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Li Jiao Yan
Neonatology
About me
Li Jiaoyan, female, attending physician, Master of Pediatric Medicine integrating Chinese and Western medicine. Graduated from Hunan University of Chinese Medicine.
Research interests include integrating Chinese and Western medicine for neonates and pediatric internal medicine, with expertise in treating common and frequent diseases in neonates and children, as well as emergency rescue of critical conditions. Proficient in monitoring the growth and development of children in early stages, assessing their developmental levels, and providing guidance.
Proficient in diseases
Treatment of common and multiple diseases in newborns and children, as well as emergency treatment of critical illnesses, monitoring of early childhood growth and development, assessment of early childhood developmental levels, and guidance.
Voices
What are the symptoms of rickets?
The condition generally referred to as rickets is most commonly nutritional vitamin D deficiency rickets, a type of nutritional disease that is prevalent among infants and young children, particularly very young babies. It primarily manifests as changes in the bones where growth is most rapid and can also affect muscle development and changes in nervous excitability. Initially, especially within the first three months, symptoms in very young infants typically include increased nervous excitability, such as crying easily, excessive head sweating, and as a result of the sweating, frequent head shaking, irritability, restlessness, and noticeable crying and restlessness at night. These symptoms at this stage are not necessarily indicative of typical rickets. As the condition progresses, changes in the skeleton gradually become apparent. In infants under six months with rickets, the changes are mainly in the skull, typically feeling like pressing on a ping-pong ball. After six months of age, the head shape becomes squared or box-like, and the head circumference is larger than normal. Later, the characteristic beading changes of rickets appear, with beaded protrusions above the ribs, followed by the formation of blunt, circular raised areas at the wrists and ankles, referred to as wrist and ankle bracelets. Around the age of one, infants may develop a deformity resembling pigeon chest. As the child begins to stand and walk, the weight bearing on the lower limbs may lead to deformities, such as bowlegs or knock-knees, and sometimes even K-shaped deformities of the legs, and some might develop spinal deformities.
Neonatal jaundice bath Chinese medicine
Neonatal jaundice is called "fetal jaundice" in Traditional Chinese Medicine (TCM). It primarily refers to infants born with jaundice as the main symptom, characterized by yellowing of the skin and facial area. This condition is related to prenatal constitution, hence it is also known as fetal jaundice or fetal dyspepsia. The causes of fetal jaundice are divided into internal and external factors. Internal factors involve the fetus being affected by the toxins of damp-heat or the evil of deficient-cold and damp-cold from the mother. External factors mainly include the baby being affected by damp-heat or cold-damp evils during or after birth, with damp-heat evils being more common. The main affected organs are the liver, gallbladder, spleen, and stomach, with the key pathogenic mechanism being prenatal damp retention. Commonly used Chinese herbal baths for neonatal jaundice, particularly suitable for damp-heat type jaundice, are generally selected based on the specific conditions of the child, adjusting formulas like Yinchenhao Tang to tailor to the exact pattern of the baby.
Kawasaki disease peeling symptoms
Kawasaki disease is a disease with unclear etiology and unclear pathogenesis of the autoimmune system. Its main pathological change is systemic vasculitis, commonly occurring in the coronary arteries. At the onset, symptoms in the hands and feet include stiff swelling and erythema during the acute phase. In the recovery phase, membranous peeling occurs at the junction of the skin and the nail base of fingers and toes, and there are transverse grooves in the nails. In severe cases, the nails of the fingers and toes may also fall off. Additionally, its skin manifestations include polymorphic skin plaques and scarlet fever-like rashes, which commonly appear in the first week of the disease, with redness and peeling of the skin around the anus.
What is the treatment method for rickets?
Rickets is primarily caused by a deficiency in vitamin D, leading to disturbances in calcium and phosphorus metabolism in the body, which results in abnormal skeletal development—a type of systemic nutritional disease. The most common form is nutritional rickets due to a deficiency in nutrients and vitamin D. Treatment focuses on controlling the active phase to prevent relapse of deformities. Therefore, early detection and comprehensive treatment are crucial. The primary treatment method involves supplementing with vitamin D. The choice of vitamin D, the dosage, and the length of treatment generally need to be tailored to the specific circumstances of the child. Additionally, increased exposure to sunlight and appropriate outdoor activities should be encouraged to enhance the absorption of vitamin D. Children should also be supplemented with calcium and a variety of vitamins. Follow-ups during the recovery phase are necessary, and training in sitting, standing, and walking should not be started too early to avoid deformities in the lower limbs. Furthermore, no medication is needed during the residual stage of the disease. For mild to moderate cases, physical exercise should be intensified, and skeletal deformities can be corrected using active or passive exercises. Severe skeletal deformities may require surgical correction.
