What Is Juvenile Rheumatoid Arthritis?

Juvenile rheumatoid arthritis (JRA), often referred to by doctors today as juvenile idiopathic arthritis (JIA), is a type of arthritis that causes joint inflammation and stiffness for more than six weeks in a child aged 16 or younger. It affects approximately 50,000 children in the United States. Inflammation causes redness, swelling, warmth, and soreness in the joints, although many children with JRA do not complain of joint pain. Any joint can be affected, and inflammation may limit the mobility of affected joints.

JRA is an autoimmune disorder, which means that the body mistakenly identifies some of its own cells and tissues as foreign. The immune system, which normally helps to fight off harmful, foreign substances such as bacteria or viruses, begins to attack healthy cells and tissues. The result is inflammation -- marked by redness, heat, pain, and swelling.

Researchers still don't know exactly why the immune system goes awry in children who develop JRA, although they suspect that it's a two-step process. First, something in a child's genetic makeup gives them a tendency to develop JRA. Then an environmental factor, such as a virus, triggers the development of JRA.

JRA may cause fever and anemia, and can also affect the heart, lungs, eyes, and nervous system. Arthritic episodes can last for several weeks and may recur, although the symptoms tend to be less severe during later recurrent attacks. Treatment is similar to that for adults, with an additional heavy emphasis on physical therapy and exercise to keep growing bodies active. Many of the strong medicines used for adults, though, aren't usually needed for JRA. Permanent damage from juvenile rheumatoid arthritis is now rare, and most affected children recover from the disease fully without experiencing any lasting disabilities.

Doctors classify three kinds of JRA, based on the number of joints involved, the symptoms, and the presence of certain antibodies (special proteins made by the immune system) in the blood. These classifications help determine how the disease will progress.

Classification and external resources
ICD-10     M08.0
ICD-9     714.3
OMIM     604302
DiseasesDB     12430
MedlinePlus     000451
eMedicine     ped/1749
MeSH     D001171

Juvenile idiopathic arthritis (JIA), also known as juvenile rheumatoid arthritis (JRA), is the most common form of arthritis in children and adolescents. (Juvenile in this context refers to an onset before age 16, idiopathic refers to a condition with no defined cause, and arthritis is the inflammation of the synovium of a joint.) JIA is a subset of arthritis seen in childhood, which may be transient and self-limited or chronic. It differs significantly from arthritis commonly seen in adults (osteoarthritis, rheumatoid arthritis), and other types of arthritis that can present in childhood which are chronic conditions (e.g. psoriatic arthritis and ankylosing spondylitis). It is an autoimmune disorder. The disease commonly occurs in children from the ages of 7 to 12, but it may occur in adolescents as old as 15 years of age, as well as in infants. JIA affects approximately 1 in 1,000 children in any given year, with about 1 in 10,000 having a more severe form

Terminology

The terminology used is evolving, and each term has some limitations.
According to some sources, JIA replaces the term juvenile rheumatoid arthritis (JRA).[4] Other sources still use the latter term. JIA is sometimes referred to as juvenile chronic arthritis (JCA), a term that is not precise as JIA does not encompass all forms of chronic childhood arthritis.

A majority of cases are rheumatoid factor negative, which leads some to consider the "chronic" or "idiopathic" labels more appropriate. However, if a cause was determined, then "idiopathic" may no longer be appropriate (making JIA a diagnosis of exclusion), and if the course was self-limited, then "chronic" may no longer be appropriate.Adding to the confusion, the term rheumatoid itself lacks a consistent, unambiguous definition. MeSH uses "Juvenile Rheumatoid Arthritis" as the primary entry, and uses "chronic" and "idiopathic" in alternate entries

Signs and symptoms

Symptoms of JIA are often non-specific initially, and include lethargy, reduced physical activity, and poor appetite.[9] The first manifestation, particularly in young children, may be limping. Children may also become quite ill, presenting with flu-like symptoms that persist. The cardinal clinical feature is persistent swelling of the affected joint(s), which commonly include the knee, ankle, wrist and small joints of the hands and feet. Swelling may be difficult to detect clinically, especially for joints such as those of the spine, sacroiliac joints, shoulder, hip and jaw, where imaging techniques such as ultrasound or MRI are very useful.

