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Li Jiao Yan
Neonatology
About me
Li Jiaoyan, female, attending physician, Master of Pediatric Medicine integrating Chinese and Western medicine. Graduated from Hunan University of Chinese Medicine.
Research interests include integrating Chinese and Western medicine for neonates and pediatric internal medicine, with expertise in treating common and frequent diseases in neonates and children, as well as emergency rescue of critical conditions. Proficient in monitoring the growth and development of children in early stages, assessing their developmental levels, and providing guidance.
Proficient in diseases
Treatment of common and multiple diseases in newborns and children, as well as emergency treatment of critical illnesses, monitoring of early childhood growth and development, assessment of early childhood developmental levels, and guidance.
Voices
Early manifestations of rickets
Rickets is a disease caused by a lack of vitamin D, which leads to a disorder in calcium and phosphorus metabolism, resulting in abnormal bone development. It primarily appears in the early stages in infants within six months old, and particularly within three months after birth. The initial presentation is an increase in nervous excitability, such as fussiness and unease in children, symptoms like excessive internal heat and sweating, especially more sweat on the head. Continuous sweating can lead to significant baldness at the back of the head. Sometimes, children may exhibit constant head shaking, but these are not very specific symptoms. Early detection involves decreased blood calcium and phosphorus levels, increased parathyroid hormone levels, and decreased levels of related markers in blood tests. Early bone X-rays appear normal, so initial symptoms are not so typical. Therefore, it is recommended that infants be taken to a pediatrician for a physical examination as soon as possible, where their developmental status can be assessed and rickets can be diagnosed. If it is early-stage vitamin D deficiency rickets, timely supplementation of vitamin D levels can be an effective cure.
What should I do if a child has an acute upper respiratory infection?
When children develop acute upper respiratory infections, the main focuses are to ensure plenty of rest, clear the exterior and reduce heat, and prevent complications. During fever, it is advisable to give liquid or soft foods, encourage increased water intake, and for infants, feed small amounts frequently to avoid symptoms of digestive upset like vomiting and diarrhea. Maintain room temperature between 18 to 22 degrees Celsius, and keep a certain level of humidity. If there is excessive nasal and pharyngeal secretion, a prone position can be helpful. For high fevers, initially use a cold towel to moisten the forehead and the entire head, or use fever patches or a warm bath to alleviate discomfort and prevent febrile convulsions. It is beneficial for the baby to drink more water to replenish the bodily fluids lost due to fever and to facilitate the elimination of toxins. Adequate hydration can help thin the secretions in the nasal passages, making them easier to clear. Medication can also be used for treatment.
Differential Diagnosis of Pediatric Pneumonia
Childhood pneumonia needs to be differentiated from other respiratory diseases such as bronchial foreign bodies, bronchial asthma, and pulmonary tuberculosis. A bronchial foreign body generally has a history of inhalation of foreign objects, sudden choking coughs, and a chest X-ray might indicate atelectasis or pulmonary emphysema. If the foreign body has been present for a long time, the disease course is prolonged and may lead to secondary infections, similar to pneumonia or concurrent with pneumonia. The differentiation of bronchial foreign body involves detailed medical history inquiries to check for inhaled foreign objects, then using symptoms and auxiliary examinations like chest X-rays for confirmation. Bronchial asthma, especially in children, might not always present with obvious wheezing attacks but rather persistent coughing. The X-ray might show increased and disordered lung markings and pulmonary emphysema, which can easily be confused with pneumonia. Typically, children with bronchial asthma have an allergic constitution and generally require pulmonary function tests and other auxiliary examinations to differentiate from pneumonia. Pulmonary tuberculosis generally occurs in those with a history of contact with tuberculosis patients. Their tuberculin skin test is positive, and X-rays may show features of tuberculosis lesions in the lungs, which can be used to differentiate from pneumonia.
Why do children get Kawasaki disease?
Kawasaki disease has an unclear pathogenesis. It is speculated that it may be related to infections by microorganisms or other pathogens, familial genetic susceptibility, or autoimmune functions. Currently, the entire medical history is unclear, and there is no specific epidemiology identified for the onset of the disease; it can occur in any of the four seasons. The disease primarily affects infants and young children, with about 80% of cases occurring in children under five years of age. The ratio of male to female incidence is approximately 1.5:1. Thus, Kawasaki disease is most commonly seen in infants and young children. Currently, there is no definitive explanation for the mechanism of the disease.
Causes of perianal abscess formation in babies
In pediatric outpatient surgery, perianal abscesses are not uncommon, and many parents visit the hospital daily for this issue. They wait, register, and change dressings. Once the wound heals, it often recurs after a while, leading to repeated incisions and drainage, persisting for several months. Eventually, the doctors say a fistula has formed and surgery is required. What exactly causes such troublesome perianal abscesses? The cause of perianal abscesses is not completely clear, but many affected children have been found to have deeper anal crypts than normal, so it's speculated that it may be related to this abnormality. In children under two years old, perianal abscesses mostly occur in boys. Some studies suggest that testosterone levels are higher in boys aged 1-3 months, coinciding with a peak period for perianal abscess incidences, leading to speculation that it may be related to the child’s hormone levels. In children over two years old, there is less gender bias in the incidence of perianal abscesses, and some cases are secondary to Crohn’s disease.
