Febrile seizures writing. Febrile seizures

… febrile seizures are not epilepsy.

Febrile seizures- paroxysms of varying duration, occurring predominantly in the form of tonic or tonic-clonic seizures in the limbs and occurring in infants, young and preschool children at a body temperature of at least 37.8-38.5 ° C (excluding convulsions during neuroinfections), with the possibility transformation into afebrile seizures and epilepsy.

Etiology. To date, the etiology of febrile seizures has not been fully deciphered, although several factors are considered as possible causes. The etiological factors causing febrile convulsions are divided into (1) infectious (any infectious disease can provoke febrile convulsions) and (2) non-infectious, primarily teething, hyperthermia of endocrine, resorptive, psychogenic, reflex and central origins; the role of metabolic disorders of certain macro- and microelements (Ca, etc.) is very significant in the development of febrile seizures; Numerous observations confirm a genetic predisposition to febrile seizures (the type of inheritance of febrile seizures has not been definitively established, but autosomal dominant or polygenic transmission is assumed).

Pathogenesis. Most authors believe that the key links in the pathogenesis of febrile seizures are acute cerebral hypoxia and cerebral edema. In this case, the cerebral circulation simply “does not have time” to maintain an adequate supply of neurons with oxygen and trophic substrates due to the sharply increasing intensity of metabolic processes during fever. The development of febrile seizures is also facilitated by age-related anatomical and physiological characteristics of the central nervous system, which are characterized by increased hydrophilicity of the nervous tissue, the predominance of irritation processes over inhibition processes, the intensity of metabolic processes and the imperfection of their regulation.

Clinic. More often, an attack of febrile seizures occurs as a generalized epileptic seizure (symmetrical tonic-clonic seizures in the limbs), but the symptoms of this condition are not always so clear. There are (1) typical and (2) atypical febrile seizures.

(1 ) typical (simple, benign) febrile seizures have a short duration - up to 15 minutes, generalized in nature; indicators of psychomotor development usually correspond to age, there are no typical changes on the EEG, and there is no history of indications of organic damage to the central nervous system; characteristic of typical febrile convulsions is that they manifest against the background of severe hyperthermia - during the period of rising temperature or directly at the peak of fever;

(2 ) atypical (complex) febrile seizures are characterized by a longer attack - more than 15 minutes (up to several hours), with them there is also generalization (a focal component is possible); lateralization is characteristic; sometimes postictal hemiplegia occurs (in 0.4% of cases), focal changes on the EEG are not uncommon; the frequency of perinatal damage to the central nervous system and traumatic brain injuries is high; complicated febrile convulsions occur at significantly lower levels of hyperthermia than typical febrile convulsions, while the manifestation of paroxysm is delayed from the moment the temperature rises or develops after the fever has stopped.

Diagnostics. The diagnosis of “febrile convulsions” is valid at the age of 6 months to 6 years. The criteria for febrile seizures are: (1) age under 6 years; (2) absence of central nervous system disease or acute metabolic disorder that could cause seizures; (3) no history of afebrile seizures. The diagnosis of febrile seizures is established on the basis of anamnesis, assessment of somatic and neurological status, psychomotor and emotional development, characteristics of the course of the attack (duration, localization, generalization, lateralization, presence of post-ictal hemiplegia, etc.). With a typical clinical picture of febrile seizures ( ! ) no additional examinations (MRI, CT, EEG) are usually required, since there are no specific changes during febrile seizures.

The diagnostic value of laboratory and instrumental methods for the pathology in question is limited. The results of a biochemical blood test can detect various metabolic disorders that can provoke convulsive syndrome. An EEG study reveals specific changes in 1.4–22% of children with febrile seizures. A lumbar puncture is performed if a child is suspected of having a neuroinfection with convulsions (against the background of febrile temperature).

Treatment. Diazepam (0.2-0.5 mg/kg/day), lorazepam (0.005-0.02 mg/kg/day) or phenobarbital (3-5 mg/kg/day) are used. To reduce body temperature, physical cooling methods are used: wiping the body with water or alcohol solutions, undressing the child, ventilating the room, etc. Also, for febrile convulsions, the administration of antipyretics is indicated (for example, paracetamol - 10-15 mg/kg/day, rectally up to 20 mg/kg/day and ibuprofen in a single dose of 5-10 mg/kg no more than 4 times a day). ( ! ) During febrile convulsions, elevated body temperature begins to be reduced even when its level has not reached febrile levels. It should be emphasized that, regardless of the clinical characteristics of febrile seizures, general emergency measures are: horizontal position of the body with the child turning “on its side” to prevent aspiration, restoration of patency of the upper respiratory tract, oxygen therapy through a mask. The absolute indications for prescribing anticonvulsants are febrile status epilepticus, complicated variants of febrile seizures, as well as serial simple febrile seizures.

