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小兒成長發育轉骨

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小兒成長發育轉骨

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我們家寶貝怎麼越看越小隻,是不是該轉骨啦?

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暑假開始,許多家長開始注意到,我們家寶貝怎麼越看越小隻,是不是該轉骨啦?

但您知道嗎?轉骨湯並非人人都能喝,太早吃反而會長不高!

想要我們家寶貝高人一等,又有哪些方法呢?

轉骨前 要先知道小朋友是否有性早熟的症狀…

就「早熟」而言,原則上女孩比男孩較常見,大約是23比1。

什麼叫性早熟呢?

男生第二性徵的出現,最先是睪丸變大,接著陰莖變長、變寬,陰毛增多變密,最後變聲,長鬍鬚。而女生則是由乳房開始發育、接著有陰毛,腋毛的產生,之後月經來潮。

那正常的第二性徵該是男生在812歲之間出現;女性則是713歲之間發生的。一般認為男性為8歲前,女生為7歲前出現第二性徵則為性早熟。

早熟的女孩可能在剛發育時會比一般人高一些,但成熟後的身高卻只有3%會超過155公分以上,多半都在150公分以下,這就是所有的爸媽最怕的事。

一般來說,小朋友的性早熟多半與現代的三高飲食與環境賀爾蒙有關,有發現小朋友不對勁,記得先到診所諮詢…

👉服用轉骨方前,先調整好小朋友的消化吸收功能…

臨床上很多坐前排的小朋友其實都是消化不良,

我們知道,每次看中醫,總是在說脾胃不好,脾胃溼氣重…好像中醫就是在看胃病的…

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嬰幼兒常見不適與中醫照顧 I

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蕭亦愷中醫師

候診區突然出現一位飽受驚嚇的小女孩,在診間門外就已經哭吼,尖叫。
⚕️心想:這小孩的白袍恐懼症,已經達到顛峰了。
…..應該是常被打針💉的結果。
然而,來看中醫的小孩經常一片祥和(除了這位以外),因為有經驗的小朋友都知道「這裡不會打針」,所以願意乖乖看病。
不打針就可以治療小朋友的不適嗎?🙀
我們來看看中醫怎麼處理嬰幼兒的日常病症…

腸絞痛:
剛出生嬰兒最容易發生夜裡啼哭不休,父母淚眼婆娑也無濟於事。
此時多半是腸絞痛。由於寶寶剛從母體出來,消化系統還無法順利運轉,腸胃道的供血不足,便容易發生腸絞痛,特別是在夜半,最好睡的時候。
對於腸胃道虛證,我們可以用小柴胡湯加白芍。小柴胡湯可以疏通肝膽腸胃系統的運作,再加上白芍把身上的靜脈血都集中到腸道,自然可以消化正常,寶寶一覺到天明。

偏食:
寶寶的味覺記憶非常厲害,可說是過舌不忘。尤其是對於甜食。甜味可說是現代人的最愛,任何食物都會加點甜,甜食更是飯後必點。
問題是,寶寶只要吃了甜食,對於其他食物的接受度就會大降,認為其他東西都不好吃。漸漸的,就成為偏食小孩。
那水果的甜味也會造成偏食嗎?會的,建議採用平性的水果,例如:蘋果、芭樂。多加些水分沖淡其甜味,再餵食。
那冰淇淋可以吃嗎?建議不要給小朋友過於寒涼的食物或是冰飲。身體成長茁壯需要熱量,冰涼的東西一下肚,就會造成消化吸收不良,自然長不高喔。
過敏:
剛起床,先噴嚏十個,衛生紙一包,這已是過敏兒的日常。過度的鼻涕不止,會造成注意力不集中,智力發育減緩。因為鼻涕也是身上的養分,帶有水分、
電解質等。都流光了,自然大腦養分不足,上課無法專心。鼻子過敏,我們常用五苓散、苓桂朮甘湯等去掉腸胃道的寒濕。
下列還有常見問題:
👉小朋友可以吃補嗎?要怎麼補?
👉睡覺時流汗是正常嗎?
👉嬰幼兒可以吃中藥嗎?會不會造成身體危害?
👉孕婦可以吃中藥嗎?

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我們來看看 中西醫對於兒童發燒的處置方式有什麼不同?

