El-Ayak-Ağız Hastalığı Nedir? Çocuklarda Belirtileri, Bulaşıcılığı ve Tedavisi

El-ayak-ağız hastalığı, özellikle bebeklerde ve 5 yaş altı küçük çocuklarda sık görülen, oldukça bulaşıcı viral bir enfeksiyondur. Özellikle kreş ve okul çağındaki çocuklarda salgınlara yol açabilir.

Hastalık çoğu zaman hafif seyirlidir ve birkaç gün içinde kendiliğinden düzelir. Ancak ağız yaraları nedeniyle sıvı alamama, yüksek ateş veya belirgin halsizlik gibi durumlarda çocuk doktoru değerlendirmesi gerekir.

Amerikan Pediatri Akademisi (AAP) ve güncel pediatri rehberlerine göre el-ayak-ağız hastalığında en önemli yaklaşım; doğru takip, sıvı desteği ve çocuğun genel durumunun dikkatli değerlendirilmesidir.

El-Ayak-Ağız Hastalığı Neden Olur?

Bu hastalığa enterovirüs ailesine ait virüsler neden olur. En sık etkenler:

• Coxsackievirus A16


• Enterovirus 71

olup çocuklarda yakın temasla kolayca bulaşabilir.

Önemli bir nokta:
El-ayak-ağız hastalığı viral bir enfeksiyondur. Bu nedenle antibiyotiklerin tedavide yeri yoktur. Gereksiz antibiyotik kullanımı bağırsak florasına zarar verebilir ve antibiyotik direncine yol açabilir.

El-Ayak-Ağız Hastalığı Belirtileri Nelerdir?

Belirtiler genellikle hafif ateş, halsizlik ve boğaz ağrısıyla başlar. Ardından ağız yaraları ve tipik döküntüler ortaya çıkar.

Ağız İçinde Yaralar

Dil, damak, diş etleri, dudak içi ve boğaz çevresinde küçük kırmızı noktalar oluşur. Bunlar kısa sürede ağrılı yaralara dönüşebilir.

Bu nedenle çocuklarda:

• Yemek yememe


• Su içerken ağlama


• Tükürüğü yutamama


• Ağızdan salya akması


• Beslenme reddi

görülebilir.

Özellikle küçük çocuklarda sıvı alamama nedeniyle susuz kalma (dehidratasyon) riski oluşabilir.

El ve Ayaklarda Döküntü

El ayası, ayak tabanı, parmak araları ve bazen bez bölgesinde küçük kırmızı döküntüler ortaya çıkabilir.

Bazı çocuklarda hafif kızarıklık, bazılarında ise küçük içi sıvı dolu kabarcıklar görülebilir. Döküntüler genellikle çok kaşıntılı değildir.

Ateş ve Halsizlik

Hastalığın ilk günlerinde şu belirtilerin eşlik etmesi sık görülür:

• 38–39°C civarında ateş


• Halsizlik ve huzursuzluk


• İştahsızlık

El-Ayak-Ağız Hastalığı Kaç Gün Sürer?

Ateş çoğu çocukta 3–4 gün içinde düşer. Ağız yaraları ve döküntüler ise genellikle 7–10 gün içinde iz bırakmadan düzelir.

Tırnak Dökülmesi Olabilir mi?

Evet. Bazı çocuklarda hastalıktan yaklaşık 4–8 hafta sonra tırnaklarda soyulma, çizgilenme veya geçici tırnak dökülmesi (onikomadezis) görülebilir.

Bu durum aileleri korkutsa da çoğunlukla geçicidir ve tırnaklar yeniden sağlıklı şekilde uzar.

El-Ayak-Ağız Hastalığı Bulaşıcı mı?

Evet, oldukça bulaşıcıdır. Virüs; tükürük, burun akıntısı, dışkı, yakın temas, ortak oyuncaklar ve eşyalar ile yayılabilir. Bulaştırıcılık özellikle ilk hafta daha yüksektir.

Bu nedenle ateşi olan, ağız yaraları belirgin olan ve yoğun döküntüsü bulunan çocukların kreşe veya okula gönderilmemesi önerilir. El hijyeni ve yüzey temizliği bulaşı azaltmada en etkili yöntemlerdir.

Ne Zaman Doktora Başvurulmalı?

Aşağıdaki durumlarda mutlaka çocuk doktoru değerlendirmesi gerekir:

• Çocuk sıvı alamıyorsa ve idrar miktarı belirgin azaldıysa


• Ateş 3 günden uzun sürdüyse


• Sürekli uyku hali veya şiddetli halsizlik geliştiyse


• Kusma veya ense sertliği eşlik ediyorsa


• Döküntüler iltihaplı görünüyorsa veya solunum sıkıntısı gelişirse

El-Ayak-Ağız Hastalığında Tedavi Nasıl Yapılır?

Hastalığın spesifik antiviral tedavisi yoktur. Tedavinin temel amacı çocuğu rahatlatmak ve sıvı kaybını önlemektir.

Tedavide Uygulanan Yaklaşımlar

• Ateş düşürücü ve ağrı azaltıcı ilaçlar


• Bol sıvı desteği


• Soğuk veya ılık yumuşak gıdalar (Yoğurt, çorba, muhallebi vb.)


• Doktorunuzun önereceği ağız bakım spreyleri

Not: Asitli, baharatlı, çok sıcak veya tuzlu yiyecekler ağız yaralarını artırabilir.

El-Ayak-Ağız Hastalığı Tekrarlar mı?

Evet, tekrar görülebilir. Çünkü hastalığa neden olan birden fazla enterovirüs tipi vardır. Çocuk bir tipe karşı bağışıklık kazansa bile ilerleyen dönemde farklı bir virüsle yeniden hastalanabilir. Ancak sonraki enfeksiyonlar genellikle daha hafif geçirilir.

Sık Sorulan Sorular

El-ayak-ağız hastalığında antibiyotik gerekir mi?

Hayır. Hastalık viral olduğu için antibiyotiklerin tedavide yeri yoktur.

El-ayak-ağız hastalığı kaç gün sürer?

Çoğu çocukta belirtiler yaklaşık 7–10 gün içinde düzelir.

