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Cause

The exact cause is unknown. Genetic influences are believed to be largely responsible.

Clinical features

The defect varies in severity, from a small notch in the upper lip, to a gaping defect of the lip and palate, and sometimes the nose. Aside from the obvious appearance of the lips and mouth, a baby with cleft lip and/or cleft palate will have significant difficulty with feeding. This is because they find it difficult or impossible to suck, even though they have no problems with swallowing. They are usually otherwise very normal children.

Treatment

Initially the baby is fed with a special spout or elongated teat that delivers milk to the back of the throat. Surgery is always necessary, and the type and extent depends on the degree of deformity. The lip is usually repaired at 2-3 months of age, and the palate at around 1 year, before the baby starts to speak. Occasionally minor corrections are made before the child starts school. The cosmetic results with cleft lip alone are usually excellent. Speech therapy can help enormously in correcting nasal-sounding speech in the case of a cleft palate. Regular follow-up with your doctor is essential, as these children are more prone to develop ear infections and subsequent problems. Specialised dental care may also be necessary.

Prevention

Cleft lip and palate cannot be prevented.

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Most premature babies have an excellent outcome. The smaller the baby and the more premature or ill he is around the time of birth, the higher the risks of him developing problems later. Careful follow-up is necessary until the child starts school. All neonatal intensive care units have follow-up programs for premature babies.

Having a premature baby can be very stressful for parents. Mixed with the joy of having a new child comes the fear of whether or not he will be all right. Seeing your newborn in a humidicrib, hooked up to tubes, can be a distressing experience.

Mothers who have had a Caesarian section may find it especially difficult to move around and visit their baby initially. It is important for parents to spend as much time as possible with their newborn, in order not to feel too distant from him. Talk to staff, who are experienced in these matters. They are generally sympathetic and encourage you to be involved in what is going on, and to touch your child as much as is practicable. Make sure that the staff do not overlook the central role you as parents play in the care of your child.

Treatment of premature babies is often a highly complex and specialised field, and you may at times feel overwhelmed by all the technology surrounding you and your baby. This is understandable, but remember also that there are human beings behind all this sophisticated gadgetry, and they are there to talk to you if you reach out to them also.

Apnoea is the term used when a newborn baby stops breathing for a short period of time, usually for more than 20 seconds. The baby may turn blue (cyanosis), and go limp, but usually starts breathing again as soon as he is stimulated by touch.

Apnoea occurs usually within the first 10 days and more often in premature babies. It is due to immaturity of the centre in the brain that controls breathing. Babies born at less than 34 weeks gestation are at risk of having at least one apnoeic spell within the first two weeks of life, and therefore require careful monitoring in a special care nursery.

Apnoeic attacks can also occur in babies who have a heart or lung problem, or who have an infection. Once the underlying condition is treated, the apnoeic attacks usually stop.

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ANSWER: Frequency of and interest in sex is not a symptom. It does not «mean» anything if medical problems are ruled out. It is a means of sharing and expression that stands in and of itself. Looking for outside affairs only avoids the real issue of strengthening the marriage. Even if an affair were taking place, the issue would still be to strengthen the intimacy of the marital relationship. To enhance the intimacy of your relationship, particularly at times of outside stress on the relationship, devote for a period of time almost all of your mental and emotional energy to this, relationship and suspend other relationships, even friendships and family ties. This doesn’t mean give them up; it means announcing that for a few weeks you are giving your full attention to your marriage. After that, you will be back in all relationships you value, even more ready to be close to others because of your new trust in the closeness of your marriage. I have found that there is little interest in returning to relationships that are only approximations of what super marital sex can be. If after these few weeks there is still a trust problem or other difficulties, look inside, at the marriage, for the cause, not outside at other factors.

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The latest research indicates, that it is not only the purity of water that is important, but also its molecular structure. To be particular, a 20 molecule liquid crystal water structure, first predicted by a Nobel Prize laureate Linus Pauling in his famous book The Hydrogen Bond seems to be very important. Such structures are formed by a phenomenon known as «hydrophobic hydration» and cause changes in the surface tension, heat capacity and other properties of the water. Water liquid crystals occur naturally in some spring water high in the mountains, and are also formed in the water inside living cells. Water impurities practically eliminate any trace of water liquid crystals.

Note, that nearly every civilisation in the past had tales, related to «living water», which was to be found only in inaccessible locations high in the mountains. In view of the current scientific research (Flanagans) it is quite possible, that such tales were based on real experiences.

