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Learning to walk is a key milestone in your baby's life.
Over your baby's first year he or she will learn to sit, roll, crawl, pull up onto the furniture and stand. Most babies take their first steps between nine and thirteen months. However do not worry if your child does not walk until the sixteenth or seventeenthmonth, this is still perfectly normal.
At about eight months your baby will probably start pulling him or herself up whilst holding onto furniture. If you hold him or her near a piece of furniture, tobegin with, he or she will hang on, but after a few weeks your baby will begin to move around whilst holding onto the furniture, known as 'cruising'.
At about nine or ten months your baby will begin to learn how to bend at the knees and how to sit after standing.
At eleven months your baby will have mastered standing solo, stopping and squatting, but will not take his or her first steps for a few weeks. At thirteen months most toddlers are walking on their own, however it is genetics and environment that determine when your baby will take his or her firststeps.
By eighteen months your baby should be a proficient walker. Many can get up stairs with help and may try to kick a ball.
At twenty five months or so your child's steps will be more even and he or she will get better at jumping.
You can encourage your baby by kneeling infront of him or her and hold out your hands. You could also try buying a toddle truck.
Baby walkers are known to make it too easy to get around and therefore prevent a child's upper leg muscles from developing.
Hold off buying shoes until your baby is walking outside. Going barefoot helps improve balance and coordination.
Do not be concerned if your baby has been a little late in developing motor skills e.g. rolling over, crawling etc he or she will probably need extra time tolearn to walk. However if your child does not demonstrate a strong interest in walking or forward mobility by fifteen months and seems to be significantlybehind consult your doctor. Your child should show a strong interest in getting somewhere, how he or she gets there is really up to them.
Swimming
Taking your baby swimming has huge benefits for you and your baby: Babies get completely free movement in the water, which they would not get otherwise Being in the water improves core muscle development and co-ordination Eating and sleeping patterns are improved Responding to commands can make your baby sharper mentally Swimming in water is the only time a baby can be completely independent It is generally agreed that you do not need to wait until your baby has been immunised to take him or her swimming, as the chlorine in the water will preventany danger of infectious diseases. However do not go swimming if your baby is unwell.
A small baby can become cold and possibly overwhelmed so keep swimming times short and take your baby out if he or she starts to shiver. Water shouldbe at least 32 degrees for a small baby. When you are in the water let your baby enjoy the sensations and get used to the water. Keep your face at your baby's eye level.
Many special swimming classes exist, these have a clear structure, including some underwater swimming (this is safe as your baby's diving reflex takesover). Though you can begin swimming with your baby when you feel the time is right for you, many classes do not begin until babies are 12 weeks old.
You may also want to wait until after your six week check.
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Illnesses
Meningitis
Meningitis is inflammation of the membranes (meninges) covering the brain and the spinal cord, a form of blood poisoning). Although the most commoncauses are infection (either bacterial or viral), chemical agents and even tumour cells may cause meningitis. The major bacteria that cause meningitis areStreptococcus pneumoniae, Haemophilus influenzae, staphylococcus and meningococcus. Meningitis is a serious illness which can be fatal or cause longterm damage to the brain and nerves. The classical symptoms of meningitis are headache, neck stiffness and photophobia (the trio are called "meningism"). An altered level of consciousness orother neurological deficits may be present depending on the severity of the disease. A lumbar puncture to obtain cerebrospinal fluid (CSF) is usually indicat-ed to determine the cause and direct appropriate treatment.
Meningitis is a medical emergency, being a condition with a high mortality rate if untreated. The cause is most commonly a bacterial infection sensitive toantibiotics. Patients with suspected meningitis should optimally initially have a CT scan to help determine if there is a raised intracranial pressure that mightcause a serious or fatal brain herniation during lumbar puncture. If there are no signs of elevated central nervous system pressure demonstrated on the CTscan, a lumbar puncture procedure is performed to obtain cerebrospinal fluid for microscopic examination, chemical analysis, and bacterial cultures. Broad spectrum antibiotics should be urgently started before the culture results are available. If lumbar puncture can not be performed because of raisedintracranial pressure (likely due to edema or concomitant brain abscess), a broad spectrum intravenous antibiotic should be started immediately (this isoften a third generation cephalosporin). When cerebrospinal fluid gram stain, or blood or CSF culture and sensitivity results, are available, the empiric treat-ment can be refined by switching to more specific antibiotics. In children (but not in adults) the administration of steroids helps reduce the incidence ofdeafness following meningitis.
Infection of the meninges usually originates through spread from infection of the neighbouring structures (which include the sinuses and mastoid cells ofear). These should be investigated when diagnosis of meningitis is confirmed or suspected.
Convulsions are a known complication of meningitis and are treated with appropriate anti-seizure drugs such as phenytoin.
Mumps (Epidemic parotitis) is a viral illness which causes swelling around the cheeks and neck. Prior to the development of vaccination, it was a commonchildhood disease worldwide, and is still a significant threat to health in the third world. It causes painful enlargement of the salivary or parotid glands.
The mumps are caused by a paramyxovirus, which is spread from person to person by saliva droplets or direct contact with articles that have been con-taminated with infected saliva. The parotid glands (the salivary glands between the ear and the jaw) are usually involved. Children between the ages of 2 and12 are most commonly infected, but the infection can occur in other age groups. In older people, other organs may become involved including the testes,the central nervous system, the pancreas, the prostate, the breasts, and other organs. The incubation period is usually 12 to 24 days.