El-ayak-ağız hastalığı bulaşıcı mı?

Evet. Özellikle ilk hafta bulaştırıcılığı yüksektir.

Hastalık tekrar eder mi?

Evet. Farklı virüs tipleri nedeniyle tekrar görülebilir.

Tırnak dökülmesi normal mi?

Bazı çocuklarda geçici tırnak dökülmesi olabilir. Genellikle kendiliğinden düzelir.

Sonuç

El-ayak-ağız hastalığı çocukluk çağında sık görülen viral enfeksiyonlardan biridir. Çoğu çocukta hafif seyretse de özellikle sıvı kaybı açısından dikkatli takip edilmelidir. Çocuğun genel durumu, sıvı alımı ve ateş seyri bu süreçte en önemli değerlendirme kriterleridir.

🩺 İzmir Alsancak Çocuk Kliniği İletişim

Çocukluk çağı döküntülü hastalıkları, ağız yaraları, ateşli enfeksiyonlar ve çocuk sağlığı değerlendirmeleri konusunda ailelere uzman desteği sunmaktayız.

👨‍⚕️ Uzm. Dr. Salih Aydemir

Pediatrician

📍 Address: Alsancak / İzmir

📍 Google Haritalar: Uzm. Dr. Salih Aydemir Klinik Konumu

📞 Telefon: 0561 616 55 35

🌐 Online Randevu Oluştur

Bez bölgesindeki kızarıklıklar, bebeklik döneminin en sık görülen cilt problemlerinden biridir. Çoğu zaman basit tahrişe bağlı gelişir ve kısa sürede düzelir. Ancak bazı durumlarda mantar enfeksiyonu, egzama veya farklı cilt hastalıkları tabloya eşlik edebilir.

Bu nedenle bez bölgesindeki her kızarıklık aynı değildir.

Özellikle uzun süren, yaygınlaşan veya klasik pişik kremleriyle düzelmeyen döküntülerde daha dikkatli değerlendirme gerekir.

📌 Bebeklerde Pişik Neden Olur?

Bebeklerin cildi erişkinlere göre çok daha hassastır. Bez bölgesinin uzun süre nemli kalması, sürtünme ve dışkı-idrar teması cilt bariyerini bozarak pişiğe yol açabilir.

Pişiği artırabilen durumlar:

• Bez değişiminin gecikmesi
• İshal ve sık dışkılama
• Hassas cilt yapısı
• Yeni ek gıdalar
• Antibiyotik kullanımı
• Parfümlü ıslak mendiller
• Hava almayan bez ortamı

Amerikan Pediatri Akademisi’ne (AAP) göre özellikle alkol, parfüm ve bazı koruyucu maddeler içeren temizlik ürünleri bez bölgesinde tahrişi artırabilir.

🔍 Normal Pişik Nasıl Görünür?

En sık görülen tablo “irritan pişik”tir.

Genellikle:

✅ Bezle temas eden çıkıntılı bölgelerde kızarıklık
✅ Hafif tahriş ve hassasiyet
✅ Kuru görünüm
✅ Cilt kıvrımlarının görece korunmuş olması

şeklinde görülür.

Doğru bakım ile çoğu birkaç gün içinde belirgin düzelir.

🍄 Mantar Pişiği Nasıl Anlaşılır?

Bazı bebeklerde pişik bölgesine Candida adlı mantar eklenebilir.

Özellikle şu bulgular mantar düşündürür:

🚩 Parlak ve canlı kırmızı görünüm
🚩 Kasık ve cilt kıvrımlarında belirgin tutulum
🚩 Kenarlarda küçük kırmızı noktalar (“uydu lezyonlar”)
🚩 Islak ve tahriş olmuş görünüm
🚩 Klasik pişik kremlerine rağmen düzelmeme

Bu durumda yalnızca bariyer krem yeterli olmayabilir ve farklı tedaviler gerekebilir.

🧬 Alerjik Bünyeli Bebeklerde Pişik Daha Uzun Sürebilir mi?

Bazı bebeklerde bez bölgesi cildi daha hassas olabilir.

Özellikle:

• Atopik dermatit (egzama)
• Besin alerileri
• Kronik ishal
• Sık dışkılama
• Hassas cilt yapısı

olan çocuklarda cilt bariyeri daha kolay bozulabilir.

Amerikan Pediatri Akademisi’ne (AAP) göre atopik cilt yapısına sahip bebeklerde tahriş edici faktörlere karşı duyarlılık artabilir. Bu nedenle pişik daha hızlı gelişebilir veya daha uzun sürebilir.

Ancak önemli bir nokta vardır:

📌 Her geçmeyen pişik besin alerjisi anlamına gelmez.

Özellikle uzun süren, tekrarlayan veya standart bakımla düzelmeyen durumlarda çocuk doktoru değerlendirmesi gerekir.

📌 Neden Bazı Pişikler Geçmez?

Geçmeyen bez bölgesi döküntülerinde yalnızca “basit pişik” düşünülmemelidir.

Bazı durumlarda:

• Mantar enfeksiyonu
• Egzama
• Seboreik dermatit
• Sedef hastalığı
• Bakteriyel enfeksiyonlar
• Nadir bazı bağışıklık ve beslenme sorunları

benzer görünümler oluşturabilir.

Özellikle 5–7 gün içinde belirgin düzelmeyen veya sürekli tekrar eden döküntülerde çocuk doktoru değerlendirmesi önemlidir.

⚠️ Her Krem Her Pişik İçin Doğru Değildir

Ailelerin en sık yaptığı hatalardan biri, önerisiz krem kullanımıdır.

Özellikle içinde güçlü kortizon bulunan bazı karışım kremler:

• Cildi inceltebilir
• Mantar enfeksiyonlarını baskılayıp sonrasında kötüleştirebilir
• Bez bölgesinde tahrişi artırabilir

Bu nedenle uzun süren pişiklerde rastgele krem kullanımından kaçınılmalıdır.

👶 Pişiği Önlemek İçin Neler Yapılabilir?

