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The New Basics
A-to-Z Baby & Child Care for the Modern Parent
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Adenoids
Adenoids are glands located behind the nose. (Don't bother looking; you can't see them without fancy equipment.) Along with the tonsils (which you can see in the back of the throat), the adenoids trap the germs we inhale. Occasionally, these glands cause more harm than good. They become enlarged, obstruct the airway, and provide a playground for viruses and bacteria.
Enlarged adenoids primarily affect young children, with the following possible consequences:
- Difficulty breathing through the nose, a nasal voice, or snoring, none of which is a major problem.
- Persistent colds: Some kids always seem to have a runny nose.
- Repetitive ear infections, because germs ascend from the adenoids up through the eustachian tubes to infect the middle ear [See: Ear Infections].
- Repetitive ear infections, which can in turn lead to a fluid buildup in the middle ear and cause temporary hearing loss.
- Sleep apnea, a condition in which a child stops breathing for more than five seconds (an eternity for the parent) several times during the night. These pauses may strain the heart by making it pump harder to meet the body's oxygen demand (See: Snoring and Sleep Apnea].
Years ago, almost all kids had their adenoids removed at the first little sneeze. These days, the thinking is more conservative. Since enlarged adenoids will most likely shrink with age, repetitive colds and snoring alone do not warrant removal. On the other hand, if your kid develops significant sleep apnea or a substantial hearing loss fromfrequent ear infections, surgery is probably indicated, but rarely before four years of age.
Removal of the adenoids is a simple outpatient procedure with swift recovery and extremely infrequent complications. When the tonsils are also removed, kids suffer slightly more postoperative risk and discomfort [See:Tonsils].
Adenoid removal is spectacularly successful in reducing sleep apnea. Recurrence of ear infections also decreases drastically after surgery, especially when ear tubes are indicated and inserted concomitantly. However, recurrent ear infections may not fully disappear.
Real Questions From Real Parents
Is there any alternative to surgery?
Some doctors prescribe antibiotics in an attempt to avoid surgery. This is a noble idea in theory, but it achieves very little. Nasal steriod sprays are another favorite treatment. Both of these approaches can buy you a little time, but they won't eliminate the need for the operation.
Can adenoids regrow?
Once removed, adenoids can regrow in a matter of months or years after the operation. By the time they do, however, the child is larger, with larger nasal passages and greater resistance to infection.
Adoption
Every pediatric practice cares for a large number of adopted kids from different countries. I love to see families bring home children from remote parts of the world, because not only does each adoption represent incredible opportunities for parent and child alike, but it's also fascinating to watch these kids adapt to their new lives. Here is what you can anticipate in terms of caring for your adopted child before, during, and after adoption.
Before
Care starts before the kid is actually in the family. Prospective parents bring me photos, medical records, and even videos of their future children. Some ask my advice concerning the health assessments they've received from adoption intermediaries. I advise them not to rely on these, because they are often inaccurate or deceptive. These kids can present a wide and sometimes undocumented variety of health concerns or diagnoses that are erroneous. However, kids adopted in the United States generally have complete health records, since they're usually adopted at birth from American hospitals.
For most parents, physical ailments would rarely deter them from adoption once they've been paired up with a child; they're ready to deal with these issues at home, no matter what. One exception of course is HIV status, because of the poor prognosis for afflicted children. In most countries, reliable HIV testing is performed at birth and made available to prospective parents. Other potential illnesses in developed countries, especially among older children, include rickets, vitamin deficiency, tuberculosis, and malnutrition. Effects of alcohol and drug use during pregnancy are less common in foreign-born children than in American kids. Family history is usually unavailable or unreliable for kids from overseas and to a lesser degree for United States kids. As with biological children, we deal with issues as they arise, no matter what family history comes into play.
During
In terms of medication or nutrition, there's not much you should bring with you to the happy occasion of meeting your child. No matter where in the world the adoption process takes you, while you're there you should feed her the same formula that she's used to [See: Formula]. If she's older, join her in eating the local food she knows until you come home, and then feed her whatever is appropriate at her age [See: Feeding].
In crowded orphanages or foster homes, kids are exposed to more than their share of colds, flus, and stomach bugs. Let the local doctor treat these conditions; even if the care is not optimal, it's your only option. I usually advise parents to call or e-mail me upon first contact with the child, and I'm sure your doctor will do the same. In a short conversation, I can get a fair idea of the child's health status and make any special recommendations if needed.
With older kids, especially, don't worry about bonding problems during the transfer of bonding from the foster home to yours. That little creature will feel your loving devotion and hang on to you right away. Within a day or so this perfect stranger will become your perfect child.
There is nothing in particular you should do on the way home; the air trip may not be easy, especially with an infant, but avoid sedative medication on the flight [See: Air Travel].
The New Basics
A-to-Z Baby & Child Care for the Modern Parent. Copyright © by Michel Cohen. Reprinted by permission of HarperCollins Publishers, Inc. All rights reserved. Available now wherever books are sold.
