The health of the child and the common sense of his relatives. Evgeny Komarovsky

22.01.202127.05.2017

I believe that we came after others in order to do better than them, so as not to fall into their mistakes, into their delusions and superstitions.

P. Ya. Chaadaev

© E. O. Komarovsky, 2007

© M. M. Osadchaya, A. V. Pavlyukevich, illustrations, 2007

© KLINIKOM LLC, 2007

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A small but very important preface

...and when they asked to bring the most beautiful thing in the whole wide world, the crow brought her child...

Parable

Almost no one ever reads popular science literature from beginning to end—like a novel. In relation to books with information about children, problems and diseases, this is especially true. Why read about the nutritional rules of a pregnant woman when the baby is constipated? We open the chapter about constipation, get the necessary information and, with a feeling of deep satisfaction, try to implement the advice and recommendations.

But, since the hopes for this are low, in order to prevent subsequent misunderstandings, I will allow myself a brief instruction-information for those who are ready to start reading (options - viewing, flipping through, studying).

1 The book consists of three main parts:

Part one is devoted to the two most important stages in the life of a child and his parents - pregnancy and the first year of life.

Part two - a child over one year old, naturally, not on his own, but in connection with his father and mother, grandparents, schools, kindergartens, the environment and the health care system.

Part three – diseases, hospitals, doctors, medicines; what you must do, what you should never do.

2 Everything you read should be considered primarily as food for thought. Not a single living soul in the whole wide world can love your child and understand your child the way you do. A completely different thing is that, understanding, loving and even at the same time thinking, reflecting, understanding, and so, under all these conditions, it is not always possible to achieve success.

3 Success in relation to the process of care and education is a relative concept: it depends from which bell tower you look. From the point of view of a teacher, the polite winner of the city physics and mathematics Olympiad, who stays in hospital, is an undoubted success. An absolutely healthy young bandit (if he is washed and forbidden to talk) will please the pediatrician with the excellent functioning of his internal organs and excellent tests.

4 The golden mean is a simultaneous and abundant balm for the soul of relatives, doctors and teachers - this is a child who is smart, well-mannered and healthy. This phenomenon occurs extremely rarely, but when implementing a certain program of care and education, we should at least know what to strive for.

5 The actual level of health or unhealth of a particular child depends on four factors:

Heredity, that is, what was inherited from mom and dad;

Environment (ecology + living conditions);

Health systems;

The process of care and education, i.e. the relationship between the child and his relatives.

6 The above-mentioned care and education represent some completely certain actions, a certain set of events. But the main paradox is this: 100% of the adult population knows how to make children, but 99.9% do not know what to do with children later.

7 The main goal of this book is to eliminate the paradoxical nature of the situation, to provide the reader with the opportunity in an accessible form to determine for himself what should be done with the child and what should never be done.

Acquaintance

The greater or lesser degree of respect accorded to an author depends on the greater or lesser resemblance of his ideas to those of the reader.

Helvetius

The author is not a professor or even an associate professor, but simply an ordinary children’s doctor who graduated from an ordinary medical institute. And this book was written for ordinary people living ordinary human lives. What theoretically creates conditions for future mutual understanding. 1
The phrase “not a professor or even an associate professor” does not at all indicate my negative attitude towards professors and associate professors. Although a certain part of readers will apparently refuse to receive information from a person who is not burdened with degrees and titles. It's a pity, of course. But for more than 25 years now I have been directly related exclusively to practical medicine, to the treatment of children. Orderly, nurse, resuscitator, head of department at a regional hospital. Now I’m hosting an appointment at my consultation center. What have you seen over the years... Dozens of hospitals. Hundreds of doctors. Thousands of children, thousands of mothers, fathers, grandmothers, grandfathers. Thousands, giving me the opportunity and moral right to write this book, without being either a professor or an associate professor.

The author addresses this book to parents - those who have already become parents, and especially those who are just about to become them. This is not a textbook, not a collection of recipes and instructions, not an encyclopedia and, God forbid, not a guide to diagnosis and treatment!

This is most likely a medium-sized guide that should help you avoid a lot of problems.

Main- a little bit of common sense, a little bit logical thinking- and we will agree on everything.

A huge number of works on a similar topic have been written all over the world. It is not surprising that, having spent money on purchasing the next “labor”, future or already established fathers and mothers want to first of all find out what are the features of this work and whether they exist at all.

There are three such features:

First feature – ability to implement recommendations. After all, hundreds of books devoted to caring for and raising children are written in such a way that the very process of communicating with a child is perceived in isolation from real life. Such “little things” are not taken into account, such as a hungry dad coming home from work, shops and clinics, missing hot water, a broken iron, a particularly wise mother-in-law, another pregnancy, downsizing, the number of days until salary, etc.

Second feature is that, having a higher medical education, the author himself does not always understand everything in intelligent works designed for a “wide readership.” Therefore, he tried very, very hard to make the book as accessible as possible, but not primitive.

Third feature , perhaps the main thing - I’m not just saying “do it this way” - I’m trying to convince you that this is exactly how you should do it.

It should be noted that modern parents rarely take on the full burden of responsibility for the health of the child. Allegedly, the state approach to this issue is that the local doctor is supposedly responsible for the child’s health “in general.” But the answers to most “children’s questions” are given at family councils, where mom and dad - as the least experienced people - are given an insignificant role. On the one hand, this is quite understandable. On the other hand, it is mom and dad who always turn out to be “extreme” if the child is sick or behaves badly. At this point, relatives, acquaintances and, of course, grandparents will not fail to notice that they had to obey their elders.

In connection with the above, I draw your attention moms and dads for the following points:

Looking around, you can easily see that neither you nor your friends are of iron health. Therefore, the phrase uttered by a mother-in-law or mother-in-law: “I raised three people” is not any significant argument;

no matter what your friends, relatives and acquaintances advise you, remember the main thing: you and only you will not sleep at night, running to pharmacies and hospitals!

You know very well: redoing (re-educating, re-educating) is much more difficult than doing the right thing from the very beginning. Therefore, do not bring your child to a state where only the most decisive measures will allow you to overcome the difficulties that have arisen. It’s better to choose the right direction from birth: it’s easier, cheaper, and more enjoyable;

if it didn’t work out from birth - you didn’t know or thought you knew, didn’t want to, didn’t understand - remember: it’s never too late to come to your senses, but the sooner, the easier.

*** * ***

In most cases, the health of our children does not satisfy either parents or pediatricians. 2
A pediatrician is a doctor who provides therapeutic and preventive care to children. Since the book is still related to medicine, it is unlikely that it will be possible to do without “especially smart” special words.

And this is doubly unpleasant considering that in terms of the number of pediatric doctors we have left far behind not only Bangladesh, but also the United States of America.

The conclusion is simple: neither the quantity nor the quality of pediatricians can solve children’s health problems. But it’s impossible, most likely because said health depends to a much greater extent on mom and dad than on all pediatricians combined. In other words, parents can make sure that their child gets sick a little, and if he does get sick, then he has the opportunity to resist illness and recover with minimal losses. 3
Losses, as you understand, can be very different - from loss of health to loss of time. We are no longer talking about financial costs.

This is where the role of the pediatrician becomes clear, which must be strived for always, everywhere and under any circumstances - the role of a consultant. And in this role A pediatrician is needed not so much for the child as for the child’s parents!

In this book we will try to help mom and dad learn the main principles of care and education, the main rules for providing assistance in case of illness. But you will have to implement them in practice yourself - there is no one to expect help from. True, the author’s principles and the life position of the parents may not coincide, therefore, in order to be completely frank, I report the following:

the author is a categorical and consistent opponent of pediatric and pedagogical extremism in all its manifestations. Therefore, any attempts to find in this book recipes on how to bathe newborns in an ice hole or take three-month-old children to the mountains, how to put urine in the nose or teach one year old child read, a two-year-old to play chess, and a three-year-old to prepare for the future family life;

The author is convinced that giving birth and raising children is not the main and only purpose of a person. Both birth and upbringing represent only one (perhaps the largest and most important) side of the polyhedron, 4
The author actually knows that a polyhedron has no sides - only edges, but this does not change the essence of the matter.

Which under no circumstances should overlap other aspects of him - love, friendly communication, work, books, pets, hobbies (knitting, fishing, a new hairstyle, a car, a vegetable garden);

no one, nothing can ever shake the author’s confidence that a happy child is, first of all, a healthy child and only then able to read and play the violin. Happy child- this is a child who has both a mother and a father who find time not only to love this child, but also to love each other.

That's all, actually. If you are satisfied, read on, if not, sorry...

Part one
The beginning of your child's life

The striped boa constrictor also has striped babies.

African proverb

1.1. Pregnancy

How much we suffered because of what did not happen, but could have happened.

Thomas Jefferson

Man is the King of Nature, but at the same time he is part of it. The part that broke the Main Law of the Jungle 5
Keep your head down!

And she rose above everyone else, creating a lot of trouble for herself and everyone else below. These troubles are based on constant and, unfortunately, not at all fruitless attempts to fight the laws of Nature. Who will undertake to argue that man as a biological species was created incorrectly? Nobody! 6
Note: it does not matter who created this species - God or evolution.

Consequently, the hereditary information transmitted from generation to generation is quite good, and Nature is trying with all its might to get rid of the deviations that arise on its own, despite the active opposition of modern medicine.

