The pediatrician Eugene Komorowski - a well-known pediatrician, who is the authority for many of today's parents. In his books and TV programs he talks about what to do, so that children grow up healthy, and parents stayed sane. Publishing The Village Reporter spoke with Dr. Komorowski on major parental fears and concerns vaccination of modern pediatrics.
Saga.co.uk Website publish this interview, because we believe it contains all the essential information, which you need to know and remember the parents, especially the young.
birth - How do you feel about the currently popular domestic and partner birth
- Affiliate birth (birth, in which the father of the child is present - Ed...) In a hospital - that's fine. Home birth, in which the risks are minimized, and if something goes wrong, you can get to the hospital, 20 minutes - this is also fine. Hence the logical conclusion: the problem is not how we call these genera, and in how to organize the process. One goal: comfort and safety of all participants. But today a home birth in our country - is a real risk to the life, and the risk clearly higher than in a hospital
-. And what is the main risk in home birth
- It is impossible to distinguish any one the most important risk, there are several. For example, there is a risk of bleeding in patients, circulatory disorders in the fetus or respiratory disorders in the newborn. All this can be diagnosed in the hospital in time, and there are effective ways to help, which is not always possible to resort to home
-. What are the issues you need to be sure to ask the pediatrician at the hospital
- I would have asked what mode of meetings with relatives of puerperal (puerpera, unlike mothers - is a woman who has given birth - Ed...). What vaccines are used? In no circumstances will the child be? What is the temperature in the room and what is the possibility of its regulation? Under what conditions will occur statement? Who will help put the child in the car seat and show you how to use it properly? I also have learned, in what terms and to whom from the hospital staff can access for advice - for example, if you have questions about breastfeeding
-. Do some research there, that it is necessary make the child in the hospital in the first days of life?
- There is nothing that can be done in the hospital, but it can not be done in a week in normally equipped clinic. Another question that a number of studies aimed at early identification of some of congenital disorders of metabolism, which is part of the so-called newborn screening, rational to do it in the hospital
about vaccinations and check-ups -. Now more and more parents refuse vaccinate their children. Are vaccinations so dangerous? Why do they still need to do?
- In our life everything less important is the diseases that gave rise to the phenomenon of light vaccination. It is through vaccination diphtheria or tetanus today - is something rare and unseen. On the Internet you can often find stories about how this or that person became ill after vaccination. But at the same time there are not writing about how unvaccinated child coughed four months, with stops breathing because infected. People do not know and do not see patients who are not interested in the everyday life of infectious hospitals.
In addition, vaccination - it is a state, and our people are not very friendly with the state. Therefore, when the state offers something or something requires, so you want to keep away from it. Nevertheless, vaccination and vaccines quality implemented in accordance with specific rules - is the most effective method for the prevention of infectious diseases. And they need to do when you have a lack of logic and common sense to compare the risks: the risk and the risk of diphtheria immunization against diphtheria, polio risk and the risk of vaccination against polio
Now, in terms of the active exchange of information, fewer and fewer people retain the ability to objectively analyze information and evaluate its sources easily agree with the opinion, which is convenient and easy to implement. Of course, not to read, not interested and do not go to the clinic for a vaccination - it is very convenient
-. If the risk of disease all clear, what are the main risks from vaccination? And is it possible to somehow minimize them? Choose foreign vaccines, for example?
- With regard to the fact that the average Russian everything is clear with the risk of disease, I would argue. But with regard to the risks of vaccination is necessary to begin to clearly understand the difference between the reactions to the vaccination and its complications.
Complications - a great rarity, this is one case of hundreds of thousands or even millions of vaccinations, which can not be predicted with the help of surveys. It is always an unpredictable individual response of a particular organism. This inadequate response is always possible when the body gets any medication - be it the temperature paracetamol, ampicillin from a sore throat or a vaccine against measles. Thus, about the complications with a certain degree of conditionality can say that here works only in case.