✅ Bezi sık değiştirmek
✅ Bez bölgesini kuru tutmak
✅ Ilık suyla nazik temizlik yapmak
✅ Sert/parfümlü mendillerden kaçınmak
✅ Bez bölgesinin gün içinde kısa süre hava almasını sağlamak
✅ Çinko oksit içeren bariyer kremler kullanmak

AAP ayrıca pudra kullanımını rutin olarak önermemektedir. Pudra partikülleri solunum yollarını tahriş edebilir.

👨‍⚕️ When to Consult a Doctor?

Aşağıdaki durumlarda değerlendirme gerekir:

• Pişik birkaç gün içinde düzelmiyorsa
• Yayılıyorsa veya kötüleşiyorsa
• Ateş eşlik ediyorsa
• Akıntı, kabuklanma veya kötü koku oluştuysa
• Bebek belirgin huzursuzsa
• Sürekli tekrar ediyorsa

📌 Result

Bebeklerde pişik çoğu zaman basit bir tahriş problemidir. Ancak bazı döküntüler mantar enfeksiyonu veya farklı cilt hastalıklarıyla ilişkili olabilir.

Özellikle uzun süren, tekrarlayan veya standart bakım ile düzelmeyen bez bölgesi döküntülerinde doğru değerlendirme önemlidir.

Erken dönemde uygun bakım ve doğru yaklaşım ile çoğu bebek kısa sürede rahatlar.

🩺 İzmir’de bebeklerde pişik, mantar döküntüleri ve diğer çocukluk çağı cilt sorunları konusunda değerlendirme ve takip için muayenehanemde sizleri ağırlamaktan memnuniyet duyarım.

❓ Frequently Asked Questions (FAQ)

Pişik kaç günde geçer?

Basit irritan pişikler uygun bakım ile genellikle birkaç gün içinde düzelir.

Mantar pişiği kendiliğinden geçer mi?

Bazı hafif durumlar düzelebilir ancak çoğu zaman mantara yönelik tedavi gerekir.

Her geçmeyen pişik alerji anlamına mı gelir?

Hayır. Ancak atopik cilt yapısı, sık dışkılama veya bazı cilt hastalıkları pişiğin daha uzun sürmesine neden olabilir.

Her pişik için krem kullanmak gerekir mi?

Bez bölgesini kuru tutmak en önemli adımdır. Bariyer kremler birçok bebekte faydalı olabilir.

Pudra kullanmak doğru mu?

AAP, pudra kullanımını rutin olarak önermemektedir.

Pişik olan bebeği sık yıkamak gerekir mi?

Aşırı temizlik bazı bebeklerde tahrişi artırabilir. Nazik temizlik yeterlidir.

Pişik hangi durumlarda tehlikeli olabilir?

Yaygınlaşan, akıntılı, kötü kokulu veya uzun süredir geçmeyen döküntüler değerlendirilmelidir.

İlgili hizmet: İzmir yenidoğan muayenesi

In this guide, we explain the common rashes in newborns, which ones are normal, and in which cases you should consult a doctor.

1. What Causes Newborn Rashes?

• Immaturity of the skin barrier
• Effect of maternal hormones
• Late adaptation of the baby to body temperature and environment
• New skin flora begins to form

2. Normal (Physiological) Newborn Rashes

These rashes do not require treatment and will resolve on their own.

2.1. Toxic Erythema

• It is the most common rash.
• It usually starts 1–2 days after birth.
• It is in the form of small yellow-white blisters and rashes.
• In most babies, it disappears noticeably within 1–2 weeks.
• Some babies may experience an intermittent rash for up to 2–3 weeks.

2.2. Milia (Whitehead rash)

• It is in the form of small white dots on the nose and face.
• It disappears on its own within weeks.

2.3. Yenidoğan Aknesi

• There may be small red pimple-like rashes on the cheeks.
• It occurs due to sensitivity to maternal hormones.
• It usually resolves within 2–3 months.

2.4. Sebaceous Gland Enlargement (Sebaceous Hyperplasia)

• It is in the form of small yellowish bumps on the tip of the nose and on the face.
• It is completely normal; It disappears within weeks.

2.5. Transient Neonatal Pustular Melanosis

• Pustules may be present at birth; After bursting, small darkly pigmented spots may remain.
• Pigments fade within weeks–months.

2.6. Mongolian Spot (Dermal Melanosis)

• It is in the form of blue-gray spots on the waist, hips and back.
• It can be confused with trauma, but it is completely innocent.
• It disappears in most babies between the ages of 1 and 4.

2.7. Cutis Marmorata (Mottled Skin Appearance)

• When a baby gets cold, a web-like purple-red pattern may appear on the skin.
• It disappears when it warms up.

2.8. Heat Rash (Miliaria/Heat Rash)

• It develops as a result of excessive dressing or sweating.
• It is in the form of small red rashes.
• It will go away on its own with a cool environment and thin dressing.

3. Pathological (Requiring Attention) Newborn Rashes

3.1. Herpes Simplex Rash

• It is in the form of grouped water-filled vesicles.
• It may be accompanied by fever, malaise and malaise.
• It requires urgent evaluation.

3.2. Bacterial Rashes

• Yellow crusting with a “honeycomb” appearance is typical.
• There may be redness and rapidly expanding areas.

3.3. Candidiasis (Yeast Infection)

• A bright red rash appears in the gland area and satellite lesions appear at the edges.
• It requires treatment.

3.4. Allergic/Atopic Rashes

• Usually in the 6th to 8th months of life. It starts in the week.
• There may be dry, red and itchy plaques on the cheeks.

3.5. Rashes That Are an Emergency Warning Sign

• Widespread bruising (purpura)
• Large water filled bubbles
• rapidly spreading rash
• Rash with fever
• Baby in poor general condition

4. Which Rash is Normal and Which is Dangerous?

5. When Should You Consult a Doctor?

• If the rash is accompanied by fever, inability to suck, or restlessness
• If the rash spreads rapidly
• If there are large water-filled blisters
• If bruising or bleeding rash appears
• If there are lesions in the eyes, mouth or genital area
• If there is a rash that does not subside within 1–2 weeks or worsens

6. Home Care Suggestions

• Do not overdress the baby; sweating can increase rashes.
• You can take a short bath with warm water.
• Do not use perfumed soaps and lotions.
• Do not apply cream, ointment or powder randomly to the skin.
• Keep the diaper area clean and dry.