Pain is an important symptom. Morning stiffness that improves later in the day is a common feature. Late effects of arthritis include joint contracture (stiff, bent joint) and joint damage. Children with JIA vary in the degree to which they are affected by particular symptoms.Children may also have swollen joints.
Extra-articular

Eye disease: JIA is associated with inflammation in the front of the eye (specifically iridocyclitis, a form of chronic anterior uveitis), which affects about one child in five who has JIA, most commonly girls. This complication may not have any symptoms and can be detected by an experienced optometrist or ophthalmologist using a slit lamp. Most children with JIA are enrolled in a regular slit lamp screening program, as poorly controlled chronic anterior uveitis may result in permanent eye damage, including blindness.

Growth disturbance: Children with JIA may have reduced overall rate of growth, especially if the disease involves many joints or other body systems. Paradoxically, individually affected large joints (such as the knee) may grow faster, due to inflammation - induced, increased blood supply to the bone growth plates situated near the joints
 

Complications

JIA is a chronic disorder which if neglected can lead to serious complications. Proper follow up with health professionals can significantly reduce the chance of developing complications.

A form of eye inflammation called uveitis is common with some types of JIA. The inflamed eyes, if left untreated, can result in glaucoma, scars, cataracts and even blindness. Often the eye inflammation occurs without symptoms, or while the JIA is otherwise in remission, and thus it is important for all children to get regular eye checkups from an eye physician.

Growth retardation is common in children with JIA. Moreover, the medications (corticosteroids) used to treat JIA have potent side effects that can limit growth. Other muskuloskeletal issues may include joint contractures, muscle weakness or muscle loss, and osteoporosis.

Children who delay treatment or do not participate in physical therapy can often develop joint deformities of the hand and fingers. Over time hand function is lost and almost impossible to recover.
 
Causes

So far the actual cause of JIA remains a mystery. However, the disorder is autoimmune[14] - meaning that the body's own immune system starts to attack and destroy cells and tissues (particularly in the joints) for no apparent reason. It is believed that the immune system gets provoked by changes in the environment or perhaps there is an error in the gene. Experimental studies have shown that certain viruses that have mutated may be able to trigger JIA. JIA appears to be more common in young girls and the disease is most common in Caucasians. Associated factors that may worsen or have been linked to rheumatoid arthritis include the following:

• Genetic predisposition; it appears that when one family member has been diagnosed with rheumatoid arthritis, the chances are higher that other family members or siblings may also develop arthritis
• Females are more likely to develop rheumatoid arthritis than males at all ages

• There is a strong belief that psychological stress may worsen the symptoms of rheumatoid arthritis. However, when the emotional stress is under control the arthritis symptoms do not always disappear suggesting that the association is not straightforward

• Even though no distinct immune factor has been isolated as a cause of arthritis, there are some experts who believe that the triggering factor may be something like a virus which then disappears from the body after permanent damage is done

Because rheumatoid arthritis is more common in women, there is a belief that perhaps sex hormones may be playing a role in causing or modulating arthritis. Unfortunately, neither sex hormone deficiency nor replacement has been shown to improve or worsen arthritis.The cause of JIA, as the word idiopathic suggests, is unknown and currently an area of active research. Current understanding of JIA suggests that it arises in a genetically susceptible individual due to environmental factors.

Classification

Juvenile Idiopathic Arthritis (JIA) / JRA / JCA is a very serious matter as it involves the age group wherein being healthy means that the mental and physical development of the child is good. Having arthritis in the childhood not only ruins the child but also ruins his future, his family and his development. The only solution the parents have for such children is the homeopathic treatment.

In allopathic / conventional treatment the similar kind of treatment is given to all the patients which include pain killers and anti-inflammatory drugs. Typically, nonsteroidal anti-inflammatory drugs (NSAIDs) are used, but children with severe systemic disease may require corticosteroids (such as prednisone) given by mouth or intravenously. The side effects include slowed growth, osteoporosis, and osteonecrosis (death of bone tissue).

If these drugs do not work allopathic or conventional doctors have even stronger drugs to offer to a child such as methotrexate. It is usually needed to treat polyarticular and systemic juvenile idiopathic arthritis. Side effects include bone marrow depression and liver toxicity, so children taking these drugs require regular blood tests.