Reactions to vaccination - is another matter. This happens often, but informed the parents have a number of effective ways to reduce both the severity of the reactions, and the probability of their occurrence. They can select and vaccines, and to influence the place-time-vaccination conditions, and perform the right actions concerning the child's way of life before and after vaccination. Another important point - Do your parents know how to properly respond to the increase in body temperature of the baby? Emblem of whether they algorithm mandatory actions required parameters of air, walking mode? How to drink, how to feed, how, when, what and how much to give the medicine? Does this medication in the house - or have to run to the drugstore at three o'clock in the morning followed by
I want to convey the idea that the reason for raising the temperature and can be vaccinated, and the virus, but in both cases are possible absolutely inappropriate parents' actions. For example, the child kept in the overheated room and pound him with vodka, then these actions cause the baby to the hospital. When the diagnosis of SARS mother humbly treat children, but if it was a reaction to the vaccine, they will immediately begin to write in all social networks about how terrible vaccinators brought the child to the dropper
-. In Russia, there is a calendar of passage medical examinations by specialists and vaccinations for children of different ages. Not whether this system is outdated? What inspections are really needed at different stages of a child's life?
- Our calendar and schedule inspections just fine. There are few countries where people are available similar frequency of routine inspections. First of all because there is no country where such a low value on physician work. Where it pays private insurance company (that is, where the pay out of pocket), any contact with the doctor - it is very responsible, and therefore very expensive. Therefore, the meeting with the doctors - a rarity
But our policy makers have 90 years may still can not see a huge problem, originally inherent in the poor doctor. Firstly, he is not ready to take responsibility, so the examination - is very often unproductive begane from one specialist to another. And secondly, the doctor is not interested in the fact that you were healthy, as healthy never say thank you. As a result - the majority of medical examination end detection of several diseases
In theory, every child should have a doctor, with whom it is necessary to uniquely meet as how parents have problems and issues. Once every three months - in the first year, twice a year - in the second year and - in the future. Plus clinical blood and urine tests - it is perhaps necessary minimum
-. Tell me, how do you assess the current state of pediatric post-Soviet space? Are there any positive or negative dynamics?
- By the medicine of the XXI century the state of our Pediatrics has nothing to do. There are some very, very rare islands of modern civilization, but the overall situation is sad, and for the better, little has changed. Negative dynamics primarily due to the fact that a decent standard of living and a degree pediatrician combined in a very small degree
fears and misconceptions about -. It is said that the use of the diaper is harmful to children. Is it true?
- It's speculation envious grandmothers who does well can not accept the fact that a modern woman free from the endless washing
-. In every situation there is to see a doctor? For example, if the child has a runny nose banal?
- You are probably surprised, but WHO has a positive attitude to self and strongly recommends that available to the public the basics of medical knowledge. The main advice is to consult a doctor is necessary when a symptom of a particular person has appeared for the first time in my life. Think about these tips and everything will become clear
-. And with what most stupid mistake on children and children's health you have come across
- The most stupid - blind faith in medicine Camoe sad -. Confidence of the majority of men that the mother of the child better than the Pope knows how to care for the baby and that he needed
By the way, there are two main parental fear. They are characterized mainly women, instinctive and, as a rule, are irrational: the fear that the child will freeze, and the fear that he will die of hunger. To overcome these fears, needs sane, for health baby daddy. Search, cultivation and preservation of these men - almost the main problem of our modern life
-. Do I need to protect children from pets? Are there diseases that animals can transmit to children?
- Not necessary. But kindly ask risks and ways to manage these risks. The dog may bite lizard - infect salmonellosis, parrot - a source of allergies. But all this can be avoided.
It is clear that the easiest way to think of the damage and to treat it as an excuse not to have one. However, the dog - a great way to get the Pope to tear the ass off the couch and go for a walk, at the same time taking with him a child. Unfortunately, the kid without a dog the majority of dads are not regarded as a sufficient reason for a walk
-. And when you can allow your children to watch cartoons
- With two years, but this recommendation is almost never anyone is not satisfied. Therefore, up to this point at least, do not exceed the limit of 30 minutes per day And it is desirable to spend it not at once, but three to four call
about nutrition .. - Do I need to give your child vitamins, and if so, what? For example, almost all pediatricians strongly recommend giving children vitamin D. Is it justified?