Frequently Asked Questions (FAQ)

How many days does toxic erythema last?

It usually disappears noticeably within 1–2 weeks; In some babies, the rash may persist intermittently for up to 2–3 weeks.

Are newborn rashes contagious?

Rashes that are considered physiological, that is, normal, are not contagious. Rashes caused by infection can be contagious.

Does neonatal acne require treatment?

Most of the time no. It usually disappears spontaneously within 2–3 months.

Does Mongolian stain go away?

In most babies, it gradually fades and disappears between the ages of 1 and 4.

How do I know if the rash is dangerous?

If there is fever, weakness, inability to suckle, bruising, large blisters or rapid spread, it should be evaluated.

Can I apply cream to my baby's rash at home?

Creams containing cortisone, antibiotics or heavy ingredients should not be used unless recommended by a doctor. Most physiological rashes require no treatment.

İlgili hizmet: İzmir yenidoğan muayenesi

Why is 48–72 Hours Important?

In the first days after birth, the baby's body temperature, circulatory system and metabolism change rapidly. Bilirubin breakdown increases, weight loss becomes evident, and milk flow is just beginning. For this reason, the safest period evaluation is between the 2nd and 3rd days of life. During the check-up, the physician; It examines in detail the weight loss percentage, degree of jaundice, nutritional efficiency and sleep safety.

Weight Loss Assessment

Weight loss of 5–10% of newborns is considered normal. However, a loss above 10% may mean alarm. The following parameters are checked during the examination:

• Mother's milk production and breastfeeding status
• Signs of dehydration (decreased urination, dry mouth, fatigue)
• Weak sucking reflex
• Daily urine and stool count monitoring

If necessary, position support, a frequent breastfeeding plan and a weight tracking chart are created for the mother. In case of excessive weight loss, the hydration and nutrition plan is rearranged.

Jaundice (Bilirubin) Follow-up

Jaundice usually occurs on days 2–4. It rises in days and can sometimes reach dangerous levels quickly. Because 48–72 days after the first examination. done per hour It is vital to catch the increase in bilirubin early.

The following evaluations are made during the control:

• Degree of jaundice of skin and sclera
• Transcutaneous bilirubin (TcB) measurement
• Serum bilirubin test when necessary
• Call for a recheck within 24 hours for babies at risk

Delayed bilirubin elevation may progress to the risk of kernicterus. For this reason, the symptoms of jaundice and the thresholds for re-application must be explained to the family.

Breastfeeding and Nutrition Control

One of the most important goals of this visit is to evaluate the effectiveness of nutrition. In control:

• Baby's sucking-reflex power
• Nozzle grip and latch quality
• Milk passing rate and swallowing-breathing synchronization
• Maternal nipple condition and pain assessment

Frequently made suggestions:

• Active breastfeeding every 2–3 hours
• Breast grip-position training for the mother
• Providing breastfeeding support before starting complementary feeding
• Daily monitoring of urine and stool count

Vitamin D Support

According to the Turkish Ministry of Health guide, 400 IU/day for all babies vitamin D should be started. During the first examination, the method of use is explained to the family and regular follow-up is recommended.

SIDS and Safe Sleep Education

A significant portion of newborn deaths are related to incorrect sleeping position. During this meeting, safe sleep rules are conveyed to parents:

• The baby should be put to sleep on its back
• Sleeping in the same bed is not recommended
• Room temperature should be kept between 21–23°C
• Pillows, plush toys and thick quilts are not used.
• The baby should not be placed on a soft surface

When Should You Come for a Recheck?

Depending on the situation, a re-examination may be planned within 2-5 days. In the following period, monthly healthy child follow-up is started. Weight gain, nutrition, neuromotor development and vaccination program are followed with the family.

This article is for informational purposes. Diagnosis and treatment should only be evaluated by a physician.

İlgili hizmet: İzmir yenidoğan muayenesi

Causes of Breastfeeding Problems

👩‍⚕️ Mother Origin

• Late or low milk supply
• Nipple problems (flat, sunken nipple)
• Wrong breastfeeding position
• Stress, fatigue and anxiety

👶 Baby Origin

• Prematurity or low birth weight (poor sucking reflex)
• Intraoral anatomical problems (tongue tie, palate problems)
• Sleepy, passive babies
• Nasal congestion or postpartum respiratory adaptation

symptoms

• The baby has difficulty latching on to the breast
• Sucking for a short time and getting tired quickly
• Restlessness or dissatisfaction after breastfeeding
• Decreased daily urine output (less than 6 wet diapers per day)
• Continued weight loss

The Importance of Breastfeeding in the First Hour (Golden Hour)

According to WHO and UNICEF, skin-to-skin contact of the baby with the mother in the first hour after birth and initiation of breastfeeding increases breastfeeding success and milk production. This process is especially critical in babies who have difficulty breastfeeding.

Common Mistakes

• Giving water or formula before breastfeeding
• Premature feeding of a bottle or pacifier (nipple confusion)
• Using wrong nipple creams or soaps
• Keeping breastfeeding intervals too long

Things to Do at Home

1. Correct breastfeeding position
   • The baby's face should be turned towards the breast, and his body should be kept close to the mother.
   • Cradle grip, side grip or cross grip can be tried.
2. skin to skin contact

   Naked skin contact between mother and baby increases milk flow and strengthens the sucking reflex.

3. try often

   It is more effective to attach the baby to the breast in calm moments without leaving him too hungry.

4. Expressing breast milk

   In cases where the baby has difficulty breastfeeding, milk can be expressed and given using methods other than a bottle (cup, spoon, syringe).

Maternal Nipple Cracks and Abscess Risk

• Crack alone does not prevent breastfeeding. Breastfeeding should be continued with correct position and care.
• Expressing a few drops of milk and applying it to the nipple before breastfeeding, moisturizing with lanolin-based creams and breast milk helps heal cracks.
• Actual contraindication: The cracks progress turning into an abscess In this case, breastfeeding from the relevant breast is interrupted. During this process, milk should be expressed and started again after treatment.