In the conventional or allopathic treatment Iridocyclitis is treated with corticosteroid eye drops or ointments, which suppresses inflammation and do not prevent the inflammation completely.

In contrast homeopathy treats every child of Juvenile Idiopathic Arthritis (JIA) / JRA / JCA as a different case of arthritis and only after a complete case taking a drug is prescribed which not only reduces the pain and inflammation but also helps to solve the other problems the child is suffering with.

Homeopathic remedies work especially well to help relieve and improve some of the symptoms that are often associated with JIA / JRA / JCA. Homeopathic doctors treat the JIA by constitutional treatment. This is the process by which a homeopathic physician selects and administers a child’s own constitutional remedy based on the totality of symptoms and the physical, mental and emotional state. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions such as Juvenile Chronic Arthritis (JCA). This strengthens the body’s vital defenses and restores a healthy balance and sense of well-being.

 If the homeopathic treatment is started in the initial stages the prognosis is good and in most cases, the condition can be reversed. At later stages of the disease homeopathic medicines may not be able to reverse the situation but can still help in easing many symptoms and can reduce the need of strong and harmful allopathic medicines which have lot many side effects.

 Homeopathy not only helps the multiple symptoms of arthritis; in many cases it works deep within the body to correct the underlining causes. This powerful ability of homeopathy remedies correct the genetic predispositions we have acquired through a thousand years of our family tree. This remarkably in-depth correction comes through an incredible discovery in homeopathy called miasms. Dr. Samuel Hahnemann, a German allopathic doctor, originally developed the concept of miasms as the "obstacle (hindrance) to the cure of disease." Homeopathy can clear these miasms from our body - thus correcting the genetic predispositions we have towards the disease.

Homeopathy uses minute doses of pure extracts from all realms of nature and activates the body to heal itself, by correcting underlying causes of diseases, rather than suppressing symptoms. There are many homeopathic ingredients that have stood the test of time - as they have been used for decades.

 How homeopathy helps in Juvenile Idiopathid Arthritits (JIA) / JRA / JCA

 Homeopathic medicines help to reduce pain, swelling and improve the mobility of the affected joint by improving the blood supply to the affected joint.
Homeopathic remedies prevent the further damage to the affected joint thus improving the quality of life of a child.
Homeopathic treatment helps in the physical and mental development of a child suffering with JIA / JRA / JCA.
Homeopathy corrects the faulty immune system of the body to restore the healing power of the body.
There are 223 homoeopathy remedies which give great relief in Juvenile Idiopathic Arthritis (JIA) / JRA / JCA. However, the correct choice and the resulting relief is a matter of experience and right judgment on the part of the homeopathy doctor. The treatment is decided after thorough case taking of the patient. Thus homeopathic medicines of juvenile arthritis are tailor made unlike allopathy in which all patients receive the same drugs although trade name may be different.

For online homeopathic treatment of Juvenile Idiopathic Arthritis / JRA / JCA, you may fill in the consultation form at
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 What is Juvenile Idiopathic Arthritis (JIA) / JCA / JRA
 Juvenile Idiopathic Arthritis (JIA) or Juvenile Chronic Arthritis (JCA) or Juvenile Rhematoid Arthritis (JRA) is an inflammation of a joint or joints beginning in childhood. It is a long-term (chronic) disease resulting in joint pain and swelling. Immune-mediated joint inflammations take place in JIA i.e. the body's immune system mistakenly attacks and destroys healthy body tissue. JRA usually occurs before age 16.
Best homeopathic doctors for treatment of juvenile idiopathic arthritis (JIA) / JRA / JCA. What is juvenile idiopathic arthritis (JIA) / JRA / JCA. Homeopathy remedies with cure for juvenile idiopathic arthritis (JIA) / JRA / JCA.
 Types of Juvenile Chronic Arthritis (JCA) / JIA / JRA
 Juvenile Chronic Arthritis (JCA) or JIA or JRA is categorized into 5 main types based on the number of joints involved :