Does thrush hurt?
Thrush is caused by an infection of Candida albicans, forming white plaques on the surface of oral mucosa. Typically, it presents as small dots or patches on the oral mucous membranes that resemble curdled milk and can gradually merge into larger patches. They are not easily wiped off, without surrounding inflammatory response. Forceful removal might result in local mucosal redness, roughness, and possible bleeding. Generally, it is painless, does not cause drooling, and does not affect feeding. In severe cases of thrush, the white mucosal coating can extend to the pharynx, esophagus, trachea, and lungs, leading to symptoms like refusal to eat, low-grade fever, difficulty in breathing, and even life-threatening conditions. Typical thrush does not involve significant pain.
How to treat baby eczema?
Infant eczema is a common type of skin allergic inflammation in children, with a higher incidence in infants and young children. General care for infant eczema primarily involves skin care, focusing on moisturizing the skin. Children who are allergic in nature are more susceptible to eczema triggered by allergens, hence it is crucial to avoid allergens. It is advisable to wear cotton clothing, preferably in light colors, which are soft and comfortable. It is best to avoid synthetic fibers or animal fur clothing, as these can easily cause allergies. Additionally, skin moisturizing is important; it is recommended to keep bath times under ten minutes and the water not too hot. Avoid using alkaline bath products, which can scrub the baby's skin and potentially damage the skin barrier, worsening the eczema. The recommended water temperature is around 38 degrees Celsius, and bathing time should not exceed ten minutes. Room temperature should not be too warm. The room's air humidity should be maintained between 50% to 70%. It is advisable for infants not to be overly full when feeding, as excessive food intake can burden their digestive system and potentially exacerbate eczema. Mothers should be cautious with their diet, avoiding spicy, stimulating foods or allergenic foods like seafood. For baby rashes, moisturizers, predominantly those with a simple composition like mineral oil and free of dyes and fragrances, are recommended. Avoid using diluted lotions with a high water content. Applying moisturizer within about 3 minutes after bathing can optimize moisture retention. If the eczema is extensive with noticeable exudation or redness, and the baby is noticeably distressed, further medical consultation should be sought at a hospital. Dermatologists can prescribe appropriate medication based on the baby’s condition. It is generally not recommended for parents to use corticosteroid ointments on their own due to potential side effects and risks of improper use.
Can Kawasaki disease be cured?
Kawasaki disease, also known as mucocutaneous lymph node syndrome, has an unclear pathogenesis. The primary pathological change is systemic vasculitis. It commonly affects infants and young children, with 80% of cases occurring in children under five years of age. Kawasaki disease is a self-limiting condition, and most cases have a good prognosis. However, there is a 1% to 2% chance of recurrence. If not effectively treated, 15% to 25% of cases may develop coronary artery aneurysms. These aneurysms often resolve on their own within two years after the disease, but often leave behind abnormalities such as thickening of the vessel wall and decreased elasticity. Larger aneurysms may not completely resolve and can lead to thrombosis or narrowing of the vessel. Kawasaki disease is also one of the causes of acquired heart disease in children. Therefore, Kawasaki disease should be treated promptly and effectively to prevent severe complications.
Early clinical manifestations of rickets
Early Symptoms of Rickets: Rickets is a chronic nutritional disease caused by a deficiency in Vitamin D, leading to disordered calcium and phosphorus metabolism and resulting in abnormal skeletal development. It primarily affects infants, especially those under six months old, with the highest occurrence in infants under three months. The general symptoms include heightened neural excitability, such as fussiness, easy irritability, sudden bouts of crying, or being so sensitive that they cry when touched. Other symptoms include excessive sweating and frequent head shaking, though these are not specific indicators of rickets. Diagnosis mainly relies on biochemical markers and Vitamin D levels, like decreased blood calcium and phosphorus levels, elevated parathyroid hormone levels, and reduced 25-hydroxy-D3. X-ray images of bones might appear normal.
How long is the incubation period for neonatal jaundice?
Neonatal jaundice is the most common phenomenon in the neonatal period, especially in early neonates, which refers to newborns within the first week of life. About 80% of full-term infants can visually exhibit signs of jaundice. Jaundice can be categorized into physiological jaundice and pathological jaundice. Typically, physiological jaundice appears about two to three days after birth. If it is pathological jaundice, it may appear earlier, possibly within the first twenty-four hours after birth. Generally, if the jaundice appears early, progresses quickly, and is severe, it is necessary to intervene and treat promptly.