Preventive treatment. In the first two days of fever, children who have previously had febrile convulsions are prescribed diazepam 0.3–0.4 mg/kg every 8 hours for prophylactic purposes; as an alternative, clobazam is used at 0.5 mg/kg/day, in 1–2 doses. The effectiveness of both drugs has not been proven. Currently, all over the world there is a tendency to completely abandon drug prevention of typical febrile seizures. For atypical febrile seizures and/or repeated episodes, continuous or intermittent use of antiepileptic drugs is sometimes resorted to, with preference given to carbamazepine and phenobarbital. In our country, pediatric neurologists often use the anticonvulsant properties of acetazolamide (Diacarb) to prevent repeated attacks of febrile seizures.

Dispensary observation Children who have had febrile seizures are cared for by a pediatrician and a neurologist. The main tasks of specialists are the correct diagnosis of febrile seizures, conducting additional examinations, determining indications for hospitalization, treatment tactics and prevention of repeated febrile paroxysms. Dispensary observation allows in many cases to avoid recurrence of convulsive paroxysms, timely exclude organic pathology of the central nervous system, prevent side effects of anticonvulsant drugs used and prepare children for vaccination.

Risk factors for the development of epilepsy for febrile seizures include: (1) indications of the presence of neurological disorders or psychomotor developmental disorders; (2) family history of afebrile seizures; (3) the complex nature of febrile seizures. In the absence or presence of only one risk factor, the likelihood of developing afebrile seizures is only 2%. If two or more risk factors are present, the likelihood of epilepsy increases to 6-10%.

Febrile convulsions in children, as a rule, form against the background of an increase in body temperature. Such seizures are not considered a type of epilepsy (“black” disease), which can manifest itself at any age. The treatment method for temperature cramps in the extremities depends on the nature of the course and the frequency of their recurrence.

General concept

Febrile convulsions are fainting of varying duration in infants and young children, which are formed at a body temperature of 37.8-38.5 o C (with the exception of convulsions during neuroinfections) and occur mainly in the form of convulsive seizures in the extremities. Outwardly they appear:

In the form of local convulsions, which are often manifested by rolling of the whites of the eyes, trembling of the upper and lower extremities due to excessive muscle tension
According to the type of tonic-clonic convulsions - the condition is characterized by severe tension of the body muscles, convulsive throwing back of the head, rolling up the whites of the eyes, as well as pressing the arms to the chest and unintentional straightening of the legs
A type of atonic convulsions - accompanied by a sharp weakening of body muscle tone, involuntary defecation and loss of urine.

An important factor in the formation of such seizures is a genetic hereditary tendency.

If the child's parents or immediate family suffer from any form of epilepsy, then the risk of developing seizures is very high.

Main symptoms of febrile seizures

According to statistics, febrile convulsions in children are usually observed between the ages of six months and 3 years, less often - up to 6 years.

Febrile seizures are classified as:

Typical (simple) – convulsive attacks lasting up to 15 minutes against the background of severe hyperthermia. Moreover, the indicators of psychomotor development at this moment correspond to age, typical changes in the electroencephalogram (EEG) are not observed, and the history does not contain any indication of organic damage to the center of the nervous system (CNS)
Atypical (with complex symptoms) - longer lasting seizures that last up to several hours. Focal (focal) changes are observed on the EEG, and postictal paralysis of half the body occurs. At the same time, the risk of perinatal damage to the central nervous system and the occurrence of traumatic brain injuries is extremely high.

Febrile seizures in children

It is still unknown why febrile seizures occur in children under 6 years of age, who have never had such cases before. It has also been established that temperature cramps can form as a result of the immaturity of the nervous system in a child.

The immaturity of the nervous system creates certain conditions for the transmission of excitation impulses between neurons of the brain and, in fact, the occurrence of such seizures.