  Oligoarthritis accounts for approximately 50% of Juvenile Idiopathic Arthritis (JIA) and is defined as involvement of fewer than 5 joints. This type often includes uveitis (inflammation in the eyes).
 Polyarthritis requires arthritis in 5 or more joints.
 Systemic arthritis accounts for approximately 10% to 20% of Juvenile Chronic Arthritis (JCA) or JIA or JRA and is characterized by high fevers, rash, and inflammation of other organs, in addition to arthritis.
 Enthesitis-related arthritis often affects the spine, hips, and entheses (attachment points of tendons to bones) and occurs mainly in boys older than 8 years.
 Psoriatric arthritis includes children who have arthritis with the rash of psoriasis.
 Causes of Juvenile Rhematic Arthritis (JRA) / JIA / JCA
 It's not known exactly what causes Juvenile Chronic Arthritis (JCA) / JIA / JCA in kids. Research indicates that it is an autoimmune disease. In autoimmune diseases, white blood cells lose the ability to tell the difference between the body's own healthy cells and harmful invaders like bacteria and viruses.

The immune system, which is supposed to protect the body from these harmful invaders, instead releases chemicals that can damage healthy tissues and cause inflammation and pain.

 Signs and Symptoms of Juvenile Idiopathic Arthritis (JIA) / JRA / JCA
 The first signs of juvenile idiopathic arthritis (JIA) / JRA / JCA can be subtle or obvious. Signs may include limping or a sore wrist, finger, or knee. Joints may suddenly swell and remain enlarged. Stiffness in the neck, hips, or other joints can also occur. Rashes may suddenly appear and disappear, developing in one area and then another. High fevers that tend to spike in the evenings and suddenly disappear are characteristic of systemic juvenile rheumatoid arthritis.

 Diagnosis of Juvenile Chronic Arthritis (JCA) / JRA / JIA
 Diagnosis of Juvenile Chronic Arthritis (JCA) / JIA / JRA is often made on the basis of the child's collection of symptoms. Laboratory tests often show normal results. Some nonspecific indicators of inflammation may be elevated, including white blood cell count, erythrocyte sedimentation rate, and a marker called C-reactive protein. As with any chronic disease, anemia may be noted. Children with an extraordinarily early onset of the adult type of rheumatoid arthritis will have a positive test for rheumatoid factor.

 Home Care in Juvenile Chronic Arthritis (JCA) / JRA / JIA
 In the presence of pain, children desire to lie down still. However, it is vital to follow a regular exercise program. Strong and healthy muscles support and protect joints. Walking, swimming and bicycling (outdoor or indoor stationary) must be executed. Before exercise, a warm-up is necessary. A balanced diet involving a lot of calcium promotes bone health.    Systemic JIA
Oligoarticular

Oligoarticular (or pauciarticular) JIA affects 4 or fewer joints in the first 6 months of illness. Oligo means few.

Oligoarticular is used with JIA terminology, and pauciarticular is used with JRA terminology.[21]

Patients with oligoarticular JIA are more often ANA positive, when compared to other types of JIA.[22]

Accounts for about 50% of JIA cases. Usually involves the large joints such as the knees, ankles, and elbows but smaller joints (such as the fingers and toes) may also be affected. The hip is not affected unlike polyarticular JIA. It is usually not symmetrical, meaning the affected joints are on one side of the body rather than on both sides simultaneously. Length discrepancy & muscles atrophy often happens which leads to asymmetric growth and risk of flexion contracture. Early childhood onset are at risk for developing a chronic iridocyclitis or an anterior uveitis, which is inflammation of the eye. This condition often goes unnoticed; therefore these children should be closely monitored by an optometrist. If ANA+, patient need routine eye exam every 3 months. If ANA- and older than 7 years old, can have eye exam every 6 months.[23] Children with late childhood onset are at risk for sacroilitis and spondyloarthropathy.
Polyarticular

Polyarticular JIA affects 5 or more joints in the first 6 months of disease. This subtype can include the neck and jaw as well as the small joints usually affected. This type of JIA is more common in girls than in boys. Usually the smaller joints are affected in polyarticular JIA, such as the fingers and hands, although weight-bearing joints such as the knees, hips, and ankles may also be affected. The joints affected are usually symmetrical, meaning that it affects both joints on both sides of the body (such as both wrists.) Children with polyarticular JIA are also at risk for developing chronic iridocyclitis or uveitis (inflammation of the eye) and should also be monitored by an ophthalmologist.[23] Rheumatoid factor may be positive i.e. seropositive in children with polyarticular JIA occurring between 9-16 years of age and is associated with HLA DR4 and HLA DW4. This group has poorer prognosis with about 50% progressing to severe disabiling arthritis, persisting into adulthood. It is generally seronegative in JIA occurring below 10 years of age with a milder disease process and responds better to treatment. Seropositivity is rare in children with systemic JIA. Due to the greater number of joints affected by polyarticular JIA as well as the tendency to worsen over time, polyarticular JIA needs to be treated aggressively.