A human baby that is born already has a set of hereditary (gene) characteristics called genotype.7
To readers who are outraged by the author’s promise to express himself more simply and not to use particularly “clever” words, I inform you: the word “genotype” is included in the biology curriculum of a regular high school.

But the born owner of the genotype does not have the opportunity to independently manage his wealth. Under the influence of the environment, the genotype turns into phenotype- a completely definite set of external signs.

With the same genotype, you can get a huge number of phenotypes - it all depends on:

1 habitat (climate, city, village, nearby factory or, conversely, pine forest, basement, tenth floor, dust, chemistry, radiation, etc.);

2 parents , more precisely, on the conditions that they create for their child.

With Wednesday, how lucky is anyone? And parents, by the way, are you and me.

The essence of the above reasoning is obvious: from the point of view of Nature (genotype), the health of a born child differs very little from the health of his predecessor, who was born 20 or 30 thousand years ago and did not know what steam heating, an adapted milk formula, a sterile nipple, boiled water and much, much more, but at the same time, managed not only to survive, but also to give birth to offspring. And this very offspring, by the way, is what you and I are. AND Our main task is not to allow the child to lose the health that Nature has already awarded him.

You need to start solving this problem as early as possible - preferably during pregnancy.

*** * ***

Pregnancy does not occur on its own, without sexual intercourse preceding it. 8
True, there are exceptions (read the “New Testament”), but they are very rare.

It follows that all other signs - the absence of menstruation and, on the contrary, the presence of vomiting, nausea and rapidly changing views on the surrounding reality - are just a consequence of one of the most interesting, significant and widespread manifestations of human existence, namely, sexual life.

The likelihood that this book will fall into the hands of a person who is not familiar with what causes pregnancy and how it manifests itself is very small. Well, since we have agreed on this, we will agree: if you have doubts (suspicions), you should consult a doctor who, by answering such questions, earns his living and is called a gynecologist.

Our goal is not to discuss the causes of pregnancy (when, after what, why, from whom, etc.). Both the author and readers are interested in pregnancy, of course, but, above all, from the child’s perspective – how to live to the expectant mother, in order to then give birth and at the same time minimize the need for a pediatrician.

The procedure in which the same person is entrusted with monitoring the pregnant woman, delivering the child and then monitoring the child, unfortunately, is not accepted at all. 9
At least in the geographical space foreseeable to the author.

And there is nothing good about that. Because the points of view of a gynecologist and a pediatrician quite often do not coincide: what is good for the mother (and the gynecologist) is not always good for the child (and the pediatrician).

So, the most ordinary woman who has reached childbearing age decided not to miss this age. This most ordinary woman is prepared by Nature itself for bearing a child and giving birth.

And Nature, and human nature, and the laws of logic, and indeed elementary common sense are not able to explain why a pregnant woman should not get tired, sleep more, not lift more than one kilogram, etc. After all, this same woman several thousand years ago in In a similar situation, I would continue to live according to the laws of the tribe - well, who would stop cooking food or moving after the deer just because someone’s stomach is in the way or, you see, he’s feeling sick... And you have to think for yourself. Imagine your husband as a large, shaggy and not very good-smelling male, and yourself as a female preoccupied with an “interesting situation”, who simply must, during pregnancy, firstly, not allow this male to move to another, and secondly, maintain optimism and, why be modest, beauty.

The most important rule is

PREGNANCY IS NOT A DISEASE!

However, many, many women view this condition this way. Gynecologists help them in many ways - rarely does a visit to a doctor not end with discussions about a narrow pelvis, a crooked uterus, inflammation of the appendages and in general: how did this happen to you, girl... And even your friends will talk about the hellish agony of the maternity hospital. Again, you need to pass a lot of tests and go through a lot of specialists. I can assure you that I have never met a person who visited a large number of doctors, passed a large number of tests and did not discover some kind of illness dormant in him. Moreover, it is customary for us to run to doctors after pregnancy has become a fait accompli, and not before...

By the way, the very fact of pregnancy in most cases gives rise to many other problems - sexual, material, and finally, housing.

And there is nothing strange in the fact that stressful state- a surprisingly common pregnancy companion. After all, it is very difficult to resist the abundant influx of negative information. To do this you need to have very, very strong brains or not have them at all. Both are rare, so it is advisable to remember:

First of all, you must listen to yourself - move if you want to move, sleep if you want to sleep, eat if you want to eat, and make love with your husband if you want to make love;

if you want a child and at the same time already are pregnant, then no diseases discovered by doctors should cause you despair. State in the depths of your soul the fact that you should have given up earlier, but do not try to save yourself, since it is difficult to find treatment methods that are simultaneously beneficial to both the child and the mother;

any treatment of a pregnant woman should be carried out only when without it definitely cannot be avoided (bleeding, obvious threat of failure, nephropathy, diagnosed diabetes mellitus, rheumatism or other passions).

You live in a country where the number of examiners and those who teach how to treat is almost equal to the number of those who actually treat. The one who treats knows very well that no one will scold him for prescribing 10 medications for a runny nose - after all, at least a Ph.D. thesis has been defended for each of these 10 medications. Pregnancy is always a risk. An obvious risk for the pregnant woman herself and an equally obvious risk for the doctor, who, given the assessment of his work by society, is not going to take risks. 10
On the issue of assessing medical work. In the first edition of the book “The Beginning of Your Child’s Life” (more about this book on p. 573), the author noted that at the time of writing these lines, the monthly work of a specialist with a diploma of higher medical education was paid the same as 1 (one) hour work of a prostitute. I really wanted to exclude this comparison from the second edition of the book. Then I wanted to exclude it from the third, then from the fifth... 10 years have passed, but it (the comparison), unfortunately, has not lost its relevance to this day. Although there are certain changes. And I can solemnly declare (rewrite): “At the time of writing these lines, the monthly work of a specialist with a diploma of higher medical education is paid in the same way as 2 (two) hours of work of a prostitute.”
And you need to have a lot of courage not to prescribe, not to send for consultation, not to put you in a hospital, not to start stimulating, not to prohibit. We need to break away from the papers and find time to calmly talk, explain and, in the end, consciously split the risk in half. But they check a doctor not on the basis of patient reviews, but on the quality of the “documents” written by him! And as soon as any diagnosis is written down in the card, then it is necessary to treat it: what if there is some kind of trouble, then the teachers and inspectors will ask in all severity: how come, my friend, you didn’t prescribe it? And indeed, sometimes troubles happen - one in 100 suffers, but they prescribe it for everyone - just in case. Help the doctor to be honest and frank with you - do not demand from him unique medicines and your immediate salvation, do not shout: “We are ready for anything!”, find out what will happen if you do nothing, and what is more dangerous - to treat or not to treat. For obvious reasons, I don’t name specific diseases; that’s not the point. A pregnant woman should just try to look at herself through the eyes of the doctor she came to see. She must understand what any doctor understands: pregnancy is a normal physiological process, and the less we interfere with normal physiological processes, the better it will be for all of us!

What if it’s not completely normal? So we need to think about whether we are so wise as to disturb Mother Nature if she stumbles a little. And if it’s not normal at all, then get treatment, but at the same time remember the wonderful aphorism that was born among practicing doctors: “What happens rarely happens very rarely; what happens very rarely never happens.”

Dr. Komarovsky is responsible for our future. Thanks to him, a huge number of children will be able to grow up healthy and strong. “The Health of a Child and the Common Sense of His Relatives” is the greatest work of the writer and part-time doctor. It contains advice and wishes on such a sensitive issue for parents as raising children. And all of them are not devoid of humor and good instructions.

From the very beginning of his medical career, Evgeny Komarovsky thought about health. This is the main component of every person’s life. It is not surprising that most feasts with family or friends are accompanied by a toast to health and longevity. And the mental and physical state of the child is all the more important because his life is just beginning. Energy fills the body, bones and tissues are formed and are in constant growth. At this stage, it is important to follow all the necessary recommendations so that the person grows strong, strong and without illnesses. Due to oversight and untimely intervention in the fate of a child, an unforgivable mistake can be made. She will be tragic and haunt her parents for an endless number of days. The task of Dr. Komarovsky is to prevent such a possibility of a dramatic outcome of events.

Thus, the idea came to write a book that included the necessary explanations on the most important issues in raising a baby. And who other than a practicing physician, who has encountered this throughout his life, can cope with such a significant task. Adding a fair share of witty jokes to the important recommendations so that the work does not seem like a sour collection of encyclopedic notes in the field of medicine. Parents and grandparents, having adopted all the instructions, will be able to give their children and grandchildren a full life. For which healthy offspring will be very grateful to them upon reaching adulthood.

Evgeny Komarovsky

First steps -

Komarovsky Evgeniy

The health of the child and the common sense of his relatives

Evgeny Komarovsky

The health of the child and the common sense of his relatives

I BELIEVE THAT WE CAME AFTER OTHERS IN ORDER TO DO BETTER THAN THEM, SO TO NOT FALL INTO THEIR MISTAKES, INTO THEIR MISTAKES AND SUPERSTITIONS.