Since convulsions in childhood occur against a background of high temperature, even a common cold or vaccination performed the day before can provoke this condition in a child.

In most cases, during an attack, the child loses his reaction to external factors, he completely loses contact with the outside world (that is, he does not hear or see his parents at all, does not cry, does not scream). In some cases, there is a temporary holding of breath, which may cause the child's skin to turn blue.

In approximately 30% of children, febrile seizures may recur with each subsequent increase in temperature.

Examination methods

Typically, the goal of diagnosing febrile seizures is to find the cause of the seizure condition in order to exclude any form of epilepsy. Of course, after the first episode of seizures, the child must be urgently shown to a pediatric neurologist.

A full range of laboratory examinations includes:

Taking a spinal tap to conduct a comprehensive analysis of cerebrospinal fluid - it is necessary to exclude meningitis or encephalitis
Urine collection for general and biochemical analysis
Taking blood samples to determine calcium levels - a lack of calcium may indicate rickets, which causes spasmophilia
Computed and NMR tomography
Electroencephalogram (EEG).

Principles of treatment of childhood febrile seizures

If the duration of a seizure attack does not exceed 15 minutes, then it would be enough to take antipyretic drugs (preferably suppositories with paracetamol) using alternative methods of reducing body temperature (cool compresses), constantly monitoring the dynamics of changes in the child’s condition. If febrile convulsions in children (frequency and strength) increase, it is necessary to urgently seek medical help.

Before the medical team arrives, the child needs first aid at home:

A child with convulsions should be quickly undressed and placed on a hard, flat surface, with his head turned to the side.
It is necessary to control the rhythm of the baby's breathing at the time of the attack. If the respiratory rhythms are very weak, artificial respiration should still be performed only after the end of the attack wave.

For more frequent and longer-lasting seizures, specialized treatment will be required, the essence of which is the intravenous administration of anticonvulsants (such as phenobarbital, valproic acid, phenytoin, etc.).

It is extremely important not to leave a sick child alone until febrile seizures have completely stopped. It is unacceptable to attempt to open a child’s mouth in order to insert a spoon, finger or any other objects between his teeth, as this can cause harm. You should not give your child something to drink during an attack or offer to swallow medicine! This can only be done after the attack has ended.

Prevention of febrile seizures

Taking antipyretic medications in advance is a preventive measure. The need for such precaution is due to the risk of degeneration of fever attacks into epileptic ones. In any case, the final decision on the need for one or another treatment is made by a neurologist.

As a rule, febrile convulsions in older children and adults are extremely rare, so the appearance of convulsions and seizures at this age indicates the presence of any neurological problems or indicates obvious symptoms of nervous diseases.

An increase in temperature in young children always causes concern for parents, especially in cases where it is accompanied by convulsions. Of course, not all children have such a reaction to temperature, but parents need to know how to act in such cases.

Daria Dolinskaya, a pediatrician and cardiologist at the Online Doctor service, told Letidor what febrile seizures are, how they occur and what to do if a child develops a convulsive reaction when the temperature rises.

What are febrile seizures

Febrile seizures are a reaction of the nervous system to an increase in body temperature. They manifest themselves in the form of repeated sudden involuntary contractions of skeletal muscles, mainly in the form of tonic or tonic-clonic convulsions.

In this case, the child does not respond to the adult’s speech, becomes inhibited, and loss of consciousness is possible.

At what age do febrile seizures occur?

A convulsive reaction to temperature (not with epilepsy) occurs in 2-5% of children. Most often observed in infants from 6 months to 5 years of age. The younger the child, the more often seizures develop; later children “outgrow” them and do not react to an increase in body temperature in the same way.

If seizures recur at an older age, a serious examination is necessary to rule out epilepsy.

Causes of febrile seizures

Experts believe that the basis of seizures is the immaturity of the central nervous system.

Any infectious disease that causes an increase in body temperature can provoke the development of febrile seizures. Seizures can also occur with acute gastroenteritis and bacterial respiratory tract infections.

But there are also non-infectious causes of febrile seizures, for example, during teething, heat stroke, intoxication, and even when the metabolism of macro- and microelements in the body, calcium, for example, is disrupted.

In addition, according to the observations of doctors, a hereditary predisposition plays a large role in the occurrence of febrile convulsions, when one of the family members had a similar reaction to an increase in temperature in childhood.

How do seizures develop?

