Diathesis in newborns during breastfeeding

Pediatrician (working with children of the first year of life)

Murzina

Oksana Yurievna

22 years of experience

Pediatrician of the highest category, member of the Union of Pediatricians of Russia

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The body's predisposition to certain pathological reactions and metabolic disorders, which is considered as a constitutional anomaly, is called diathesis. Manifestations of this pathology most often occur in children from the age of three months, but sometimes develop in adults. In modern medicine it is generally accepted that diathesis is not a disease. It is, rather, a failure of the physiological adaptation of the body, expressed in the form of allergic reactions, nervous disorders and predisposition to certain diseases.

What does diathesis lead to?

If an exacerbation is not treated in time, the child’s allergic diathesis can become chronic.
In addition, allergic diathesis is the first stage of the atopic march. The atopic march is the sequential development in the same child of first atopic dermatitis, then allergic rhinitis, and by the age of 5-6 years - bronchial asthma. Therefore, the outcome of the entire atopic disease, in particular the development of bronchial asthma, largely depends on the treatment tactics of atopic dermatitis.

Why should you contact the Mama Papa Ya clinic?

When a child has diathesis, it is important to pay attention to the little things - organizing nutrition, care, drawing up an individual vaccination calendar, a regime of hardening procedures, and so on. Often an examination by specialized specialists is required. The network of family clinics “Mama Papa Ya” offers medical services for the prevention and treatment of diathesis. By contacting one of our clinic branches located in Moscow or other cities, you will receive:

• consultation with a qualified pediatrician on all issues of interest;
• necessary diagnostic and treatment procedures;
• visiting all the necessary doctors in one clinic;
• possibility of observing children of different ages.

Make an appointment with a doctor by phone or on our website.

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How to recognize atopic dermatitis in time?

Clinical manifestations of atopic dermatitis - food allergies - can be as follows:

• Allergic skin lesions: the skin becomes dry, redness, rashes, peeling, cracks, weeping appear - these manifestations are localized on the skin of the cheeks, forehead, neck and scalp, and later the process is localized in the area of ​​the extensor and flexion surfaces of the joints;
• Atopic dermatitis is often combined with gastrointestinal disorders (regurgitation, nausea, vomiting, colic, flatulence, diarrhea, constipation, unstable stool), acute respiratory viral infections, obstructive syndrome, allergic rhinitis.

At the first such symptoms, you should immediately consult a doctor.

What to do if symptoms of diathesis appear?

Nursing mothers should remember that when symptoms of diathesis appear in infants, they themselves need to follow a diet and exclude from their diet foods the consumption of which leads to an exacerbation of the disease. It must be remembered that restricting the diet is not an end in itself. Products are excluded for a time; if their exclusion leads to improvement in the child, then a conclusion is drawn about the connection of such products with an allergic reaction and vice versa. If it turns out that excluding a product does not affect the course of the disease, then there is no point in limiting yourself.

Products with varying levels of allergenic potential:

• The following have a high allergenic potential: whole cow's milk; eggs; caviar; wheat, rye; carrots, tomatoes, bell peppers, celery; strawberries, wild strawberries, raspberries; citrus fruits, pineapples, pomegranates, kiwi, mango, persimmon, melon; coffee, cocoa; chocolate; mushrooms; nuts; honey;
• Average allergenic potential: beef; buckwheat, oats, rice; peas, beans, soybeans; potatoes, beets; peaches, apricots, cranberries, lingonberries, cherries, blueberries, black currants, rose hips, bananas;
• Low allergenic potential: fermented milk products; horse meat, rabbit meat, turkey, lean pork, lean lamb; cauliflower, white cabbage, broccoli, zucchini, squash, cucumbers; green varieties of apples and pears, white and red currants, white and yellow cherries, yellow varieties of plums; garden greens (parsley, dill);

If the child is bottle-fed, then special food is selected for children with allergies. If the child has already begun to be given complementary foods, then you should remove foods that can cause food allergies one by one, so as not to remove excess foods. It should be remembered that unreasonable dietary restrictions, especially long-term ones, can lead to disturbances in the development of the body.

Methods for treating diathesis in newborns

If the newborn is bottle-fed, sometimes changing the formula can have an effect.

Symptoms can be relieved with antihistamines, such as:

1. Suprastin;
2. Tavigil;
3. Fenistil.

Additionally, the doctor may prescribe probiotics and prebiotics to restore normal intestinal microflora, as well as vitamins B6 and B15 to accelerate the restoration of the skin and enterosorbents.