- As a rule, they do not need to give, and a standard WHO recommendation - choose a varied diet Admission complex vitamins. However, reception of vitamin D has many more advantages than disadvantages. At a dose of 500 units per day, he can not hurt anyone and never, but I would still prefer an individual approach in dose selection, and recommended to take into account the place of residence, walking regimen, diet and skin color
. - Is there a grain of truth in a fashion to breastfeed for up to three years, and sleep with the child?
- Everyone has their own ideas of rationality. For me as a pediatrician main measure of rationality - medical science, serious study, analyzing a real benefit or harm of any action
Breastfeeding for up to six months - a very important and necessary, up to a year - it's desirable, and after a year of no real benefit to the health of the child is not breastfeeding, if we are talking about a country in which to observe the principles of safe food. In some countries, especially tropical, with low levels of medicine in general, and sanitation in particular, the WHO recommends breastfeeding up to two years, as the stop before - means to subject your child at risk of dying from an intestinal infection. To us, this recommendation is not particularly true, and it is very often do not understand the long-term supporters of breastfeeding.
With regard to co-sleeping, there is still more definitely - it's not recommended neither WHO nor pediatric associations in most countries
-. Is Critical completely abandon breastfeeding? What might be the consequences of feeding the baby with a mixture of the very first days of his life?
- And critically, and dramatic, and deadly in countries with poor hygiene and poor health. According to some reports, in such countries, the lack of mother's milk is 14 times increases the likelihood of the baby's death from an intestinal infection.
But in a civilized country, familiar with soap and such specialties as pediatrics, critical - not quite the right word. Do not breast-feed - wrong, unnatural, irrational, costly, unprofitable both for the mother and for the child. Although modern infant formula to minimize health risks, authentically proved that the artificial feeding substantially increases the risk of diabetes, ear infections, intestinal infections, obesity and allergies
-. Can I start with the lure of canned puree?
- Of course, it is possible, if it is a vegetable puree. Fruit puree - it desserts that are not considered as self-feeding. If you do focus on the "jar" word, then I'm definitely for that mom instead of standing in the kitchen an extra hour spent with a child in the fresh air, while Dad will buy high-quality canned food.
- should the child nutrition differ from adult food
- On the ground, no mammal which cubs have not fed as adults. Milk mum, then a short-term period, the chewed food by parents, and forward - to a conventional food. Another issue is that adult human head and share a bunch of individuals completely unnatural and harmful products: sweet, fatty, spicy, bitter, salty, containing alcohol. It is clear that any recommendations can not be parents to instill caution and a sense of proportion.
And here is the right eating habits in the child form can and should be. But it should be understood that the cubs instinctively copy the eating habits of adult members of the pack. It is impossible to form correct habits in the child, if, for example, the Pope, they are not formed
-. Is it true that it is recommended as long as possible to give their children sweets and chocolate
- As long as possible - this is an inflection. But it is not accustomed to sweet foods and sweet drinks especially - is very important. Without the chocolate up to three years we can do uniquely. In any case, it should be remembered that the sweets are allowed only when there is no excess weight, and create conditions for the child's motor activity
-. And if your child should eat the soup several times a week ?
- No. The first dish - a tradition of certain peoples of the world, and we definitely treat such people. But medical science does not consider soup as a mandatory component of the diet of children
-. Critical whether the lack of meat in the diet of the child, if the parents - vegetarians and want to raise a child, vegetarian
- Uncritical, if the parents are informed about their choice of a doctor who is able to give accessible and comprehensible recommendations - how to examine the baby, how to reduce the risks, what to do accents in the diet. In addition, parents need to clearly know how - what products, food additives and drugs - and compensate for the possible and the probable deficiency of protein, iron and certain vitamins. At least twice a year to do the child a normal blood count
-. If both parents have allergies, there are there any ways to reduce the likelihood that a child will be allergic, too ?