MMR immunisation (vaccine) protects against measles, mumps and rubella and should be given to children 15 months old. The vaccination is repeated insome locations between 4 to 6 years of age, or between 11 and 12 years of age if not previously given.
swelling of the parotid glands (neck swelling) M u m s Mate
swelling of the temples or jaw (temporomandibular area) Additional symptoms in males that may be associated with this disease: A physical examination confirms the presence of the swollen glands. Usually the disease is diagnosed on clinical grounds and no confirmatory laboratorytesting is needed.
There is no specific treatment for mumps. Symptoms may be relieved by the application of intermittent ice or heat to the affected neck area, acetaminophen,oral for pain relief (do not give aspirin to children with a viral illness because of the risk of Reye's syndrome). Warm salt water gargles, soft foods, and extrafluids may also help relieve symptoms.
The probable outcome is good, even if other organs are involved. Sterility in men from involvement of the testes is very rare. After the illness, life-longimmunity to mumps occurs.
Measles, also known as rubeola, is a common disease caused by a virus of the genus Morbillivirus. It is highly infectious and used to be the commonestchildhood disease. Reports of measles go back to at least 700, however, the first scientific description of the disease and its distinction from smallpox is attributed to theMuslim physician Ibn Razi (Rhazes) 860-932 who published a book entitled Smallpox and Measles. In 1954, the virus causing the disease was isolated,and licensed vaccines to prevent the disease became available in 1963.
Measles is spread through respiration (contact with fluids from an infected person's nose and mouth, either directly or through aerosol transmission), and ishighly contagious. 90% of people without immunity sharing a house with an infected person will catch it. Airborne precautions should be taken for all sus-pected cases of measles.
The incubation period usually lasts for 10-12 days (during which there are no symptoms). Infections occurs by droplets from the mouth or nose. It maystart like a bad cold with lots of catarrh and a temperature. Infected people remain contagious from the appearance of the first symptoms until 3-5 daysafter the rash appears.
The classical symptoms of measles include a fever for at least 3 days duration, and the three C's, cough, coryza (runny nose) and conjunctivitis (red eyes).
The fever may reach up to 40 degrees Celsius (105 Fahrenheit). Koplik's spots seen inside the mouth are pathognomic (diagnostic) for measles but are notoften seen, even in real cases of measles because they are transient and may disappear within a day of arising.
The rash in measles is classically described as a generalised, maculopapular, erythematous rash that begins several days after the fever starts. It starts onthe head before spreading to cover most of the body. The measles rash also classically stains by changing colour to dark brown from red before disappear-ing later. The rash can be itchy.
A detailed history should be taken including course of the disease so far, vaccination history, contact history and travel history.
Clinical diagnosis of measles requires a history of fever of at least 3 days together with at least one of the three Cs above. Observation of Koplik's spots isalso diagnostic of measles. Alternatively, laboratory diagnosis of measles can be done with confirmation of positive measles IgM antibodies or isolation of M u m s Mate
measles virus from respiratory specimens. Positive contact with other patients known to have measles adds strong epidemiological evidence to the diagnosis.
There is no specific treatment for uncomplicated measles. Patients with uncomplicated measles will recover with rest and supportive treatment.
Complications with measles are relatively common, ranging from relatively common and less serious diarrhea, to bronchitis, ear infections, and croup; topneumonia and encephalitis (affecting the nervous system). Complications are usually more severe amongst infants and adults who catch the virus.
The fatality rate from measles for otherwise healthy people in developed countries is low: approximately 1 death per thousand cases. In underdevelopednations with high rates of malnutrition and poor healthcare, fatality rates of 10 percent are common. In immunocompromised patients, the fatality rate isapproximately 30 percent.
In developed countries, most children are immunised against measles soon after birth as part of a three-part MMR vaccine (measles, mumps, and rubella).
Vaccination rates have been high enough to make measles relatively uncommon. Even a single case in a college dorm or similar setting is often met with alocal vaccination program, in case any of the people exposed are not already immune. In developing countries, measles remains common.
Measles is a significant infectious disease because, while the rate of complications is not high, the disease itself is so infectious that the sheer number ofpeople who would suffer complications in an outbreak amongst non-immune people would quickly overwhelm available hospital resources. If vaccinationrates fall, the number of non-immune persons in the community rises and the risk of an outbreak of measles consequently rises.
According to the World Health Organisation, measles is the leading cause of vaccine preventable childhood mortality - there are 30 million cases and875,000 deaths caused by measles every year.
Chicken pox
Chicken pox, also spelled chickenpox, is a common childhood disease caused by the varicella-zoster virus (VZV), also known as human herpes virus 3(HHV-3), one of the eight herpesviruses known to affect humans.
One history of medicine book claims that Giovanni Filippo (1510 - 80) of Palermo gave the first description of varicella (chicken pox). Subsequently in the1600s, an English physician named Richard Morton described what he thought was a mild form of smallpox as "chicken pox." Later, in 1767, a physiciannamed William Heberden, also from England, was the first physician to clearly demonstrate that chicken pox was different from smallpox. However, it isbelieved that the name chicken pox was commonly used in earlier centuries before doctors knew what they were seeing.
Symptoms Chicken pox is characterised by a fever followed by itchy raw pox or open sores. Chicken pox has a two week incubation period and is highly contagious byair transmission two days before symptoms appear. Therefore chicken pox spreads quickly through schools and other places of close contact. Once some-one was infected with the disease, they usually develop an immunity and cannot get it again. As the disease is more severe if contracted by an adult, par-ents have been known to ensure that their children became infected before adulthood.
The disease is rarely fatal: if it does cause death, it is usually from varicella pneumonia, which occurs more frequently in pregnant women. Doctors advise that pregnant women who come into contact with chickenpox should contact their doctor immediately as the virus can cause serious problems for the foe-tus. Later in life, virus remaining in the nerves can develop into the painful disease, shingles. If your not sure about certain symptoms always contact your local GP or local health authority.

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