In those rare cases where the skin is infected with streptococci or staphylococci, antibiotics are used.

In addition, for the treatment of rashes it is important:

• change underwear and diapers as often as possible;
• thoroughly iron all children's underwear;
• remove down pillows and soft toys from the baby’s room;
• do not allow pets into the premises;
• choose only high-quality toys that are safe for the baby’s health;
• clean the room daily;
• Do not use aerosols or other substances with a strong odor around your child;
• use only hypoallergenic baby care products, and wash all home clothes not only for the baby, but also for all members of your family with baby powder or soap and soda;
• strengthen the baby’s immunity with the help of hardening, as well as special gymnastics and massage for children under one year old.

To get rid of seborrheic crusts on the face and head of a baby, you need to apply bandages with retinol or boiled vegetable oil for several hours, after which they will easily come off.

How to relieve exacerbation of diathesis?

You can prevent the development of an allergic reaction if you immediately take Enterosgel. The drug removes allergens and toxic substances, avoiding the use of excess medications. You should adhere to a hypoallergenic diet.

If the symptoms of diathesis have not disappeared, you need to consult a doctor who will supplement the treatment with external, anti-inflammatory and antihistamine drugs.

Enterosgel is the only enterosorbent that is officially recommended for children from the first days of life. Kazan and Moscow Pediatric Schools and Allergy Centers in Russia and the CIS and Far Abroad (from New Zealand to Great Britain) widely use Enterosgel for allergic dermatoses in clinical settings.

Recommended regimen for using Enterosgel during exacerbation

• First of all, nursing mothers are recommended to take Enterosgel internally themselves to improve the quality of milk (1 tablespoon three times a day);
• A child under one year of age is given Enterosgel (paste) without the “sweet” label immediately before meals, before each feeding;
• For infants up to 6 months: add 2/3 of water or breast milk to 1/3 teaspoon of Enterosgel paste and give before each feeding;
• For children under one year of age Enterosgel: 1/2 teaspoon + ½ teaspoon of water, also before each feeding;
• After a year, Enterosgel is usually given simply 1-2 teaspoons three times a day, added to fruit puree;
• Locally, when it gets wet, periodically apply Enterosgel, diluted with 1/3 of the Tsindol mash, to the affected areas, and alternate this procedure with conventional local remedies.

Recommended regimen for using Enterosgel for prevention

Prophylactic administration of Enterosgel is usually carried out twice a day, in the morning and at night, in the dosages indicated above and in the manner described. If no exacerbation occurs within a month, you can stop taking Enterosgel prophylactically.

Locally, to care for “problem” areas (perineum, natural folds), Enterosgel is used once a day, usually before putting on a diaper at night or before an air bath. The diaper area is treated with Enterosgel mixed 1:1 with water (applied simply with the palms of the mother).

• Diet for diathesis;
• Treatment of diathesis in infants;
• Treatment of diathesis in children;
• Treatment of diathesis in newborns.

Consequences of the disease and prognosis

Diathesis in newborn babies on the face, which can be treated in various ways, has certain consequences for the child’s health in the future.

In infancy and early childhood, the disease in question can provoke frequent respiratory inflammation and cause poor weight gain. However, diathesis in newborns poses the greatest danger in adulthood, when various allergic diseases can develop: bronchial asthma, seasonal rhinitis, dermatitis, allergies to dust, wool, food.

Therefore, it is so important to treat diathesis in a timely manner so as not to get a whole set of unwanted ailments in the future. The disease, once under control, will go away on its own by the age of 4, and the child will become resistant to food products, household chemicals, etc.

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Children whose diathesis is pronounced and does not show noticeable improvements can lead to all the diseases that were listed above.

What is diathesis: a disease or a reaction of the body?

Translated from Greek, the word “diathesis” means a tendency, a predisposition to something. Diathesis cannot be regarded as a disease. It is more correct to consider it a hereditary predisposition of the body, an inadequate response to certain factors, for example, food.

Each of us inherited from our parents a whole “genetic archive”, for example, eye color, nose shape, predisposition to allergies or an ear for music.

The tendency to diseases is realized when the body is exposed to various unfavorable factors: stress, bad habits, polluted environment, unhealthy diet, occupational hazards.