Febrile seizures occur at the onset of the underlying disease, usually when body temperature rises above 38°C.

They usually last less than 15 minutes and do not recur within 24 hours.

How to act as parents

At the time of seizures, parents do not need to give any medications in the form of syrups or tablets!

Call an ambulance immediately!

Place the child on his side to make it easier for him to breathe and to prevent liquid (saliva, vomit) from entering the respiratory tract.

Remove all objects with which the child can injure himself, and remain close to him the entire time the convulsions last, without trying to hold him by force.

5. Under no circumstances should you insert any objects into the child’s mouth to hold the tongue.

After the seizures have completely stopped, before the doctor arrives, you can give the child antipyretics in an age-appropriate dosage based on paracetamol or ibuprofen.

For hot skin, you can use physical cooling methods - wiping with water at room temperature. Treatment of the underlying disease that caused the fever is also necessary.

When examining a child at the time of convulsions and after them, the doctor assesses the general condition and vital functions: consciousness, breathing, blood circulation. Doctors administer a lytic mixture (it contains three active components and has an antipyretic and analgesic effect) intramuscularly to quickly relieve fever, which is sufficient for these seizures.

For prolonged seizures, strictly according to indications, doctors administer anticonvulsants.

It is important to note that single seizures that develop only at high temperatures are benign and have a good prognosis; children “outgrow” them. Such convulsions only require monitoring the child and preventing the development of fever above 38°C. That is, if the temperature rises quickly, you should not wait until 38-38.5°C, but give an antipyretic earlier, already at 37.5°C.

If seizures become more frequent or occur not only during an increase in temperature, consultation with a pediatric neurologist and additional examination are necessary.

Even if a child has had episodes of febrile seizures, there are usually no absolute contraindications to vaccination. Another thing is that immunoprophylaxis in this case is carried out strictly individually, taking into account EEG data and the duration of the last episode of seizures.

Febrile, or temperature, seizures are convulsive (convulsive) seizures that occur as a reaction to elevated body temperature (usually over 38 0 C) in children under 6 years of age, subject to the obligatory condition of the absence of seizures without fever.

Such seizures are most often observed in children from 6 to 18 months. life. According to statistics, about 5% of children under 6 years of age are susceptible to febrile seizures. The duration of the attack can be up to 15 minutes.

Such seizures are not epilepsy, a disease that can affect children of any age. If convulsions are observed in children over 6 years of age or the duration of convulsions exceeds 15 minutes, then a thorough examination is necessary to exclude childhood epilepsy.

Causes of temperature convulsions

The causes and mechanism of the development of seizures against the background of hyperthermia are not fully understood.

Experts believe that the main role in their occurrence is played by the immaturity of the central nervous system, in which the inhibition processes are weakened.

The thermoregulation center is also immature. For this reason, the excitation that arises in this center is freely transmitted, spreads between cells in the brain and causes convulsive muscle contractions.

This reaction in the brain develops regardless of the cause of the elevated temperature: viral or bacterial infection, post-vaccination reaction, etc. As the central nervous system matures (by the age of 6), temperature cramps stop.

Hereditary predisposition also matters: if the child’s close relatives have epilepsy, the likelihood of temperature cramps is higher.

Types and symptoms of febrile seizures

If, with an increase in temperature, redness of the hot skin is usually noted, then before a convulsive attack, a sharp pallor of the skin appears, sometimes with a bluish tint. The baby's body is covered in sticky sweat.

There are tonic, atonic and local convulsions; let’s talk about each type in more detail:

During tonic convulsions, the child’s body is stretched, the head is thrown back, the eyes roll up, the teeth are clenched tightly, foam is released on the blue lips. The baby's legs are tense and straightened, the arms are bent and pressed to the chest.

The baby is experiencing shortness of breath. Loss of consciousness may occur. Rhythmic twitching of large muscles is noticeable. Gradually, the shuddering or muscle twitching becomes less frequent and stops altogether.

Atonic spasms are characterized by maximum relaxation of the muscles of the entire body. Urination and defecation occur involuntarily.

With local convulsions, twitching of the muscles of the limbs (upper or lower) appears, and the eyes roll up.

With any type of seizure, the child becomes inhibited, does not respond to the speech and actions of an adult, and a kind of numbness sets in. Lost contact with others. The baby does not cry; due to holding his breath, a bluish tint of the skin is noted.

