DRA. PRISCILLA MASSOTE (PEDIATRA) - PODPEOPLE #146

[Music] [Music] [Music] [Music] [Music] Our guest today is a pediatrician who seeks to establish a special bond with each child and their family, practicing medicine with affection and dedication. In addition, she uses social networks to create content in a light and relaxed way, helping to educate parents about child development and individualized supplementation, we will learn a little more about breastfeeding and child sleep. The Introduction, nutrition, guidance on child development and preventive care with you, the doctoral pediatrician Priscilla Massote [Music] Hello everyone, welcome to another episode of pod people a place where we meet to see

and hear people People who Do People who happen People who inspire Our guest today is a pediatrician doctor Priscila maot I said it right, I said it correctly, thank you for the invitation. It's a great pleasure to have you here, everything is good. It's a great pleasure to have you, see Priscila, you're very welcome, thank you, Anabela, oh, Anabela hasn't been introduced to us yet, come on, look, dear, it's difficult to have good pediatricians today, do you think It's a kind of extinction, I don't think it's a question of niches, right? As I'm in the

area, I know a lot of good pediatricians too, that's a good thing, I like you because hey, I studied medicine, but at that time we were already talking about Wow, there are so few pediatricians in a class of 120 Oh, no, that's true, it was 120, right in terms of percentage, right, there aren't that many people who want to spend time and people, I always say, people, pediatricians are a much improved clinician because they have to know a lot about clinical practice. and he has to know how to apply this to a body that has

totally different dimensions, totally different reactions, so it's difficult, it's not easy, so I wanted to know from you what the selection process was, what made you choose Pediatrics, first of all, what made you choose medicine and then Pediatrics Oh yes, well, since school I've always really liked learning new things, so studying wasn't a torture for me, I really liked it, I really liked it, I also liked helping my teaching colleagues to learn to teach and when I taught I learned a lot more, so I thought this challenge of learning new things was really cool, at

first I didn't want medicine, I wanted to do aerospace engineering. After all, I went to bed completely, I wanted to do music and then my family didn't like it very much because unfortunately in our country it's not valued very much, so I would have to think about a career abroad and my family is from Minas Gerais, right? attached, if you talk about aerospace engineering, there wasn't much space in my house anymore because I would have to go to São Paulo, no, that wasn't acceptable, right, everyone was stuck to that And then they said Oh, why

don't you do medicine and At first, I had a reluctance towards medicine because what does a teenager do? What does he rebel against, right? I was completely against everyone. And then I didn't open up much after all, after a while they stopped talking. They stopped talking a little, right? I think that during this period that I decided that I wanted to do music, I completely abandoned my studies at school, I abandoned it, not in the sense that I went to classes, but I didn't dedicate myself assiduously as you liked, I stopped being assiduous and And

then there was even an episode when a physics teacher of mine picked up a very bad grade from me, he said, but it was a disappointment, what happened, you liked it and I said it like that, wow, worse than I really liked it, right? And then it seems like a lie, but it hit me wind like that judged my test behind the platform I never took this test again so I said like this guys she fell there in the in the space in the Lady Murph in that only space that she would fall and not

be exactly there I, no, obviously because of that, right, but I said that, wow, that's boring, right? I really liked it because I don't like it anymore, I started to question it a little, that's what I said, oh, I'm going to open up to this again, like the fact that he and I were talking to me. Look at the fact that you wanting to choose a profession that does not take the traditional subjects doesn't mean that you don't need traditional subjects, I said, you're right. Then I started dedicating myself again, I started studying mathematics, physics,

but just out of curiosity, I ended up having a music band. I arrived, you know there's a large percentage of doctors from colleagues what I'm talking about, I was in a group, I was in the State class here in Rio de Janeiro, Ah, it was 120, it was divided into four groups, ahem, of 30 and I remember after a while, we had great musicians and great heads of kitchen Yes, and today it's a problem that my second profession is a doctor , a doctor colleague of mine who left after training and went on to be

a restaurant owner . band sab I looked at her face I said she had a band you were what vocalist vocalist and rhythm guitar both So you also play as well as sing I wasn't a big fan of biology I had a teacher who was very good in the third year look at that I'm lucky , I'm lucky, I'm lucky, right? And then I started to get interested in the human body and everything else. Then I started watching Dr House. I started to think it was cool. I'm not trained in Grace Anatomy. That's very interesting,

Oh, it must be cool that what these people do, right, and so on, I started to influence a lot of people. You also believe in a very popular R. Medium, I came to Rio and there was an exhibition about Doctor Without Borders. I said wow, how cool, this must be cool to work with, this must be cool to do. And then, your family wouldn't let you win the world, mom, don't let me, mom, no Leave it, but today, today is already different, right, today you can go, but for the family from Minas Gerais, getting out

from under the tree is very difficult, it's true, it's true, it's complicated and then you started medicine and then I decided, I decided I wanted to and I went and in the last inspiration it was Doctor Without Borders, passed by R, passed by House, passed by Front, cool, God, he was trying to give you some tips like that, right ? I decided that this was exactly what I wanted and then I dedicated myself to studying for the course and then I passed Viçosa Uhum And I went to Viçosa so I didn't know where Viçosa was

because, right? Vestibular medicine is like that, it takes me to Brazil Wherever there is Going to us is exact, takes me to Brazil, takes me to Brazil and then I f program like this, right, there was, it's from, it's a painting from Fantástico, it takes me Brazil, it takes me Brazil, it's a doctor, it's a medicine, it takes me to Brazil, I went, I just went, I didn't know where it was if it was beautiful if it was ugly but I was the best experience of my life so I was able to live with people

who were very different from me, different places, different places, so there were practically no people who were from there, most of the people or they were from Minas, there were people from all over Minas Gerais, there were people from Bahia, there were people from São Paulo, there were people from every possible place and from different social classes too, which was interesting, right, cool, so there was a uh an opening, a very big opening, until the fact even interacting with people from other courses with other experiences was very good and then during college, you know, for

a long time, I thought that Pediatrics must be a bit boring, I said it like this, oh, no, I think that diseases are, it's all the same thing, picking up perb poop, that's all, there's nothing good about her that she doesn't like, she'll like it later, it was like that with you, she doesn't like it, she'll like it later, she's against it at first, not with me, it was different Ah, so at the top, it's more or less, more or And then I thought that because we, as mediciners, we come in very dazzled, then the

surgery, then because I'm going to study Neurology and I don't know, I don't know, and I had this thing a lot, and then in the end, what happened? In the middle of the course I gained a niece, no, no, not even a niece, in fact, she is She is a first cousin, but in my family, like everyone, she is very close, like a sister, as if my aunt was very young when I was born then the age difference was as if I had getting a niece, so I say she's my niece, educational paraphrases, niece, niece

And then I started talking like this, people like what a cool child, right? is that she learned to jump and and how she does it I thought it was incredible I kept filming her the whole time and then I started to think it was really cool interesting interesting and And then some doubts that sometimes I thought Wow, what a silly doubt why the person is worried about it, that's not relevant, I started to see it with different eyes, right? So, for example, a cold, wow, the child isn't able to poop properly, so when you put

it on the same level, a person in C ends up dying, of course This will be less relevant, but for that family there that is watching the child suffer, suffering is suffering and for the child, for the child as well, and from a clinical point of view, it is also suffering, its functionality is also exact And then we enter, right? Several issues related to motherhood, typical of raising a child, sleep, nutrition, are things that I could understand, right through my experience with my niece, that they were not urgent, life-threatening things , but they are things

that have to do with quality of life in the short, medium and long term. term, so I started to look at it in a different way and then along with that I started to have more skills with children because Because before I would talk to children, I didn't even know what to say to them, once at the Health Center they told me to do a waiting room about hypertension, diabetes, there were some mothers there with their children waiting for dental care, so I said, hi, do you know what diabetes is, then the child, no, no,

you know what hypertension is, no, no, then I said, do you like B you like B you like B 10 10 that's ok there that's ok then people were laughing at me like that teacher everyone I didn't know how to interact with then I start and they don't teach either right I think it's so interesting because they don't teach either They teach you like B 10 then it started, more or less, my onslaught wasn't much like that, it wasn't cool like that, you love it Well 10 but the way you arrive, right? Like you ch

Today you arrive Wow, how cool is your colored nails and the child already looks at you and shows you, you know, a little shy. So these things my niece teaches me and I started to like dealing with children, I think it's fun to be with them, right ? No, and then I decided that I didn't, I think I really want to be a pediatrician, but I still had doubts about what year you made this change of route, and in the last two years, I still had horrible existential crises, I didn't know what what I was

going to do I had doubts and I reached my surgery internship I transferred it to BH because I wanted to make sure I already knew I didn't like it but I wanted to make sure it's not because it's an inner city in a city big I don't like surgery either so I did the internship it was excellent I learned a lot No it's not that it's really cool it made me admire my fellow surgeon but it's not my thing but it's not my thing it's and then I tried to exclude it and then I said

Well, I think what I really want is Pediatrics and then I made an effort to do the residency that I did in BH, which is one of the biggest hospitals in Minas Gerais, Hospital da F Mig, Hospital Infantil João Paulo I, there are 150 beds exclusively for pediatrics only. child a floor with 50 children and there I had contact with a medicine that was very thought-provoking despite, you know, Because in my view, Pediatrics was just a child with the flu, a child with otitis, a child I wish, because it is, I think the emotion came

too much, right? at the CGP, which is where, as it used to be called the General Pediatrics Center, we had a sample of everything, rare diseases, not so rare diseases, but common diseases, everything, and then I went to see how broad it was. And then I said, people, what a good choice , I did it because I'm also a person who gets bored very quickly so I need to do a lot of different things. I need to go to the delivery room to receive the baby that's being born. I need to go to the hospitalization

unit with the babies that are hospitalized there. thing I need to go for the children's ward, the big office is me, so I said, wow, I needed this, what I needed is the general clinic, right? And that you can, at any time, still specialize in some things, not necessarily one, right, yes, true, but it's something that colleagues always They say that the pediatrician, even when he does a subspecialty , never stops being a pediatrician. Of course, he still has that look there, that's not the case, he continues to be a general practitioner. niece Zinha there

niece cousin who recommended you and child did the internship with you you don't have medical relatives I have Ah yes I did but not so close not so PR but my father's family which is a family I don't live with so much, right, so there are dentists, many people focused on the health area , but no one is a pediatrician, you were the first, a Pediatrician, it's a Pediatrician now from my family, even from my family, even so, you know, there's coexistence, right? Really, I think I was, I think. that I was the first and

at what point did you say that I'm going to start flirting with the social network I want to pay for some knowledge that I think I can be useful and that I'm not seeing people do that what moment was it this and when it started, already in residency, a strong point for me as I connected well with my patients and with my patients' families was communication, so how I explained what was happening and I always found this very important Always I thought it's important, for example, when I was a child, I remembered that my pediatrician

came to examine me and I missed him. Like talking, look, I'm going to listen to your heart, look, I'm going to look at your mouth, suddenly I was there, Neida's friend, um toothpick in my mouth and then you get scared out of nowhere, right no, I started aaa I already had that for myself and in Pediatrics, the mouth closes, breathes through the mouth, yes, no, and then you tell them to breathe and the person starts to get dizzy, dizzy and the child gets dizzy, dizzy, I don't think this is horrible for children, normally I don't

even ask, I just listen to them, I let them breathe normally, I let them exist and then I listen, so that was one of the things, the physical examination, So this communication with the child for me It was very important from the beginning to come and talk, Look, I'm touching your body, excuse me, so I thought this was important, and communication with the family too because I saw a lot of clashes, a lot of It must be very complicated for you, right, really, a lot of shacks because of It's a lack of professionalism to look

at that fam talking, let me explain to you what's happening, this is happening, Ambassador, it's one person's fault or another's fault, this can happen, look what, because many of the fights between the people who leave from the hospital who run away from the hospital is because there was no one who arrived and talked, explained Look, aren't you, of course there are some cases that are out of the curve, right, that people already do it anyway But it's an exception, it's an exception, it's a very exception, lack of information and there is always something behind there,

you know, this incongruity in communication And then I realized that I could explain it in a way that they could understand and even for me I had a bit of a problem, I didn't have any difficulties in my academic life Pre-school in Medicine at the Faculty of Medicine, I found it very difficult to understand some things, understanding some pathophysiology and some mechanisms. And then when I understood, I said, man, that's cool, I managed to understand, and then I said, Wow, it would be interesting if the person, the patient, understood this because understanding this here, he