P.Ya. Chaadaev

DATING 8

PART ONE 11

THE BEGINNING OF YOUR CHILD'S LIFE 11

1.1. PREGNANCY 12

1.1.1. WHEN IS IT BETTER TO GET PREGNANT? 14

1.1.2. WHAT TO EAT AND DRINK? 15

1.1.3. HYGIENE 17

1.1.4. WHAT TO WEAR? 17

1.1.5. WHAT TO DO WITH YOUR HUSBAND? 17

1.1.6. WHAT TO DO WITH YOURSELF? 17

1.1.7. SEX? 18

1.1.8. WHAT SHOULD A FUTURE DADDY DO? 18

1.2. MATERNITY HOUSE 20

1.3. YOUR NEWBORN 23

1.4. PRINCIPLES OF CHILD CARE AND THEIR IMPLEMENTATION IN LIFE 26

1.4.1. CHILDREN'S ROOM 27

1.4.1.1. TEMPERATURE CONDITION OF CHILDREN'S ROOM 28

1.4.2. CLOTH. 30

1.4.2.1. SEPARATELY ABOUT DIAMPERS. 31

1.4.3. WASH 34

1.4.4. SON 34

1.4.4.1. PREPARING THE BED 35

1.4.4.2. HOW TO SLEEP? 35

1.4.4.3. HOW MUCH TO SLEEP? 36

1.4.4.4. MOTION MOTION SICKNESS 36

1.4.5 NAVEL 36

1.4.6. LEATHER 37

1.4.7. BATHING 37

1.4.8. PARTY 38

1.4.9. MANIPULATIONS WITH A BABY 39

1.5. FEEDING 40

1.5.1. NATURAL FEEDING 41

1.5.1.1. NUTRITION FOR NURSING MOTHERS 42

1.5.1.2. SPECIFICALLY ABOUT WOMEN'S BREASTS 43

1.5.1.3. Basic rules natural feeding 46

1.5.1.4. Dummy 48

1.5.1.5. NIPPLES 49

1.5.2. MIXED AND ARTIFICIAL FEEDING 50

1.5.2.1. What to give? 50

1.5.2.2. Separately about donor milk. 52

1.5.3. GENERAL PRINCIPLES OF CHILD NUTRITION 53

1.5.3.1. SUPPLEMENTARY FEEDING and COMPLEMENTARY FEEDING 55

1.5.4. ACTIONS AFTER FEEDING 60

1.5.5. ABOUT VITAMIN D. 60

1.5.6. WHAT, HOW AND IN WHAT QUANTITIES SHOULD I DRINK? 61

1.6. BATHING 62

1.6.1. WHERE AND WHAT TO BUY 63

1.6.2. WHY BIG BATH? 63

1.6.3. PREPARING THE BATH AND BATHROOM 64

1.6.4. WATER PREPARATION 65

1.6.5. WATER TEMPERATURE 65

1.6.6. ORGANIZATION OF THE PROCEDURE AND PREPARATION OF THE CHILD 66

1.6.7. BATHING 68

1.6.8. ACTIONS AFTER BATHING 71

1.7. GROWTH AND DEVELOPMENT, AND ALSO SOME “LITTLE THINGS” NOT worthy of a separate CHAPTER 73

1.7.1. VISION 74

1.7.2. RUMOR 75

1.7.3. YOUR CONVERSATIONS WITH YOUR CHILD AND THE CHILD’S “CONVERSATIONS” WITH YOU 75

1.7.4. REASONS FOR CRYING 75

1.7.5. SITTING, CRAWLING, STANDING, WALKING 76

1.7.6. DROIL AND TEETH 77

1.8. THE MAIN TASK OF THE BEGINNING OF LIFE 78

PART TWO 79

YOUR CHILD'S LIFESTYLE 79

2.1. FAMILY MEMBERS: TACTICS OF RATIONAL ACTION 80

2.1.1. MAMA 80

2.1.2. PAPA 82

2.1.3. GRANDPARENTS 85

2.2. FOOD 88

2.2.1. APPETITE 89

2.2.2. FEEDING BY THE HOUR 90

2.2.3. I WANT THIS, I DON'T WANT THIS 90

2.2.4. FEEDING BETWEEN FEEDINGS 90

2.2.5. SWEETS 91

2.2.6. FIRST COURSE 91

2.2.7. NUTRITION AND DISEASES 91

2.3. WALKING 92

2.3.1. WALKS FOR HEALTHY CHILDREN 93

2.3.2. WALKING AND ILLNESS 95

2.4.1. SLEEP FOR HEALTHY CHILDREN 97

2.4.2. SLEEP AND DISEASES 100

2.5. SUMMER HOLIDAY 100

2.5.1. BATHING 103

2.6. KINDERGARTEN 105

2.7. RELATIONSHIP WITH THE DISTRICT PEDIATRIST 107

2.8. PREVENTIVE VACCINATIONS 110

2.9. HARDENING 114

PART THREE 120

YOUR CHILD'S DISEASES 120

3.1 A VERY NECESSARY PREFACE 121

3.2. IMMUNITY: WHAT IS IT 122

3.3. INFECTIOUS DISEASES: GENERAL AND MANDATORY INFORMATION 124

3.4. VIRUSES 126

3.5 ACUTE RESPIRATORY VIRAL INFECTIONS (ARVI) 129

3.5.1. COLD 131

3.5.2. ORZ 132

3.5.3. INCREASED BODY TEMPERATURE 133

3.5.4. Runny nose 135

3.5.5. COUGH 136

3.5.6. DIFFICULTY BREATHING 137

3.5.7. BED REST 137

3.5.8. DISTRACTION PROCEDURES 137

3.6. VALIABLE VIRAL INFECTIONS 138

3.6.1. MEASLES 138

3.6.2. RUBELLA 139

3.6.3. CHICKEN POX 140

3.7. MUMPS 141

3.8. VIRAL HEPATITIS 142

3.9. SUDDEN EXANTHEMA (ROSEOLA) 146

3.10. SCARY VIRAL INFECTIONS 146

3.10.1. POLIOMYELITIS 147

3.10.2. RABIES 147

3.11. INFECTIOUS MONONUCLEOSIS 148

3.12. HERPETIC INFECTION 149

3.13. CYTOMEGALOVIRUS INFECTION 151

3.14. BACTERIA AND BACTERIAL INFECTIONS 152

3.15. DIPTHERIA 154

3.17. WHOOPING COUGH 157

3.18. INTESTINAL INFECTIONS 163

3.19. SCARLATINE 167

3.20. SOLISH 169

3.21. MENINGITIS 173

3.22. PULMONARY 176

3.23. CHLAMYDIOSIS AND CHLAMYDIA 182

3.24. INFECTIOUS HOSPITAL 185

3.25. RASH 187

3.26. DYSBACTERIOSIS 190

3.27. OTIT 192

3.28. ADENOIDS 196

3.29. DIATESIS 198

3.30. CONSTIPATION 203

3.31. ANTIBIOTICS 206

3.32. I'M NOT AFRAID OF INJECTIONS 212

3.33. SCARY DOCTOR 215

AFTERWORD, REQUESTS AND COORDINATES 219

DIARY 221

"...and when they asked to bring the most beautiful thing that is in the whole wide world, the crow brought her child..."

Almost no one ever reads popular science literature from beginning to end - like a novel. In relation to books with information about children, problems and diseases, this is especially true. Why read about the nutritional rules of a pregnant woman when the baby is constipated? We open the chapter about constipation, get the necessary information and, with a feeling of deep satisfaction, try to implement the advice and recommendations.

The author, of course, really wants you to read everything in order. But, since the hopes for this are low, in order to prevent subsequent misunderstandings, I will allow myself a brief instruction-information for those who are ready to start reading (options - viewing, flipping through, studying).

1. The book consists of three main parts:

* Part one is devoted to the two most important stages in the life of a child and his parents - pregnancy and the first year of life.

* Part two - a child over a year old, naturally not on his own, but in conjunction with his father and mother, grandparents, schools, kindergartens, the environment and the health care system.

* Part three - diseases, hospitals, doctors, medications, what you must do, what you should never do.

2. Everything you read should be considered, first of all, as food for thought. Not a single living soul in the whole wide world can love your child and understand your child the way you do. A completely different thing is that understanding, loving and even at the same time thinking, reflecting, understanding, and under all these conditions it is not always possible to achieve success.

3. Success, in relation to the process of care and education, is a relative concept - depending on which bell tower you look at from. From the point of view of a teacher, the polite winner of the city physics and mathematics Olympiad, who stays in hospital, is an undoubted success. An absolutely healthy young bandit (if he is washed and forbidden to talk) will please the pediatrician with the excellent functioning of his internal organs and excellent tests.

4. The golden mean is a simultaneous and abundant balm for the soul of relatives, doctors and teachers - this is a child who is smart, well-mannered and healthy. This phenomenon occurs extremely rarely, but when implementing a certain program of care and education, we should at least know what to strive for.

5. The actual level of health or ill health of a particular child depends on four factors:

* Heredity, i.e. what was inherited from mom and dad;

* Environment (ecology + living conditions);

* Health systems;

* The process of care and education, i.e. relationship between the child and his relatives.

6. The above-mentioned care and education represent certain very specific actions, a certain set of activities. But the main paradox is this: 100% of the adult population knows HOW TO MAKE CHILDREN, but 99.9% do not know WHAT TO DO WITH CHILDREN THEN.

7. The main task of this book is to eliminate the paradox of the situation, in an accessible form to provide the reader with the opportunity to determine for himself what should be done with the child and what should never be done.