Systemic-onset juvenile idiopathic arthritis

Systemic JIA is characterized by arthritis, fever, which typically is higher than the low-grade fever associated with polyarticular and a salmon pink rash. It accounts for 10-20% of JIA and affects males and females equally, unlike the other two subtypes of JIA, and affects adolescents . It generally involves both large & small joints. Systemic JIA can be challenging to diagnose because the fever and rash come and go. Fever can occur at the same time every day or twice a day (often in late afternoon or evening) with a spontaneous rapid return to baseline (vs. Septic Arthritis of continuous fever). The rash often occurs with fever. It is a discrete, salmon-pink macules of different sizes. It migrates to different locations on skin, rarely persisting in one location more than one hour. The rash is commonly seen on trunk and proximal extremities or over pressure areas.

Systemic JIA may have internal organ involvement: Hepatosplenomegaly, Lymphadenopathy, Serositis, Hepatitis, Tenosynovitis, etc.

It is also known as "systemic onset juvenile rheumatoid arthritis".
A polymorphism in macrophage migration inhibitory factor has been associated with this condition.

It is sometimes called "adolescent-onset Still's disease", to distinguish it from adult-onset Still's disease. However, there is some evidence that the two conditions are closely related.

Rheumatoid factor and ANA are generally negative in systemic JIA.
Other types

Some doctors include two other, less common forms: enthesitis-related arthritis and psoriatic JIA. Enthesitis is an inflammation of the insertion points of the tendons. This form occurs most often in boys older than 8, characteristically causes back pain, and is linked to ankylosing spondylitis and inflammatory bowel disease. Psoriatic JIA occurs most often in girls, in conjunction with psoriasis, although joint problems may precede the skin manifestations by several years drop injection
 
Diagnosis
Diagnosis of JIA is difficult because joint pain in children can be from many other causes. There is no single test that can confirm the diagnosis and most physicians use a combination of blood tests, x rays and the clinical presentation to make an initial diagnosis of JIA. The blood tests measure antibodies and the rheumatoid factor. Unfortunately, the rheumatoid factor is not present in all children with JIA. Moreover in some cases the blood work is somewhat normal. X rays are obtained to ensure that the joint pain is not from a fracture, cancer, infection or a congenital abnormality.

In most cases, fluid from the joint is aspirated and analyzed. This test often helps in making a diagnosis of JIA by ruling out other causes of joint pain.

Treatment
JIA is best treated by a multidisciplinary team. The major emphasis of treatment for JIA is to help the child regain normal level of physical and social activities. This is accomplished with the use of physical therapy, pain management strategies and social support. Another emphasis of treatment is to control inflammation as well as extra-articular symptoms quickly. Doing so should help to reduce joint damage, and other symptoms, which will, help reduce levels of permanent damage leading to disability

There have been very beneficial advances in drug treatment over the last 20 years. Most children are treated with non-steroidal anti-inflammatory drugs and intra-articular corticosteroid injections. Methotrexate, a disease modifying anti-rheumatic drug (DMARD) is a powerful drug which helps suppress joint inflammation in the majority of JIA patients with polyarthritis (though less useful in systemic arthritis).Newer drugs have been developed recently, such as TNF alpha blockers, such as etanercept There is no controlled evidence to support the use of alternative remedies such as specific dietary exclusions, homeopathic treatment or acupuncture. However, an increased consumption of omega-3 fatty acids proved to be beneficial in two small studies.

Celecoxib has been found effective in one study

Other aspects of managing JIA include physical and occupational therapy. Therapists can recommend the best exercise and also make protective equipment. Moreover, the child may require the use of special supports, ambulatory devices or splints to help them ambulate and function normally.