The duration of a convulsive attack is from 30 seconds. up to several minutes (usually 2-5 minutes). It is important to provide assistance and stop the seizure syndrome as quickly as possible. The longer a seizure lasts, the more dangerous the consequences can be.

Febrile seizures can develop one after another. In many children (30%), they develop again with any increase in temperature.

After stopping or ending an attack of convulsions on its own, the child is lethargic, drowsy, has difficulty oriented in space, and does not remember what happened.

Examination of children with fever cramps

If a convulsive seizure occurs in a child, even just once, an examination by a pediatric neurologist is necessary to rule out epilepsy and other causes of seizures.

In addition to the examination, the doctor may prescribe additional tests:

clinical examination of blood, urine;
blood test for calcium content (prescribed to infants to exclude spasmophilia);
CT or MRI of the brain.

In some cases (if a child is suspected), it is carried out with a subsequent study of the cerebrospinal fluid.

Treatment

It is impossible to stop a seizure attack that has already begun. It is necessary to immediately call an ambulance, and before the team arrives, take the necessary measures to prevent injury to the baby.

To provide first aid:

If febrile seizures in a child are short-term (less than 15 minutes) and occur very rarely, then, as a rule, no special treatment is prescribed. In order to prevent the development of seizures, it is necessary to give the child antipyretics for any disease already at a temperature of 37.5 ° C.

For longer or more frequent seizures, it can be carried out, but only as prescribed by a neurologist. Children are often prescribed Phenytoin, Phenobarbital, and Valproic acid.

Summary for parents

You should not panic if your baby develops seizures at elevated temperatures. You need to immediately call an ambulance and begin providing first aid or immediate assistance to your baby. Correctly provided assistance will prevent the development of negative consequences after seizures.

Consultation with a pediatric neurologist in these cases is mandatory in order to exclude another cause of a seizure and provide the child (if necessary) with anticonvulsant treatment. The probability of developing epilepsy in a child with fever seizures is 2%.

Pediatrician E.O. Komarovsky about febrile convulsions in children:

Seizures frighten most people, and if they occur in a child, it is doubly shocking and alarming for parents. The first questions that concerned mothers and fathers ask are: what is it, is everything okay with their baby, and how dangerous is the pathology? These issues will be discussed in more detail in the article.

Febrile seizures are a pathology that occurs in preschool age.

What are febrile seizures?

Febrile seizures in children are a convulsive condition accompanied by high fever. It mainly occurs in children aged six months to 6 years. In older children and adults, this condition practically does not manifest itself. According to statistics, pathology affects from 5 to 15% of all children.

To diagnose the disease, a consultation with a neurologist is necessary. This is especially necessary for children whose seizures occur systematically.

The doctor prescribes additional examinations, including:

general analysis of blood, urine, feces;
CT scan of the brain (we recommend reading:);
electroencephalography of the brain;
blood test for sugar;
rarely - spinal cord fluid puncture.

Causes, symptoms and types of pathology

The main cause of febrile seizures is fever. It is divided into febrile (38.1 to 39 degrees), high febrile (39.1 to 41 degrees) and hyperpyretic fever (temperature above 41 degrees). If convulsions occur at a temperature below 38, then they are called subfebrile.

The causes of seizures are divided into:

infectious (if the child has intestinal, neurogenic, respiratory diseases);
non-infectious (overheating, teething, shock, reaction to a vaccine, allergies, hereditary factors, etc.).

By type, seizures are divided into the following categories:

Tonic. The child's legs are straightened, hands are pressed to the chest. At the same time, the muscles tense and the head is thrown back.
Clonic. The child's facial muscles twitch, and the muscles of the arms and legs also contract involuntarily.
Local. Cramps occur in a certain part of the body (twitching of the muscles of the face or arms/legs).
Generalized. Cramps affect all muscles of the body. After some time, their activity subsides, then they resume.

Every time before the onset of seizures, the baby cries

The main symptoms of the pathology include:

redness of the skin is observed;
before the onset of seizures, the child cries a lot (more details in the article:);
the baby does not react to external stimuli, does not hear when parents address him;
the baby turns noticeably pale and becomes covered in cold, sticky sweat;
involuntary emptying of the intestines and bladder occurs;
lips turn blue, teeth clench tightly, eyes roll back, foam appears at the mouth.