ACQUAINTANCE

“The greater or lesser degree of respect accorded to an author depends on the greater or less similarity of his ideas with those of the reader.”

Helvetius

The author is not a professor or even an associate professor: just an ordinary children's doctor who graduated from an ordinary medical institute. And this book was written for ordinary people living ordinary human lives. Which theoretically creates the conditions for future mutual understanding. 1

Most likely, this is a medium-sized guide that should help you avoid many problems.

The main thing is a little common sense, a little logical thinking - and we will agree on everything.

A huge number of works on a similar topic have been written all over the world. It is not surprising that, having spent money on purchasing the next “labor”, future or already established fathers and mothers want, first of all, to find out what the features of this work are, and whether they exist at all.

There are three such features:

The first feature is the ability to implement recommendations. After all, hundreds of books dedicated to caring for and raising children are written in such a way that the very process of communicating with a child is perceived in isolation from real life. Such “little things” are not taken into account, such as a hungry dad coming home from work, shops and clinics, missing hot water, a broken iron, a wise mother-in-law, another pregnancy, the number of days until salary, etc.

The second feature is that, having a higher medical education, the author himself does not always understand everything in intelligent works designed for a “wide readership.” Therefore, he tried very, very hard to make the book as accessible as possible, but not primitive.

The third feature is perhaps the main one - I’m not just saying “do it this way” - I’m trying to convince you that this is exactly how you should do it.

It should be noted that modern parents rarely take on the full burden of responsibility for the health of the child. Allegedly, the state approach to this issue is that the local doctor is generally responsible for the child’s health. But the answers to most “children’s questions” are given at family councils, where mom and dad, as the least experienced people, are given an insignificant role. On the one hand, this is quite understandable. On the other hand, it is mom and dad who always turn out to be “extreme” if the child is sick or behaves badly. At this point, relatives, acquaintances and, of course, grandparents will not fail to notice that they had to obey their elders.

In connection with the above, I would like to draw the attention of mom and dad to the following points:

* looking around, you can easily make sure that neither you nor your friends are distinguished by iron health. Therefore, the phrase uttered by a mother-in-law or mother-in-law: “I raised three people” is not any significant argument.

* no matter what your friends, relatives and acquaintances advise you, remember the main thing: you and only you will not sleep at night, running around pharmacies and hospitals!

* You know very well: redoing (re-educating, re-educating) is much more difficult than doing the right thing from the very beginning. Therefore, do not bring your child to a state where only the most decisive measures will allow you to overcome the difficulties that have arisen. It’s better to choose the right direction from birth: it’s easier, cheaper, and more enjoyable.

* If it didn’t work out from birth - you didn’t know or thought you knew, didn’t want to, didn’t understand - remember: it’s never too late to come to your senses, but what earlier than that simpler.

In most cases, the health of our children does not satisfy either parents or pediatricians2. And this is doubly unpleasant considering that in terms of the number of pediatric doctors we have left far behind not only Bangladesh, but also the United States of America.

This is where the role of the pediatrician becomes clear, which must be strived for always, everywhere and under any circumstances - the role of a consultant. And in this role, a pediatrician is needed not so much by the child as by the child’s parents!

* the author is a categorical and consistent opponent of pediatric and pedagogical extremism in all its manifestations. Therefore, any attempts to find in this book recipes on how to bathe newborns in an ice hole or take three-month-old children to the mountains, how to bury urine in the nose or teach a one-year-old child to read, a two-year-old to play chess, and a three-year-old to prepare for the future are doomed to failure in advance. family life;

* the author is convinced that giving birth and raising children is not the main and only purpose of a person. And birth and upbringing represent only one (perhaps the largest and most important) side of the polyhedron,4 which under no circumstances should overlap its other sides - love, friendly communication, work, books, pets, hobbies (knitting, fishing, new hairstyle, car, garden);

* no one, nothing can ever shake the author’s confidence that a HAPPY child is, first of all, a HEALTHY child and only then can he read and play the violin. A happy child is a child who has both a mother and a father who find time not only to love this child, but also to love each other.

That's all, actually. If you like it, read on, no, sorry...

A striped boa constrictor has striped babies

African proverb

PART ONE

THE BEGINNING OF YOUR CHILD'S LIFE

1.1. PREGNANCY

“We suffered so much over something that didn’t happen, but could have happened.”

Thomas Jefferson

Man is the King of Nature, but at the same time - a part of it. The part that violated the Main Law of the Jungle5 and rose above all the others, at the same time creating a lot of trouble for itself and everyone left below. These troubles are based on constant and, unfortunately, completely fruitless attempts to fight the laws of Nature. Who will undertake to argue that man as a biological species was created incorrectly? Nobody!6 Consequently, the hereditary information transmitted from generation to generation is quite good, and Nature is trying with all its might to get rid of the deviations that arise on its own, despite the active opposition of modern medicine to it.

A human baby that is born already has a set of hereditary (gene) characteristics, which is called a genotype.7 But the born owner of the genotype does not have the opportunity to independently manage his wealth. Under the influence of the environment, the genotype turns into a phenotype - a completely defined set of external characteristics.

With the same genotype, you can get a huge number of phenotypes - it all depends on:

1. Habitat (climate, city, village, nearby factory or, conversely, pine forest, basement, tenth floor, dust, chemistry, radiation, etc.);

2. Parents, more precisely, on the conditions that they create for their child.

With Wednesday, how lucky is anyone? And parents, by the way, are you and me.

The essence of the above reasoning is obvious: from the point of view of Nature (genotype), the health of a born child differs very little from the health of his predecessor, who was born 20 or 30 thousand years ago and did not know what steam heating, an adapted milk formula, a sterile nipple, boiled water and much, much more, but at the same time, managed not only to survive, but also to give birth to offspring. And you and I, by the way, are this very offspring. And our main task is not to allow the child to lose the health that Nature has already awarded him.

You need to start solving this problem as early as possible, preferably during pregnancy.

Pregnancy does not occur on its own, without previous sexual intercourse.8

It follows that all other signs: the absence of menstruation and, on the contrary, the presence of vomiting, nausea and rapidly changing views on the surrounding reality - are just a consequence of one of the most interesting, significant and widespread manifestations of human existence, namely, sexual life.

The likelihood that this book will fall into the hands of a person who is not familiar with why pregnancy occurs and how it manifests itself is very small. Well, since we have agreed on this before, let us agree: if you have doubts (suspicions), you should consult a doctor who, by answering such questions, earns his living and is called a gynecologist.

Our goal is not to discuss the causes of pregnancy (when, after what, why, from whom, etc.). Both the author and readers are, of course, interested in pregnancy, but, first of all, from the position of a child - how to live as an expectant mother, in order to then give birth and at the same time minimize the need for a pediatrician.

The procedure in which one and the same person is entrusted with monitoring the pregnant woman, delivering the baby, and subsequently monitoring the child is, unfortunately, completely not accepted.9 And there is nothing good about it. Because the points of view of a gynecologist and a pediatrician quite often do not coincide: what is good for the mother (and the gynecologist) is not always good for the child (and the pediatrician).

So, the most ordinary woman who has reached childbearing age decided not to miss this age. This most ordinary woman is prepared by Nature itself for bearing a child and giving birth.

And Nature, and human nature, and the laws of logic, and indeed elementary common sense are not able to explain why a pregnant woman should not get tired, sleep more, not lift more than 1 kilogram, etc. After all, this same woman several thousand years ago in a similar situation would have continued to live according to the laws of the tribe - well, who would stop cooking food or moving after the deer just because someone’s stomach was bothering them or, you see, they were feeling sick... And you have to think for yourself. Imagine your husband as a large, shaggy and not very good-smelling male, and yourself as a female preoccupied with an “interesting situation”, who simply must, during pregnancy, firstly, not allow this male to move to another, and, secondly, maintain optimism and, why be modest, beauty.

The most important rule

PREGNANCY IS NOT A DISEASE!

However, many, many women view this condition this way. In many ways, gynecologists help them - rarely does a visit to a doctor not end with discussions about a narrow pelvis, a crooked uterus, inflammation of the appendages and in general - how did this happen to you, girl... And even your friends will talk about the hellish agony of the maternity hospital. Again, you need to pass a lot of tests and go through a lot of specialists. I can assure you that I have never met a person who visited a large number of doctors, passed a large number of tests and did not discover some kind of illness dormant in him. Moreover, it is customary for us to run to doctors after pregnancy has become a fait accompli, and not before...

By the way, the very fact of pregnancy in most cases gives rise to many other problems - sexual, material, and finally, housing.

And there is nothing strange in the fact that stress is a surprisingly common companion to pregnancy. After all, it is very difficult to resist the abundant influx of negative information. To do this you need to have very, very strong brains or not have them at all. Both are rare, so it is advisable to remember:

* you must listen, first of all, to yourself - move if you want to move, sleep if you want to sleep, eat if you want to eat, and make love with your husband if you want to make love.