True and False Contraindications of Breastfeeding

Actual Contraindications (WHO & AAP 2022)

• Galactosemia (rare metabolic disease)
• HIV infection (varies depending on country policies, not recommended in Turkey)
• Maternal chemotherapy or radiotherapy treatment
• If the mother uses heavy psychoactive drugs or illegal substances
• Breast abscess (temporary contraindication from the affected breast)

False Contraindications

• Mother cold, flu
• Maternal antibiotic therapy (most medications are compatible with breastfeeding)
• Mastitis (breastfeeding from uninfected breast should be continued)
• breast milk jaundice
• Mild jaundice in baby

Supports for Mother

• Drinking plenty of fluids and eating a balanced diet
• Breast massage or warm shower before breastfeeding
• Stress management: If the mother is relaxed, milk flow becomes easier
• Getting breastfeeding consultant support

When should you see a doctor?

• The baby does not suck at all or constantly refuses to suckle
• Inadequate weight gain or weight loss
• Urinating less than 6 times a day
• Vomiting, bloody stools, bruising
• Severe restlessness and non-stop crying

❓ Frequently Asked Questions (FAQ)

1. My newborn baby has difficulty sucking the breast, is it normal?
   It can be seen frequently in the first days. With the right position and patience, most babies recover in a short time.
2. Does tongue tie cause difficulty sucking?
   Yes. Tongue tie may reduce suction power. A pediatrician or ENT specialist should evaluate it.
3. I feel like I don't have enough milk, what should I do?
   Breastfeeding the baby frequently, drinking enough fluids and managing stress increases milk supply.
4. Is my baby breastfeeding but constantly restless and not getting enough?
   Monitoring the baby's weight and daily urine count shows that the baby is full. If in doubt, a doctor's check is necessary.
5. If I have to give formula, should I give up breast milk?
   No. Breast milk is always priority. Formula should only be used as a supplement with a doctor's recommendation.
6. Why do premature babies have difficulty breastfeeding?
   Because the coordination of sucking-swallowing-breathing is weak. These babies require special methods and close monitoring.
7. My nipple is flat, my baby can hardly latch on. What can I do?
   Support can be provided with a chest shield or appropriate apparatus. It is useful to get help from a lactation consultant.
8. My baby does not want to breastfeed while sleeping, is this normal?
   Newborns tend to sleep. Feeding can be tried by gently awakening (diaper changing, light touch).
9. Is it right to express my milk?
   It is beneficial for the baby's weight gain. However, if possible, contact with the mother's breast should continue.
10. I have breast cracks, should I continue breastfeeding?
    Yes. Crack does not prevent breastfeeding. However, if an abscess develops in advanced cases, that breast is temporarily suspended.

🍼 Conclusion and Call

Every baby's sucking habit is different. Problems such as breast cracks, difficult breastfeeding, and lack of milk can often be solved with the right methods.

In our clinic, one-on-one breastfeeding training is provided by our neonatal nurse, and mothers are taught the correct techniques. We are at your service for newborn follow-up and breastfeeding consultancy in Izmir Alsancak.

📚 Resources

• World Health Organization (WHO). Exclusive breastfeeding for optimal growth, development and health of infants. 2023.
• American Academy of Pediatrics. Policy Statement: Breastfeeding and the Use of Human Milk. Pediatrics, 2022.
• T.R. Ministry of Health, Baby Friendly Health Institutions Program, 2023.
• Cochrane Database of Systematic Reviews: Interventions for promoting the initiation of breastfeeding, 2020.
• Cochrane Review: Management of Breast Abscesses, 2018.

İlgili hizmet: İzmir yenidoğan muayenesi

Meeting with the pediatrician before birth both reduces the risks and ensures that your baby is welcomed safely as soon as it is born. But not only that... Other preparations before birth also play a critical role in the health of the mother and the baby.

In this article, you will find what to pay attention to before birth, why the meeting with the pediatrician is so important, and recommendations from around the world.

1. General Prenatal Preparations

1.1. Birth Bag and Basic Needs

Clothes for expectant mothers, first clothes for the baby, blankets, diapers, wet wipes and basic care materials are indispensable parts of the birth kit. It is comforting to make these preparations in advance to avoid panic at the time of birth.

1.2. Checks for Maternal Health

Routine checks, ultrasound follow-ups and blood tests recommended by your gynecologist should not be missed during pregnancy. Vitamin and mineral supplements also support the healthy development of the baby throughout pregnancy.

1.3. Psychological Preparation and Family Support

Birth is a major process not only medically but also psychologically. The support of the spouse and family is very important for the expectant mother to feel strong. One of the most effective ways to reduce anxiety is to know in advance how the process will proceed and to have confidence.

2. Prenatal Meeting with the Pediatrician

This is perhaps the most critical step of prenatal preparations. The American Academy of Pediatrics (AAP) recommends that families meet with their pediatrician during the third trimester of pregnancy. This meeting ensures that the postpartum process progresses in a safer and planned manner.

2.1. Purpose of the Meeting

• Family history is taken and genetic or hereditary risks are evaluated.
• The baby's first examination after birth is planned.
• The family is given brief information about postnatal screening and vaccinations.
• Possible risks (premature birth, low birth weight, multiple pregnancy) are reviewed.
• The road map to be followed in case of emergency is shared with the family.

2.2. Feeling of Confidence

This interview is not just medical information for the family; It is also a psychological preparation. At the time of birth, “Who will take care of my baby?” The question disappears and the family prepares for the birth safely.

3. Preparation for Risky and Risk-Free Births

Most babies adjust easily to postpartum life. But scientific data shows that one in every 20 babies (5%) needs additional support at birth.

• Preterm babies
• low birth weight babies
• Babies with congenital anomalies
• Babies who experience meconium aspiration at birth

Moreover, even babies without risk factors may experience respiratory distress, cardiac arrhythmia, or other unexpected problems at birth.

Therefore, at every birth:

• A pediatrician to meet the baby
• Medical team trained in neonatal resuscitation (NRP)
• Necessary equipment must be available

4. Choosing the Right Hospital and the Right Team

Not every hospital's facilities are the same. The answers to the following questions should be clear before birth:

• Is there a neonatal intensive care unit in this hospital?
• Are the necessary devices available in case of emergency?
• Is an experienced neonatal team available at any time?