will understand, help me with the treatment Exactly that, so I felt that the strength of my communication was in this direction and in parallel with that, my husband Pedro, he had a company, he has a company, in fact, in communication, Pedro is advertising Uhum And that he worked with education using non-traditional methods so using images using memes using funny things PR bringing the public closer How cool it was aimed at Enem and then I started thinking he started talking to me look, make an Instagram me I was still at the residence finishing I still had

no idea that I wanted to do a consulting practice, but when I started thinking about consulting, he said, do Instagram, come on, I'll help you, we'll create a visual identity, we'll start, and then, with his encouragement, I started, we'll do some videos that have nothing to do with the videos I make today, right? I started, I started, the sooner you start, the faster you get to where you need to be, I'd like to, right? And then I started there, then for a while I made more posts writings And then we arrive at the format we

have today, which is that these are the videos that I make that involve funny images, memes, sometimes even my way of speaking, really, Minas Gerais, Minas Gerais, but that's cool, I think it's cool to give up with accents we have so many Brazilians, right, and we, I love accents, and you bring with you a joy, something, and a good pedagogical humor, you know, Thank you, it's an honor, because I worked for a long time with children, today, not anymore Uh, but I think you have this touch, you know how to transform what is seriously important

into a didactic communication for them and your way of being makes this communication arrive . you make the scripts yourself one by one, the subjects, you see what catches your attention the most, what the parents, I don't know, have more difficulty understanding, yes, but where did it go? So it's one of the topics that you take up and you notice a greater search for families, doubts like that because they are things that are logical, you are a medicine as a whole, you have everything, little heart, everything, but what comes to you a lot and what

do you do you realize that in your communication with pediatrics it is such a big search it is a brand it can be a very common thing what you said ah the little child is not pooping but it is something that happens a lot so I wanted you to know what has you like this of challenge and that you are always there helping these parents is nutrition and hygiene is this intestinal issue anyway Look, I think a little bit of everything but my main focus is to bring information based on scientific evidence uhum and adapt

this to the reality of family for practice because it's not like that Giving up things that are non-negotiable in any way the treatment has to be done this way it has to be done this way but some things we can make flexible and bring a little more lightness to mothering I think This is what is very difficult because if you go to see pediatrics, it is full of specialists, so there is a sleep specialist, there is a nutrition specialist, but we need to add all of this and we need to add this with everything very

carefully because everything involves culture of each family and we have to respect, of course, some safety limits, right? So when we go to very controversial topics such as sleep, right? Then I will have professionals who argue that a 5-month-old baby can sleep 12 for hours at a time, this is crazy for me, right? There may be one or another out of the curve who will sleep for 12 hours at a time and who will remain healthy, maybe so, but I sometimes see people selling certain services, disrespecting the child's physiology and disrespecting the reality of many

families too and then that mother that her son doesn't sleep 12 hours a night she feels like an ET she feels like an ET she feels that her son has a problem and then that's it I created a problem that I didn't I didn't even need to create it because sleep deprivation is already there, so I think that ooo my objective, right, with the network is to get these themes, so sleep, let's talk here, what's the evidence in relation to sleep ? do it inside your family inside your R sweat I'm not going to lie

to the mother and tell her that you'll be able to make your baby sleep 12 hours at 5 months I'm not going to do that even if it costs me my job because a lot We use this to sell it, right? So, in the same way, I can't say to a family like you, it's okay, don't give antibiotics, the baby has pneumonia, it's okay, don't give antibiotics, so it's non-negotiable, right, so I think that there has to be common sense and a balance, not even being a person who only looks at science and disregarding personal

choices and traditions, but a person who is flexible to the point of being responsible, so it is very difficult to find this balance fine This control so as not to go too far to one side or the other on some topics I'm going to be very scientific on others I'm going to be more in the sense of accepting and understanding and seeing what works best I think it's difficult find this common sense Today you said something very interesting, for example, the issue of food or tradition, for example, Minas, I really like Minas, uh, and Minas

had a tradition, I don't know if it still does, when I attended, a male boy is born if wet the pacifier in the cachaça, oh my God, but I saw it too, it's not me, nor me, more with Minas, with El patients, I wet, I wet the pacifier, I said, if he's a rump, it's your responsibility. That was a trigger to awaken genetics, I just I know I had to explain this, thank God we did this thing with greater affection, right? And then the second child didn't have anything like the wet pacifier in the cachaça,

that's surreal, right? So these are traditions, for example, food, and, uh, there's the Hey, today people talk like this, take the baby's milk, take out gluten, take it out, I don't know which one, I don't know why, I don't know why, people don't, it's not like that, everything has common sense, eh, the other day I was with a lady, she said something like this Ah Look, I discovered, right, I don't know, I studied that autism is caused by gluttism, I said love, it's not like that because you can't even say no unless the person, right,

you're far away from the bubble, I said, no, it's not like that, crazy. No , but it's not possible, right? I say like that, no, it's not like that, look, there has to be genetics, so, for example, in several factors, now if you say like that, oh, I removed gluten from that child, he's autistic. It could even be that he gets better, but that's not because. that caused it, right, it's different things, you have to say it in another way and we live in times when there is either this or that Uhm, everything is very

polarized, everything is polarized, medicine is also polarized because there are those like that, nothing about allopathy, uhm, just I just don't know that when I think that it's good that there's supplementation, we gain another resource, that it's good that there's an antibiotic, we gain another resource at such a stage of the illness And you've noticed this in polarized families Wow, but very, very much. with evolution too, right, what my grandson had doesn't mean that now the grandson's son is exactly like this and building this must be very difficult, this case, even with food, is very

interesting because like that, we have and And So, it's one of those subjects that I really like to address with the didactic question because if the person understands it, it becomes easier for them, it doesn't just seem like a bunch of boring rules, right? So we have today, for example, children up to 2 years old She shouldn't be exposed to sugar or ultra-processed foods for up to 1 year. She shouldn't be exposed to salt. behind this, it shows that children who are exposed to salt at an early age increase the chance of hypertension in adulthood

and it is difficult to make this correlation because it is not the same as antibiotics, I did not give antibiotics, the child will get worse in two days, in 20 30 40 years you won't see it and it may be that moment there and it may be that it may not be that I offer the salt before the year and the child doesn't become part of it. It may be that I don't offer it and it becomes Then, uh, but from a statistical point of view we have data that support it, it's worth it, it's

worth it, right, avoiding you, you have, it's something I hear a lot in my practice with bariatric surgery Uhum And I also went through this in my childhood I really think it's a bit of a myth, but now I'm with a specialist, I'll be able to answer this question, oh, a lot of my patients, when I get them, the first thing I want to know is their history with obesity, if it's something that It's happened to a lot of people lately after Covid, and there's a side that shows like this, after Covid, The issue of

staying at home, the confinement made me gain a lot of weight, but that's how I always come up with a story Oh, I was very skinny and my mother gave me Biotônico Fant Taurus, my grandmother gave me Biotônico Fant Taurus, because my skeleton appeared stunted, I went through the Biotônico Fonton phase. Also understand, I was R critical I only saw the knee like this. Guys, I'm going to say exactly what I said was that I communicated through the knee. For a long time, I was very skinny, you know, and Biotônico Font takes Biotônico Font and

today, of course, when I'm at the appointment, I'm very me. I'm serious listening but I'm like this Oh my God I also went through this but I'm here Oh so they say this a lot that opened up that child's appetite so much that the child today is this is a myth it's true this has meaning but not because of Biotônico Fontora But also because of the pressure that I'm now discovering that I was introduced to alcohol from an early age even though I don't drink today, that's the way it is. I think we could do

a Clinical study. I believe that perhaps the social pressure to have a chubby child perhaps has more of a psychological effect and not only psychological because I was also a skinny child and not only as a child in adolescence they said that your knee communicated first, no my nickname was just cricket idea, cricket, my friend called me cricket, see Guilherme, kiss PR, you, my best friend, he liked you, that's not it, but we communicated in a less violent way Gu, Guilherme is my best friend, but today, Guilherme, no, Guilherme, he's slender and wonderful. My best

friend, okay, okay, okay, we were going to do a revue, no, no, but we, but we had one, one, we fought like brothers, but we were very close to my best friend, very big-eared, oh, my God, you were pure knee pur. ear Dumbo they call dumbo but stopping at this side of science if we stop there for behavior there is much more I would give the Biotônico but together with the Biotônico I was already giving a few things PR child no I pressure like talking about your body pressure on your family has to say, Look,

this child is not normal to be like this, and I remember when I used to go to my mother, I said, Mom, for the love of God, what's happening? I'm very thin, there has to be a problem. animal ah it said that I was full of worms that the worm that I was feeding on didn't even have worms in the beginning, so in childhood I didn't eat much, but in my adolescence we had days when pizza was 20 pieces, you and I, it doesn't seem like it, me, and I eat well. Today I'm still today

it was biot it was Biotônico that's what they always say to me that it's done there PR from then on the effect is in adult life preferably After 30 I fell Oh but is that really what you're saying they say? They say what at the time has no effect but that in the long term biot we don't have any randomized scientific study that does ISO You start and from an early age food disappears such an important role then cut to the current times our busy life we ​​don't have time for nothing you arrive at your

house you will want to cook you will you will order one you will order one because there are a lot of healthy things on iFood come on me we don't want things sa because people say that way it's iFood's fault, it's not the fault of the a friend from iFood knew and I can I am I am living proof that she is the only thing that is healthy and healthy is not but like this but it is much easier and in the app of that little business that comes Ráo do the sandwich of the yellow

business of M Amarelo po tem There's an AP, there's a really cool podcast by an anthropologist who talks about food, she's called Eliana de Azevedo, she calls it a printing pan . It's multifactorial, so it involves your exposure and genetics, yes, but our exposure to the environment is much greater, whether from a psychological point of view or from the point of view of the foods that you're exposed to, so for example, when you have it, you're in a she even talks about Da Da Da The logic of supermarkets, as well as how they arrange the

shelves with higher calorie items , there are some studies that even say that when you are in a place that plays classical music you you have to spend more classical music classical music you have to spend more money maybe I thought it was the opposite but it makes sense you feel chic I don't know if chic can't come from that side but I think also relaxation too but it's like baby with the drink because the drink the store offers a restaurant not so much in the supermarket but in a restaurant for example with classical music

you order the most refined refined dishes it can be wine but Car po can be it has meaning for food it has this on her podcast too, and so it's a failure, right ? A very busy life is very difficult for you if you plan, go shopping, cook at home when you, if you are hungry, go to the supermarket, you will buy more junk, you will buy more than Maybe you need and it also leads to the fact that you are going to get more caloric things because it's the day I deserve it Wow, what

a shitty day I had, I stopped, it's true, you can't talk, there's a problem, what kind of shit did I have, I'm going to treat myself, I'm going to celebrate, I'm going to treat myself, so the food ends up small we do this with the child child cried I gave the food food is child child how do we reward the child who cleaned the plate with more food with dessert table everything is awarded, right The Prize is always food and so I am a person I love food, I love cooking, I love gastronomy. So for

me it's even painful to say that, right, but unfortunately, our relationship with food goes a little overboard and then it's not Minas, it's more, right, and Minas Wow, go to someone's house and don't accept a girl It's part of it, right ? It seems like we're food, we 're not we have to eat. If you don't accept it, you're a mess, it's really messed up by these people, right? Ex, it's that the scrapped people didn't accept it, we really like it, so it brings this up to this multifactorial issue and one of the principles, right,

of food that we defend, you know, that I study. a lot about respecting society is not overvaluing those who eat and not Super and not overvaluing when they don't eat uhum we right ooo the studies that permeate there blw which is the style of eating that we leave blw blw okay baby Lad Winning you Instead of giving the child crushed things on a spoon, you give the child whole food, he stirs it, he picks it up, of course there are safety prerequisites, it has the appropriate cut, the appropriate consistency and we allow the child to

demonstrate the your satiety, we combine this with the free demand, right, of the baby breastfeeding And then normally, if you, if this child has no health issues, no feeding difficulties, and, you know, you will see the perfect growth curve, that is, her nature knows what she needs to know what they need, we don't have it, for example, the person who has anemia who starts trying to eat bricks Uhm, it's the organism . You can treat it with a brick No, we can't treat it with a brick, it's a sign that something is wrong, it's not

exactly the organism. Do people comment, oh my God, not that doctor there who said that with you, that's a sure sign. the signs that we receive this, so there are some periods, right? I already read an article about food selectivity. Because there is a certain age of the child, right, between 5 years old, the child starts to really select what they want, it goes through selectivity exactly. and normally she starts to choose more foods like this that are whiter in color. These are usually the foods that contain carbohydrates, right, so it's a phase in which

the child needs a lot of energy to play and everything, so the child who wants more potatoes will want more Rice noodles Then you put a green thing in front of them, they just have to vomit uhm and they get really nauseated because of the smell of the food, everything that has a stronger smell so Eh, there is this period and then we of course, right? Considering the pediatrician will monitor this child, the child is not sick, the child is developing well, we will respect it, right ? of a normal standard, it's expected, right? But

it's interesting that I think there's a lot of influence from the parents of the family, I see this with my great nephews, Giovana, who was the first great niece, she simply had a passion for pure strawberries with the years ago she spoke like this, you, titi, I'm going to your house to buy molango, oh no, and she took it, I left everything clean, ahem, she was eating it as if it were a bunch of phew, then it went into the Grape period, to this day she doesn't eat it, she doesn't drink soda because the mother

went to tell her that she did ballet so she didn't use soda to avoid cellulite and she told her my niece since she was a child, they were little, you know, she didn't have anyone to leave her with, she took her to the gym, she left the shift, she's a doctor, she also leaves the shift, takes her Same example then she says no I won't take it if you offer it she said you don't want any soda she says no I don't take it I just take juice and you see and go to the house

brother came in the same situation because he imitates, right he imitates so it was like that and the father My niece, not so much, is a little more undisciplined, she has never gained weight because she has no genetics to ever gain weight, right, because she eats her father, she is a good candidate for the study of Biotônico, right, Her father, her husband, Gabriel, who is also a doctor, he used to go to her since he was little. going to the supermarket he would take her then put her there she knows how to choose nowadays if