* if you want a child and are already pregnant, then no diseases discovered by doctors should cause you despair. State in the depths of your soul the fact that you should have given up earlier, but do not try to save yourself, since it is difficult to find treatment methods that are simultaneously beneficial to both the child and the mother;

* any treatment for a pregnant woman should be carried out only when it is clearly impossible to do without it (bleeding, a clear threat of failure, nephropathy, diagnosed diabetes, rheumatism or other passions);

You live in a country where the number of examiners and those who teach how to treat is almost equal to the number of those who actually treat. The one who treats knows very well that no one will scold him for prescribing 10 medications for a runny nose - after all, at least a Ph.D. thesis has been defended for each of these 10 medications. Pregnancy is always a risk. There is an obvious risk for the pregnant woman herself and an equally obvious risk for the doctor, who, given the assessment of his work by society, is not going to take risks.10 And one must have a lot of courage not to prescribe, not send for a consultation, not to admit him to a hospital, not to start stimulating , do not prohibit. We need to look away from the paperwork and find time to calmly talk, explain and, in the end, consciously divide the risk in half. But they check a doctor not on the basis of patient reviews, but on the quality of the “documents” written by him! And as soon as any diagnosis is written down in the card, then it is necessary to treat it: what if there is some kind of trouble, then teachers and inspectors will ask in all severity - how come you, my friend, didn’t prescribe it? And indeed, sometimes troubles happen - for one in 100, but they are prescribed to everyone - just in case. Help the doctor to be honest and frank with you - do not demand from him deficits and your immediate salvation, do not shout: “we will get it”, find out what will happen if you do nothing, and what is more dangerous - to treat or not to treat. For obvious reasons, I don’t name specific diseases; that’s not the point. A pregnant woman should just try to look at herself through the eyes of the doctor she came to see. She must understand what any doctor understands: pregnancy is a normal physiological process and the less we interfere with normal physiological processes, the better it will be for all of us!

What if it’s not completely normal? So we need to think about whether we are so wise as to interfere with Mother Nature if she stumbles a little. And if it’s not normal at all, then get treatment, but at the same time remember the wonderful aphorism that was born among practical doctors: “What happens rarely happens very rarely; what happens very rarely happens never.”

1.1.1. WHEN IS IT BETTER TO GET PREGNANT?

To our great, great regret, pregnancy planning is still not a universal rule. But if your family in its evolution has reached the point that, firstly, it can afford pregnancy at a certain moment, and, secondly, it can make this pregnancy a real fact, then you should know: the higher the level of health of future dads at the time of conception and mothers, the healthier the child will be.

Therefore, it is advisable BEFORE:

* check your health and, if necessary, receive treatment;

* be sure to visit the dentist;11

* have a good rest (optimally - spend your vacation not on the couch, but in nature);

* “quit” with various harmful substances (smoking, drinking strong drinks, watching TV);

* limit contact with as much as possible household chemicals and use of pharmacological agents;

* somewhat limit sexual activity.

Many people are concerned about the time of year, the month, and even a specific day. I can’t say anything about the day (it’s better to find out from astrologers), but regarding the time of year I will note the following. The maximum level of health of a particular person occurs in autumn (September-October): a sufficient amount fresh vegetables and fruits, summer holiday(sun, air, water, physical activity). On the other hand, it is very good that when a child is born in the fall, it is easier to organize hardening; winter is ahead (it will be more difficult to overheat). Again, it is very good when the first half of a child’s life falls in the winter months - the immunity inherited from the mother to many viruses is still in effect, therefore, the likelihood of getting sick is noticeably lower.

The logic, most likely, is that if future parents do not have serious health problems, conception should be planned for January-February in order to give birth in the fall. Well, if your health is not good, “do” the child in the fall.

A special issue is the age of the expectant mother. It is clear that at 18 you will be healthier than at 35. But the main thing is that you give birth to a child for yourself, and not as a gift to grandparents. Therefore, it is better to be a mother at 30 than a cuckoo at 18.

And one more thing. Even when getting a puppy, people usually think about where he will sleep, what he will eat and who will walk him. For the child you have born, it is you and only you who are obligated to provide an existence worthy of a human being...

1.1.2. WHAT TO EAT AND DRINK?

For many millennia, your ancestors ate approximately the same food, and those who could not digest this food became extinct long ago.

Every food product contains certain proteins that are digested by other, also completely specific proteins (enzymes). There are native proteins to which we are genetically accustomed; our ancestors consumed them (bread, meat, apples, fish, etc.). There are proteins that our ancestors never saw - citrus fruits, coffee, cocoa.

Think about where your great-great-grandfather got his oranges? However, we eat them with pleasure, and nothing happens to us. Because everything in the intestines that is not properly digested (completely undigested) is then neutralized by a wonderful processing factory called the liver.

There is a sufficient load on the liver of a pregnant woman - it is the liver that is the main fighter against toxicosis12, a neutralizer of fetal secretions, etc. Let's take care of her. If you want your child not to suffer from the fact that he cannot eat a tangerine or a chocolate bar, then you should not, while pregnant, consume these same tangerines and chocolate bars (undigested particles will pass through the fetus before being neutralized by the liver, causing reactions , and the child will then be allergic to these products).

Simply put, avoid everything that your great-great-grandfather did not eat. You will be healthier.

No need to eat:13

* fatty foods (cook broths - skim off the fat, respect the “blue birds” - skinny chickens and hungry domestic hares - rabbits);

* cocoa and its derivatives (chocolate, chocolate candies, chocolate butter);

* citrus fruits - including lemons, which everyone is advised to take with them to the maternity hospital;

* very spicy, very sour, very salty;

* less canned food;

* fresh yeast products;

* strawberries, raspberries, wild strawberries;

* all sorts of goodies with butter creams.

* vegetables, especially green onions, potatoes and cucumbers;

* fruits: pears, apples, apricots;

* berries: grapes, cherries, cherries, watermelons;

* dairy products: excellent - cottage cheese and kefir (ryazhenka, yogurt, yogurt), just regular milk from an ordinary cow;

* meat (lean), normal fish (not dried roach or herring);

* raisins, dried apricots;

* dried fruit compote;

* green tea.

* better steamed, boiled and baked than fried and smoked;

* it is better to undereat than to overeat;

* if you can’t, but really want to, then you can, as long as you don’t want to;

* if in doubt: is it possible or not? - come on;

* you don’t need to eat a lot at night;

* generally a lot - not necessary;

* if circumstances, traditions and people around you do not allow you to do without alcohol (for example, New Year in the midst of pregnancy), then either red grape wine (like Cahors) or Champagne (a little bit of both);14

* if you want chalk, chew it for your health (no need for colored crayons and plaster), but it’s still more optimal - calcium gluconate or (even better) calcium glycerophosphate - 3 tablets a day plus cottage cheese - that’s enough for both you and your child;

* it is advisable to take complex vitamins for pregnant women; they differ from other multivitamins by the obligatory presence of vitamin D (for example, domestic “Gendevit” or overseas “Pregnavit”15). If you were unable to buy (get) such vitamins or there is no money to purchase them, then remember that on those days when you are not in the sun (especially in winter), you need to receive 500 units per day. vitamin "D";16

* when there is a lack of sweets, drowsiness occurs;

* they recover not so much from the amount of food, but from the restriction of physical activity;

* if you feel normal, there is no reason to drink less. If difficulties arise (swelling, nephropathy), be sure to coordinate your drinking regimen with your gynecologist (what? how much?).

1.1.3. HYGIENE

* wash your hands;

* brush your teeth more actively and more often than before pregnancy;

* a bath is not advisable, optimally - a shower at least once a day, and no need for hot water;

* wash your hands again.

1.1.4. WHAT TO WEAR?

* something that does not press or press; that which emphasizes; what he (husband) likes;

* something that is neither cold nor hot;

* the less synthetics, the better;

* heel - yes, but no more than three centimeters - we just needed to fall.

1.1.5. WHAT TO DO WITH YOUR HUSBAND?

* remember that he is also a person;

* treat him with understanding;

* encourage, not forgetting to say thank you;

* remind that in the family of which he is the head, there will soon be one more person, and, therefore, he will become even more important;

* don’t whine in front of him and try very, very hard so that your pregnancy doesn’t make him feel inferior - it’s not at all necessary (if possible, of course) for him to know how sick you are - it won’t make you feel better, but he will twitch, all this, sooner or later, will come out sideways.

* sad as it may be, pregnancy is not a reason for your husband to go to work hungry and unironed (we don’t need him to be ironed and fed somewhere).

1.1.6. WHAT TO DO WITH YOURSELF?

* be guided, first of all, by your instinctive desires. In order for the fetus to develop normally, you must move a lot - the more actively the mother’s heart works, the more active the blood flow through the placenta, the more the baby gets all the necessary things dissolved in your blood. Don’t lose your sense of proportion - the author’s statement that motor activity for a pregnant woman - this is good, does not at all mean encouraging athleticism, parachuting and rock climbing;

* do not love yourself more than before (pregnancy is not a disease!!!);

* watch and be in shape (eyes, lips, cheeks, nails, hairstyle) and, God forbid, think that now he’s not going anywhere;

* no need to stay in the sun for a long time and be sure to wear a hat;

* fewer aerosols (deodorants, hairsprays) and in general, the less chemicals that surround you, the better ( washing powders, dichlorvos, mineral fertilizers, mosquito repellents, etc.);

* work or study have a huge positive impact, as they give you the opportunity to think less about pregnancy;

* Please note: any infection in a pregnant woman is fundamentally dangerous for the fetus. Of course, it is very difficult not to catch a cold even once in 9 months, but it is not at all necessary to consciously seek adventure, roaming around the shops, visiting guests and cinemas. Know that the most dangerous disease for a pregnant woman is rubella (the rubella virus has a very bad effect on the fetus). Avoid visiting children's hospitals and clinics. All foods potentially dangerous in terms of diarrhea should be categorically excluded (again, watch what you eat and wash your hands);

* you don’t have to treat all sorts of ailments, colds and stomach upsets with pills yourself;

* travel less later pregnancy - plane and train are not the best alternative to the maternity hospital.

