LOCAL BACTERIAL INFECTION

A bacterial infection is any type of infection that is caused by bacteria (rather

than a virus). Bacteria are very common in our bodies and in the world around
us. Many of them are helpful. Less than 1% of bacteria will actually make us
sick. When they do make us sick, it is called a "bacterial infection."
Some common bacterial infections include strep throat, salmonella and e. coli.
When we get bacterial infections, they usually have to be treated with
antibiotics. The specific type of antibiotic depends on the type of bacteria that
is causing the infection. Your doctor can decide which type of medication is
best for you based on your symptoms and diagnosis.

CAUSES
Bacterial infections are a common cause of disease in human populations,
mostly only affecting one individual, but at times becoming quite contagious
and quickly infecting vast numbers of people such as the bubonic plague of the
middle ages which at its height was responsible for the deaths of a third of
Europes population.
Bacteria are microscopic single celled organisms that dont reproduce, instead
dividing to replicate, making their control difficult since a small population can
quickly reach huge numbers of bacterium, in fact pathogenic bacterial
infections can reach epidemic proportions in a matter of days or weeks.
The actual causes of bacterial infections obviously depend on the specific
bacterium at work, but identification can only be carried out in a laboratory
from blood samples or swabs of the affected area, and only then is it possible
to prescribe the correct dosage of antibacterial medication. In most cases,
diagnosis can be completed within a short period of time, leading to full recover

COMMON INFECTION CAUSING BACTERIA

E. coli

Neisseria gonorrhea, commonly known as gonococci (plural), or gonococcus

(singular)

Listeria monocytogenes

Salmonella bongori and Salmonella enterica

Staphylococcus bacteria

Streptococcus

Use of Antibiotics

Numerous types of bacterium are out there, creating their own brand of havoc.
Usually, bacterial infections are treated with antibiotics that are specifically
designed for the particular infectious bacteria. Different types of infections are
caused by different types of bacteria, so you should not take antibiotics without
consulting your physician. Many risk factors are involved in use of antibiotics. In
order to maintain your health, antibiotics should be used sparingly. Raw garlic,
wild indigo, yogurt, tea tree oil, colloidal silver are some examples of "natural"
antibiotics which can battle bacteria.

MANAGEMENT
Bacterial infections are very frequent in advanced cirrhosis and become the
first cause of death of these patients. Despite numerous experimental data
and significant advances in the understanding of the pathogenesis of sepsis
in cirrhosis, the outcome remains poor.
Classical diagnostic parameters such as C-reactive protein and SIRS criteria
have less diagnostic capacity in the cirrhotic population, often delaying the
diagnosis and the management of bacterial infection. Prompt and
appropriate empirical antibiotic treatment of infection and early
resuscitation of patients with severe sepsis or septic shock are essential in
determining patient's outcome.
A strategy of careful restriction of prophylactic antibiotics to the high-risk
populations could reduce the spread of multidrug resistant bacteria. This
review is focused on the currently recommended diagnostic, therapeutic and
prophylactic strategies for bacterial infections in the cirrhotic population.

JAUNDICE
Jaundice is a yellowish discoloration of the skin, mucous membranes and of
the white of the eyes caused by elevated levels of bilirubin in the blood

(hyperbilirubinemia). The term jaundice is derived from the French word

jaune, which means yellow. Jaundice is not a disease per se, but rather a
visible sign of an underlying disease process. Jaundice is typically seen when
the level of bilirubin in the blood exceeds 2.5-3 mg/dL (milligrams per
deciliter).

Causes jaundice in newborns?

Jaundice occurs because your baby's body has more bilirubin than it can get
rid of. Bilirubin is a yellow substance that's made when the body breaks
down old red blood cells. It leaves the body through urine and stool. When
you're pregnant, your body removes bilirubin from your baby through
the placenta. After birth, your baby's body must get rid of the bilirubin on its
own.
In most cases, babies have what's called physiologic jaundice. It occurs
because their organs aren't yet able to get rid of excess bilirubin very well.
This type of jaundice usually appears about 24 hours after birth. It gets
worse until the third or fourth day, and then it goes away in about a week.
In rare cases, jaundice may be caused by other things, such as an infection, a
problem with the baby's digestive system, or a problem with the mom's and
baby's blood types (Rh incompatibility). Your baby may have one of these
problems if jaundice appears less than a day after birth.

MANAGEMENT FOR JAUNDICE

Jaundice occurs in most newborn infants. Most jaundice is benign, but
because of the potential toxicity of bilirubin, newborn infants must be
monitored to identify those who might develop severe hyperbilirubinemia
and, in rare cases, acute bilirubin encephalopathy or kernicterus. The focus
of this guideline is to reduce the incidence of severe hyperbilirubinemia and
bilirubin encephalopathy while minimizing the risks of unintended harm such
as maternal anxiety, decreased breastfeeding, and unnecessary costs or
treatment.
Although kernicterus should almost always be preventable, cases continue to
occur. These guidelines provide a framework for the prevention and
management of hyperbilirubinemia in newborn infants of 35 or more weeks
of gestation. In every infant, we recommend that clinicians
Promote and support successful breastfeeding;

 Perform a systematic assessment before discharge for the risk of severe

hyperbilirubinemia;
Provide early and focused follow-up based on the risk assessment; and
When indicated, treat newborns with phototherapy or exchange transfusion
to prevent the development of severe hyperbilirubinemia and, possibly,
bilirubin encephalopathy (kernicterus).