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🤔當【心臟】超時工作,肩膀、肩胛、都會酸酸的
如果是初期的心臟問題,上手臂、甚至連到我們的小指跟無名指都會麻麻不舒服。

🎈可是為什麼辦公室那麼多人?
我的肩頸酸痛最嚴重,
這就是 【越有”心”,越疲勞】,

承擔較多的壓力與疲勞,加上身體動的角度太少,可能窩在電腦,可能一直看手機,沒有做開胸與通暢經脈的運動,當然肩頸 ”特” 酸痛。

#校正【辦公室⇒酸痛】
#原來是【心臟】遞出請假單 !
#你願意讓【心臟】渡假嗎 ?
#越有”心”,越疲勞

這些穴道都可以改善酸痛。
按摩風池穴及天柱穴改善頭頸部血液循環與眼睛疲勞。
肩部肩井穴可舒緩肩部痠痛,
背部肩胛骨上的天宗穴及
內側的膏肓穴可以緩解背部附近的酸痛。

按摩這五個穴道可以緩解頸肩背附近的痠痛症狀。

另外背部的天宗穴及膏穴肓,因位於背後不易自行按壓,可以利用大小適中的按摩球(或網球)平躺利用身體重量按壓穴位。並且可以透過旋轉伸展運動,鬆開肩背部肌肉以舒緩肩背痛。

另外其他的經絡按摩,對心臟都很好
1.腋下每天撥15-30下。
2.拍一拍手或按一按【跟心臟有關的經絡在內側】

可是為什麼辦公室那麼多人? 我的肩頸酸痛最嚴重,這就是 【越有”心”,越疲勞】,
承擔較多的壓力與疲勞,加上身體動的角度太少,可能窩在電腦,可能一直看手機,沒有做開胸與通暢經脈的運動,當然肩頸 ”特” 酸痛。

很多人覺得大腦想太多,所以才累,其實累的都是【心臟】,心的背後有個老闆【心神】,管理我們的意識跟情感…
就問一句話 !
你玻璃心碎滿地的時候,是碎在胸口 ? 還正碎在大腦 ?

為什麼是心在碎,因為【心】負責我們的情感跟意識,

大腦是來幫我們寫腳本的,但真正指揮這個腳本運作,執行你許多夢想與計畫,是我們的心神喔,這個心神就住在我們的【心臟】周圍。

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兒童肥胖
小時候胖,就是胖…

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蕭亦愷中醫師

近來常見過重兒童出入診間,小小年紀愛吃冰,食量大,但卻有血壓過低,或是失眠等症狀…
這些症狀不是慢性病人才有的嗎?

以下節錄臺灣兒科醫學會聲明稿,我們該如何防止小孩過重…

A.飲食習慣建議:
1. 母乳哺餵對嬰兒未來一生的健康具有保護作用,可降低日後肥胖及其他急慢性疾病的風險。
2. 不吃早餐者容易肥胖。鼓勵每天在家中吃早餐,減少至速食店用餐。
3. 避免高熱量飲食,包括高脂肉類、油炸與燒烤食品、甜食、油類調味料等。
4. 避免喝含糖飲料,最佳飲料是白開水。
5. 不建議節食、少吃一餐,或使用藥物減重。
6. 學校飲食原則:由六大食物種類選擇天然新鮮食物:蔬菜、水果、全穀類乳製品、富含蛋白質食物 (如瘦肉、魚、蛋、堅果、果仁醬、種籽類食物)。
7. 避免高度加工的食物,並盡量減少糖的添加。

B.運動建議:
1. 二歲以下的嬰兒和兒童,應排除看電視、上網和玩電子遊戲。二歲及以上的兒童,上述活動每天不得超過2小時。
2. 每天做至少60分鐘中度至重度體能活動,若採累計計算,每次至少10分鐘。體能活動不僅包括運動,還包括走路、徒步旅行、騎單車、戶外遊戲與活動、滑輪活動、遛狗等。

C.睡眠建議:
1. 睡眠不足與肥胖有關。
2. 建議兒童睡眠時間:
o 1-2歲:每天睡眠1114小時,包括非常規睡眠時間的小睡。
o 3-5歲:每天睡眠1013小時,包括非常規睡眠時間的小睡。
o 6-12歲:每天睡眠912小時。

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經方中醫治療言語遲緩

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蕭亦愷中醫師

一位面容憔悴又帶著急迫的媽媽來到診間:醫師,我這孩子三歲多了還不會講話,你看看有什麼問題?

一般來說: 1 歲的孩子已經會自己玩,叫他的名字有反應;2歲~2歲半的孩子會開始模仿大人說話,直到兩歲半逐漸消失。2歲半後的孩子語言能力急速增加,但因為字彙還不多,因此可能會有口吃的現象。所以孩子在7歲以前講話不流利仍算正常範圍。

語言發展是一個十分複雜的過程,會受到很多因素的影響。像這位小朋友就是因父母太過忙碌,長時間與平版相伴,而漸漸喪失與人相處的機會,畢竟卡通就是用鮮艷的顏色去吸引孩子的注意力,但也失去了學習跟人相處的機會。

初步觀察這孩子進到診間,開始發出怪聲,四處遊走,無法坐定。但一言…只是發出無意義的聲響。不看人,就自顧自在診間繞。

經方中醫問診有個小技巧介紹給大家,到診所先詳細述說病人的症狀,西醫的診斷結果可以等到有需要時再補充。經方中醫是一門古老卻有效的科學,在漢朝是沒有西醫幫忙診斷的,一位訓練完整的經方醫師到了現代當然也不需要西醫的診斷結果來搭配治療。