I take her to the supermarket she chooses the fruits better than me then Peter literal literal I'm serious I said it guys what a cool thing she learned how to make bread with Paiu Look just then she put away the food, the other one already came, I think the second one, the father was already more relaxed, and they also have more activities, right ? I can't believe the most sweet thing she ate was mango Look, she said, this is sweet Because she was used to strawberries, which were sour, look at the flavor that went to

more sour things, which wasn't typical, right, so I remember that I don't even expose us to that Wow, how evil of you to give lemons to a child, ex-she was choosing, she chose, they put the fruits and she 's in the supermarket, the father said this here, it's guava, this here, I don't know, I saw her choosing by color I think she liked the red oh today she's already seven years old I said but why did you like me so much I said I didn't, right tititi I like it she says it anyway But why

she said I don't know because it's beautiful it's beautiful look It's just beautiful Just like that, it's much more beautiful than something white Ahem, for sure because if you give the exuberance of colors that fruits have, the child will be dazzled by it, yes, that's true now, if you don't give them the option to be dazzled by the colors of nature are literally this the color of a melon the color of a papaya the color of a strawberry right she won't she does it directly in the cookie ball can you deal with the torture of

vaccines that I think a little baby me I I can't stay inside watching, no, I wasn't born for it, you mean it in the sense of a vaccine that has to be given to the baby today in the thigh, right, it's not me who gives it, oh no, that's why you just send it, right? Ah, that's what I wanted. knowing I'm loving it but we have to give it to people it's a bad thing it's not a bad thing it's not a valuable tool necessary PR health the heel prick test is still done when it's

born on the first day or then we do it on the fifth fifth day qu And then we can do it at the health center, right at the health center through the SUS, we do the collection at the same foot and we have the option of doing it expanded through the health plan or or private, which is a collection of normal blood in the vein and everything ah it's no longer obligated to be through the heel, no because when you go to a laboratory they run other tests too then it doesn't go the same way

it's a blood collection that is done in the vein Uhm but I always recommend do both, even because our heel prick test expanded, I didn't I know, here in Minas, it has already expanded to 15 diseases, so the dup plan there was worth 10 and the SUS plan was worth 15. That's cool, isn't it, the SUS one? That's cool, SA, but there are some diseases, for example, that the plan has and the SUS doesn't have, I say. it does both, that's very important, right, because it helps and saves lives, right, wow, for sure, right, the

prerequisite for being in the heel prick test is that it's a disease that's treatable, right? It's no use, I discovered a disease that has no cure and whose treatment it has to be early exactly and that has a statistical relevance in the population, right ? So, a super important screening in the period, right from the first early month, right from the earliest first month, that's usually the fifth day, but if it's premature, it's much more harvested between the first and the third, then another with five, another with 10, depending on the month and if months

we also have to repeat some tests, it really depends, yes, it's prematurity, prematurity, the number has increased, it's a fact, yes, because now we can make them live exactly, right, so in the past, a very premature baby didn't survive, right, he or he didn't survive or he survived with many sequelae and um and he would die soon after but today we already have a lot of resources to deal with these babies Wow and it's delicious I love it and and they came and uh diseases resulting from the excess prematurity that we get save Oh, complications

did come, right? Some retinal diseases, eye diseases that have to be monitored with certain rigor, these children depend, right, if it was a child who needed longer respiratory support, a child who will have a lung more fragile, so sometimes these children are even recommended to take an antibody, right, to prevent bronchiolitis, which is a disease that comes from the flu, right, so it's a price that we pay for therapy, an immunotherapy for these children, that's it, but it's even a a certain gestational age at birth, if it was very premature, take it, if it wasn't

that premature , there is no indication, right? So, there are some very special precautions, right ? suddenly starting early stimulation with physiotherapy from an audiologist from a very early age, yes, and it also depends, right? For example, a very premature premature baby, I will need to do this, a not so premature premature baby who was born, I don't know, a month before the time in quotation marks, the month is If he's doing well, maybe he won't need it, that's the role of the pediatrician, we have to monitor it to know who really needs it and

who doesn't. And then when you come in, you'll do it individually, right ? That's the pediatric consultation, it involves a lot, right? evaluate growth food supplementation because there is standard supplementation it's nothing like that we can take from our homes nothing from adults that everyone wants to supplement It's nothing like that, no, it's not like that for this age, it's recommended to do that, right? And then the We're going to monitor all of this and then at a given moment we're going to evaluate it as a whole, right, so much so that the chances of

the child's illness are just like that, there's a hypothesis, his, heh, Adequate or not adequate nutrition, adequate vaccination, not adequate, adequate sleep, not adequate, we learn. So in college, I don't know if everyone continues to do it But I continue because I think it gives a very broad vision. You have to look at everything, right? And then, among these questions, if something is out of line with expectations, we will turn to others. professionals to another treatment , right Uhum And what is the cheek test ? take a smear of those cells and send those cells

for a genetic analysis uhum the purpose of the cheek test is that the disease is also identified or not because I'm going to identify the gene so I'm going to identify the risk of having a certain disease the risk the risk It's not the disease so there's the test probabilistic heel prick probabilistic probilistic Exactly this probabilistic ooo heel prick test what it does it identifies a substance that characterizes that disease so it identifies disease it is clear that once a heel prick test shows any changes you will have to look for other tools to confirm

this So I'm going to look for confirmation, some are already confirmatory, others we're going to do a more in-depth examination, the cheek test, it finds the gene and we know that many of the diseases are the genetic component plus an environmental component, so I may have a gene for a disease and never manifest that disease or I can have the gene and manifest it that's why the cheek test finds the gene it will find the risk of getting sick uhum and then and the cheek test it evaluates more than 400 diseases and the proposal at

first would be diseases that T treatment if started early 400 top genetic this genetic probability this but when I suggest it to families, right? I like to put all the possibilities on the table, I like to talk here, they are not all the diseases that can be cured uhum it doesn't mean that you can't do anything for the child but there is no cure, so for example you have the gene for Du Chen's muscular dystrophy there, this disease has no cure But it means that you can't do anything for that child Of course, not quite

the opposite, you can do physiotherapy, so you can strengthen these muscles so that if the disease manifests itself, it will have better conditions, and so it won't change, maybe it won't change the final outcome, but it changes the path, changes the how So not only from a physical point of view, but also from a psychological point of view, for sure, because it's a child that you know will grow up with this stigma that you can do for them, right, so I always think there's something to do. in any situation, so in my opinion, Priscila, if

I would do it to my son, I would definitely do it now, too, there are parents who don't want it, it's because I also think that people have different ways of dealing with this information, so there are people who will receive a news about Look, your child has an altered genus for illness. This person's life will never happen again. It might not open. It might not open . Maybe this doesn't manifest itself, right? But the few experiences I had with the test were good, they made a difference, I had a patient who discovered hemophilia. Rare

uhum, if he never had any surgery, maybe he would die without knowing of this and it wouldn't make the slightest difference in his life but let's imagine that this child needs to have emergency surgery or appendicitis that has to be done and quickly yes uhum the anesthetist is aware, right? That this child Look this child has this condition Here it created stress for that family for a period, yes, but if one day this child comes in need , they are well prepared, they will be better prepared, right? that child in what way what factor has

to be added to the blood, supplemented to the blood, yes, and there is even Thiago Leifer, he has a little daughter who has bilateral retinoblastoma, that's it, and it's difficult to diagnose because the test of the red reflex, which is the test that we do in the maternity ward, the ideal would be for us to repeat it in the office with a certain regularity, as I don't want to keep memorizing how often I have to do it, I do it at every appointment, which already makes it easier for me I don't spend five seconds doing

the test, right? And then they got suspicious because his little daughter had one eye, making a nystagma, a movement like that, it's just that they've already seen it at an older age. And then, right, so one of the The genes that are identified in the cheek test are retinoblastoma, it doesn't mean that the child will have it, but let's say if I have a gene in a child, you'll keep monitoring it, stay alert, I'll be more attentive, I'll go to the ophthalmologist every few so many months at least that it was something that helped a

lot, right, because we don't see hult I'm going to take him to the pediatrician but it's not customary to take him to the pediatrician since he was little, although we should, we have to refer him, right ? even if there is, there is no such culture now that you are talking about, right? A child should go to the F such as when he is six months old, from six months onwards, he should go for months after months, we go for a check, right? Of course, if this child is a Premature, for example, before, I understand,

and then we maintain regularity, normally the ophthalmologist himself says, look, come back in a year, come back in 2 years. Normally they assume this standard commitment, this protocol, more than standard, this protocol, uhum, so It's a lot to coordinate, no, I don't require the family to know this in any way, but whoever is taking care of this child, whether it's a pediatrician, a family doctor, or a clinician, right? You have an obligation to know a little about these routines and do a good job. right And those families that have a grandmother, of course it's wonderful,

who decides to talk like that, I raised everyone and I know how to create, no one died, but for exactly everything went well, how do you deal with it internally, the desire for us to talk like that, we were supposed to die It was, it was to kill, it was to kill, Sab, but we really survive, right, people, we survive, and the lack of knowledge, even from past generations, doesn't do any harm, I'm sure they don't, they believe that that is the best, and so I In defense of grandmothers, there are many things that grandmothers

do that were absolutely certain that today we know what was right, right, but there are some little things, right? For example, cachaça on the pacifier, exactly for the love of God, people, baby's belly button, right, so much pudri, I want it The baby's bellybutton has already been taken, folks, I'm going to talk about a childhood trauma here, smoke dirt, I think it's on this side here, I have a scar here that [ __ ] was already a tragedy for the whole family to have to take me to the hospital, the saddest thing is that I

even wanted to recognize this doctor, he must be very old, right, because I opened this from here, I was a calm child, but I decided to go down a pile of sand and hit an iron. You can put the car on the sidewalk, put those irons, I hit it with it from here like that, then I opened it, right, three three dots, I remember the three pon humor P for coffee So I remember clearly that the doctor said that he did this, he had to clean it up, the child was already screaming and then You

have to remove grain by grain from that coffee, I don't know how I have leftovers that don't even burn toothpaste, right, my other skin on the back, right, it's not enough to be burnt, it has to be burnt on top, the skin on the back, exactly, the toothpaste is applied, it's passed. the toothpaste on the burn Have you ever thought about how hard it is to clean that PR, remove the toothpaste, oh my God, so I say it like this grandparents said it and today it proved to be true B girl Mel PR tó Mel