Surgery is only used to treat the most severe cases of JIA. In all cases, surgery is used to remove scars and improve joint function.Home remedies that may help JIA includes getting regular exercises to increase muscle strength and joint flexibility. Swimming is perhaps the best activity for all children with JIA. Stiffness and swelling can also be reduced with application of cold packs but a warm bath or shower can also improve joint mobility.

Occupational therapy

The best approach to treating a child with JIA involves a team of medical professionals including a rheumatologist, occupational therapist (OT), physical therapist, nurse and social worker.[citation needed]

The role of the OT is to help children participate as fully and independently as possible in their daily activities or "occupations", by preventing psychological and physical dependency. The aim is to maximize quality of life, and minimize disruption to the child’s and family’s life. OTs work with children, their families and schools, to come up with an individualized plan which is based on the child’s condition, limitations, strengths and goals. This is accomplished by ongoing assessments of a child’s abilities and social functioning. The plan may include the use of a variety of assistive devices, such as splints, that help a person perform tasks. The plan may also involve changes to the home, encouraging use of uninvolved joints, as well as providing the child and their family with support and education about the disease and strategies for managing it. OT interventions will be changed depending on the progression and remission of JIA, in order to promote age-appropriate self-sufficiency. Early OT involvement is essential. Interventions taught by an OT can help a child adapt and adjust to the challenges of JIA throughout the rest of their life.
 
Self-care

OTs can provide many strategies to assist children in their dressing routine. Clothes with easy openings and Velcro, as well as devices, such as buttonhooks and zipper pulls can be used. For children who have difficulty bending, a long handled reacher and sock aid is recommended. OTs may also show children how to sit during dressing so less strain is put on their joints.

OTs can help children maintain cleanliness through recommending assistive devices. For children who have trouble reaching all areas of their body, a long handled sponge with a soft grip can be provided. If children find it difficult to sit in a bath or stand in a shower, an OT can prescribe a bath bench or bath seat to be installed to help the child remain in a pain free position. If tooth brushing is challenging, a toothbrush with a larger, soft grip or an electric toothbrush may be recommended. For flossing, a flosser with an adapted handle may be provided. Long handled hairbrushes may be used by children who have difficulty reaching the back of their head. Razors handles can be adapted for easier grip, or an electric razor may be used for shaving. The OT can also show girls wishing to use make-up, ways of increasing the sizes of the handles of make-up application tools for easier grip.

For children with pain in their hands and wrists, utensils and devices that are lightweight with large handles as well as other devices (such as angled knives, strap-on utensils, jar and bottle openers, turning handles, door knob extensions, etc.) can be provided to make the task easier, less painful and more enjoyable.[40] Tilted glasses can be used for children who have neck stiffness. Education can be provided about good eating habits that help control bone loss caused by inactivity and drug side effects. Occupational therapists provide a myriad of strategies to assist children with JIA in performing self-care tasks.
Leisure

One of the best ways OTs can help children with JIA participate in activities with their friends is by helping them make their home exercise programs into play. Exercises are prescribed by both physiotherapists and OTs to increase the amount a child can move a joint and strengthen the joint to decrease pain and stiffness and prevent further limitations in their joint movements. OTs can provide children with age appropriate games and activities to allow the children to practice their exercises while playing and socializing with friends. Examples are crafts, swimming and non-competitive sports.

OTs will often prescribe custom made orthotics which are devices that support and correct body position and function. Orthotics help keep the child’s body in good alignment. Orthotics reduce discomfort in the legs and back when the child participates in physical activities such as sports. Splints can be used to support the joints during activity, to reduce the child’s pain and increase participation in their preferred leisure activities. Resting splints may be prescribed for children to wear during the night to reduce swelling and stiffness in joints, allowing children to have less pain and stiffness while participating in play activities.Furthermore, working splints are used to support the joint and relieve pain while working the with hands such as during crafts. A series of casts might be used to gradually extend shortened muscles allowing for increased participation in leisure activities.

OTs can help a child learn how to interact with their classmates and friends by collaboratively brainstorming strategies, role playing and modeling. OTs also help children see what activities they are good at and which ones give them difficulty. Furthermore, OTs can help children learn to communicate their pain to others. Benefits of OT treatment include: improved social interaction, improved self-confidence and a positive self-image. OTs can help children build friendships with other children suffering from similar diseases to help them feel less alone or less different from others. Many OTs run summer camps for children with similar diseases so children can get to know others with their disease.Education sessions on JIA and leisure, and activities such as swimming, canoeing and nature trails are common.

