues, causing swelling. Swelling and Protein in urine could also be seen in other types of kidney disease, especially glomerulonephritis. The exact cause of NS is not known. Research is ongoing into cause and treatment. The usual age group is young children between 11/2 to 5; this however can happen in any age group. How can you as a parent tell if your child has it?
- Swelling around eyes in the morning
- Swelling around ankle
- More tired
- More irritable
- Eating less
- Pale looking
- Child may have trouble putting on shoes or buttoning clothes because of swelling.
What to do?
-see your family doctor or pediatrician. The doctor will examine and take BP measurements, and do blood and urine tests.
Treatment
Prednisone is the first line treatment. It will stop loss of protein in urine, gets rid of free water in the body and increase amount of urine occasionally other treatments or medications are necessary. The total course of prednisone treatment may be 8 weeks. First 4 weeks high dose and then slowly reducing the dose while checking urine for protein. Many children would be absolutely fine after prednisone therapy less than 5% may relapse( get sick again) at any time, even after a long time with good health the trigger could be the viral infection such as cold and flu.
Prednisone is very good but may have side effects-
- Being hungry
- Weight gain
- Acne
- Mood change
- More risks for infections
- Slow the growth rate
Side effects are more common if used in large dose far prolonged period of time. Once prednisone is stopped, most of these side effects go away.
What can parents do?
- Much of your child’s care will be given by you.
- Do not over protect the child
- Low salt diet
- Allow child to drink as much fluid as he or she wants
- Check urine for protein by dipstick
- Weigh child on regular basis
- If protein returns in urine, contact your doctor
- Let the child play and go to school
Prognosis
With prednisone 95% of children go in to remission (very good control) few children keep on having relapses. If your child does not have another attack for 3 years after the first one the chances are quite good that your child will not get sick again. Even with relapses most children will not develop kidney damage of permanent nature. And always be optimistic!
Colic is a condition in which new born babies cries a lot over and above the normal accepted range. “Colic is any recurrent inconsolable crying in a healthy and well fed infant that is experienced by the parents or care givers as a problem”.
It is essential that 10 to 25% of all babies may experience it. There is no difference noted by gender breast versus formula feeding. Birth order or full term versus preterm babies. It is slightly more in Industrialized countries and if we are farther away from the equator. It usually begins at 1 to 2 week after birth in otherwise healthy babies. The typical pattern is being fussy for few hours usually in the evening time. Sometimes it could occur at any hour and being hyperirritable baby. The good news is that it stops mysteriously by 3 months in 60% and by 4 months in over 90% of infants. There are many theories for cause of colic but none is only or sole factor responsible for it.
1. Cows milk protein intolerance, Lactose intolerance faculty feeding techniques, infrequent burping.
2. Hormones such as motilin or serotonin causing spasm of intestines.
3. Temperamental-difficult temperament emotional discharge at end of day
4. Parental handling-non optimal handling may worsen colic symptoms
What to do?
1. Get your baby checked by your family doctor or a pediatrician to rule out any organic causes such as infections, acid reflux, urinary problems, cardiac arrythmias etc
2. If the diagnosis is colic be patient. It will resolve by 3 to 4 months.
3. Have lot of family support, take with people and elders
4. Do not feel guilty, as a parent you are not doing anything wrong.
5. Regular follow up with your doctor
What the doctor may do?
1. Formula change from cow’s milk to Soya or predigested formula like Nutramigen.
2. If mother is breast feeding do not stop, mother should stop caffeine and cow’s milk consumption.
3. Change nipple or bottle. Feed in upright position with frequent burping
4. Change the external scene by a music mobile, car ride, swing, front baby carrier such as snugli
5. Oval drops and gripe water has been used they are over the counter and have no side effects
6. Bio Gaia- These are lactobacillus drops; they are available recently and have good benefits.
Discuss any treatment change etc with your doctor or public health nurse
Colic is a condition in which new born babies cries a lot over and above the normal accepted range. “Colic is any recurrent inconsolable crying in a healthy and well fed infant that is experienced by the parents or care givers as a problem”.
It is essential that 10 to 25% of all babies may experience it. There is no difference noted by gender breast versus formula feeding. Birth order or full term versus preterm babies. It is slightly more in Industrialized countries and if we are farther away from the equator. It usually begins at 1 to 2 week after birth in otherwise healthy babies. The typical pattern is being fussy for few hours usually in the evening time. Sometimes it could occur at any hour and being hyperirritable baby. The good news is that it stops mysteriously by 3 months in 60% and by 4 months in over 90% of infants. There are many theories for cause of colic but none is only or sole factor responsible for it.
1. Cows milk protein intolerance, Lactose intolerance faculty feeding techniques, infrequent burping.
2. Hormones such as motilin or serotonin causing spasm of intestines.
3. Temperamental-difficult temperament emotional discharge at end of day
4. Parental handling-non optimal handling may worsen colic symptoms
What to do?
1. Get your baby checked by your family doctor or a pediatrician to rule out any organic causes such as infections, acid reflux, urinary problems, cardiac arrythmias etc
2. If the diagnosis is colic be patient. It will resolve by 3 to 4 months.
3. Have lot of family support, take with people and elders
4. Do not feel guilty, as a parent you are not doing anything wrong.
5. Regular follow up with your doctor
What the doctor may do?
1. Formula change from cow’s milk to Soya or predigested formula like Nutramigen.
2. If mother is breast feeding do not stop, mother should stop caffeine and cow’s milk consumption.
3. Change nipple or bottle. Feed in upright position with frequent burping
4. Change the external scene by a music mobile, car ride, swing, front baby carrier such as snugli
5. Oval drops and gripe water has been used they are over the counter and have no side effects
6. Bio Gaia- These are lactobacillus drops; they are available recently and have good benefits.
Discuss any treatment change etc with your doctor or public health nurse.