PR cough honey for coughs really not because of honey because honey is something from another world but because the substance is hyperconcentrated here in the throat and that secretion that remains dripping there in the throat makes your throat less sensitive so you can sleep I understand because when you're sick you're you lie down that's when it starts TS TS TS TS no because it becomes more sensitive so it's like it reverses it reduces the sensitivity it does a little bit due to the thickness, that's it, you know, it could be honey uhum or it could

be a licking syrup which is licking syrup licking syrup I loved it it looks horrible but but it really helps because we can only use honey after a year due to the risk of botulism so enter if due to the risk of botulism bot it would be botulism botulism is that disease, you are not a doctor but you have to tell the people who don't know, botulism is a disease caused by a toxin from a bacterium that paralyzes the person's muscles So, first it paralyzes the intestine, then it paralyzes the respiratory muscles, a very serious

disease, right, and children up to one year old have no defense to protect themselves against this bacteria. So up to one year old the child can't take honey under any circumstances, if we can have it, um, we can have the bacteria, we can't handle it, right ? If we're going to talk about the nutritional point of view, honey has sugar in it . we are giving a medicine because we already have mothers who are there for a moment, it's a slice of life there, that's a resource if you're going to think about any medicine you're

going to give a pyrone, a paracetamol or an antibiotic, it will have sugar or if It's even worse because there isn't even any education for children, so exactly, right? Something will have to be palatable for children, so we assume that honey or honey are used as medicine, just so it doesn't get too contradictory. Because you said that you can't give sugar now you're talking about giving honey, right? So after a year we could use honey as a But what is licking charope? Licking charope is a preparation in which you will put some slices of onion,

add sugar slices of beetroot, add sugar, slices of carrot, add sugar and let this jar rest to release that broth, you that broth and keep it in the fridge, you will offer this to the child, there is critical evidence. like, in a little covered pot, a pot, right, it's a pot, leave it in the fridge and it will release some broth into the imaginary world, here's a broth, right, it's a broth Ah, I could already see the child licking the aa aaba with with with no, it's not the broth that it will come out and

leave it in the fridge for how long it can rest, I think it will stay there from one day to the next, I'm not sure, day then take out the onion, take it all out, just take the broth And then this broth can be given to children to drink, it won't be as tasty as Honey, because it has onions, is a lot of work, right, oh, it's not that much work, no, no, honey, it's easier, right, it's honey, it's easier. It's already ready. more dried sweetener today, I think that in fact the syrups that in

the past we used to give thinking that they were doing something, perhaps they provide some comfort due to the sugar saturation, certainly and not because of the medicine that is there behind it because there is none evidence It's true and this one has evidence onion beetroot and because they release some substance yes the sugar itself and these these foods they may have some anti-inflammatory properties um it's nothing like that for me to talk about, right I I always look for it like this Well, this really has evidence because it shouldn't be tasty, it shouldn't be

pleasant to do so, it shouldn't be pleasant to take. So it really is, but oooooh, desensitization of the throat due to sugar and these other substances due to their anti-inflammatory power, so much so that honey, sometimes I give a recipe for a pineapple syrup with honey that the person will make at their home, it doesn't have to be a R$80 syrup that you will buy, you buy a pineapple, buy the honey and make it, and then it's natural and it helps, it will treat pneumonia, won't it? It will treat sinusitis, it won't if it's sinusitis,

if it's pneumonia, if it's otitis, you'll need treatment with antibiotics. Now it's a relief, it's a comfort. Yes, we already have mothers who are watching me. so that they really make sense that they really have evidence that it will help licking syrup licking syrup and honey after a year Honey after a year and every time there is a recipe for something like that propolis propolis I have never read anything about it I have So I'll even say, right, because of a negative experience of mine, I have Panic, my mother used to say when I had

a sore throat, take USA for the love of I didn't do it with Mel, but the worst part isn't even because of Where's this child's grandmother Where's this child's grandmother I thought I was alcoholic But they made me feel alcoholic and it burns, you know, but for me the problem wasn't the burning, the problem for me was the taste, it made me crave, the smell and the taste, I didn't like it at all So I said, I said I just said my God, my G is already hurting, I still have to take this bad train

for the love of God and then I ran away, I did everything I could to avoid using it Uh, but I honestly don't know much about propolis, I don't know if there is If there isn't any evidence, okay Bru, let's PR for our questions L, let's go Alex, well, we have a community called sustainable human beings. It is made up of people who like knowledge and self-knowledge Uhum And they are people from all areas, okay, there isn't one specific area is not Ah because I'm from Health I'm in this community not just anyone who wants

to know more and get to know themselves and then we always introduce our guest to them two weeks before you are here guide them to follow you to see We give all your content on Instagram anyway, but we ask them not to follow you until you come and the episode goes public And then that's why they take your content and put together these questions and They're very interesting questions, okay Ah, cool, so we're going to start now Bia is going to start and then I'll do it so let's go after how can I ensure that

my baby is eating correctly while breastfeeding How to deal with obesity in babies still lactate, so we if the baby breastfeeds we practically It doesn't talk about obesity , um, of course I'm going to evaluate a context, right ? suppose a baby is breastfeeding only milk, only breast milk, and if it's only breast milk, no, no, there is no such thing as breast milk obesity, that doesn't exist, that doesn't exist, because the baby can breastfeed a lot, what happens is that normally babies who breastfeed only breastfed for the first two months, they breastfeed a lot

and then they make a little curve, sometimes they go up two curves on top of their growth curve, you know, we have a graph that we plot, always noting the weight of this child throughout of the months, so the curve of the breastfed baby, she usually has a little tummy in the beginning, in the first few months, then she can even stop, she can stay for up to a few months without gaining weight, that's it, but we don't talk about breast milk obesity if this baby only breast at the breast uhum let's assume that I

started feeding this child, right? How many months and if months do we start introducing food What is the type of food I give to this child? Well, I only offer healthy foods. I offer fruit . Natural, minimally processed, I don't give Ultra processed to this child, I don't give sugar and this child is climbing the growth curve Most likely everything is fine uhum if I have a lot of doubts I'll do some tests but most of the time, no, this doesn't happen if You're giving the child adequate nutrition, right? Now, let's assume that this six-month-old

child started taking musilon. Can you say the name of the brand? It's not present , right? Because, from the question, the baby is still breastfeeding and started to give ultra-processed foods, so I have a child with a dietary error, so I'm going to approach it in another way. There is no such thing, wait, I'm there, there is a dietary error, I'm adding other things, I'm adding things that are not suitable, so in this case I 'm going to correct this and continue monitoring the child continues to climb the curve even after this adjustment, then I'll

investigate if necessary, I'll do exams, right, but it's very difficult to do what I said when the child has her satiety respected, it's very difficult to go wrong if something else goes wrong, we look at them, they're very cute Uh, but like the face, that's possible, and that's it. completely healthy is possible because I need to know, from the constitutional point of view of that child, what was the birth weight of that child because we have a very large variation if we take Wow, the growth curves are suddenly for a baby 1 year old I

can have a 1 year old baby weighing 6 kg go have a one year old baby weighing 10 I don't I don't know if my speech is correct But what I want to say is we have a variation According to the growth curves of the World Health Organization by the Brazilian Society of Pediatrics also that using these Curves from the WHO we have a big variation so I can have a skinny child with us it was just bare knees and ears and the knee has Biotônico Font Okay, taking Biotônico Fontora and we can also have

an absolutely normal healthy child at the same age as us who eats the same amount everything is the same that eats the same amount and that this child will have a much greater weight than ours. So this is a possibility, the reasoning is much deeper, it is not so superficial, just because of the visualization, there is not so much that they're cheeks, you know, with little folds, lots of folds, folds, folds, no, sometimes the mother is still gaining weight, so yes, it can happen, mainly because in the child's first two years, what's important is not

genetics, it's nutrition How that child was born What weight was she born at? If this is something normal , right ? If it wasn't a premature child born with low weight, we expect this child to follow its growth curve, so I can have a child born with a little more than 2.5 kg which will be normal and I may have a child who was born with more than four and then I will follow this growth curve, in some cases the children go down a little to adapt, others and if they were lower they go up

But in general, we expect her to follow that curve, so at the same age, I can have children with much less weight, with very different weights. I even have a patient whose little girl is very big, and at six months she was like this. exclusively breastfed and she wasn't even rising in the curve, it was the same curve she had always been in, but when the other mothers of children the same age saw her little girl, she told me that she even lied about the girl's age, oh, she was afraid of not because She was

afraid that her mother would feel bad because her child was so light compared to her little girl, which was always the case. So she said that her little girl was younger, no, she was older than others, so she wasn't I said, Thank you, I made conversation , I pretended I hadn't understood the question so that these mothers wouldn't feel bad because there is a comparison , so in the same way it will exist, right? That's how these curves are made, right? We take an entire population and look at a healthy population and 5% of the

population has this weight, 50% has this weight, so the middle curve is 50, it's the curve that half of the population is there at the extremes it has 25 5 75% 25 and 25% and we have 5% who are very big and who are healthy and we have another 5% who are very small and who are also healthy So it's not that we 're going say who is normal and who is not, we will say who is more and is close to expected And then I can have at these extremes children who have a higher

weight and who are healthy and not healthy either, of course I hope that at some point At the moment, this weight is appropriate, but at some point, it doesn't have to be in the first months of life, sometimes it will be later on, right, what will it tell us if everything is going well or not, it's just a point on the curve, right? He even says this, the child is not a point on the curve, the child is a curve, growth and this growth has an impact on several factors, weight alone is a variable that

is greatly influenced by everything, so for example a family has changed From home, you can park on the growth curve, the child got sick, you can lose weight, what will that tell me that everything is fine, this stagnation or this loss ? to return to their standard growth, that's it, that's it, exactly, so we monitor a set of if this child has a weight that seems to me to be Above the WHO standard curves, but this family eats a healthy diet, I've already done the tests, this child is normal then I I'll understand that it's

her way, everything is fine, exactly perfect, next Bru What are the essential vaccines recommended to protect my baby during the first months of life? Yes, our SUS vaccination calendar is available in the SUS, it is one of the most complete in the world A world like this, it's a great privilege, an honor to say this, right? It's true, now we also have private private vaccinations, some complementary vaccines that replace some SUS vaccines, so for example, in the 2 4 vaccines and if months I have them in Susa pneum Mocóca dec Valente against 10 types of

pneumococcus which is a bacteria that can cause pneumonia otitis sinusitis And then in the private network I have pneumo 13 or 15 so there are three or five serogroups or serotypes forgive me if I say the wrong name more protection, so if the family has the conditions and is interested in this, it is the pediatrician's duty to always mention the two options, and I always present them at the first consultation of the babies, the differences for the family to understand What is the difference between the vaccine and SUS and the private sector and I always

say, look, this is the minimum, there is no way to do without it, if you want to give others more, this is where people close packages for the first second year of life, the clinic goes to the vaccine at home At home, give me some affection, give me a fever and everything, I think, is great, but the family that doesn't have the means to do that either F well, there's another way, there are some ways for us to do it according to what the person can do, so there are some places in Belo Horizonte for

example, there are cheaper prices that divide I don't know how many thousand times on the private card, you're talking about private ones, right? There's a place there in Belo Horizonte that has both, there's the SUS one and the private one, you want to give this one from the SUS and this one. from the private sector you can give uhum and I always like to discuss together with the families eh What are the priorities because for example we have vaccines from the private network that they propose to be less reog gives less reaction then I say

so look if you If you have to choose between this and a vaccine that enlarges, choose one that enlarges because the vaccine reaction takes a maximum of two days, this will pass unless your child actually has an indication of taking a less photogenic vaccine, only if it has an indication she will get it for free at cri, exactly which is a clinic for special vaccines that is aimed at children who have conditions that require it, so whoever has a real indication will receive it for free, whoever doesn't have it can pay for it, but if

you are a choice, not a need, no No, but if it's a choice, I think it's my role to tell the family, look, choose, don't expand here, it's better if you can pay for just one vaccine. So pay for this, for example, a premature child. She has a greater need for This range of vaccination, depending on the seasonal age at birth, may be recommended to take this less rogic vaccine and what if the premature baby is old enough to be vaccinated and he is hospitalized? He will receive this less ketogenic vaccine, understand that even in

the hospital where I work We made a bridge with the cri, which is this post with these special vaccines so they can take these vaccines to our patients because I had a patient hospitalized in the maternity ward for over a year, 9 months 9 months of his life in hospital, he did not receive any vaccine That's not right, right? No way, so we made this bridge, we managed to bring it, but every hospitalized child will receive this special vaccine, except Cogic, so, I'm sorry, I got lost in the question, that's right, it prevents prematurity, there

doesn't have to be a little more expansion exactly has some small differences like the hepatitis B vaccine for example instead of three doses he has to take four you know so there are small differences enlarge a little n enlarge a little and they can even vaccinate in this special post called cri Regional Center of special immunobiologicals all ISO there but probably in each state in each must have its own, every capital has it. Every state, that is to say, every capital, has cri cri, has created. So, let's assume I'm in the interior of Rio Uhum,