For children who find that cool or damp weather make it hard to play with friends outside, OTs can give ideas for clothing that will keep the child warm and dry without limiting movement. An example of this is biking gloves which allow children to move their fingers while still keeping their hands warm, as opposed to large winter gloves which limit hand function.Warm pajamas and electric blankets can reduce pain and improve sleep.

Productivity

Children with JIA often require school activity modifications due to disease symptoms. OTs can work with families and schools to improve attendance at school. Therapists help children to succeed by providing ways for full participation at school by working with staff, taking part in activity planning and assessing the need for accommodations and adaptations.

OTs work with children, families and schools to develop strategies for helping children manage pain, stiffness and tiredness, which may sometimes limit their ability to participate in school related activities. A balanced plan will allow children to get enough activity that they do not stiffen up, but also enough rest that they do not tire. For example, a plan might be worked out with a teacher so a child will be allowed to stand and stretch during prolonged sitting, perform modified gym activities or take rest breaks during gym classes. Other common management strategies taught by OTs include waking up early before school and taking a hot bath and then doing exercises to reduce stiffness and pain throughout the day. Using proper body movements when performing activities helps reduce strain on joints and thereby decrease pain and stiffness. OTs can also teach children how to relax their muscles.

OTs may prescribe special equipment for children at school to make them more comfortable. Desks and chairs of a proper height for children are very important. The desk may have the ability to tilt into a comfortable position for writing. Pencils and pens with larger, softer grips can be used to make writing easier and less painful. Special keyboards may be prescribed to keep a child’s arms in a position that will reduce strain on joints when using a computer.[39] OTs can work with teachers to educate them about a child’s condition, limitations and ways they can help make school a positive experience for the child. Recommendations might include two sets of textbooks, one for home one for school, to prevent carrying a heavy load of books. Additional recommendations may involve a reduced amount of writing and typing, sitting on a chair instead of the floor, extra time to move between classes, an elevator key for schools that have elevators but restrict them to students with health problems, providing a student note-taker, and extra time to complete assignments.

As teenagers become adults, OTs can start working with them regarding their future education and employment plans. OTs can assist teenagers in finding ways to tell their employers about their disease in a positive way. OTs can also help teenagers understand their rights as an employee with a disability. Assistance with obtaining funding for post-secondary education might be provided. OTs may help teenagers set up volunteering in the community, to gain experience and self-confidence in their abilities. It is important that teenagers with JIA understand how to take care of themselves and manage their disease when working full-time or attending university. OTs can help teenagers develop strategies that will allow them to function at their greatest ability by taking care of their health.
 
Prognosis

With proper therapy, some children do improve with time and lead normal lives. However, severe cases of JIA which are not treated promptly can lead to poor growth and worsening of joint function. In the last two decades, significant improvements have been made in treatment of JIA and most children can lead a decent quality of life. The prognosis of JIA depends on prompt recognition and treatment. Many children with JIA have gone on to play professional sports and have a variety of successful careers.

Epidemiology
JIA occurs in both sexes, but, like other rheumatological diseases, is more common in females. Symptoms onset is frequently dependent on the subtype of JIA (see Types of JIA) and is from the pre-school years to the early teenage years.
Prevalence

Juvenile idiopathic arthritis affects somewhere between 8 and 150 of every 100,000 children, depending on the analysis. Of these children, 50 percent have pauciarticular JIA, 40 percent have polyarticular JIA and 10 percent have systemic JIA. It has been shown, that in a preselected group (children under 16 years with orthodontic treatment need) prevalence rises to 1 out of 100 (0.88% out of 1024 children)

Definition
Juvenile rheumatoid arthritis, also known as juvenile idiopathic arthritis, is the most common type of arthritis in children under the age of 16. Juvenile rheumatoid arthritis causes persistent joint pain, swelling and stiffness. Some children may experience symptoms for only a few months, while others have symptoms for the rest of their lives.

Some types of juvenile rheumatoid arthritis can cause serious complications, such as growth problems and eye inflammation. Treatment of juvenile rheumatoid arthritis focuses on controlling pain, improving function and preventing joint damage.