Since predispositions are different, scientists have described various diathesis. The most common are exudative-catarrhal diathesis, lymphatic-hypoplastic and neuro-arthritic, also known as uric acid diathesis.

Hemorrhagic and salt diathesis are considered as separate diseases. Hemorrhagic refers to blood diseases, and saline refers to metabolic diseases.

Forecast

If all measures to prevent diathesis are followed in full, then the disorder can be overcome by 2-4 years. The child ceases to suffer from allergies to those substances that previously caused an inflammatory reaction in him. He will begin to tolerate cow's milk protein, eggs and fruit.

If diathesis cannot be brought under control and the disease worsens all the time, then in the future this threatens the development of allergies and immunodeficiency.

If there are cases of diathesis in the family, then prevention of the disorder should begin during pregnancy. A woman should exclude allergic foods from her diet. Smoking is prohibited during pregnancy. This bad habit not only increases the likelihood of developing diathesis, but also other serious diseases.

Author of the article:

Sokolova Praskovya Fedorovna |
Pediatrician Education: Diploma in general medicine received from Volgograd State Medical University. Immediately received a specialist certificate in 2014. Our authors

Exudative-catarrhal diathesis

“Owners” of allergic or exudative-catarrhal diathesis are predisposed to infectious diseases and allergies.

The following factors provoke exudative diathesis:

• unfavorable course of pregnancy (toxicosis, infections);
• genetic predisposition (the child’s parents are allergic);
• smoking matter;
• maternal nutrition during breastfeeding;
• complications after childbirth (birth trauma, fetal hypoxia);
• unfavorable living conditions, industrial hazards;
• medications, household chemicals and other potential allergens.

Often, babies under one year old are bothered by exudative diathesis; they cry and sleep poorly due to itchy skin.

Pets can also become “culprits” of exudative diathesis: cats, dogs, hamsters.

Exudative-catarrhal diathesis can manifest itself in different ways.

Atopic diathesis: the child develops redness, dry skin, pimples, peeling or diaper rash on the cheeks.

Allergic diathesis on the face can be a harbinger of allergic rhinitis and bronchial asthma.

The mucous membrane of the eye also often becomes a target for exudative-catarrhal diathesis. The patient is concerned about itching, lacrimation, swelling and redness of the conjunctiva, and photophobia.

Early detection and timely treatment of diathesis will prevent the development of autoimmune and allergic processes.

Food allergens that provoke exudative-catarrhal diathesis can cause enterocolitis. The mother notices that the child has bloating, diarrhea or constipation, and regurgitation of food. Older children with exudative-catarrhal diathesis report pain in the navel and nausea.

Breastfeeding mothers should remember: diathesis has appeared in infants - it’s time to “go on” a strict diet.

Diathesis in newborns who are on artificial nutrition involves the selection of special hypoallergenic mixtures, and when administering complementary feeding, the exclusion of potential food allergens.

For inflammation of the skin, pediatricians prescribe special lotions and ointments for diathesis.

Exudative diathesis in adults is usually called atopic dermatitis. Quite often, allergies in adults (hay fever, food allergies, asthma) can originate from childhood. That is, a consequence of exudative-catarrhal diathesis.

Food allergies: it's not so important what you eat, it's important how much

Speaking about food allergies, parents often sin on certain foods in vain. And they are often mistaken, saying: “My Petya is allergic to strawberries,” “My Sonya has diathesis from kefir.” In fact, allergic dermatitis (the same notorious diathesis in everyday consciousness) in children most often occurs not as a result of the food itself, but as a result of its excess.

What's the matter? To understand the nature of the phenomenon, it is worth being curious about how allergies arise in the first place.

In a nutshell, the mechanism of allergy occurrence is as follows: upon extremely detailed examination, the food that enters our stomach is one or another set of amino acids linked together in a single chain using peptide bonds. These chains are called proteins. In order to digest and assimilate protein, the body needs to break it down, namely, break down peptide bonds with the help of enzymes and separate the “trolleys” of amino acids from each other.

Even in an adult, the required amount of enzymes is not always released during the digestion process. And even more so for kids!

It often happens like this: a baby has eaten the 50 g of milk or formula required by his age - and his enzymes are quite enough to digest this amount of food. And another time he ate 100 g per feeding - and immediately his cheeks were “sprinkled” with red “semolina”. This means that the baby simply overate and did not have enough enzymes for some of the food eaten. Then it’s simple: the protein that remains undigested becomes, in fact, the very allergen from which the notorious diathesis “blooms” on the cheeks and butt a little later.