The pediatrician guides the family on these issues. If there is a possibility of risky birth, you can be referred to a pre-equipped center. These decisions should be made before birth, not when labor begins.

5. Approaches in the World and in Turkey

• AAP (American Academy of Pediatrics): Recommends a prenatal meeting with the pediatrician in the third trimester.
• WHO: Emphasizes that all births should be carried out in well-equipped centers and accompanied by a team knowledgeable in neonatal resuscitation.
• Canadian and European guidelines: In high-risk births, it is recommended that the pediatrician be present at the birth, and in others, it is recommended to be examined as soon as possible.
• Türkiye: The Ministry of Health has made newborn screenings mandatory. Prenatal consultation with the pediatrician is not yet routine; but it is preferred by more and more families.

6. The Most Common Mistakes Families Make

• Focusing only on clothing and room preparation.
• Starting to look for a pediatrician after birth.
• Not researching hospital facilities.
• Underestimating screening tests and initial examination.

7. Checklist for Families

• ✔ Make a prenatal appointment with your pediatrician.
• ✔ Learn about the newborn facilities of the hospital where you will give birth.
• ✔ Ask about alternative centers for risky situations.
• ✔ Write down your postpartum questions in advance.
• ✔ Prepare your birth bag and documents.

8. Most Frequently Asked Questions (FAQ) by Families

• Is it necessary to meet with the pediatrician before birth? Yes, it is essential to learn about postpartum preparations in advance.
• Should a pediatrician be present at the birth? Yes, there must be a pediatrician to meet the baby at every birth.
• Is the midwife competent for birth? He or she can manage the birth, but a pediatrician is essential to evaluate the newborn.
• If there is no risk factor, is preparation still required? Yes, even 5% of babies who seem risk-free may require additional support at birth.
• When is the first examination performed after birth? As soon as the baby is born, the first examination is performed by the pediatrician.
• Why is choosing a prenatal hospital important? Giving birth in a center equipped according to the baby's needs provides confidence.
• What is discussed at the first meeting with the pediatrician? Information is given about the initial examination, screening and vaccinations, and possible risks are evaluated.

For additional questions, you can call our clinic and consult directly.

9. Conclusion

The most important preparation you make before birth is the meeting with your pediatrician. Thanks to this meeting, the moment of birth and its aftermath become much safer.

• Surprises decrease after birth.
• Possible risks are known in advance.
• The right team and the right hospital are selected.

Don't forget to take this step to give your baby a healthy start to life.

In Izmir Alsancak Dr. Salih Aydemir ClinicYou can safely get information about prenatal preparation and newborn care at.

İlgili hizmet: İzmir yenidoğan muayenesi

The first 60 seconds after birth, the Golden Minute, is the most critical time for your baby to step into a healthy life. Applications made during this period; It plays a decisive role in the baby's breathing, circulation, temperature balance and initial bonding process. The World Health Organization (WHO), American College of Obstetrics and Gynecology (ACOG), American Academy of Pediatrics (AAP), CDC and Turkish Neonatology Association (TND) particularly emphasize the importance of this period.

Why is the Golden Minute Important?

neonatal adaptation

– Doğumla birlikte bebekte solunum, dolaşım ve ısı regülasyonu hızla devreye girer.
– Bu dönemde yapılan basit uygulamalar, ömür boyu sağlık üzerinde kalıcı etkilere sahiptir.

Golden Minute in international guides

– WHO ve ACOG, Altın Dakika’da geciktirilmiş kordon klemplemeyi önermektedir.
– AAP ve TND, Vitamin K uygulaması ve Hepatit B aşısını doğum sonrası ilk saatlerde zorunlu kabul etmektedir.
– Sağlık Bakanlığı Yenidoğan İzlem Protokolü’nde de “Altın Dakika” kavramı açıkça yer alır.

Routine Practices in Healthy Babies

Delaying the cord

The cord is cut after waiting 30-60 seconds after birth. Additional blood flow to the baby occurs, and hemoglobin and iron stores increase. It reduces the risk of intraventricular bleeding in preterm babies.

Drying and removing wet covers

Wet linens are quickly removed and the baby is dried. The risk of hypothermia is reduced.

Putting on a hat and gloves

It is applied to prevent heat loss from the head and extremities.

skin-to-skin contact

The baby is laid on the mother's breast and a warm blanket is covered on her back. Thermal balance is maintained, bonding is strengthened, and breastfeeding becomes easier.

eye care

Prophylaxis is performed to prevent eye infections.

Vitamin K injection

It prevents neonatal bleeding (VKDB).

Hepatitis B vaccine

It reduces the risk of transmitting the virus from mother to baby. It is recommended to do it in the first 24 hours.

first examination

The baby's vital signs such as breathing, pulse, and muscle tone are evaluated. Weight, height and head circumference are measured. Congenital anomalies and trauma findings are checked.

Special Situations

Babies born prematurely

Although basic care is similar, additional precautions are needed to prevent hypothermia and respiratory problems.

Babies with health problems

Resuscitation and additional interventions may be performed in babies with low Apgar scores, birth trauma, or risk of severe infection.

Risk factors in the mother

In cases of hepatitis B, HIV or active infections, the baby's care protocol is specially regulated.

Prominent Findings in the Literature

– Geciktirilmiş kordon klempleme → daha yüksek hemoglobin ve demir depoları (ACOG, 2020).
– Ten-tene temas → hipotermi riskinde %70 azalma, emzirme başarısında artış (WHO, 2017).
– Vitamin K uygulanmayan bebeklerde → geç tip VKDB ve beyin içi kanama riski belirgin yüksek (AAP, 2022).
– Hepatit B aşısı → doğumda yapılmazsa anneden geçiş riski %90’a kadar çıkabilir; aşılanan bebeklerde %10’un altına düşer (CDC, 2023).

Frequently Asked Questions (FAQ)

Why isn't the baby washed immediately during the Golden Minute?

Because early bathing causes the baby to lose heat. Thermal balance is maintained by drying and skin-to-skin contact.

Is late cord cutting harmful?

No. On the contrary, it increases the baby's blood volume. The only risk is that the chance of jaundice increases slightly. This can be managed with follow-up and phototherapy.