Seek fresh air as much as possible. Even if you live in the city, and you are forced to breathe polluted air, make an effort to go to the country, forest or at least to a park as often as possible. Trees and other plants purify the air for us there. Use an ozone generating lamp to purify the air in your home, if the air outside is worse than inside. You can leave the lamp on when you are away.

With regard to other ingredients of the diet, again there is remarkable agreement found in wisdom of many civilisations. They all agree, that we should eat PURE FRESH FOOD. Note for example, that «kosher» means «pure» in Hebrew. (Be careful here: the modern definition of «kosher» food should be carefully examined, because it most likely has lost its exact meaning over the centuries, similarly to fasting in other cultures)

Again, the emphasis should be on purity. The best foods from such a point of view are fresh fruits and vegetables. Even if grown in quite polluted environment, fruits accumulate very little pollutants- They are created from simple inorganic compounds with the aid of photosynthesis. Their content is mostly water.

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If this symptom of indigestion is of recent onset then it may be safely treated without further investigation. If it is severe or persistent or recurrent, then it is necessary to investigate the person further to determine if a condition such as an ulcer is present.

Usually an X-ray is necessary and the stomach can be outlined in the procedure known as barium meal X-ray where a radio opaque salt of barium outlines the hollow organ of the stomach and can reveal abnormalities in its structure.

Sometimes, to differentiate the symptoms from the stomach or gallbladder, it is necessary to carry out an X-ray procedure on the gallbladder. Here a radio opaque dye containing an iodine salt is taken. This substance passes through the liver into the bile and so outlines the gallbladder.

There are available many proprietary preparations which patients can obtain directly from the chemist without a doctor’s prescription … all designed to relieve indigestion. These usually work well.

As well, attention to the diet is helpful. The taking of small meals frequently rather than large meals infrequently so that there is always some food in the stomach to neutralise the acid is most helpful.

Antacid mixtures, tablets or powders all can give relief.

Prevention, of course, is usually better than cure and if one is certain of the cause of indigestion, such as over-indulgence, then a little more prudence next time may prevent the development of this disorder.

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Originally, penicillin had to be given by injection but now derivatives are available which can be taken by mouth. This drug is bacteriocidal and has such a low toxicity that massive doses can be given without risk to the person.

However, allergy to penicillin is probably the commonest of the drug allergies. Some may show an allergy when first they take this drug, having previously been sensitised by minute quantities in milk. This gets in the milk because the antibiotic may be given to cows to prevent or treat mastitis.

Others can develop an allergy after having taken penicillin for years without trouble.

Some of the newer derivatives of penicillin, such as ampicillin, are more effective against a wider range of organisms than penicillin itself.

Ampicillin may cause a fine rash which is not due to allergy, although anyone allergic to penicillin will also be allergic to its derivatives.

Amoxycillin, a derivative of ampicillin, has now supplanted it. It has all the benefits of ampicillin but is absorbed in the presence of food and gives higher blood levels.

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Yoghurt is often recommended for its nutritional properties: it is a good source of protein, calcium and other minerals and A and B vitamins. Because yoghurt also contains lactose, the calcium is readily absorbed by the body. Yoghurt stimulates the synthesis of lactase, so that some people with a lactose intolerance are able to eat it without ill effect.

The inclusion of yoghurt in the diet is useful in preventing the proliferation of toxic intestinal bacteria which are often introduced into the body by contaminated foods. There are substances in yoghurt which have an antibiotic effect in the gut, reducing the concentrations of pathogenic bacteria such as E. coli so that a balanced concentration of friendly bacteria is encouraged. As a result, yoghurt may be beneficial in treating diarrhoea and other digestive disorders.

In the treatment of thrush or Candida, live acidophilus and bifidus bacteria can help to recolonise gut flora which have become unbalanced by the fungus. The lactobacilli in live yoghurt are the same which normally inhabit the vagina, so when these have been killed by some cause, such as a course of antibiotics, yoghurt inserted into the vagina for a few days, either with a spoon or a plunger, is often of benefit.

Orotic acid, a substance found in some yoghurts, interferes with the synthesis of cholesterol in the liver. Inclusion of acidophilus and bifidus yoghurts in the diet is therefore recommended in the prevention of heart disease.

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Now, according to the Journal, a young boy who played with a toad of this type required intensive care in a hospital for over seven days before he began to recover from paralysis, seizures, and difficulty in breathing, and probably would have died without such treatment.

Accordingly, while it is quite safe for children to play with frogs, don’t let them ever even touch a toad. Telling frogs and toads apart, however, may not always be so easy.

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