Good pediatric medicine is preventative as well as curative. The important aspects of a healthful life for children include the following: adequate nutrition (a diet high in proteins for growth and carbohydrates and fats for energy, but not so much as to cause overweight); physical exercise and play (stimulate growth and development, improve resistance to illness, and allow the acquisition of life skills); intellectual stimu­lation (toys, games, educational materials, contact with people and places, good schooling, books, and so on); protection from accidents and proper medical care (regular checkups, immunizations, prompt treatment of illness and injury, emergency care); and an emotionally secure, loving, supportive, nurturing, relaxed homelife.

WELL-BABY VISITS: Every baby should be examined by a pediatrician once a month for the first year of life and every three months during the second year. At these well-baby visits, the doctor will examine the child for evidence of any infections, birth defects, abnormalities or other anom­alies; will weigh and measure him and check on his growth and development; will immunize the child against diphtheria, whooping cough, tetanus, polio, measles, German measles, and mumps; will check the infant’s diet, give advice to parents, and treat any abnormal conditions as they arise.

INFANT-WHEN TO CALL THE MWTOR: If the baby is not looking or acting well; if he is pale, bluish, or yellow; is behaving oddly listless, lethargic, overly drowsy or ex­cessively irritable, or unconscious; is having convulsions or is obviously in pain and can­not be comforted; has severe diarrhea or is vomiting persistently or coughing; is bleed­ing from the nose, ears, mouth, or navel or shows blood in his urine, stools, or vomit; has lost his appetite for more than a few feedings; or has injured his head and is not back to normal in ten or fifteen minutes ­call the doctor.

A tenacious, recurring, unsightly disease affecting approximately 5 to 7 percent of the population in the United States, psoriasis involves mostly adults between the ages of twenty and fifty. Despite intensive research, the cause of this disease remains unknown. The few good things that can be said about it is that it is neither a threat to life and health nor contagious; but it remains, however, a very distressing ailment because of its unsightliness and discomfort.

The Danger: Psychologically only, except for occasionally associated arthritis.

Symptoms: Psoriasis first appears as small dull red patches (rash) covered with dry, silvery, or asbestos-like scales. The definitive symptom is a tiny bleeding point under a scale. The areas most affected are around the elbows, knees, low back, ears, and scalp. The small patches tend to coalesce into larger ones. The lesions heal without scarring. There may be itching. Fingernails are often affected. The nails may be split, cracked, discolored, pitted, and separated from the bed.

Treatment: Psoriasis is controllable but not curable. Remissions, which may last from weeks to months to years, occur about 20 percent of the time. More than half the remissions occur in the summer, generally a good period for this disease.  Although no specific treatment is available, a large number of different procedures are employed. The most consistently beneficial treatment, more than any other, is full body exposure to sunlight. Such topical measures as steroid creams and coal tar derivatives are often effective.

Recently medications derived from drugs used in cancer therapy (antimetabolites) have been administered internally but are dangerous except in very expert hands. Steroids taken internally are usually contraindicated because of their frequently dangerous side effects.

Psoriasis is an erratic disease that responds and behaves differently with different individuals-a medication that will help one patient will do very little for another.

Outlook: Modern methods of treatment have somewhat improved the outlook for psoriatic patients. Many patients have spontaneous remission, which may last for a prolonged period of time even after the disease has had many years of duration.

The Danger: An immediate and urgent feeding problem exists, because infants with cleft defects often cannot suck or swallow properly. Later on there are likely to be speech problems and hearing defects (caused by infections of the middle ear to which these children are extremely susceptible) in approximately half of all cleft cases. Other complications include pneumonia, bronchitis, other respiratory infections, and dental problems.

Symptoms: Obvious physical malformation, the inability to suck or swallow, ear infections, dental problems, and a nasal voice.

Treatment: The primary treatment is surgery, performed immediately after birth or at a weight of 8 to 10 pounds in the case of cleft lip

(which effectively closes the gap between the two sides of the upper lip), followed by cosmetic surgery during the second year of life. Cleft palate surgery is usually performed after the first year. Other treatment involves revised feeding techniques (including the possible use of prosthetic devices), speech therapy, monthly ear examinations, and treatment of infection. The services of a pediatrician, oral surgeon, plastic surgeon, audiologist, orthodontist, otolaryngologist, and speech therapist may all be required in the effective treatment of these defects.

Outlook: With early treatment and proper surgical procedures, the child with cleft defects will reach school age with only the most minimal disfigurement or impairment of function.