Lymphatic-hypoplastic diathesis

What does diathesis look like? Children are predisposed to sore throat, allergies, the formation of nasal polyps, and enlarged lymph nodes. They may have a positive Mantoux test.

Diathesis in newborns is manifested by pastiness, decreased muscle tone, lethargy, and adynamia. Babies can gain weight quickly and lose weight just as quickly.

Diathesis in infants may be accompanied by congenital malformations of internal organs.

Frequent ARVI occurs with high fever.

Diathesis does not appear on the face, but is more often located on the legs, buttocks, and in the folds of the skin. Fat fiber is unevenly distributed, with more of it on the lower part of the body.

Neuro-arthritic diathesis (uric acid)

This diathesis is characterized by an increase in the intensity of protein metabolism and an increase in the synthesis of uric acid.

Diathesis occurs in children whose parents are predisposed to gout, urolithiasis, hypertension, diabetes and vascular atherosclerosis.

Uric acid diathesis is provoked by meat foods. It promotes increased formation of uric acid salts - urates.

Diathesis in infants makes itself felt by poor weight gain, unstable stools, and poor appetite.

Children sleep poorly, are fearful, restless and the reason for this is, again, diathesis.

In children, symptoms of metabolic disorders manifest themselves in the form of periodic acetonemic vomiting.

Kidney diathesis can provoke bronchospasm, skin rashes, intestinal colic, constipation, pain in the heart, and decreased blood pressure. Often accompanying uric acid diathesis are enuresis and night terrors.

There are also positive aspects of uric acid diathesis: the products of protein metabolism stimulate the central nervous system and children begin to speak and read early, and have a good memory.

Uric acid diathesis leads to acidosis - a shift in the body's environment to the acidic side.

Kidney diathesis causes dehydration, electrolyte imbalance, and convulsions.

The targets of uric acid diathesis are joints and kidneys. An increase in the specific gravity of urates in the urine (a symptom of uric acid diathesis) in adults quite often causes stone formation in the renal pelvis and deposition of salt crystals in the joint capsules.

Diathesis in adults predisposes to obesity, gout, atherosclerosis, allergic dermatitis, and bronchial asthma.

To prevent diathesis in an infant from becoming the cause of the above-mentioned diseases over time, a nursing mother must follow recommendations regarding lifestyle and nutrition.

Treatment with drugs

A child with diathesis is prescribed antihistamines:

• 1st generation allergy medications have a sedative effect on the body. Therefore, they are used when the baby is excessively restless, suffers from sleep disturbances, and cries a lot. The drugs are prescribed for a period of up to 14 days. They are changed every 5 days. Such medicines include: Suprastin, Pipolfen, Tavegil.
• 2nd generation allergy treatments. They quickly relieve allergy symptoms, but do not have a hypnotic effect. Therefore, you can take them for several weeks. Such drugs include: Zyrtec, Elastin, Claritin.

Sedatives are prescribed if the child is too restless or crying.

Probiotics are indicated for use when a child is diagnosed with dysbiosis. They are prescribed courses. For this purpose, Bifidumbacterin, Linex, Normobact, etc. can be used.

Many doctors question the use of immunomodulators. In infants, the immune system in any case does not differ in maturity. While additional drug load can lead to a weakening of defenses and can become a trigger for autoimmune processes.

Hemorrhagic diathesis

Hemorrhagic diathesis is a whole group of congenital and acquired diseases accompanied by bleeding and hemorrhage.

Hereditary hemorrhagic diathesis “make themselves felt” already in childhood and “pursue” throughout life.

The main role in the occurrence of diathesis in infants is played by congenital defects of blood cells, deficiency of coagulation factors and defects in the vascular wall.

Acquired hemorrhagic diathesis develops while taking certain medications, infectious diseases, liver and kidney diseases.

Hemorrhagic diathesis in children. Symptoms

The main manifestation of all hemorrhagic diathesis is increased bleeding.

Nasal, uterine, stomach, and intestinal bleeding are possible. With frequent bleeding, anemia develops. Hemorrhagic rashes and “bruises” appear on the skin and mucous membranes.