Why does rickets cause sweating?
Rickets is a chronic, nutritional disease characterized by skeletal lesions due to a deficiency of vitamin D in the body, leading to disturbances in calcium and phosphorus metabolism. It is primarily caused by a lack of vitamin D, which can increase neural excitability. Research shows that the vitamin D metabolite, 1,25-dihydroxyvitamin D3, is not only an essential nutrient but also a precursor to hormones. It is potentially related to various cells including those in the thyroid, pancreas, stomach, brain, and those involved with calcium balance, as well as the immune, endocrine, reproductive systems, skin, and tumors. A deficiency in vitamin D can increase myocardial excitability and lead to symptoms like excessive sweating.
Will newborn jaundice cause the ears to turn yellow?
Neonatal jaundice is one of the common symptoms in neonates, especially in early newborns. It can be a symptom of normal development in newborns, or it can be a manifestation of certain diseases. Jaundice is generally divided into physiological jaundice and pathological jaundice, with the main symptom being the yellowing of the skin and mucous membranes. Typically, jaundice starts from the face and then spreads to the trunk and limbs. If the degree of jaundice is relatively severe, yellowing will appear on the entire body, including the ears. Generally, if the baby is visibly yellow, it is advisable to monitor the jaundice. If the jaundice value is significantly high and confirmed to be high in the blood, it is considered pathological jaundice, and it is recommended to seek timely intervention and treatment.
Is a bilirubin level of 20 high for a newborn?
If a newborn's skin jaundice reaches a level of twenty, it is a warning sign that the jaundice is significantly elevated. It is advised to promptly go to the hospital for an examination. If the bilirubin levels in the blood are indeed that high, timely intervention and treatment are necessary. Normally, for physiological jaundice, the levels should not exceed fifteen after seventy-two hours in infants. Even during the peak period of four to five days, it should not surpass fifteen. If the jaundice noticeably increases within the first three days and exceeds twenty, the severity of the jaundice might be worse. The younger the newborn, especially with levels above twenty, the higher the risk of bilirubin entering the brain, potentially leading to bilirubin encephalopathy. Therefore, with jaundice reaching twenty, it is still recommended to promptly go to the hospital for intervention and treatment.
Nursing Measures for Children with Rickets
Rickets requires relevant home care. During the active phase of rickets, it is best to avoid early sitting, standing, and walking. For chest deformities, prone neck lifting and chest expansion exercises can be performed. For lower limb deformities, muscle massage can be done. For bow legs, massage the outer leg muscles and perform abductive and external rotation exercises after massaging both knee joints. For knock knees, massage the inner muscle group and perform internal rotation exercises after massaging both ankle joints. For posterior protrusion of the lumbar spine, massage the lumbosacral area and frequently lie prone to increase muscle tone, assisting in the recovery of deformities. For mild to moderate bow legs, it may be appropriate to slightly elevate the outside of the shoe by about 0.5 cm. For mild to moderate knock knees, it may be appropriate to slightly elevate the inside of the shoe by about 0.5 cm. Observe for one to three months and adjust the padding height as necessary, which generally can correct the condition. Additionally, children should be exposed to more outdoor sunlight and have a rich nutritional intake, including nutrient-rich proteins and dairy products to aid in recovery from the disease.
Do newborns with jaundice love to sleep?
In newborns with jaundice, it is important to determine whether it is physiological or pathological jaundice. Typically, babies with normal physiological jaundice are generally in good condition, able to eat and sleep well. If they are hungry or uncomfortable, they will cry and wake up. However, if a baby continuously sleeps without waking up for a long period of time, does not wake up even when stimulated, it might indicate a condition of excessive sleepiness, which then falls into a pathological state. If the jaundice significantly worsens and affects the brain, it is often referred to as bilirubin encephalopathy, which might initially manifest as excessive sleepiness. Severe infections or other diseases can also present excessive sleepiness as a symptom. Therefore, if you notice that the baby is sleeping significantly more than usual, and appears lethargic and unresponsive, it is advisable to seek medical attention promptly.
Is it useful for newborns with jaundice to take probiotics?
Probiotics are useful for newborn jaundice. After oral administration of probiotics, they help establish a normal gut microbiota in babies and then reduce the enterohepatic circulation of bilirubin, which aids in the treatment of jaundice. Common probiotics, often referred to in layman's terms as live bacteria, include species like Saccharomyces boulardii, Bifidobacterium, or Lactobacillus, among others. These probiotics are available in pharmacies. Generally, for newborns, especially those who are breastfed and do not recover well from jaundice, oral probiotics can have a therapeutic effect on reducing jaundice, so it is suitable for newborn babies to consume certain probiotics.