I have a little baby. premature baby who needs this vaccine that he is recommended by his gestational age, then I will have to make a connection between my health center and the cri so that the baby can send this vaccine to my clinic, I will sign the child. The problem is that few people know this, I understand, I shouldn't, but now we say what how to help more pediatricians would have to inform this the pediatrician the health center has to get in touch because sometimes they can send this special vaccine for this child but it's

difficult, right? If we think about our reality, I think it's super difficult, it's difficult because the professionals, right in the interior, are already so overloaded, they can know everything that's going on, everything that needs to be done and how to deal with it and how to do it, it's true, it's a lot, right, but it's good, what you're talking about, it's good to know closely, Bru, in addition to maintaining the clean and dry area , what other precautions should I take with my baby's belly button so that it does n't bulge out? that Anabel ended

up staying because the children like Anabelle But she's nice Anabelle is nice, sometimes she moves a chair here and there, yes, yes, she has her own life, she has her own life, but the children love Anabelle And then I'll just take Anabelle to demonstrate, right, can you take it, please, you are very welcome, Anabelle What happens to every baby, when the umbilical cord passes the muscles that remain, they need to separate, right, and it takes a while for these muscles to return to their normal place It can take up to 2 years So, in the

past, people used to cure navels, they put a lot of dirt on boys' navels, the muscles are between the two rectus abdominis muscles here, so as time goes by, these muscles come back into place after the navel has already fallen, so for navel falls , right, first step , what do I need to do? any other substance here because what causes the navel to fall are the child's immunity cells as if they were phages They go macr phagocytizing everything there that goes the immunity itself goes Eating that navel it falls off it becomes mummified becoming

hard then it falls off eh so when we have a delay in the belly button falling, including one of the things we need to think about, immunodeficiency, some problem with the exact immunity, so when I eee it's the work of immunity along with the good bacteria that live there, so when I use alcohol I I remove bad bacteria But I also remove good bacteria, so if a child like Anabelle was born in a sterile environment inside a hospital, right with all the appropriate asepsis care, the care would be dry care. I'm not going to use

alcohol, I'm not going to use anything, I'm just going to take care to fold the diaper down to leave the navel exposed so that it doesn't come into contact with urine and feces and if it does, that's what I always say to the mothers, wash it, it's new, just clean it, no, there's no suffering, they're just suffering, very worried. Our poop dirt will get the disease in the child, no, don't worry, just clean and dry with water and water, soapy water, washed, I ran out of soap, sometimes we notice, you know, a little belly button

smell, like a bad smell, then I have a little smell It's a bad smell in the belly button, when it's just a bad smell, it's not an infection. I need to improve it. I need to clean it better . It doesn't hurt to get better at cleaning it to keep it dry so that when the navel falls out, the belly button smell is gone too And then, after the stump falls out, there's that umbilical scar , sometimes you can drool a little bit of blood, we'll just keep it dry and that's it. that may stick

out a little bit, there are children who already have a tight tummy, but there are children who take a little longer for these muscles to return to their place and this is a huge concern for people Wow, I'm going to have to use a band to close it No There is no evidence of doing this that doing this makes the belly button look prettier and it also interferes with the child eating right because imagine you eating a great feijoada with your pants all tight isn't going to work, right? So when the child goes to breastfeed,

they need to have comfort so that their tummy expands, it expands, so Eh, it ends up being very uncomfortable, so we hope that Until the age of two, this returns to its place, but until then, it's natural for the child to have a slightly bloated belly and that sometimes, when the child exerts some force like this, with the tummy, like doing a sit-up, a little bit appears. here in the middle, which is what we call rectus abdominis diastasis, ugly name, but it's just to say that these muscles are separated Uhm And when you have this

little belly button, it goes out, even if you consider it a hernia, right? really looking like a hernia the umbilical hernia it doesn't pose a risk it doesn't imprison so we can wait until the age of two we normally don't talk about hernes before the age of two because there's this period of time of two snuggle this snuggle this perfect So there's no need use a banner don't use tobacco leaf don't use Terra po used Terra coffee coffee here what's the dirtiest thing in the house ah that's it here so let's put it in the

boy's Bigo like yeah make a salad make a salad there no syrup what LAMB LAMB licks no LAMB LAMB the licker can but oh but it is important to say that it is after six months, the lambor takes carrots onions and beets and before six months the child is not exposed to any of this only after six months LAMB months licking this leaves the coffee powder for Café da Pro café exactly which now you can only have caffeine after the age of 12 but I was drinking it since I was three and I loved it

we give you a little coffee with milk PR you a bottle of coffee with milk Zinho, right ? kids love coffee pure CAF it was pure coffee I loved it grandma said Let's go to so and so's house for a cup of coffee we have some children who love it there's an AD I think it was that little pink cup that you got from the little store ã with those little toy stores Oh beautiful with coffee month Only after 12 of 12 caffeine caffeine only after 12 but Biotônico fantou can take dick can alcohol hit

him dick let's go what is the safest position for my baby to sleep in the crib and how is sleep regulation managed in the first months Wow, this is a wonderful question because it's something that raises a lot of doubts, right? The safe position for a baby to sleep in a crib is on their back, I know it seems very counterintuitive because we think that's the way it is, it's true, that's what I I've already seen some comments Wow, Hendrix died, that's how it was, so I say it like that, because he's a really drugged

person, a drug addict, exactly like that, no, he's not a drug addict, a drugged rocker, he's a baby, right, so they're very different situations that sometimes, but but it's natural for a person to think that because they think like that if the baby swallows a lot and the milk comes back in the mouth, he can swallow it back and go to the lungs, right? But then what do we have, right? up , today we have many studies on sudden baby death, which are situations in which a baby under 1 year of age dies suddenly, unexpectedly,

and the studies show us that this is associated with the position aa um um unsafe sleeping environment including the way and position this baby sleeps, right? There are several hypotheses, there is a hypothesis that says it is the breathing muscle that is fatigued, there is a hypothesis that this, there is another hypothesis, that it is believed to be arrhythmia, there is one, there is another hypothesis that thinks that these are elements that can cause the baby to suffocate in the crib And then it is very difficult for us to define, right? What is sudden death

or not because all our studies are observational, I cannot find a group of baby says like that, ready, the start has been given, now we're going to see who dies, we're going to see who dies, it can't be unethical, no parent wouldn't have a study like this, there wouldn't be a study, there will never be one, right? So what we do is let's see what these babies that came to death have a lot in common and And so, right, I'm just going to dwell on this to explain where this reasoning comes from, and we identify

that some things were taken, may have been taken, one of them is the inappropriate position and others are, uh, objects or or inadequate utensils in the sleep environment uhum basically what we understand this to be is this sudden death or a baby that is immature that cannot respond to a choking stimulus cannot escape this choking stimulus being subjected to this choking stimulus either because he buried his face down in the mattress and couldn't get up, or because he buried his face in a blanket and couldn't get it out, or because the mattress he slept on

with his mother was suddenly a very soft mattress, he rolled over and ended up face down and It sank, it sank, so we assume that this unsafe sleeping environment could lead to this risk and then the safe position of being on the stomach, being on the back, prevents this child from lying face down in such a way that he or she will suffocate his or her face. right, and also in relation to regurgitation, it would also be safer because when the child is on their back, when the regurgitation returns, you know, that milk, they will

turn their face to the side by reflex and put it out a little, it should probably stay in the throat. and come back if she's on her back the tendency is for this to come Where does gravity go which is my esophagus that leads to the stomach So what's left she swallows if she's face down or on her side this comes forward it can fall into the trachea and being suffocated, suffocated exactly perfectly So it has to be from the bar upwards perfect bar upwards from the belly upwards there are even some cool images to

explain this but basically the reasoning is this is not completely logical next Bru and you They had also asked about sleep regularization. I was there. Sorry, I was. Ah, sorry, sleep regularization is done in the first months, but how is this regularization of sleep done in the first months ? view endocrinological chemist a notion of what is day what is night he doesn't have it doesn't produce melatonin uhum he doesn't have a neurobiological pathway that responds if I give him melatonin he goes to sleep there's no point, right ? building up, so in the first

months what we do is good prevention and prevention in the first three months, especially since I still don't have melatonin, it will assess and mark very well what is day and what is night, so I will schedule something that I always suggest to the family. I write two walks a day, one in the early morning when I'm in natural light and one in the late afternoon when the light is starting. you can't do it because the first months are chaotic , right, you only survive them when it's very difficult, I say this, so do at

least the morning one Ahem, because exposing the child to natural light helps to make this marking this process of opening the The melatonin circuit wouldn't be that, but to show the child that during the course, we stay awake in the dark. We then sleep during the first three months . That changes until the child is three months old. close to the child and it shouldn't be because I need to show them what the biggest problem is Why do we need to say the Obvious and guide people to do this because our life in civilization is

very dysfunctional if we think about it Well, during the day, to save energy, we turn off the lights, so sometimes during the day our house is darker than at night, we turn on a lot of lights, turn on a lot of screens, depending on the house in the house. most uhum mainly because of the LED on the cell phone television screen so we need it as we no longer live in caves we don't go hunting and everything else we have to try to adapt to our reality as civilized beings who live in houses in buildings

and everything to make it as natural as possible so as not to be so aggressive to the child's nature, so one of the tips is to make everything as clear as possible by leaving the window open and at night try to use as little light as possible And then exactly artificial light And then basically from zero to three months the thing is to score well from now on. be it with brightness with movement and from three to six months we establish a routine in a more organized way, this is a preventive approach before 6 months,

no type of sleep training is recommended, nothing that can from three to six months what would be the routine to create the routine, a regularity of activities during the day and before bed, and a regular schedule for sleeping, that's a regular schedule for sleeping and waking up, and a regular schedule for other activities as well, because the child needs this, he needs predictability to feel safe, so a child who doesn't know what's going to happen right after, a child becomes anxious and this really harms the consolidation of sleep, right, it's this act of sleeping for

a long time at night, now I'm not promising anyone here that a 5-month-old baby will sleep 12 hours, it doesn't exist, because from the point of view there may be some who will, there may be some who will, in the same way, there may be some children who are outside of what is expected and who are OK, they may be, but eh not the majority, the majority will still wake up to feed, they will still wake up because the baby is wet, he depends 100% on us, he is wet, he feels cold, certainly if we

get wet we will feel it too if we get cold at night we wake up Why is be exactly not perfect then basically this next Bru are there specific treatments for colic in babies or is it a question of symptom management controversial also because don't even tell me funchicory what is that fun F put it in ch I don't even know what What is it, but the smell touches your dick, touches your dick, it's just like cachaça on a pacifier, isn't it, so it really gave it to the people, it didn't give it fun, Chicó

gave it ah, whatever it is, how much it is, right, so aaa, first, first question, that's how which is colic, right ? three, right, how is it from three weeks to three months, it's around 3 hours of crying a day, yes, at more or less the same time, at least three times a week Wow, it's three, three is the rule of three for medical definition That's it, that's all, then we 'll understand, but where does this colic come from ? You don't know , he has difficulty coordinating his muscles to get the fart out to

get the poop out and when he tries to do this he will get nervous and cry. You don't really understand what 's happening, I'm moving, suddenly I was in a dark, warm, wet environment, now I'm in this dry place with all these lights, so many people talking, laughing at me, I don't know what that is, no, ee that instinct didn't work during the nine months of comfort of warm comfort and of and of and of darkness ex that, so That's the strange thing that 's moving exactly so the baby, right, some of these periods of

crying are inconsolable, it's going to be because he He feels like farting and can't understand a certain time It may have nothing to do with farting, sometimes he's just overstimulated, there's a lot of light in his face, he's tired, he wants to sleep but he can't, it's the only expression that he has it, right? The only expression he has is the exact cry so, uh, today we want to understand more like where this colic comes from and then it's interesting because it has no in zimbabwe it's a country that doesn't in the no um right

there there is there no There are colic there, there are no colic, no, no, from what I studied, there isn't, or if there is, there's very little compared to us, and then look how interesting there, the women, they keep their babies in the sling in the baby carrier until they are only one year old. You take it out to change it for breastfeeding, it stays straight all the time, it does everything with the baby in the sling there. In this culture, you take it out, feed everything or feed it there in the sling, but the