不過,這母親很擔心也很盡力的"先"將「小兒神經科」,「復健科」,「身心醫學科」的診斷結果一一完整呈現,之後才斷斷續續的將孩子身體的症狀告知。

其實被宣告「發展遲緩」後,這母親已經好幾天睡不著覺,忙著帶小朋友到處去找醫生,最後被朋友介紹到診所。

經方中醫觀察人的症狀集中在「吃、喝、拉、睡」這四個部分:發現小朋友過動、精神不集中,夜晚睡覺流汗嚴重(濕到要換衣服,才能繼續睡)。

方藥:

「桂枝龍骨牡蠣湯」

針灸穴位:

「四神聰」+「智三針」

請記住,小兒針灸不能留針,他們無法靜靜的等待,扎針後隨即取針即可。

經過50天的治療,基本上一個星期來診所針灸兩次。目前已經可以說出簡單字彙:媽媽、 飯飯等,也會看人的嘴型學習說話了☺️。

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麻疹有多危險?中西醫如何治療?

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最近打開電視見到麻疹橫行,全台大警戒
我們先認識一下疹疹病毒好了;麻疹,是一種好發在兒童身上的傳染病,但成人也有一定可能感染。兒童常見的急性病毒是由麻疹病毒引起[1]。初期的症狀包括發燒超過40 °C、咳嗽、鼻炎及結膜炎。症狀發生後兩天,口中可能出現白點,稱為柯氏斑點,約有半數人會出現。在有症狀後五天就會開始出現紅色平坦的疹子,一開始常出現在臉部,再擴散到身體的其他部位。在接觸麻疹者後約十到十二天會有麻疹症狀,會持續七至十天。病患中有三成會有併發症,像是腹瀉,視力障礙,腦炎及肺炎等疾病。

 

複習一下,簡單來說麻疹主要症狀有四大特徵:

  • 持續發高燒、流鼻水、咳嗽。
  • 鼻炎、結膜炎。
  • 發燒3至4天後,口腔下臼齒的內頰側黏膜上,會出現典型的柯氏斑點。
  • 耳後出現典型的斑丘疹,之後再擴散長滿整個臉面,斑丘疹並會由上向下、從頭長到腳。

麻疹在台灣的消失,還是要感謝減毒麻疹疫苗的誕生💉,麻疹疫苗可以阻絕95%的感染率,也讓麻疹在台灣消失一段時間。若不幸感染,西醫在治療上💊,主要依靠支持療法,以及隔離病人。支持療法,仍是以症狀治療為主,在較完完善的醫療機構可以提供負壓病房,以避免病毒由空氣傳播感染。麻疹的傳播方式,與感冒是一樣的,發作的前期也與感冒類似。

中醫對抗麻疹的歷史,在疫苗出現前,已經持續了好幾千年🏹
中醫治麻疹的要訣,是要使麻疹出的透徹💦。麻疹是肺熱,也就是肺稍有發炎,這些發炎的熱一定要能夠散出來,病毒就很快可以離開身體。反之,若是用點滴、抗生素去抑制身體的發燒現象,就會讓疹無法透發,病毒留在體內,反而為身體帶來更大負擔。
👉麻疹初起,常常出現發熱、咳嗽、噴嚏、眼睛發紅、流淚等症狀,我們用葛根湯加減銀花、連翹,讓身體流點微汗,去透散病毒,讓它們快速離開。
👉當出現紅色平坦的疹子,要注意觀察,疹子的分布與數量,頭面部發疹的數量較多且最先開始發疹,是能夠回復健康的前兆。要由頭部往身體發疹,最後是手腳起疹。
👉若是發疹不順,病患身體煩燥,疲倦、口渴,臉部紅通通甚至乾熱,我們用麻杏甘石湯加減去散發肺熱,驅除病毒,讓身體不會過度耗損。
👉發疹後期,仍有一些斑點,我們用竹葉石膏湯加減麻黃、荊芥、防風,一方面補充腸胃道的營養,一方面持續發散肺熱,讓病毒跑光光。

麻疹並不可怕,只是台灣民眾比較少聽到,其實每年在台灣的確診案例仍約有1020例左右。美國疾病管制局統計,麻疹死亡率約千分之三,低於流感死亡率

大家不用太過緊張,若發現類似症狀,例如:高燒、咳嗽、噴嚏、眼睛發紅、流淚等症狀,記得先致電醫療機構☎,我們可以先準備適當設備,避免群聚感染喔!

[1]Caserta, MT. Measles. Merck Manual Professional. Merck Sharp & Dohme Corp. September 2013 [23 March 2014].
[2]我到底是不是得了麻疹?3招保護自己、分辨症狀. 蘇曉凡. 天下雜誌

 

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