32^nd European Pediatrics Congress July 22-23, 2020 Florence, Italy

The aim of the study of pediatrics is to reduce infant and child rate of deaths, control the spread of infectious disease, promote healthy lifestyles for a long disease-free life and help ease the problems of children and adolescents. It can be acknowledged that this can be reached by learning the major and primary subject on General Pediatrics. The most remarkable problems can be due to nutritional insufficiency to the overall health of infants and children because growth and development can be seriously hindered by shortages in essential vitamins or nutrients.

Neonatology is a subspecialty of pediatrics that consists of the intensive care of newborn infants, especially premature newborn. It is a hospital-based specialty and is usually practiced in neonatal intensive care units (NICUs). Neonatologist is trained particularly to handle the most complex and high-risk situations.

Perinatology is a sub-branch of Obstetrics. It is meant for mother-fetus at higher than normal risk. It deals with the complications in child development during pregnancy. It starts at 20^th to 28^th week of gestation and ends 1 to 4 weeks after birth. Perinatologist work very closely with neonatologist after a child’s birth. Perinatologists assist in complications like pre-existing health concerns and complications caused by pregnancy.

Attention deficit hyperactivity disorder (ADHD) is a mental nerve development disorder. It usually affects children before the age of 12 and the symptoms can persist for more than 6 months. It affects boys and girls equally i.e. it is not gender biased. The Symptoms in of ADHD in girls can vary from boys. ADHD is characterized by problems paying attention, excessive activity or difficulty controlling behavior for an age. For ADHD to be present, it must cause significant problem in at least two settings (e.g. social, school or work, home).  By 2015, 51.1 million people have been diagnosed with ADHD.

Birth of a baby at or fewer than 37 weeks of gestation age and are known as preemies or premmies. Though the accurate reason of preterm birth is unknown, some of the risk factors include, diabetes, high blood pressure, being pregnant with more than one baby, vaginal infection, and psychological stress, tobacco smoking, obese or underweight. Babies born before 25 weeks of gestation age do not survive. Even if they do, they do with neural impairment for life. In case of a premature birth, the baby is kept in NICU (Neonatal Intensive Care Unit) if the baby’s health is critically unstable. If the conditions are somewhat better, the mother is asked to keep the baby warm through skin to skin contact. Breast feeding is a very crucial part for the child’s survival. Since in babies the lungs are the last organs to develop, they are given breathing support. Sometimes surfactants are used help the breathing process. Corticosteroids have also been helpful in maturation of the premature baby. The survival % is highest at 72% at 25 weeks, 55% at 24 weeks, 26% at 23 weeks and about 6% at 22 weeks.

For a neonate, mother’s milk is the best nutrition which he can get. Hence, breastfeeding becomes an important part of the diet for the child’s proper growth. Mother’s milk has such nutrition which even the baby food fed as a supplement to mother’s milk cannot provide. Even still breastfeeding is recommended up to 6 months of age. After 6-24 months they must be fed with “complementary food” since after 6 months of age, the milk alone is not enough for the child. Malnutrition due to negligence to diet during this period of growth can be very difficult to reverse. The lack of complementary feeding is the major cause of high rates of under-nutrition in children under 5 years of age. By the age child reaches adolescence, their growth is still accelerated, and their caloric demands are higher than normal. For boys, the caloric needs are higher than that of girls of the same age due to metabolic differences.

A pediatric immunologist treats allergies and other immune system in children. In case of pediatric allergies, the most types of them are from pet dander, pollen dust, mold spores, dust, insect stings, food (e.g. peanut butter allergy). A pediatric allergist treats these unusual behaviors of a child’s immune system towards harmless particles. Such are the cases of hypersensitive immune system. In case a child’s immune system is not working properly, he may suffer from frequent and uncommon infections. Some of them are sinusitis, pneumonia, thrush and abscesses that keep coming back.

Pediatric allergies are the most common form of ailment which children suffer. Allergies can be caused by several factors such as food (e.g., peanut butter allergies), dust, cold, pollen etc. Some of the most common childhood allergy includes hay fever (allergic rhinitis). It causes itchy, watery red eyes, runny nose and chronic ear problems. Ear infection due to accumulation of fluid in the ear can lead to poor speech development in children. They also cause earaches, itching, popping and fullness. Food allergies are also very common affecting almost 6 million children in United States alone. In some special cases an infant can have allergy to their mother’s milk due to the mother’s diet. In such cases, the food to which the baby is allergic to must be eliminated from the mother’s diet. In case a child a severe allergy to peanuts, the school authorities must be informed about it from beforehand. Such children must always carry anti-allergic remedies.

It is the nursing of the new-born baby with the mother’s milk just after an hour of the birth of the child. It is suggested to breast feed a neonate for at least six months of age after which complementary feeding is recommended. Mother’s milk has sufficient nutrients for the growing neonate and only Vitamin D supplement are given to the child. In the beginning, the mother’s milk is called colostrum. It has a laxative which helps in the digestion process and helps prevent jaundice by helping to pass excess bilirubin. The composition of the mother’s milk keeps changing depending on the duration of feeding session and age of the baby. In the later stages, the milk becomes thick since contains more fat required for the growth for the baby. Mother’s milk contains antibody IgA which attacks germs in the mucous membranes of the throat, intestine and lungs.