baby stays glued to the mother's body all the time, what a comfort, what a comfort exactly then we move on to another definition which is the definition of human steroglass caused babies to have a very large growth in the brain mass of the brain, as well as the skull and that if the baby were to be born at a time of Total readiness, baby and mother would die, then our baby in quotation marks He is born prematurely He is born in his theory 3S months before, but there are people who think that this pregnancy is

even longer because if you compare the human baby with a baby from a horse, for example, the horse is already born and walks away, ours doesn't take about 2 months. years if it's silly at some it takes up to 40 years to live without a baby so we, right, so our baby is very dependent but it's a price we pay for having a species evolution So that 's a theory, right, there's nothing cerebral Otherwise it also doesn't go down, it doesn't go down, it doesn't go down, it goes through the bone, right through the pelvis,

it doesn't go through the pelvis, it doesn't go through So it has to come out first, it has to go out first, that's exactly And in his theory, these first three months are chaotic for the baby I understand then the more stimuli he has, he would still have to be in there, he would still have to be in there . theory, they believe that colic is a manifestation, right, of this, of this pregnancy, outside of this pregnancy, and then the stimuli that send to the uterus can bring this calm to the baby, so rocking because

during pregnancy the woman is walking, the baby is being ninado the SH that we make is the noise you hear on the ultrasound the SH is a white noise the bucket bath is well contained, right It's that warm liquid all the things that refer to others they tend to the Xi how does the no ultrasound when when you do a duper ultrasound of the pregnant woman you hear the sound of the baby's heartbeat, but a lot of that is the beating of the mother's arteries, right , the blood flow of the mother's arteries, which is

the noise that the baby makes, that the baby Listen inside the abdominal garden, okay, I understand, I understand perfectly, perfectly exempt, so it would be a stimulus that ends, so it seems like a very crazy trip, what I'm talking about, but they are still theoretical studies, but they make a lot of sense, exactly, there is a logic, we can't so prove ISS by A plus B with studies But it is something that has plausibility and that works in practice When you go there the baby is nervous, you put him aside in your room, there is

a great chance of getting better, until he is ready Staying on the slink can take a while but when it is well adapted they tend to like it a lot, they tend to be very calm with a bucket bath and it really is a trial and error scheme and then we keep thinking Wow but this doesn't have a logical explanation, right? Then, on the other hand, medicine comes with some logical explanations, for example, rocking, right, we can think from Ester's point of view, pregnancy, but rocking is a vestibular stimulus, right, certainly inside the little ear

at the back of the ear, which calms the child. right, not all, but the vast majority, shake slowly, shake slowly, it was shaken in the uterus, right, because we go here, we go there, he got it out, but there's the water, there's everything, but that gives it a little shake there, can't you imagine a mother doing gymnastics It's like sure ISS baby will have that the baby won't and there's one thing baby music baby I heard music, you recognize it I think it's beautiful and emotional regulation happens And it's proven music I'm serious Look, choose

carefully the songs you're going to listen to during pregnancy because that child will like that song, that's what happens in my family, it literally happens, it's mathematical, so be careful, people, no songs, at the moment, just choose quality songs that are going to like that, and so, answering the question , right, managing symptoms today, more and more of us uses behavioral measures Because studies like this Eh, let's assume that that colic at that moment is the baby trying to fart and he can't, by the time he farted there, it's already forming another pile up there

because it's the immature intestine that has a Flora that is maturing so you can use medicine to help release pum to help at that moment when the tummy is like a drum, yes yes, it will relieve it at that moment, so I don't think it's completely disposable, but we have to understand the reason for its use, because otherwise the family will give gas medication every four hours, God, and then the boy is there taking medication for gas. that 4 hours won't change anything and there are other medicines there is also a darker one that is

not recommended at all I normally don't, I don't prescribe it, I personally have never seen any serious problems because of this medicine, but if my Brazilian society tells don't prescribe it if the guidelines say not to prescribe it I won't prescribe it if the family wants to use it then there are another 500 and there is one that is a probiotic, a little black one, this one is charcoal-based, that's why it's little black and has another one which is a probiotic which is very famous and people tend to use it uhum but that's how the

study is very conflicting, right? It says that it only works for the baby in breast milk . It's a good probiotic, right? So I'm not sure, it's trustworthy, but these, for example, if the family wants to use it, I'll tell you, look, there's no problem, you can use it. But know that there isn't, it might not do any good, it might not do anything, no. It's bad but it's not good, that's pretty much it, Bru What are the causes of reflux and how should I treat it? Seek medical help, um, it depends on which reflux

we're talking about. If I'm talking about the little baby, the little baby actually swallows uh, that's normal if the baby golfs Until what age up to about 18 months can he golf a little normally the first six is ​​more pronounced, right so the little baby who golfs if This little baby Golf gains weight if he is not an extremely irritable baby I can understand that this It's normal, it's normal for him to have what we say is the happy vomiter, the happy vomiting baby, pediatrics is full of these papts, happy vomiters, happy vomiters, the little

baby that's there laughing, BL blind, Guilherme and I were like that. It's Guigui, it's when I started to bluff, suddenly laughing, it's not vomiting, but it's a big boy, today, it's a little baby, so he has water, it's not forced, it's not like vomiting that you do with force, it has nuse and the vomiting is as if it were leaking, it leaks suddenly, it's swayed a lot, that's it, so this baby, if he doesn't have a problem related to weight, if it's a baby that's developing normally, everything's fine, he's happy, he's happy and Of course,

he can be happy and not have a good weight curve, but if he is happy and has a good weight curve, I don't understand that it is a reflux that we call physiological in the baby, I don't need to treat what is not a disease. and there is no muscular movement, there is no forced movement, it is passive It comes out of nowhere, for example, it is now the reflux disease in this age group, what is the baby that will have a pathological reflux, is that baby that vomits a lot and that he has an

impact on weight is a baby who doesn't gain weight well, it's a baby who's always irritable, it's a baby who's always there and who's with you, you see that he's a little baby who's not doing well, right? And nowadays, every time but we have addressed pathological reflux our first our first approach will treat this as if it were a cow's milk protein allergy uhum at first so the baby who only breastfeeds we exclude cow's milk from the diet of the mother, the baby who uses formula, we will switch to a formula with broken protein. I

understand, so we don't use medicine for the stomach first, right, that's what we don't treat with medicine because aaaa pathophysiology the mechanism of this reflux is not Stomach acidity mechanism of this reflux, right, except in cases of sick children, right, a child with a neurological condition, a child who lives in hospital who has some health problem, right, most of the time this reflux will be adaptive, adaptive, but it's just that some children who have allergies to cow's milk they will need a medical approach even not for the mother, right, he is being breastfed so ISO

cow's milk influences him through the mother through the protein through the protein now a lot eee it's a diagnosis that it's not very simple I always ask for support from a gastropediatrician together with me when I'm suspecting when this case is very borderline because an allergy to cow's milk where the child has blood in the feces, for example, there's not much doubt, we manage it in a good way, right now, in this case here, it's a reflux that can be pathological, it can not to be I always ask for support from a gastropediatrician to go

with me so as not to run the risk of us creating a restriction unnecessarily because I at least think it's very serious for you to say to someone you can't eat such a thing, yes. This has such an impact on a person's quality of life that I'm very careful, that's why I get really angry when I see it, oh no, don't eat glutem, don't eat this, don't eat that, because I talk like that, people, sometimes people haven't done any studies in in relation to this, it's removing a lot of things Ah, milk is inflammatory gluten

is inflammatory Take these things out of the person's diet without any care uhum without even having it without having any evidence without being sure this creates other problems down the road for them. Right, the person will compensate with other things, so I think it's a very serious diagnosis, so I like to have the support of a specialist with me so as not to weigh my hand too much or too little, I've had, for example, babies who vomited a lot and had a lot of reflux. but he was gaining weight wonderfully well, he is an extremely

happy baby, this boy has reflux, he has allergies Milk V, there is nothing he will grow and he will get better when he grows up he will stop drinking just liquids and start eating using his gestation tube maybe be a little slower but it's going slow, so it's time for him to start eating food, sit down more, stay on his skin more, he'll swallow less, maybe he'd stay three months longer in his mother's womb, he wouldn't even need Fonton Biotonic, exactly, he wouldn't need it, he wouldn't. you need it next time, Bru, but then if

it's an older child with reflux, you have to seek help, yes, at what age after 18 months, then we have to look at it anyway, at any age, it's a good idea to talk to the pediatrician But it's been 18 months It's no longer expected, so maybe we have to think about the mechanism of antacid pain, right, but at this age it's physiological reflux most of the time, when and how do you remove the pacifier from my eight-month-old son? Is there an effective strategy without create trauma Oh my God the months Look at the pacifier

when you should remove it the sooner the better, right because it has impacts on the formation not only of the teeth but on the formation of the entire respiratory muscles, right on the face but that's the strategy for removing the pacifier There are a series of possible strategies, the ideal is for us to replace the comfort of the pacifier with some other type of comfort or something that interests the child a lot, so we can do with what we do when the We want to do, for example, Gentle weaning, gradual weaning, reduce the time and

reduce the times in which we will actually use it, because it ends up being a bit trivialized, you know, when the child cries, sometimes the family is not in a position to provide assistance. welcoming that cry at that moment, you know, we can't judge that either because everyone has their own reality, it goes with the pacifier, so if I'm willing to take the pacifier off, I need to define what's going to happen, when am I going to take it out, when am I going to let it go and replacing this Snuggle with other snuggles and

being consistent with our agreement, an 8-month-old baby is very difficult for you to talk to him, explaining certain difficult things, but like that, and it's no more difficult than an older child who will counter-argue, I understand, right? It's complicated because it's going to require a lot of attention, a lot of presence, but it's not like you should give up, so no, I've already seen one once, I even took a course on it, about speech delay, that the pacifier really has a good impact. negative in relation to speech actually delays because the movement, the moment the

child will manifest, we silence with the pacifier And besides, it weakens the muscles, which are the muscles responsible for speech, so in one of her classes she was talking about how to remove the pacifier and then she said Look, no, there is nothing in the literature that guides us in relation to this, I'm going to tell you what I did with my daughter, I thought it was interesting, she said that she had a hole in her pacifier, so the pacifier starts to lose its vacuum, right, it becomes different. That's it. then she would cut a

little piece then cut another until at a certain point it was just a piece of Dea that was left, there was no PR to suck it but there was no suha but which I thought was cool because I think that this way she has to take it off, right she understood How good I am the adult in the relationship, so I'm going to resolve this, but I'm going to resolve this in such a way that my child gradually doesn't suffer so much, I think it's great, it's going to lose some of its fun, right, but

then the problem is because people tell me, Doctor, I've already done it. That's it but then he's crying crying crying I'll go there and buy another one ready then he re-presented it then Remember I said it has to be consistent , it really has to be, right? and persistence, I liked it and understand that this will create frustration Of course it will, but it's part of life, right, we have frustrations, it's a matter of accepting that frustration, that's an unaccepted stress, it's a toxic stress, an accepted stress, necessary because it's not just any stress You're

not doing this because you want the child not to pacifier, you're doing this because you understand that this is what's best for your child, so you'll assume that and if you think this isn't the right time, that 's okay too. what I say from the point of view of science, you shouldn't use it, but we understand that you use it because everything is very difficult, right? In my time, we used to give up pacifiers late, right, it was very late and I remember that the tactic in my family with TR I think I went there,

my mother was very quick when once she said this suspicion is dirty with poop, I took it and I threw it out the neighbor's window, promised me, the neighbor promised me an ox cart, then you went if I took the pacifier, then the pacifier and I got the cart full of Ox Oh my God, it's cute, isn't it three, Dev, no, it's that old bath that looked like that, oh the Naninha, you know, you ca n't even wash that there, right, you can't even wash it, it was already a ball, right, it wasn't anymore mine

was taken away like this, my mother said this, here we are going to give your pacifier to Dr. Gui, who was my pediatrician, so he could give it to Santa Claus because in my mother's mind and in my mind, my pediatrician was a superior being who had counting on Santa Claus, right? To give it to Santa Claus so he can give it to needy children And then he will bring your gift and I was thinking like this, at what moment did I say that I wanted to give in exchange for what? What was the moment

when I wasn't even negotiated? I wasn't even consulted, so I kept quiet, then I kept quiet, then my mother thought I wouldn't remember that because they think that a child, right, is a being, has no memory, has no reasoning, so I got to the pediatrician, I looked at him and said : listen here three years okay Listen here I don't want to give my pacifier to Santa Claus or any needy child I want my pacifier back where you kept it and I started looking in his drawer and he doesn't understand anything, right This child is

