Nutrition and Growth in Infancy and Childhood

This is the most important survival issue in cloacal exstrophy and the surgeon has an important role in the management of the bowel. Half of the patients at 1 year of age, and one-third of those at 5 years age experience failure to thrive [37]. Although "anatomical" short bowel is seen in 15% of cases, physiological short bowel is more common, especially in myelo-dysplastic children [29,38]. Neurogenic bowel dysfunction and repeated abdominal surgery may play a role in malabsorption. Thus it cannot be overemphasized that all of the available bowel including the tailgut be incorporated into the alimentary pathway. Parts of the bowel can later be used for genitourinary purposes once the child is thriving [30,37]. Paren-teral nutrition is required in the neonatal period for most cases, but much more so in those with ileostomy compared to those with a colostomy (tailgutostomy) [26,27,30,31,36]. After the age of 3 years, the nutritional differences between the two groups become less significant [19]. Once the child is thriving on an oral diet, survival is generally assured, and it is time to consider quality of life issues.

Getting Back Into Shape After The Pregnancy

Getting Back Into Shape After The Pregnancy

Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.

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