Consequences for the child and prognosis

Convulsions that occur once at a high temperature are not considered dangerous. Increased attention is paid to attacks that are repeated systematically. Without proper treatment, they cause serious harm to the child, since frequent repetition of seizures entails irreversible negative consequences for the baby’s nervous system that has not yet formed.

Seizures are especially dangerous for babies from 0 to 6 months. Subsequently, such children are given close attention to prevent recurrence of attacks. General prognosis for children who regularly have seizures:

risk of recurrent attacks;
risk of epilepsy;
the likelihood of developing neurological problems and developmental delays.

It is especially necessary to monitor infants with febrile fever, as seizures may recur

If the baby receives timely medical care, then the risk of complications after febrile seizures is extremely low. According to statistics, only 2% of children who have had seizures subsequently develop epilepsy.

What to do if seizures occur?

If a pathology occurs, parents of the baby should not panic, but act competently and quickly. You need to be able to provide emergency assistance, and when the attack passes, immediately contact a specialist. Below we discuss in detail the rules of first aid and methods of treating the disease.

First aid

If a child experiences seizures, it is important to remain calm and call an ambulance. Actions of parents (or other loved ones near the child) while waiting for the arrival of specialists:

remove tight and constricting clothes, a belt, a belt from the baby, loosen the collar;
ensure the supply of fresh air;
place the baby on a flat surface on its left side;
if there are hard and dangerous objects near the baby, they must be removed to prevent accidental injury;
make a tourniquet from a handkerchief or gauze and place it between the child’s teeth so that he does not accidentally bite his tongue;
if convulsions are provoked by high temperature, then the use of an antipyretic agent is mandatory.

What should you not do during an attack?

If a child has an attack, it is important not only to competently provide emergency assistance and call specialists, but also to know what actions are strictly contraindicated for the child at this moment. Forbidden:

Overheat the child, be in the hot sun during an attack.
Give the baby artificial respiration, as this will not help in this situation.
Give your child medicine or water during an attack. After the crisis has passed, you need to wait until the baby fully regains consciousness. Only then can he drink and eat.

Treatment

Appropriate treatment is prescribed by a neurologist if the seizures are recurring. Treatment consists of injections of special anticonvulsants administered intravenously. In modern medicine for children, Phenobarbital, Valproic acid, and Phenytoin are used.

Only a neurologist can determine whether a child needs medical care. Parents cannot draw such conclusions on their own. Even with a single attack, you need to seek help from a specialist.

What is prevention?

Seizure prevention is carried out if seizures recur regularly and last more than 15 minutes. First of all, you need to consult a doctor. If he reveals the exact cause of seizures, then it is worth adhering to preventive measures based on the doctor’s opinion.

If febrile convulsions in a child are systematic, then for preventive purposes the doctor prescribes a course of intravenous injections in order to subsequently relieve the baby from unpleasant symptoms. It is worth noting that doctors rarely resort to this measure, since anticonvulsants have a number of side effects. For this reason, they are prescribed as a last resort, when there is a high risk of the baby developing epilepsy (we recommend reading:).

If a baby’s seizures occur due to a high temperature, then there is no need to wait for its critical temperature; the child must immediately be given antipyretic drugs. In the future, when the baby’s nervous system strengthens, such a reaction to an increase in temperature will no longer occur.

Vaccination and febrile seizures

In very rare cases, febrile seizures are triggered by routine vaccinations. If a child had a similar reaction to a certain vaccination, then the likelihood of a second attack for the same reason is very low. At the same time, routine vaccines are a kind of preventive measure for febrile seizures.

There is no vaccine against this disease, but vaccinations themselves protect the child’s body from infection by many types of infections, and they, in turn, can provoke high fever and convulsions.

In the Russian Federation, DTP vaccinations against tetanus, whooping cough, hepatitis B and diphtheria are currently mandatory. Mumps, measles, etc. are done on a voluntary basis (we recommend reading:).

Although febrile seizures look scary and cause a lot of anxiety for parents of babies, their consequences are rarely serious. As a rule, these are isolated cases that occur due to the child’s nervous system not yet being formed.

Correct actions on the part of parents and timely consultation with a doctor will help the baby cope with this illness and not encounter a similar problem in the future. Dr. Komarovsky explains in detail in his videos in which cases consultation with a specialist is mandatory.