If blood clotting is impaired as a result of a deficiency of clotting factors (hemophilia), diathesis in newborns is manifested by bleeding from the umbilical wound; bleeding can occur even with minor bruises, scratches and injuries.

Hemorrhagic diathesis in adults is complicated by hemorrhages in the internal organs, in the retina of the eye, in the cavity of the joints, in the membranes of the brain.

Diathesis in an infant and an adult can manifest itself as vasculitis, hemophilia, thrombocytopenia. Hematologists know how to treat diathesis in children, adolescents and adults. Anti-inflammatory therapy, antihemophilic serum, blood clotting factors, hormones, and special ointments for diathesis are prescribed.

Baths with medicinal herbs

It is necessary to treat diathesis in a child at home with baths made from decoctions of beneficial herbs. The baby's skin is saturated with essential vitamins and minerals, gains energy and begins to effectively resist the disease. Folk remedies have been used against the disease for centuries.

1. If you plan to bathe your child in a full bath, you will need about 1 kg of oak bark. It can be purchased at the pharmacy, the price is reasonable for any pocket. Before you start treating your child in the bath, you need to soak the bark in cold water for about 1-2 hours. Then we boil it for 30-40 minutes. Only after this add it to the bathing water. Oak bark is very useful for children and their immunity. In addition, if you have time, you can make homemade cream from it.
2. Chamomile. Treatment with infusion of chamomile leaves has a positive effect on the immunity of a small child. The flower can be added to a bath for children - it cleanses the skin, soothes itching, and relieves redness.
3. If you have fresh walnut leaves in the house, this is the most effective treatment for diathesis. Brew them and add them to your child's bath. After the first use, a significant improvement in his condition will be noticeable. By the way, for prevention, buy a cream based on these leaves at the pharmacy and sometimes lubricate your baby’s skin.

Folk remedies have long been very popular when it comes to how to treat diathesis in children. Effective, simple and inexpensive methods will help you always be on guard of your child’s health.

Salt diathesis

Salt diathesis is considered as a metabolic disease. As a result of disruption of biochemical processes, a large amount of salts accumulate in the urine.

Why does salt diathesis occur in adults and children? A number of factors contribute to the development of the disease:

• congenital deficiency of kidney enzymes;
• inflammatory kidney diseases;
• dietary habits (meat, legumes, chocolate).

Often diathesis in adults “makes itself known” with insufficient water consumption. The content of phosphates, urates, and oxalates in the urine increases; crystals form from the salts and “precipitate.”

Salt diathesis is manifested by painful and frequent urination and lower back pain. Over time, salt diathesis can lead to cystitis and kidney stones.

“Traces” of salt diathesis are present in various organs. Crystals accumulate in joint capsules, provoking the development of arthrosis and gouty arthritis.

Salt diathesis provokes hormonal “disruptions”, disrupting the functioning of the endocrine glands.

It is not difficult to identify salt diathesis: you need to pass a general urine test and undergo an ultrasound examination.

How to treat diathesis?

Human health largely depends on nutrition and lifestyle. Food affects overall well-being, mood, brain function and all internal organs. Malnutrition, like overeating, can cause various ailments.

Since food allergens are of great importance in the development of exudative-catarrhal diathesis, doctors recommend excluding foods that cause food allergies, for example, honey, seafood, nuts, sea fish, citrus fruits.

Food allergens often pass through mother's milk, causing diathesis in children. Treatment should begin with correction of the mother's diet. Unfortunately, not everyone follows medical recommendations and products from the “disgraced list” enter the body, provoking dangerous symptoms. And treatment must be started immediately to prevent anaphylaxis from developing.

Doctors prescribe elimination therapy, that is, the removal of toxic products and allergens from the body. This is possible thanks to gastric lavage, cleansing enema, injection of solutions into a vein and taking enterosorbents. Enterosgel is considered one of the best sorbents for the treatment of diathesis. For skin manifestations (rashes, dryness, cracks), a special ointment for diathesis is prescribed, containing anti-inflammatory and antiallergic components.

For neuro-arthritic diathesis and salt diathesis, meat dishes, broths, offal, mushrooms, sausage, radishes, sorrel, and chocolate are not recommended. Enterosgel will also help reduce the concentration of uric acid in the blood.

Salt diathesis. Treatment

Therapy for salt diathesis begins with correction of the water regime and diet. Depending on the detected salts, certain foods will be limited and herbal medicines will be prescribed. Enterosgel can help remove metabolic products.