Is Vitamin K injection mandatory? Does it have any side effects?

Vitamin K injections are the gold standard for preventing neonatal bleeding. It has no serious side effects.

What happens if the hepatitis B vaccine is not given at birth?

If the mother is a Hepatitis B carrier, the probability of transmission to the baby increases to 90% if the vaccine is not given at birth.

Is the Golden Minute applied the same for premature babies?

Yes, the core practices remain the same; however, additional precautions are taken for hypothermia and respiratory support.

Conclusion and Recommendations

Golden Minute practices—cord lagging, drying, hat and gloves, skin-to-skin contact, eye care, Vitamin K injection, Hepatitis B vaccine, and initial examination—should be routine for all healthy babies.

Although care for premature babies or babies with health problems is basically similar, additional interventions may be required.

 To get more information about Golden Minute and newborn care, you can contact our clinic in Izmir Alsancak.

Source

1. ACOG Committee Opinion No. 814: Delayed Umbilical Cord Clamping After Birth, 2020.

2. WHO. Delayed umbilical cord clamping for improved maternal and infant health outcomes. 2014.

3. American Academy of Pediatrics. Vitamin K and the Newborn Infant. Pediatrics, 2022.

4. CDC. Hepatitis B Perinatal Vaccine Guidance. 2023.

5. Turkish Neonatology Association. Newborn Resuscitation Guide and Clinical Practice Recommendations.

6. T.R. Ministry of Health. National Immunization Schedule and Newborn Surveillance Protocols.

Golden Minute, newborn care, delayed cord cutting, Vitamin K injection, Hepatitis B vaccine, skin-to-skin contact, eye care, baby examination, Izmir pediatrician, neonatal doctor

İlgili hizmet: İzmir yenidoğan muayenesi

“Can I wear sunscreen?”,

“Is it safe to take my baby into the sea or pool?”,

“How should I dress in hot weather?”,

“Should I give water?”

In this article, we explain the things to consider in summer care, especially for babies between 0-24 months, based on scientific sources, and answer frequently asked questions.

🧴 1. Sunscreen Use in Babies: When Should It Start?

The use of sunscreen is not recommended for babies aged 0-6 months. Because during this period, baby skin is very sensitive and permeable; should not be exposed to chemicals. The most effective protection in this age group:

• Staying under the shade

• Avoiding hours when sunlight is direct (not going out between 10.00 and 16.00)

• It is to use physical protection such as hats and long-sleeved thin cotton clothes.

For babies older than 6 months, sunscreens with mineral (physical) filters can be used if they are going to stay outside.

🔹 Products containing zinc oxide or titanium dioxide should be preferred.

🔹 Does not contain chemical filters (oxybenzone, avobenzone, octinoxate etc.),

🔹 Perfume-free, dye-free, alcohol-free and hypoallergenic products are safe.

🔹 The product label should include the words "for babies", "physically filtered" or "hypoallergenic".

🔹 SPF 30-50 protection is sufficient.

⏱️ Application: It should be applied 15-20 minutes before going out, and should be renewed after entering water or excessive sweating and every 2 hours.

📚 Source: American Academy of Pediatrics (AAP), American Academy of Dermatology (AAD)

🌊 2. Can the Baby Go to the Sea or Pool?

Babies love water from birth, but care should be taken in open areas such as the sea and pools.

🐚 When can you go swimming?

• After the 3rd month, short-term sea baths (not exceeding 5-10 minutes) can be taken.

• Sea water should be clean and warm (around 30°C).

• Hours when sunlight is not direct (before 9 in the morning, after 17 in the evening) should be preferred.

• After swimming, the baby should be washed immediately, his skin should be dried and he should be dressed in clean cotton clothes.

🏊 Is the Pool Safe?

• Pool is not recommended for the first year of age. Public pools are especially risky in terms of microbial contamination.

• If it is a hygienic pool specially prepared for babies, whose water is frequently disinfected, short-term trials can be made after the 6th month.

• After the pool, the baby's skin should be rinsed with clean water and a moisturizer should be applied.

• The use of baby swim diapers is a must.

👕 3. How Should My Baby Dress in Hot Weather?

It is important to keep your baby cool but also protected from the sun. It is not right to overdress or leave bare.

• 100% cotton, thin, light-coloured clothes should be preferred.

• If going out in the sunlight, a hat must be worn.

• UV protected sunglasses can also be preferred for babies after the 6th month.

• If your baby's neck is sweaty and hot, he may be overdressed.

🟡 Tip: If the baby's hands and feet are cool but not cold, the temperature balance is generally appropriate.

🍼 4. How should fluid support be in hot weather?

Babies 0-6 Months:

• Water is not given to babies who are exclusively breastfed.

• Breast milk meets both fluid and nutritional needs in hot weather.

• Breastfeeding frequency may increase during this period.

6 Months and Above:

• Babies who start complementary feeding can additionally be given a small amount of water several times a day.

• If your baby shows diarrhea, vomiting or excessive sweating, his fluid needs may have increased. In this case, consult your doctor.

🛁 5. How Many Times Should You Wash a Sweating Baby?

• Daily bathing is not necessary.

• On days when you sweat excessively, it is good to take a short shower with warm water.

• To prevent skin dryness after frequent bathing, special, perfume-free moisturizers for babies should be used.

⚠️ 6. Other Points to Consider in Summer

• Never leave the baby alone in the car. Even if there is shade, the temperature inside the vehicle increases rapidly.

• If air conditioning is used, make sure it does not blow directly on the baby and that the room temperature is between 23–25°C.

• To protect yourself from mosquitoes, choose chemical-free fly repellents or mosquito nets.

• Urine amount, stool color and general condition should be monitored in hot weather. If there is long-lasting restlessness or loss of appetite, a doctor should be consulted.

🩺 Conclusion: It is Possible to Spend the Summer Safely!

Summer months can be enjoyable for both babies and families — as long as we take the right precautions. Your baby can spend the summer comfortably and healthily with protection from the sun, choosing the right time for contact with water, appropriate clothing and fluid support.

📍 You can make an appointment at our office for your baby health and routine check-up during the summer months in Izmir.