crazy and the my mother , she's crazy, like, I was the most lucid one in that place, right ? And then the mother had to help the doctor, right? Today I'm that doctor that mothers say, here the doctor is going to give you an injection, I'm not going to give it to your mother, who's talking, it's your mother who's talking, I think it's absurd, using my name, my person, the fear I'm going to have From there, that woman who keeps saying that she's going to give me an injection, I don't remember, there's a mother who

has to do it. Sometimes they use me, they use me because the doctor PR says, look, if you don't keep quiet, the doctor will give you an injection, folks. I did this when I saw children with a psychiatrist, now you can imagine, right? You, the child, looked like this Then I said what your mother says, you're going to hate me injection, your mother, look, I don't know, your mother is about to come in because there's no here, there's no gan No, mother, you confused me, you confused me, what an ugly thing, then I said, let's

go Let's leave your mother there because she's not well, that 's not it, that's right, we have to remember our reasoning as children, aren't you? What are the possible health problems associated with prolonged bottle use? There are other options, so the bottle, right? it comes in as what we call an artificial nipple when the baby breastfeeds he makes a movement that is very complex but it is a movement that is very good for good formation of the muscles of the face, that and the bottle she this musculature becomes flaccid, the opposite of what breast-feeding milk

does, so prolonged use of a bottle will make the face flaccid now, but it's not flaccid from an aesthetic point of view, it's functional, so it gets in the way a little and the child can get in the way. in speech, it can get in the way, in feeding, in chewing, it's not that this child will stop talking, it's not that And also and it's not necessarily not that it's okay, it's okay, it's not that every child who uses a bottle will have it speech delay or you won't be able to speak I used a

lot of bottles I'm here talking a lot aba Well, it's to God, right? I didn't have any delays, I drank coffee, everything that could go wrong, I did, right, but from the point of view, right, from the point of view of studies and everything else, We avoid it because it leads to oral breathing also because due to sagging the mouth has to be more open and then this can lead to other respiratory problems , right? that can get in the way, people have to be very careful when talking like that. Yes, it can be a

shortcut. So it's worth doing the right thing, that and the bottle itself, right? There are other problems, for example, using the bottle in the early hours of the morning because many people think that weaning from Mom, go put the bottle in and your problems are over, that's not true, you just swapped breast for bottle, now instead of taking the breast out you have to go and prepare Milk, boil water, mix in the powder, wait for it to cool before giving and then this ends up prolonging the nocturnal awakenings in a certain way from a certain

age, right because up to a certain age it is normal to breastfeed in the early hours of the morning, whether breast or bottle, and it increases the risk of breast feeding and the act of breastfeeding, breastfeeding while lying down can increase the risk of otitis, breast no You can breastfeed lying down with a bottle, not an ear infection because of the movement you make of your muscles, it can lead to interesting secretions. Interesting, I didn't know how cool it is, there are other options, we can teach the child to drink from an open cup, of

course. He's not going to take it like we do, right, the little baby, he supports his mouth and he licks it, you bring the liquid here, he comes licking it, there's a little spoon, a measuring spoon, which is like a bottle, but the interface is a spoon, uh, there are transition cups. that look like a bottle But they are more rigid, they all have their negative point, of course, except for the open cup, the open cup, it's ok. There's flow confusion, right? Because the flow comes faster than the flow from the breast, which comes from

impulses. Right, but everything will have some cost, but from the point of view of orofacial training, it's better, there are others, but slowly, slowly, you have to train like this, it will drown the child, it's not so, we talk as if it were all very simple, but I know that deep down, everything is not difficult, right, everything is difficult, you, you think like this, many families that I follow, eh, I bring all this information, there is the possibility of it being in a cup, I don't know what, and sometimes the family ends up going to

the bottle even though they know that It's not the best and it's all because this family wants the worst for their baby, in no way is it because it's very difficult, you have to coordinate your entire support network, the grandmother also has to be willing to give the cup, the school has to be willing to give the cup today, luckily there are many schools that agree, there are many grandmothers who go to the appointments I think this is incredible because then I can teach them, right? They train a certain amount of time in advance so

they stay calm. Now if the family doesn't stay calm, we'll end up fighting with everyone, fighting with the entire support network. It's possible love, right? It's not perfect. right, that's it, choose your battles exactly you how can I dress my baby appropriately for different weather conditions without overdoing it with the agas oh guys I'm already laughing because signs of overheating signs of overheating I must be careful there are really people who swaddle that child just stay the look and tie it, right, it's like putting that band on a little child with that flower that size,

it stays there on your little arm, I see myself that a butterfly is going to come out of your ass soon and Alex, I felt that you, you suffered from this in your childhood, wouldn't I? I know because I don't remember, but the children I follow were scary, that really is and another thing is that sash of the Porcina widow and the child's hair stretched all the way back here Ah, but that's what the girls suffered from, free of the ponytail or What was it, people pull it to the soul, pull it to the soul,

we started to have a headache, it was then it wasn't the coffee when I was TR years old, it was the cabin, I think it started, people who have headaches, it was how long this child lasted You're cold , so you have to have common sense, but the poor thing starts to sweat, right? Poor thing, the cocoon is also sad, it's painful, but as soon as we can, I can explain it, that's how I explain it, even in consultations before the baby is born. that I have a prenatal consultation as a pediatrician, it's a meeting

for the family to get to know me to see if the saint suits me, that's important, there's no point, I really want a person with a friend if that person doesn't like me It doesn't go with my style, communication won't work and then also to bring some information, right? So in relation to how to wrap up properly, right? There's a little rule that sometimes it works, sometimes it doesn't, but I think it helps for a start, which is us. think that the child, the baby, needs one more piece of clothing than we do, so if

we are comfortable with one piece of clothing, the baby needs two, right? OK, in theory, rule of two, one piece of clothing extra If now, let's assume in extreme situations it's a killer heat, there's not much of a way I'm going to have to use common sense because then I would be very well naked, I'd be wearing one less outfit, right, there are some situations where we're completely naked, leaving children alone. child how he came from Minas to Rio is You see how the child comes from Minas She comes like this anab is Anabelle came

without anything cut caraval Rio carnival exactly oh oh And then there's this little rule but we also have to understand that Babies can be warmer or colder, sure, depending on each one, so we're going to use this little rule for a start, so I look at my baby, he's happy, he looks like he's happy, the way I put it, I'm suffering, Nea. Oh my God, how many children and happy people I've seen, me too, I was also remembering. Look, it 's our role as a society. say oh let's get there a little bit PR give

it in your hand D she's going to come give it in my hand a little fan I'll call Nani P go to L's fan that little makeup fan and I'm going to ask for it now to dry the makeup is But I think that sometimes, poor children, poor Mothers, I also think that you really need difficult information about this situation, but for me it's less difficult because they ask me, do you think, for us, it's for us that we can't, right? That's it. I turn around and say, look, we can use this little rule, but

let's see the baby, look, the baby is sweating a lot if he 's sweaty, the baby is full of brute. I even think he's lost the last month's weight because he made so much salt, isn't the baby okay? full of gross ejo exactly gross put cornstarch on the raw this part people at home I would see you, right there was even a lack of food which was coffee or cornstarch in the Child's b that's why you are like this that's why you were skinny you dried up you used up the food everything didn't work cornstarch,

this is a porridge, maybe Our Lady knows about cornstarch, let's do the following, let's go with a porridge so that this little porridge feeds this child Uhum, but that's how it is, if you, then you bring the family to observe the child with a little more care, teach exactly, teach But that's it for you think, look, brutu , you're sweating too much, mom , tadin, so you have to see this, right? I teach this, people, you see how it's curled up in the hospital, I think it's beautiful, but when it's wrapped up in the hospital,

and when V brings it to PR, the mother, when V brings it to the mother, Unrolls it Unrolls it for us to examine, it's even difficult for the baby to come, people, big children, right, the sun fits in mine Hand people, it's a lot of people who don't even know what it is like LOL in a hotel, right, man, I'm sweating, lower the temperature, it can lower a B olar a little bit, oh, people, the guest crying, crying from endorphin, endorphin, oh oh you, have you seen it? In the hotel you're going to try, you

have to start here, right Pedro, I'm pulling, start, for the love of God, start, it was to get your P's feet stuck . but this has to do with exterogestation Ah, because the baby needs restraint, but at the beginning, it doesn't need it for the baby's entire life, but after the first three months it's no longer necessary, but there are those babies in the stroller that are so curled up that [Laughs] aab just wants to be a mother guys I'm going there I go there whenever I see a little baby ass I put my hand

alive no PR know he's sweating I think he gave up I think he [Music] He gave up no I have a theory if you don't I heard a complaint from a baby that there comes a time when he has to ask for help, he will create an adult who will want him and will understand that there is no point in asking for help because he will never be helped, he will not be a victim of what an abusive relationship because of this is We don't have any evidence, that's it, I'm talking about thoughts. Meo, it's

without any evidence, but it makes sense. I did one. I sometimes work with trauma. A patient who was yours passed it on to me. Thank you, it makes sense . the trauma treatment because it's all because my entire relationship was abusive so she made the connection that when [ __ ] was four years old she loved going to her aunt's house her mother put tight jeans on her and she joined in the house I was going to play with my aunt and those pants were tight and the mother wouldn't let the girl take them off,

so she went home crying to her aunt wearing them and her mother fought with her father in the car, in the end it was a huge mess and everything happened from the abusive relationship she she associated it with jeans when she was a child, tight, which was bad, but there were good things to play with in the house, it's because the pants didn't let her play, oh I understand, Tad, since she was little, she should have been compressed exactly like the rhos. Let's go to PR, but just stop to finish so what signs do you

have to pay attention to, you will look at the child overheating And then if the child is Sweaty with the skin red and hot on the chest, the child is hot because the little hand and foot are always more purple, colder even so the A little hand is not a parameter for a baby who is cold, he will shiver, he will be uncomfortable, so we can look to see if he is cold, it is more difficult because the child is more like this, trembling, shaking But what about the little hand It is not used as

a little hand and foot It is not used as a parameter but to know if the child is hot it's not very difficult, Alex himself has already given his testimony , it's really true, right? What should I do in case of choking in a child? There are first aid techniques so that I can perform it. Yes, it is very important that parents know how to do this. eat and I'll send you a little video. I have a little video recorded on YouTube that has the whole technique from start to finish, which is very important. It's

very serious because it's very serious because sometimes it's the family that will provide the first aid cza Of course and even then, right It's very important that this is done correctly until you call the emergency because first of all I need to understand the which is a silly choking like me here I'm talking to you it starts to tcir this is a silly choke Bobo or sometimes I'm eating I choke on something I keep choking there for hours but but I'm breathing I'm talking uhum o The choking that concerns us is severe choking that will

normally lead to a total obstruction of the airway, right? That's why we take great care when eating to make an appropriate cut, an adequate consistency and also be careful with objects because the child can choke when picking up one. little toy and putting it in her mouth I've seen a child who swallowed something that held hair uhum it didn't block it and it didn't make her choke but it got stuck in her windpipe she had to do an endoscopy to get it out oh so like that and she was a big girl of about 11

years old, can you imagine a little baby a little baby any little thing there is enough to obstruct when I have a total obstruction I need to do the unchoking maneuver here anab let's go Anabelle helps me So the first thing I'm going to do I'm going to and normally hand put the baby in my arm, I like to place the baby at the length of my entire forearm and hold it at the neck here so that I can do the first, let me take it here, try the maneuver, I look at the child facing

me so that if I find the object In the mouth I come with my little finger and take it out. If I don't find anything, I don't put my hand in because the chance of me pushing something in is much greater. And then I'm going to do five compressions between the nipples, right in the middle. Zinho, that little hole Zinho, go in here, this at this point in the middle with two fingers, so 1 2 3 4 5 and then no, I didn't visualize anything, nothing came out, I 'm going to turn the child the

other way while I'm doing this here, someone else has already called the Samu is already calling Samu or seeking help if there is a doctor who lives in the building a doctor who lives nearby normally we learn how to do it then it didn't work it didn't work I already did these five steps I'm going to turn the child face down I always like to do it with support from this inclination, I lean on my knee and do it with this inclination here because I help, gravity will help me too And then when I'm in

this position I'm going to do five blows to the back, this blow he's doing as if it were a jot like that Uhm, forward, of course the child won't be holding his head, I won't lay him down, I won't, but it's a maneuver that is violent and can break ribs, so we're only going to do this in a context where I'm suspecting a total obstruction and the child is turning purple, right ? The strongest mother, the mother, says he is capable , I had a patient who didn't swim at all, her son fell into the

club's pool, she was the first to jump in and brought the child and the paralyzed father passed out because he was a swimming champion. But that's the same, but we can't predict it either, right? There are people who will be able to maintain it, everyone also has to know, the more people know the better, the better because one helps the other and if she forgets a detail he helps but in the end Ultimately, it's quite simple, what can generate doubt is the positioning because when I'm holding the child like this I need to hold the

child's neck like this to have a good air intake because otherwise the child becomes ISO Tumbled, I need to maintain this so I'll keep it in this position I'll do the five blows if the child puts PR out I'll start crying again and breathing again I'll stop everything but I'll keep doing this until the rescue arrives or until the child gets better I'll go back to the previous position or I'll stay on the back I'll go back to the anterior position and keeping an eye on it, because if it appears here, you take it off,