A completely separate issue is the numerous sets of exercises for pregnant women. The author is convinced that a woman who is ready for systematic exercise will find time to buy (optionally, borrow from the library or from friends) literature on this issue, written by specialists. It seems that a pediatrician should not take up space with drawings and claim originality.

The main thing, however, is to understand that any gymnastic exercises are deeply secondary in comparison with the importance of lifestyle (fresh air, physical activity). Paradoxical as it may seem, I have repeatedly had to deal with a situation where expectant mother She lies on the sofa for 12 hours, then does gymnastics for 15 minutes, after which she again lies on the sofa for 11 hours and 45 minutes, consoling herself with the thought that she is doing everything possible to prepare for childbirth.

1.1.7. SEX?

* from the point of view of the Christian religion it makes no sense (during pregnancy, of course);

* dangerous if there is a threat of failure (uterine contractions during orgasm);

* if he insists on this more often than you, then alternate explanatory work with occasional contacts (you cannot completely separate from the body - competitors are not asleep);

* if you insist on this more often than he does, the situation is the most dramatic and one hundred percent unresolvable, actions are possible in three directions: a) your appearance, b) his nutrition; c) limiting your whining.

* if you want the same thing - as much as you want;

* a variety of options allows you not to put pressure on the expectant mother’s stomach (if you don’t know how, watch TV for a week - you’ll definitely learn).

1.1.8. WHAT SHOULD A FUTURE DADDY DO?

First of all, don’t say: “I’ve already done everything that needs to be done.”

Despite the fact that pregnancy is not a disease, you still need to reconsider your attitude towards your spouse. Since you will never be able to experience what your wife experiences during pregnancy, you will never be able to fully understand and explain to yourself her various whims. Understand and realize: the number of harmful stimuli in a pregnant woman is quite large (going to doctors, talking with friends, feeling unwell). Therefore, see your main task as not to become an additional stress factor.

Golden rules for a future dad:

* talk less about whether you want a boy or a girl more. The sex of the child is determined by the father's sperm, therefore, if something happens, there is no point in blaming the mirror...;

* don’t be upset that they are paying less attention to you - maybe there will be more when you really become a dad;

* take an interest in everyday life - by visiting a store or untwisting your underwear, you will not lose your manhood;

* find time to calmly discuss your joint actions - where the crib will be, what and when to buy, what to do while your spouse is in the maternity hospital;17

* do not buy her any goodies that are not desirable for consumption (see above). It will be very reasonable and noble if you do not eat with your wife what she is not allowed to eat, but wants;

* do not encourage your wife to simply do nothing (sofa, TV). It’s better to take a walk with her in the fresh air, sit somewhere in the park on a bench and read this book out loud;

* measure your sexual fervor with your spouse’s responses and don’t sulk if something happens; remember that a pregnant woman is less inclined to forgive compared to just a woman;

* smoking in the apartment is not at all necessary;

* if in your sleep you have the habit of tossing and turning, and also jerking your legs, then it is advisable to sleep separately during the last weeks of pregnancy;

*pregnancy, after all, only lasts 9 months.18

The obvious gist of this chapter is:

in most cases, pregnancy proceeds normally. And you need to behave normally during pregnancy. And remember that, even though our medicine is free, it is not the doctor who is responsible for the health of a specific person, but the specific person himself. And don’t fool yourself by looking for illnesses. The vast majority of difficulties are caused by you yourself, being nervous and needlessly worrying.

Don't create additional problems for yourself. Register at the clinic in a timely manner, visit the doctors and get tested before your stomach prevents you from getting on the tram.

Calm down, for God's sake! You are not the first, you are not the last, forgive the banality. We’ll give birth, we won’t go anywhere.

Therefore, we went to the maternity hospital.

1.2. MATERNITY HOUSE

"No harm will appear in a duck's nest if you hatched from a swan's egg!"

Hans Christian Andersen

It is necessary, first of all, to prepare yourself for a stay in the maternity hospital psychologically. No matter how rich and healthy you are, a successful birth is still a lottery, albeit with very significant chances of winning.

Childbirth is a phenomenon for modern woman rare, but natural and most often occurring normally. The chances of having a bad birth are not very high, from a statistical point of view, although you, of course, have reason to worry. At the same time, having reached the emergency room of the maternity hospital, you are already to a very small extent able to influence the situation.

The main thing is not to panic, try to listen to what they tell you and, as accurately as possible, follow the instructions of the person who is delivering the baby.

Less initiative. Extra brains are the main obstacle when it comes to childbirth (it is not surprising that women with higher education and the intelligentsia generally have more difficulty giving birth).

We will not describe in detail the rules of behavior during childbirth (there is plenty of literature on this issue). After all, the maternity hospital interests us as the place from which a child’s life begins, and, in fact, this book is dedicated to the interests of the latter.

Very, very much of what happens in maternity hospitals is not unequivocally correct. But there is no reason to start a discussion, because - I repeat once again - you and I cannot influence the situation and, most likely, we will give birth in an ordinary state maternity hospital.

It is impossible not to mention that in the very, very recent past, any woman who dared to give birth outside the maternity hospital aroused feelings of pity and angry bewilderment of the public. Currently, the situation has begun to change - at least the state maternity hospital has ceased to be the only and uncontested place where a child has the right to be born.

On the one hand, non-state ones appeared, i.e. not theoretically free, but practically paid maternity hospitals, on the other hand, significant progress is being made in the maternity hospitals themselves - they are allowing fathers who want to come see and be sick, they are organizing “shared wards”, where the child is with the mother immediately after birth.

In some large cities, “interest clubs” have emerged that prepare pregnant women for childbirth at home, naturally under the supervision of medical workers.

The changes that are taking place have their pros and cons. In the maternity ward, instead of helping the woman in labor, they pump out unconscious fathers; in the “shared ward” there are not a mother and a child, but five mothers and five children, etc.

Common sense seems to be about choice. And if the pregnant woman has no health problems (not a narrow pelvis, confirmed ultrasound examination normal fetal position, etc.) then why not give birth at home, where it is more comfortable, where there is less stress. And if after giving birth you have the strength and mood to be with your child, then why not? But why do this if the new mother feels bad, if she has postpartum depression, if the child is restless?

In any case, no matter where we give birth and no matter what experiments are carried out on us, our ultimate goal is the same: to get home with the child as soon as possible.

After all, at home, responsibility for the baby falls entirely on the shoulders of the parents, who have the opportunity to act not in accordance with the instructions and orders of the Ministry of Health, but in accordance with logic and common sense. At the same time, a week spent in the maternity hospital can have a very negative impact on the mother, so there are still some things you need to know.

1. One of the most important tasks is to preserve breast milk. Its quantity depends not on the size of the breast, but on nervous system mother. Try, I beg you, try not to be nervous. This is very difficult, because they will tell you a lot of “good” things about you and your child, and even your roommates will share their fears. If you are very scared, know: women who have given birth and during their entire stay in the maternity hospital have never heard of any abnormality in themselves or their children, simply do not exist. Maybe somewhere there are such women, but we don’t have them. At the same time, almost all sick and abnormal people return home sooner or later, becoming normal and healthy.

2. The sooner a newborn is put to the breast, the better (optimally right in the delivery room) - this fact has been convincingly proven by physiologists and doctors. Firstly, the very irritation of the nipple during sucking promotes contraction of the uterus, which is very important immediately after childbirth. Secondly, the first drops of milk - colostrum - contain substances that “trigger” the development immune system and normal digestion, preventing the occurrence of allergic reactions and intestinal disorders in the future.

However, in hundreds of maternity hospitals, children are brought in for their first feeding on the second or third day, or even later. This is motivated by the mother’s fatigue, the child’s weakness, and the possibility of some congenital diseases in which breastfeeding is dangerous, and time is required to clarify the diagnosis. In fact, there are very few real reasons for not breastfeeding immediately after birth. Ways to solve the problem - a confidential conversation between the future parents and the doctor who makes the decision about the time of the first feeding - the pediatrician of the maternity hospital. You should always remember that not feeding right away is a less risky and less responsible decision, and paying a pediatrician in no way encourages him to make responsible decisions.

Therefore, if in the maternity room you were given a baby to feed, then either everything is fine with your baby, or you are surrounded by excellent specialists, and both are simply wonderful. If the child was not given, then this is not a reason for concern at all. The reasons can be very different. Obstetricians-gynecologists, for example, are always on duty around the clock and in all maternity hospitals, but neonatologists19 are not always and not in all. An OB/GYN doesn't always want to take the risk of making feeding decisions that should be made by a pediatrician.

In the end, please don’t be nervous - they didn’t give it and don’t need it: millions of children who were brought in to be fed only on the second or third day live on their own, pleasing their parents.