İlgili hizmet: emzirme eğitimi ve danışmanlığı

Ear infections are quite common in infancy and childhood. The most common type is middle ear infection (acute otitis media) and usually develops following upper respiratory tract infections.

While some infections can go away on their own, others require treatment and follow-up.

In this article, you can learn about the symptoms, diagnosis, treatment of ear infections and when you should consult a doctor.

📌 What is Ear Infection?

Middle ear infection (otitis media); It is inflammation caused by the proliferation of bacteria or viruses in the space behind the eardrum. Generally:

• Develops after upper respiratory tract infections

• It is more common in children between the ages of 6 months and 3 years.

• Its frequency increases in children starting nursery.

🔍 What are the symptoms of ear infection?

Symptoms may vary depending on age:

👶 In babies:

• Unexplained fever (38°C and above)

• Pulling or rubbing the earlobe

• Constant restlessness, crying

• Frequent waking up at night

• Feeding difficulty, refusal to suckle

🧒 In older children:

• Earache, hearing loss

• Discharge from the ear (the eardrum may be pierced)

• Dizziness, balance disorder

🧪 How to Diagnose?

The diagnosis of ear infection is made through an otoscope examination by a pediatrician.

• Redness, swelling and fluid accumulation in the eardrum are observed.

• If necessary, hearing test or audiology evaluation may be performed, especially in cases of recurrent infections.

💊When is Treatment Required?

Ear infections do not always require antibiotics.

The treatment decision is made based on the following factors:

Paracetamol or ibuprofen can be used for pain.

🔁 Why Do Ear Infections Recur?

Ear infections may reoccur frequently in some children.

This condition is associated with the following risks:

• Early start to nursery/kindergarten

• Exposure to secondhand smoke

• Feeding while lying down with a bottle

• Anatomical structures (adenoid size, eustachian tube structure)

📌 An ear tube (ventilation tube) may be recommended for children who have more than 4 infections per year and 3 or more infections in 6 months.

👨‍⚕️ When to Consult a Doctor?

If you have the following symptoms, you should definitely consult a pediatrician:

• Fever over 38°C and earache

• Foul-smelling discharge from the ear

• Significant decrease in hearing

• Frequent waking up and restlessness at night

• Frequent ear infections

💡 Suggestions for Families

✅ Continue breastfeeding – breast milk supports immunity

✅ Do not bottle feed your baby while lying down

✅ Keep away from cigarette smoke

✅ Take care to be checked by a doctor in case of upper respiratory tract infections

✅ If the nursery age is young, it may be beneficial to stay at home for a short time with the advice of a doctor.

📌 Result

Although ear infections are common in children, they often heal without leaving any permanent problems with proper follow-up and treatment.

However, recurrent infections, especially during infancy, can negatively affect hearing and speech development.

Therefore, it is of great importance to recognize the symptoms early and consult a pediatrician in time.

🩺 I have coverage in my practice for children with ear infections and recurrent fever in Izmir.

İlgili hizmet: emzirme eğitimi ve danışmanlığı

Urinary tract infections (UTI) are one of the most common infections in infancy and childhood. Especially in the first 2 years of age, the only symptom may be fever and delayed diagnosis may cause kidney damage.

In this article, you can find all you need to know about the symptoms of UTI, how it is diagnosed, when it can be dangerous, and the treatment process.

📌 What is UTI?

Urinary tract infection; It is an infection that can involve the bladder (cystitis), ureters, urinary tract or kidneys (pyelonephritis).

Urine is a sterile liquid, but in some cases, germs reach the urinary tract and cause infection.

UTI specifically:

• It is more common in girls

• It can also cause serious infections in newborn male babies.

🔍 Symptoms May Vary Depending on Age

👶 In babies:

• Unexplained fever (above 38°C)

• Restlessness

• Malnutrition, decreased absorption

• Bad smelling diaper

• Urine that is darker than yellow and has a strong odor

• Sometimes vomiting or diarrhea

🧒 In older children:

• Frequent urination

• Burning when urinating, crying

• Pain in the lower abdomen

• Bedwetting during the day, sudden bedwetting at night

• Blood in urine

🧪 How to Diagnose?

The most important step for the diagnosis of UTI is urinalysis and urine culture.

✅ How to collect urine?

• For diapered babies: with a sterile bag (for preliminary screening), if in doubt, with a catheter.

• In a child who is toilet trained: midstream urine can be collected.

• Urine culture: shows which microbe is causing the infection

• If necessary: ​​complete blood count, CRP, kidney ultrasound

💊 How is Treatment Done?

Treatment is planned according to the child's age, general condition and location of infection:

• Oral antibiotic treatment for mild infections

• Intravenous antibiotics (hospitalization) in children with fever and poor general condition.

• Usually 7-10 days of treatment is sufficient

• Fever subsides within 24-48 hours after starting treatment

🔁 Why Does UTI Recur?

UTI may recur in some children. In recurring cases:

• Urinary tract reflux (VUR): urine leaking back into the kidneys

• Congenital kidney and bladder structural disorders

• Constipation and hygiene problems

• Family history of UTI

🩺 When to Consult a Doctor?

In the following cases, a pediatrician should be consulted without delay:

• Unexplained fever over 38°C

• Bad smell in urine

• Crying or restlessness while urinating

• Seeing blood in the urine

• Day or night bedwetting (especially if it has just started)

• If there is a history of UTI before

💡 Suggestions for Families

✅ The only cause of fever in babies and children is not always apparent — urinary tract infection should be kept in mind

✅ Hygiene is very important when changing diapers

✅ Girls should be taught the habit of wiping from front to back.

✅ Constipation should be prevented

✅ Consuming plenty of fluids should be encouraged

✅ Day and night toilet habits should be monitored

📌 Result

UTI in babies and children is an infection that is often unnoticed but can be completely treated with early diagnosis.

If the cause of fever is not clear, the urinary tract should also be evaluated, as it may cause permanent damage to the kidneys if diagnosis and treatment are delayed.

🩺 I would be happy to host you in my office for the evaluation and follow-up process of urinary tract infection in babies and children in Izmir.

İlgili hizmet: İzmir yenidoğan muayenesi