FEEDING PROBLEM OR LOW WEIGHT FOR AGE

COMMON FEEDING PROBLEM
Are you struggling with baby feeding problems? Don't worry! Baby feeding problems are
normal, whether you're breastfeeding, bottle feeding, or at the solid foods stage. And
we can help you resolve common issues. If your baby spits up, we have some tips to
help him keep his food down. If breastfeeding is uncomfortable because your nipples
are sore, we can help.

Why babies spit up

About 40 percent of young babies spit up regularly. The peak age for spitting
up is 4 months, and things can get really messy. We have tips to help your
baby keep his food down.

Gagging in babies
It's common for babies to gag especially when they're first starting to
breastfeed or trying their first spoonfuls of cereal. But there are some things
you can do to help your baby relax and eat more easily.

Baby feeding problems: Food allergies

An estimated 6 percent of children suffer from food allergies. If your baby
has a food allergy, his body's immune system reacts to a particular food as
an intruder. Learn what can be done about it.
Breastfeeding problem solver
Breastfeeding can be enjoyable for both you and your baby, but sometimes
especially in the first few weeks you might face difficulties. Let our Problem
Solver be your first stop as you search for answers.
Sore nipples
A little soreness is common, but what's not normal or necessary is pain

that lasts throughout most or all of the feeding. There's no need to stop
nursing. If you're in pain, we can help you.
Thrush in breastfeeding babies and moms
Thrush is a common and harmless yeast infection in a baby's mouth that can
affect your nipples during breastfeeding. Yeast is a normal part of everyone's
digestive system, but when there's an overgrowth, an infection sets in.
When you just can't breastfeed
Not all moms can breastfeed, and that's okay. Whatever your reasons for not
breastfeeding health, intense discomfort, or unrelenting frustration the
first order of business is to give yourself a break.
Formula safety: How to prevent food-borne illness
preparing baby formula isn't hard, but because your baby doesn't have much
immunity to germs just yet, especially as a newborn, it's important to take
precautions to protect him from food-borne illnesses. Here's what you need
to know.

MANAGEMENT

The benefits of breast-feeding have been well documented in the literature:

it reduces morbidity from many illnesses and is considered the ideal
nutrition for the newborn infant. This paper reviews common breast-feeding
problems that family physicians may be called upon to manage: maternal
problems, infant problems, and problems related to the need for maternal
medication.

Ensuring proper position of the infant at the breast and attention to the letdown reflex is the recommended method for prevention and treatment of
nipple soreness. Prompt identification and treatment of blocked ducts,
mastitis, and monilial infection of the nipple can prevent complications and
allow uninterrupted nursing. Poor weight gain in the infant is managed by
more frequent nursing.
Neonatal jaundice or infant gastroenteritis rarely requires discontinuation of
breast-feeding. Although physicians frequently recommend that women
discontinue breast-feeding because of the administration of some maternal
medications, maternal illness can often be managed with medications that
do not interfere with nursing. Given proper advice and support, many
mothers continue to breast-feed even after returning to work.

Helpful hints for beginning to breastfeed

Expressing some milk onto your nipple or the baby's mouth may encourage
licking, latch-on, and sucking.

The "football" hold (clutch hold) is often the easiest to use when
breastfeeding a premature baby.

If your baby latches on but keeps letting go, or if the baby's suck is weak,
you may find the "dancer's hand" hold to be helpful. A nurse or a lactation
consultant can show you how to support the baby's chin under the breast in one
hand.

If your baby is gavage-fed (tube-fed), it may be possible to practice

breastfeeding as the baby receives food through the tube.

You may find certain breastfeeding devices help your baby make progress at
the breast. Since most devices also have disadvantages, they should be used with
guidance from a certified lactation consultant or your feeding team. Devices that
may be helpful include:

A thin silicone or latex nipple shield. This is centered over the nipple
and areola and helps baby latch on. It encourages a more effective sucking
pattern and better milk intake during breastfeeding.

A feeding-tube system may be taped to the breast in such a way that a

baby receives additional milk through the tube when the baby sucks. You or a
helper can gently press the plunger to deliver a few drops of milk in the baby's
mouth even if the baby "forgets" to suck. Commercial feeding-tube systems are
also available.

Your baby probably will do better for some feedings. Do not be discouraged
if he or she seems to "forget" how to suck from feeding to feeding, or if he or she
is too sleepy for more.

Some feedings will last longer than others. Your baby may need time to "get
going" at the breast for some feeds.

Try to be available to breastfeed for as many feedings as possible, especially

when feedings must be kept brief to prevent your baby from overtiring. Frequent,
brief feedings can be very helpful.

Continue to pump your breasts regularly during the baby's learning process.
Milk removal is not the purpose of these "practice feedings," and milk production
will fall if you are not removing milk in some manner.

Ask the NICU staff if there are other mothers who are expressing milk and
learning to breastfeed their high-risk babies on the unit. It can help to talk to
other mothers who understand your experiences.