3. Don’t worry if the baby sucks reluctantly or sluggishly - of course, tell the doctor about this, but don’t panic yourself. If, from your point of view, he was carried away without food, then, believe me, he will not be allowed to die of hunger.

4. On the second or third day after birth, your baby will definitely turn yellow - maybe a lot, maybe a little. Don't be nervous - this is how it should be, and it's called "physiological jaundice of newborns."

5. In the first days after birth, the child does not gain weight, but, on the contrary, loses it - maybe a lot, maybe a little. Don't be nervous - that's how it should be.

6. There is no need to worry too much due to the fact that you cannot influence when and how long to feed him, what to dress him in, who his roommates are. Don't be nervous! It is almost impossible to spoil a normal living being in a week.

7. You will most likely hear a lot of scary words, such as “asphyxia”, “umbilical cord entanglement”, “impaired hemo-cerebrospinal fluid dynamics”, “encephalopathy”, etc. etc. All of these conditions are treatable and do not often produce noticeable consequences.

Perhaps the words mentioned will apply specifically to your child, but when you come home, you will not find any painful traits in him. Of course, one can be indignant and ask: why then frighten a woman who has just given birth, knowing that her milk may disappear, her sleep may be disturbed, her appetite may disappear, etc.? Please don't be offended. A newborn baby is little predictable. And every doctor knows that we are not talking about any one hundred percent guarantees. Well, who wants to hear: everything was fine, so they ruined it! But they don’t ruin. They get what you gave them - no better and no worse. And they try to immediately tell you that not everything is fine, so that they don’t have to hear from you later.

And we all, the whole society, are to blame for this, because we are used to always looking for extreme ones in all our own troubles. Who has ever been outraged by the high temperature in the neonatal ward? Nobody ever! And God forbid it will be cold - they will tear you to pieces. If you want warmth, here you go! And at home you will find that your child has diaper rash - but it was warm! I didn't catch a cold...

How did nature manage to come up with a biological species that gives birth to babies that can only exist at a temperature of at least 22 degrees?20

Thus, the postpartum woman21 has to solve three main tasks:

1. Don't be nervous.

2. Rest (option - sleep).

3. Engage in your own breasts.22

The actions of the dad, who is running around the maternity hospital in agonizing anticipation, are more varied and are as follows:

1. Prepare for the meeting - make sure once again that everything has been purchased, clean the house, stock up on groceries, invite grandmothers or friends, so that at least on the first day after returning home, mommy doesn’t think about the kitchen.

2. Regarding products sent to the maternity hospital, remember: everything that was prohibited during pregnancy is also prohibited during breastfeeding.23

3. It is obligatory to regularly send notes to your wife (preferably letters and longer ones) containing recognition, admiration, praise and gratitude. Ask: “What do you want?” and, if possible, fulfill all wishes. Calm down. Know for yourself that on the third to fifth day after giving birth, a woman’s mood may unreasonably deteriorate due to various hormonal changes.

4. Think about clothes for the baby, transport, flowers, champagne and sweets in advance.

5. On the day when you need to pick up the mother and child, under no circumstances be late for a second!

After the car leaves the gates of the maternity hospital, a completely new stage in your life will begin. And it doesn’t matter whether this child is the first or the fifth, a boy or a girl.

Now the baby’s health depends only on you - on mom and dad, which, as we have already agreed, is the basis of his future happiness.

1.3. YOUR NEWBORN

"I'm only two days old.

I don't have

Still a name.

What shall I call you?

I am glad that I live.

Joy - that’s what you call me!”

William Blake

The conditions in which a child delivered from the maternity hospital will be will largely determine his future health.

To our deepest regret, the belief that a newborn is very weak, susceptible to numerous illnesses, and in general his life simply hangs by a thread, is firmly rooted among the general public. The basis for such widespread beliefs are people of the older generation (including health workers).

Their main “life” theses are as follows:

Do you feel sorry for the child? (option - “All the best for children!”);

Crying, poor thing...;

His heels are cold (an option is a cold nose);

Draft!

The most interesting thing is that these same people say: “No, just look - the Ivanovs have five, everyone is running around naked and hungry, and no matter what! And ours...”

The absence of any logic is immediately evident, especially considering that everyone knows that beloved children get sick more often.

A newborn baby is a truly tender creature, but not so much tender as unexpected. His surprise lies primarily in the fact that you cannot even approximately determine what his abilities are, what he can do, what he wants, what he is afraid of. Guided by your own experience, you are sure that he wants the same thing as you, is afraid of the same thing as you, but cannot do the same thing as you, because he is weak, small and in general he can only be called a human being. taking into account the fact that his dad and mom are human.

In fact, this is not at all the case, and you simply must know its capabilities.

The main and completely unique distinguishing feature of a newborn is its ability to adapt to environmental conditions.

As has already been explained, the child you brought from the maternity hospital differs very little in its ability to defend its right to life from exactly the same baby who was born somewhere in a cave many, many centuries ago. To this day, children are safely born in yurts, tents and wigwams (deserts, jungles, mountains, taiga, tundra, etc.).

A newborn is not afraid of much, because he can adapt to anything if he gets a little help.

When there is nothing to adapt to (nourishing, clean, warm, not blowing, etc.) - the adaptive systems simply turn off.

If during the first two to three months of life you create for your child comfortable conditions, then in the future it will be very, very difficult for him to exist without such conditions.

But human life is not very short after all. And sooner or later drafts and puddles, hot sun and sleet with rain will appear on your baby’s path, the need for a visit kindergarten(schools). Who, looking around, can be absolutely convinced that our children will not have to freeze in the trenches and wash their clothes in an ice hole...

You can, of course, try to restore what you have lost at three years old or at twenty years old. But is it wise to lose what you already have? It is not only unreasonable, but also stupid, since being healthy is not only more pleasant, but also easier and cheaper...

Dear dad and mom! You are young, full of strength and plans.

You certainly don't want to:

For your child to get sick;

So that he screams at night;

To throw tantrums in public transport;

So that every fall ends in a dislocation or fracture;

So that wet feet, a random draft, a portion of ice cream, an orange, a glass of cold water, a snotty neighbor's child turn into a tragedy;

So that a popular medical encyclopedia can replace all the treasures of world literature.

You certainly don't want to:

Calling friends in search of a good doctor, and then racking your brain about what, how much and in what form to present him with;

Run around pharmacies in search of especially valuable medicines and around stores in search of especially valuable products;

Treat treatment complications;

Seeing the world through the window of a hospital room or hearing him scream: “Mommy, take me away from here!”

But at the same time, you probably really want:

Sleep at night;

Do not be afraid every minute and hourly for his life;

Feel free to visit and travel;

See him healthy and happy.

You hope that he will soon grow up and you will again easily find time for theaters and friends, for your favorite books and hobbies, for each other, finally.

Your dreams are completely achievable! But stop and think, think simply and calmly, putting fears and emotions aside. Having returned from the maternity hospital, you are at a crossroads - three roads are in front of you:

I - the traditional path - by the way, traditional not from the point of view of medicine, but from the point of view public opinion;

II - an exciting and adventurous path of pedagogical extremism;

III - the path of logic and common sense, which is a path that winds, adapting to the surrounding area, smoothly bends around everyday and material obstacles, trying to lead to the intended goal by the shortest route.

So, "Your newborn"...

The title of the chapter, despite its apparent simplicity, requires decoding. First, you need to know that a newborn, from the point of view of medical science, is a child from birth to 28 days. Secondly, the word “Your” is key to understanding the essence of what is happening. After all, when you were discharged from the maternity hospital, you probably thought that your baby was already 5, 7 or 10 days old (depending on your luck with the timing of discharge). But, having soberly compared the facts, you must agree that in the maternity hospital “Your” the child was not yours at all. You fed when it was brought, or when you were allowed to feed; You could not influence what medicines he was given, what syringe he was vaccinated with, what woman he was fed with and what milk he was fed with.

I don’t want to say that they brought him to feed him incorrectly, gave him bad medicine, injected him with an unsterile syringe, or fed him milk from a woman who had previously eaten a kilogram of chocolate. I just want to emphasize: you had no direct involvement in making any decisions regarding the baby and, of course, did not bear any responsibility for these decisions. It is quite natural that you cannot call yours what (whom) you do not own and do not dispose of. To confirm these words, I give a definition from the explanatory dictionary of the Russian language:

“TO OWN - to have one’s property, to hold in one’s power, to manage.”25

Having received from the maternity hospital nurse a tightly packed package with your own brainchild, you finally take real ownership of it. It is not surprising in this regard that, having brought the child into the nursery, you will first begin to examine the baby.

Let us note the following: if you and your child came home during the newborn period, then most likely your baby is healthy, he is normal, like everyone else, or almost like everyone else. He may have some shortcomings, but if you were sent home, then these shortcomings can be eliminated at home, and, therefore, there is nothing particularly terrible.26

The attitude towards what you see when you unwrap the diapers can be very different and depends on who is looking (mom, dad, grandmother, grandfather, older brother, etc.), what time he is looking (this is your first child, second, third, etc.), at what cost did you get it (9 months of wandering around hospitals, 10 years of infertility treatment, difficult birth etc.) and many other factors.

You, of course, do not know very well what a newborn should be like (unless, of course, you graduated from medical school, but this is not a guarantee either). The “specialist relatives” next to you also don’t know very well. Therefore, do not try to evaluate what you saw in your baby by comparing him with yourself. A lot of things that you consider bad or wrong are actually not so. I repeat once again: if you are at home with your child during the newborn period, then there is nothing particularly bad or particularly wrong.