I understand, right, and do five compressions because it's facing you like if it was a cardiac massage uhum Then turn around Then turn around now if at any moment this child faints faints then I'll treat it as if it were a stoppage Car then I'll put this child On a surface it comes out of the arm and I'm going to do resuscitation and I'm going do mouth-to-mouth resuscitation, which probably won't do much good. You do it. Ah, you have to do it. You have to do it, right ? if it arrives quickly like that, no,

it's not quick, it wears off, it takes time, it's not quick, and I'll tell you, we've seen it once, it's in the cool guidance that the police know how to do this, I've seen a police officer save a child in Praia, a child in an impressive restaurant, how to differentiate bronchitis from other respiratory conditions common in children such as the flu or cold, then bronchitis, right, it usually presents with more respiratory symptoms that are easier for the doctor to identify because the doctor will listen, the child will listen, it doesn't feel like there's a kitten

inside when it's very intense, yes. now a lighter wheezing sound Sometimes you won't be able to hear it Without the stethoscope without the stethoscope So what we can notice a lot is when the child has the flu, they start to rumble, then you feel it, you put your hand there on their back or chest and you will feel that vibration, that one, but then it 's more of the secretion. this vibration It's because it was just secretion, but bronchitis, right? It's a chronic disease Uh, so bronchitis or asthma, right? It's a chronic disease, so the

child can have it as a trigger or exposure to something that they have Allergy or or as a trigger an infection, a flu, a cold and this child will not only have a snot in the nose, but also a wheezing in the chest and this wheezing indicates that everything is obstructed and the air passage is bad, then the child has bronchitis, right? For me To make the diagnosis, I need to do some tests, some tests that may even require the child's collaboration, which is why it is so difficult for us to diagnose asthma in a

very small child, but if we have a child who wheezes a lot, we will approach it differently than that child. who wheezed once in her life and never again, so the child diagnosed with bronchitis, after I did the tests, I confirmed that she really has asthma, this child will have treatment for the attacks and a maintenance treatment that is for prevent these crises prevention exactly perfect next bru what is Neonatal inqu tercia and what are the signs of jaundice in newborns what is the best treatment jaundice turns yellow it turns yellow is jaundice right Christmas

is when the newborn it turns yellow the color of the skin turns yellow and the child turns yellow Because there is accumulation in the blood of a substance called bilirubin here the eye in the eye normally starts in the eye and goes down it starts in the eye goes to the face the trunk the belly and the members, that's why sometimes people see it only in the eyes, when they only see it in the eyes, it's usually an ey that ends up with the child with black skin, we have to base it on the eyes.

she cries or when she does you will see on the skin bed, the part that normally becomes clearer when we do this has our expressions or when we squeeze our little finger like this, what is left deep down in the little child with black skin we will seeing the yellow in the background when lightened is interesting, we have to pay attention because it is more difficult to see, right, it is not as glaring as the glaring child as the skin child and Clara exactly And then there is an accumulation of this substance that takes the

child turning yellow if it were just because of the color it wouldn't be so much of a problem the issue is that this bilirubin is toxic to the brain So from a certain point it is normal it is expected from a certain point it can cause problems so the action is up complicated because there are several graphs according to the gestational age at birth, birth weight, if it is less than 35 weeks, the hours of life, so my indication for phototherapy now is different from that of 2 hours later, so I always have to look

at a graph to play that value on the graph to know if this child is indicated to start at that moment or not, right? There is an app but I like the curves better, I have the curves on Google Drive Zinho like this and I look at them, right? In the hospital we always have these curves like this in a folder on the computer because in the past, when there was no such thing as calculators, pediatricians, damn it, they suffered in the handheld folder, it was terrible. If you're talking about this, there are curves, perfect,

perfect, and then we 'll see if this child already has to start. the treatment is just something that I like to explain to families, when you discharge a baby from the maternity ward normally that baby spent 24 48 hours maximum with you there on those days I normally don't go to see Sec it would be at that time at that moment because the peak is between RRT and 5 days if it is premature between c and seven then the family has to be careful and in addition to the family being attentive to the little baby

he has to have an appointment around the fifth day of life with a pediatrician because sometimes the family won't understand but the pediatrician knows how to see, he has to know, right? And then when there is an indication for treatment, we treat a treatment that has not been carried out, right ? It can be serious, it's very serious, and it can leave consequences, deafness, and intellectual deficit, it can lead to many very serious problems, and why it happens, right? Because it 's an immature organism. um a rest that is the bilirubin that sends this B

rubina although it is the liver together with the intestine that will carry it in the poop so if the child is not feeding properly if he is not breastfeeding due to some difficulty this can increase the chance of jaundice if the child and for some reason and her liver has become more lazy which is something that can happen she will produce more bilirubin if there is a blood incompatibility between mother and baby I will have greater destruction of the baby's blood at the beginning for a renewal I will I'm going to have a greater production

So until this liver is ready I need to do the work that it doesn't do and then we do that through phototherapy which is the treatment that the only treatment that there is There is no sunbathing It doesn't solve it, but people used sunbathing, which cures but doesn't cure. It's a light bath , it's a light bath. phototherapy until we are discharged today we use a blue light which in two three days has already resolved, it's wonderful, right? But like that in the sun, right ? In the past, people used it, today we no longer

recommend it because the effect it produces on a person is not significant. that really needs treatment, even there is the length of light that will disguise what I was going to say, right? It gives the impression that you are doing something, it actually delays the treatment that will solve it, and the length of light that does the real phototherapy, it even it is in the sun but it is a very small proportion that is not significant for a treatment, right, so today we no longer recommend it, I understand, perfect, it has to be seen on

the fifth day, it has to be seen on the fifth day, normally I advise two days after the hearing because then the pediatrician is already starting to help That family there, in the first consultation, they already clear up the millions of doubts that will arise and already keep an eye on this jaundice, so if it's on the second, on the third and fourth day, that's great, already advises the heel prick test if this guidance failed in the maternity ward And if it's difficult, book on the fifth on the fifth, no Look, I think children have

to come with a booklet, they have to have the family PR, I don't think even a car manual knows that I've never read it, but this way I know that anything whatever happens I'll try to find it I think this had to be done because it's a lot of information, but the course goes, you have to do the manual, and go home with the basic cilinha, right, it's difficult, the Ministry of Health booklet is very good, it has a lot of cool information, but I feel It's missing, but it's not given in the maternity ward,

now it's given out again, that cute booklet is given out again in the SUS in the SUS, but in the private maternity wards, also in mine, so it's given out, I have one that I work in the SUS and in the private sector, right? It's happening to both of us Look, you have to ask for the manual, the little book is, but there are a lot of things that aren't there too, so it's a lot, I know. It's a lot for the family to coordinate a lot of information to acquire from so many places, a

new moment, a very new moment, so have a Pediatrician to accompany you helps a lot for sure, but there's a basic idea because sometimes the person doesn't go, there's no need to try, right ? There would have been here, right, there wouldn't have been Christmas, Rosinha was created that way, and he doesn't even wear very few clothes, right, what he really likes is this little doll, listening to good content, oh great, he doesn't like light, that's why he always wears glasses and because he likes it so much. of good content during his episode, he listened

to so much good content that he played a game for his mother, which is ping-pong, where he separates some words that his mother will play through him, representing to you whatever comes to his mind. your mind you respond responds it's not to elaborate anything hit P hit played and if you don't want to answer step is he's polite and he's super polite happy it's very good very calm good it's being created without Biotonic without biot nothing feeds on good great content we can we can one childhood childhood childhood free two purpose of life to inform

three happiness my patients four challenge challenge to inform without being Inconvenient difficult, right, but I think it's a good challenge a good challenge to inform without complicating and without being empty or Inconvenient perfect five affection Oh our dog I love how the name Cis C Cis c is a giant Chin oh how cute is the most beautiful thing six love Cis Cis Cis I'm also playing see what came into your m Ah I think it's perfect listening listen seven If you could entering a time capsule would you choose the past or the future why? Wow,

I think I could just take a little stroll and come back like this, yes, but either one or the other would come back a little. The past relived some very good moments as a child. My childhood was very good. College was very good, so was Viçosa, Viçosa, feeling that Viçosa's business was good, was very, very, very, very, very, very, very, I'm feeling, I'm feeling, we have a little patient Camilinha is Camila deosa eight Child Development what what is Child Development is Independence autonomy working on the autonomy of perfect child Complete the sentence caring is being

vigilant and acting when necessary and 10 If you could choose a super power which one would it be ? Which one would you like to have? And then I would put some to work while I mulation I know a guy who did this I think it was Jesus Christ his name then pass it multiplied it was bread right there with P Wow that's it so I could do the millions of things I like do it and I want to do it and I need to do it, I understand now if we asked mom this, she

wanted Cora for the cold, for sure, anything that would cure her children, what is it, dear, thank you very much, it was a pleasure, let's close our circle here, thank you very much. It was an honor to be here, it was a pleasure for us, now let's get to the little gifts Oh, what a wonderful book by Alex talking about what a cool Happiness book was written during the pandemic, restless minds, which is about TDH and depressive minds, which here has a chapter on depression in children who cool Wow, I loved it, I loved it,

wonderful, wow, there's more gifts, my God, look, you're getting a pipinho kit, oh Bon, it's an ecobag, it's consistent, made from recycled material on the back, it has the words, look, look exactly inspire, it happens, I went, I might be disgusting, oh, I'm going to be disgusting, I'm going to be disgusting, no one will put up with me, that's right, this is a pipim mug to remind you of us and it's also cute, right, not very beautiful, son, it's very I totally agree And there's also a little notebook to do the PR projects, write everything

down carefully, take care of us wonderful people, wow, it's not over now you have to look at that camera there just for there now forget about us and your messages all messages network who wants to follow everything everything everything is here now it's you with them so come on whoever wants to have access to my content my Instagram is dra. Priscila comsci i2l pediatrician has a lot of content there about maternity about illnesses vaccines everything you need and want to know in Stories there's a little bit of stuff, we also do a little bit of

day to day stuff so it doesn't become such a boring thing to just talk about content content content my office is in Belo Horizonte and I treat all ages of children, I really like babies, older children, and I have this perspective more focused on the integral aspect, even looking at the feeding part, sleep and I also take care of illnesses responsibly because we ca n't just thinking about prevention when there is treatment we need treatment and we have a new project that is almost coming out which is our manual you said we would need it,

we didn't know, okay, it's supposed to be like an instruction manual a course focused on an environment in fact because the course seems like it's just one thing, one person teaching another, an exchange environment and with knowledge also in a way that mothers can access in the time they have, so it can't be a class Although classes are very long, they have to be short classes on certain subjects So everything you need to know about vaccines everything you need to know about hygiene everything you need to know about food so we have this project coming

out of the oven to follow these families and will include some meetings, probably also online with some in person. Cool So that's what we 're proposing, thank you very much. I appreciate it, PR. Thank you very much, see you next time, God willing, dear, today we are finishing another kite dust, today it was a bath of class here about babies phlegm breathing poop colic Because babies are like dressing and not dressing we had fits of laughter Because everything has to be given with great humor because there is a lot of information we can't weigh it

in our hands and we make mistakes Mothers make mistakes but we are here with Doctor Priscila precisely to guide you if you don't follow her, follow @d Priscila pon pediatrician Prisca pediatrician Doctor pon Priscila pediatrician should be appearing below here, follow there, it is very high quality information and very good humor If I Were You I wouldn't miss a big kiss and see you next time