- Methods have not overfeed, do not overheat to avoid sterility, minimize contact with pharmaceutical products and household cleaning products, exercise, monitor the timely bowel cleaning. The trouble is that the inheritance is transmitted not only allergy as pedagogical principles parents. Выросшие в тепле, при изобильной еде и лекарствах аллергики делают своих детей такими же, наступая на грабли уже своих родителей.
— Нужно ли вообще заставлять ребёнка есть? Почему дети иногда едят слишком мало и отказываются почти от любой пищи?
— Никогда! Аппетит определяется образом жизни, уровнем энергозатрат, а также интенсивностью роста, который прямо связан с количеством вырабатываемых гормонов. Уровень этих гормонов повышается и понижается, соответственно реагирует и аппетит. Вы не удовлетворены аппетитом ребёнка? Спорт, прогулки и активные игры вам в помощь.
О воспитании— С какого возраста ребёнку необходимо регулярно находиться в детском коллективе?
— Ребёнка можно вырастить вполне адекватным и успешным без регулярного посещения детских коллективов. Но искусство общаться с себе подобными — одно из важнейших человеческих умений, освоение которого требует регулярных тренировок. Поэтому детский коллектив — условие не обязательное, но весьма желательное. Эпизодические контакты с детьми приветствуются уже с 9–12 месяцев, а после 1, 5–2 лет посещение детского коллектива на регулярной основе — это очень даже хорошо.
— В раннем развитии больше вреда или пользы?
— Это как с лекарством — всё определяется дозой. В умеренном количестве — сплошная польза, но когда вместо того, чтобы бегать, прыгать и скакать, ребёнок учит фамилии американских президентов — это уже патология, причём патология того, кто организовывает подобное раннее развитие. Ребёнок учится с самого рождения, инстинктивно рассматривая взрослых как пример для подражания. Будьте правильным примером.
— Правда ли, что нельзя наказывать и ругать ребёнка до трёх лет?
— Есть огромное количество самых разнообразных педагогических методик. Хорошие, умные, добрые люди вырастают и там, где детей ругают и наказывают. Обсуждать надо скорее не саму возможность наказаний и ругани — без этого не обойтись никому и никогда, — а методы наказаний, способы, посредством которых взрослые могут дать детям путёвку в жизнь. Но взрослых этому никто не учит, хотя это абсолютно обязательные, прикладные знания. Основы семейной педагогики и основы семейной медицины, на мой взгляд, должны быть обязательными предметами в школе.
— А стоит ли разрешать бабушкам и другим родственникам вмешиваться в воспитание детей?
— Все принципиальные решения могут принимать только мама, папа и педиатр. Родственники могут, во-первых, советовать — при условии, что способны не обижаться на то, что их советы не используются. Если же они обижаются, следует немедленно ввести мораторий на советы. И во-вторых, они могут пассивно помогать, требуя от родителей решения всех принципиальных вопросов. Так, бабушка может отправиться на прогулку с ребёнком, но предварительно она должна согласовать с мамой, что на него надеть, куда пойти и сколько гулять.
— Должен ли у ребёнка быть режим дня?
— Режим дня делает удобной жизнь семьи и жизнь ребёнка в обществе. Режим дня устанавливают родители, руководствуясь интересами семьи. Другое дело, что родители сплошь и рядом не в состоянии добиться удобного режима по причине собственной лени или незнания. Вы хотите уложить дитя в 21:00, но не хотите погулять перед сном и почитать сказку? Ну, тогда может так случиться, что ребёнок не согласится с режимом, который вы пытаетесь ему навязать.
— А как вы относитесь к тому, что многие современные дети быстрее учатся пользоваться планшетами и смартфонами, чем говорить?
— Плохо отношусь, но это целиком и полностью ответственность родителей. Именно мама и папа дают ребёнку ответы на вопросы о том, что такое хорошо и что такое плохо, именно мама и папа вводят малыша в этот мир и навязывают определённые правила игры. Вы просто должны понимать, что у смартфона могут быть другие ответы на основные жизненные вопросы. Поэтому не удивляйтесь, если в дальнейшем планшет станет для малыша большим авторитетом — и в значительной степени более надёжным другом, чем мама и папа.