In the assessment of the child’s condition by parents, as a rule, two clear trends can be traced: some are deeply convinced that they have never seen greater beauty in their lives, others direct all their efforts to finding shortcomings that must be immediately eradicated. Try, first of all, to push away unnecessary emotions. This is, of course, very difficult for the mother, but the father is simply obliged not to whine, not to shout: “I’m afraid to break something for him” - and to share less with his wife his fears about the fact that the baby is thin (fat), bald (hairy) , lethargic (restless), quiet (noisy), pale (red), etc. etc.

Your newborn is healthy. For many years he did not breathe the atmosphere of the city, did not drink, did not smoke, did not suffer many different diseases, did not stand in queues, did not get nervous, did not jostle in public transport.

It is very likely that he is now the healthiest in your family. Thousands of generations of ancestors have passed on to him many adaptive reactions. And there is no need to treat the baby condescendingly or underestimate him.

Parents are simply obliged to take a number of measures in order not to waste in vain the health given to the child by Nature. Some of these measures are urgent.

But before we begin to consider specific recommendations, we must pay attention to one extremely important circumstance: the basic principles of child care related to clothing and temperature conditions, bathing and walking, feeding and sleep do not change with age. A newborn is no exception.

It goes without saying that each age has its own characteristics, and we, of course, will pay attention to them, but the principles are constant.

1.4. PRINCIPLES OF CHILD CARE AND THEIR IMPLEMENTATION IN LIFE

"Circumstances change, principles never."

Honore de Balzac

“You need to be guided by principles, and not principles by you.”

MM. Zhvanetsky

Child care is carried out in two directions - creating an optimal living environment and directly meeting the needs.

From the point of view of the baby’s relatives, his most important need is nutrition, and it is simply pointless to dispute this. But the importance of proper feeding cannot be overestimated without solving other children's problems. Therefore, we will do the following: we’ll talk about everything except food, saving the latter for a snack (we’ll have a snack in the next chapter).

1.4.1. CHILDREN'S ROOM

It is sad to note that a children's room is a theoretical concept for many of our compatriots. The option in which only mom and dad are in the same room with the child is considered quite wonderful, but that’s not the point. It is fundamentally important that the conditions necessary for the child can never, under any circumstances, be unsuitable for other family members.

If you have the opportunity to choose a room (with which I would really like to congratulate you), then it is advisable that this room is not a walk-through room and has access to a balcony. If you are so prosperous that you have several balconies and can choose the cardinal directions to which the windows of your room are oriented, choose the southwest, but this is not important - a room on the north side, but with a view of the garden, is better than a southwest room with a view to the motorway. The larger the room, the easier it will be for the baby to breathe in it and the more difficult it will be for you to maintain proper order in it.

The child does not need careful sealing of windows (to prevent drafts) and tight fitting of doors (to avoid drafts). If mom and dad are afraid of this, then tape it up and adjust it, but you don’t need to cover up your own frailty with caring for the newborn.

Important rule:

The room should have the minimum possible number of dust accumulators (carpets, paths, books, unnecessary things). This is especially true for carpets, which, recently, have become almost an obligatory element of well-being. You should know that many microbes that quickly die in the air or during washing can survive for weeks and months in sources of house dust: staphylococci, streptococci, diphtheria bacillus, salmonella (the list is incomplete, but I think this is enough).27

Thus:

The fewer carpets the better;

Books are only behind glass;

Be patient with soft toys;

The number of souvenirs hanging on the walls is moderate;

There is no storage of unnecessary things on cabinets, in corners and under beds.

There’s a lot you can’t give up, so:

All dust accumulators in the children's room (upholstered furniture, for example) must be constantly and systematically put in order using a vacuum cleaner;

It is advisable to strive to ensure that the surface of all objects can be subjected to wet cleaning;

If, due to the lack of storage rooms, you are simply forced to use the closet as a storage for not very necessary things (they lie on it, covered with dust), then wash them, fold them carefully and cover them with plastic wrap.

An aquarium cannot be a hindrance, and in some cases even useful (humidifies the air), especially if you know how to care for it and do not have the habit of bullying the fish, forcing them to absorb dry food. It is better to place a stuffed animal of a beloved parrot who suddenly died or the skin of a bear defeated by grandfather in an unequal struggle in grandfather’s room.

In the children's room we will need:

The CRIB is optimally made of wood, it’s good when you can adjust the height of the bottom and sides. Commercially available wooden beds are quite acceptable, but the same cannot be said for the vast majority of mattresses. No pillows are needed (regardless of softness and size).

A NADDLE TABLE is a very desirable thing, although you can, of course, swaddle your baby on the sofa, on the coffee table, and in his own crib. As a rule, there is no need to purchase a special table - there is always a table in the house that you can do without for six months. It’s very good when the mother doesn’t have to bend over while swaddling her baby (this is about the height of the table).

Next to the changing table it would be nice to place a cabinet or shelf for storing children's things: hats, diapers, etc. Since we will use the changing table as a place where we will put the baby in order (wipe, wipe, cut, sprinkle, lubricate, treat), then directly on it or next to it (on the cabinet, for example) it would be necessary to place a FIRST KIT and all sorts of CARNS (with cotton wool, with pacifiers, with pacifiers) and BOTTLES (with water, oil).

A ROOM THERMOMETER is a necessary and useful thing. Just, most importantly, don’t get rid of yourself by following the path of beauty and size. Reliability comes first. A regular alcohol thermometer is optimal. Hang it near the child's bed at a height of approx.

Evgeny Komarovsky

The health of the child and the common sense of his relatives

I believe that we came after others in order to do better than them, so as not to fall into their mistakes, into their delusions and superstitions.

P. Ya. Chaadaev

The best from Dr. Komarovsky

“The beginning of life. Your child from birth to one year"

The health of a child depends to a much greater extent on his parents than on all pediatricians combined. The famous children's doctor Evgeny Komarovsky offers a guide that will help you avoid many problems. This accessible and fascinating book will tell in detail about the most difficult and important stage in the life of a child and his parents.

"ORZ: a guide for sensible parents"

What is ORZ? How to prevent the disease? How to prevent complications? Read Dr. Komarovsky's new book - a comprehensive guide dedicated to the most pressing topic of children's acute respiratory infections. Helpful and effective recommendations await you - help your child quickly and safely, with minimal effort and expense.

"A Handbook for Sensible Parents. Part one. Growth and development. Analyzes and examinations. Nutrition. Vaccinations"

Dr. Komarovsky is a pediatrician whose books have been recognized by millions of mothers and fathers.

Objective and accessible information from trusted sources - even very complex phenomena are presented in the book in an accessible and easy way. The directory covers health issues for children of any age and, without a doubt, will become a necessary guide for all caring and sensible parents for a long time.

"A Handbook for Sensible Parents. Part two. Urgent Care"

You are responsible for the safety of your children and you must do everything to have a real, practical opportunity to provide emergency assistance. The famous children's doctor Evgeny Komarovsky presents a complete guide dedicated to emergency care. The purpose of this book is to provide mothers and fathers with the necessary knowledge in order to be able to keep their child alive and healthy.

A small but very important preface

...and when they asked to bring the most beautiful thing in the whole wide world, the crow brought her child...

1 The book consists of three main parts:

Part one is devoted to the two most important stages in the life of a child and his parents - pregnancy and the first year of life.

Part two - a child over one year old, naturally, not on his own, but in connection with his father and mother, grandparents, schools, kindergartens, the environment and the health care system.

Part three – diseases, hospitals, doctors, medicines; what you must do, what you should never do.

5 The actual level of health or unhealth of a particular child depends on four factors:

Heredity, that is, what was inherited from mom and dad;

Environment (ecology + living conditions);

Health systems;

The process of care and education, i.e. the relationship between the child and his relatives.

6 The above-mentioned care and education represent certain very specific actions, a certain set of activities. But the main paradox is this: 100% of the adult population knows how to make children, but 99.9% do not know what to do with children later.

7 The main goal of this book is to eliminate the paradoxical nature of the situation, to provide the reader with the opportunity in an accessible form to determine for himself what should be done with the child and what should never be done.

Acquaintance

The greater or lesser degree of respect accorded to an author depends on the greater or lesser resemblance of his ideas to those of the reader.

Helvetius

This is most likely a medium-sized guide that should help you avoid a lot of problems.

Main- a little common sense, a little logical thinking - and we will agree on everything.

There are three such features:

First feature – ability to implement recommendations. After all, hundreds of books dedicated to caring for and raising children are written in such a way that the very process of communicating with a child is perceived in isolation from real life. Such “little things” are not taken into account, such as a hungry dad coming home from work, shops and clinics, missing hot water, a broken iron, a particularly wise mother-in-law, another pregnancy, downsizing, the number of days until salary, etc.

The best from Dr. Komarovsky

A small but very important preface

Acquaintance

* * *

Part one The beginning of your child's life

1.1. Pregnancy

* * *

Nnod children of senior preschool age (6–7 years old)

What harm can hyaluronic acid cause?

Daughter-in-law hates mother-in-law, advice from psychologist

*** * ***

Part one
The beginning of your child's life

*** * ***