A pediatric hematologist/ Oncologist treats the diseases related to blood and cancer in neonates and adolescents through to adulthood. Hematologists not only deal with blood related disease but also with blood processing organs too such as spleen, bone marrow, etc. They treat cancers including lymphomas, brain tumors, leukemia, bone tumor and solid tumor. They also treat blood related disease like disorders in WBCs, RBCs and platelets. The needs of children or teens are different from that of adults. Since they are growing, the need special care. Since they are immature, they always cannot answer medical questions and are impatient and non-cooperative. Hence such people know how to deal with such patients.

Pediatric Cardiologists treat congenital cardiac and cardiovascular abnormalities. They not only treat neonates and fetuses but also adolescents and young adults. These cardiologists have a wide scope of application including Intensive Cardiac Care, Cardiac Catherization, Imaging, Fetal Cardiology etc. They also have their field of application in congenital heart defects, heart muscle disorders, rhythm disturbances, hypertension, and other systemic disorders. Tetralogy of Fallot is a ventricular septal defect along with overriding aorta.

Pediatric surgery is specialization in surgery involving children, infants, adolescents and young adults. They generally deal with birth defects and surgeries required for congenital malformation, lymphangioma, necrotizing enterocolitis, undescended testis etc. Pediatric surgery has subspeciality which includes, neonatal surgery and fetal surgery.  Pediatric surgery requires further training during residency and fellowship. Other types of surgeries include pediatric cardiothoracic, pediatric nephrological surgery, pediatric neurosurgery, pediatric urological surgery and pediatric oncological surgery etc.

 Physical health is an important aspect of any child’s life. The symptoms of being physically unfit or well is easily noticed and treated. Unlike physical health, mental health and the problems related to it is often neglected. If a child behaves in an aggressive way or is not behaving in a way a child should, he is often shunned and mistreated. Any child who does not fit into the societal norms of being normal is often bullied. If an overweight child is teased about his weight, he will socially withdraw. He would be reluctant to make friends, exercise or participate in any social activity. This will lead low self-esteem, depression and low levels of confidence in the child. This will not only hamper his performance at school but also take a toll on his physical health.

Having excess body weight is known as obesity. Body mass index or BMI gives an easy way to estimate whether a person is overweight or not. BMI is measured by person’s weight in kilogram divided by the square of a person’s height in meters. An obese child is often bullied more than normal weighing child. Also, these children also have a high tendency to grow obese. As a result, they are more prone to asthma, bone and joint problem, type 2 diabetes, sleep apnea and risk factors for heart disease. In order to prevent childhood obesity, schools should include more fruits and 60minutes of daily physical activity with few fewer food and beverages that are high in added sugars or solid fats.

Vaccine is the delivery of killed or weakened viruses or bacteria to the host body so that the host’s immunity develops immunity towards them without causing the disease. The resistance which one’s body develops after the vaccination is known as immunization. Mumps can cause serious complications including hearing loss, encephalitis, infection of the ovary, serious infection of the testicles, etc. MMR vaccine is given to children who are 18 months old. Influenza vaccine develops immunization for flu. Each year, the vaccine is changing as new strains are introduced; the vaccine is changed and updated.

Pediatric Critical Care deals with children who are seriously ill and in unstable condition and need immediate attention and cure to live. The unstable condition may include severe asthma, deep diabetic ketoacidosis, infections like pneumonia, and serious injuries from accidents like cares, bicycles, skateboard or rollerblades or near drowning. In case if the child is critically ill and requires careful monitoring, he is placed in pediatric intensive care unit (PICU).

Emergency medicine deals with the immediate condition of the patient, his seriousness of injury and how to stabilize his condition. These medicines are targeted towards improving the current unstable condition of the patient and they are generally not given for long term.

Any physical, sexual or psychological maltreatment or neglect of a child by a parent or caregiver is known as child abuse or child maltreatment. Physical abuse is causing any non-accidental or intentional injury to a child. Sexual abuse is when an adult uses a child for sexual gratification or uses him for sexual acts. Emotional abuse is when a child’s mental or social development or cause severe emotional harm. Most emotional abuse is caused by a pattern of behavior and is often repetitive. Apart from the above types of abuse, neglecting a child from its basic support needed for a child’s health, safety and wellbeing such as inadequate supervision, emotional neglect, medical neglect or educational neglect come under child neglect. Since charity begins at home, the act to prevent child abuse must start at home as well. The following steps must be followed. One should never discipline a child when you are angry. You must get to know your child’s friend and participate in your child’s activity. They must be taught to raise their voice to prevent them from abuse in their own life. If your child doesn’t want to stay with someone or go to a certain place, do not ignore this red flag. It is also important to notice sudden change in your child’s behavior since it could also be a sign of ongoing child abuse.

Rehabilitation includes challenges like development delays, injury, illness or disabilities. Rehabilitation includes several ranges of diseases which it can cure. They include, autism spectrum disorder, cerebral palsy, developmental delay, Down syndrome, neurological condition, post-surgical rehabilitation, sports injuries, brain injury, etc. The technologies included for facilitation of recovery of the children include assistive technology clinic, audiology, augmentative and alternative communication, feeding and nutrition program, neuropsychology, wheelchair and equipment clinics, Sensory Integration Praxix Testing (SIPT).