How can I parent my autistic child?

How can I parent my autistic child? My husband and I feel like the world's worst parents. Our nine-year-old autistic son pushes us to the breaking point daily. We try to manage his behaviors appropriately but often end up yelling or hitting. We know his behaviors are not his fault. But in the heat of the moment our best intentions are overwhelmed by nine years of frustration. We have talked to a psychologist for family counseling, but just got a lot of sympathy. We love our son and want to do a better job.

Your yelling and hitting are the result of your frustrations with a situation that just isn't fair. Human hardship is not distributed equally, as Rabbi Harold Kushner wrote in When Bad Things Happen to Good People. Rabbi Kushner himself lost a child to a rare disease and knows all too well the struggles of parents. I remember myself how angry I was when my son was seven years old. I had a hard time accepting his autism and that he would need special services for the rest of his life. I walked around with a chip on my shoulder-- ready to rage and ready to cry;the tears were never far.

I appreciate your courage in leveling with how you feel. Anger, one of the most intense and least understood human emotions, and is probably the scariest and most socially unacceptable feeling to own up to. It often arises with the thought, "Why me? Why did this have to happen to me?" Losing something precious--the child you dreamed of--hurts and seems unfair. It is natural for parents to get frustrated and direct it at themselves, each other, the doctor, mercury, the local school district-- or your child who is hard to live with. Many people in your situation also feel guilty as you mention that your son's behaviors are not his fault.

It may help you to think about what other feelings you may have besides the frustration and the anger. Is there fear? Sorrow? Worry? What would be there if the anger vanished? Parents like you are trying to make sense out of what has happened - "If we are decent people, how could this happen to us?" I believe that parents need to allow themselves to experience anger, to cry, and to scream. It is all part of the grief. Indeed autism can be terrible, and it makes no sense. Trying to deny or minimize how hard it is to have a child with autism only prolongs the suffering you are describing.

Anger is a reflection of the hurt. Gaining perspective, along with time and compassion, can help to heal the heartbreak. It is probably worth another try to connect with a mental health professional who can guide you through this. If nothing else, our special children teach us patience with what we cannot change -- about them, with ourselves, and with the world around us.

The first thing you have to realize is that you are not the world's worst parents. Your seeking of help and even writing to ask this question gives evidence of the facts you wrote: that you love your son and want to do a better job. Over time relationships develop patterns and sometimes these can be self defeating as in the relationship pattern that you are describing between you and your husband and your son.

In terms of behavior, yours and your son's, you and your husband can learn some straight forward behavioral techniques that will help you. It sounds to me like you could use some strategic guidance and not just sympathy. This can be gained through some good self help books on the subject or by trying once again to reach out to a mental health professional who is willing to both guide and support you through this difficult time and experience.

As with most negative patterns of behavior, it is likely that you promise yourself on a daily basis that this time you will not yell or scream or hit but at this point your relationship with your son ends up in the same place because none of you can figure a way out of the trap. That is where a third party can help you to see the options in your responses and actions toward your son. Things may need to be set up differently in your home to help you to optimize your relationship with your little guy. Your son may be reacting to things that many of us would not realize or understand. He himself may not understand or be able to let you know what it is.

You are not in this situation because you are bad parents or lack the skill in raising a child. You may lack some of the skill necessary for raising a child with autism and that is not surprising given the level of complications that children with autism may bring. Some of the habits and behaviors of children with autism could push any one of us to our breaking point. It is important to remember, as you stated yourself, that your son is not purposely pushing you to your breaking point, just as you are not purposely "breaking."What needs to be broken is this self defeating cycle and a new one set up that is positive and has all of your family members feeling positively about themselves and each other. You are on track for this sort of change.

Anak autis

AuAutisme adalah gangguan perkembangan yang sangat kompleks pada anak, yang gejalanya sudah timbul sebelum anak itu mencapai usia tiga tahun.

Gejala yang sangat menonjol adalah sikap anak yang cenderung tidak mempedulikan lingkungan dan orang-orang di sekitarnya, seolah menolak berkomunikasi dan berinteraksi, serta seakan hidup dalam dunianya sendiri. Anak autistik juga mengalami kesulitan dalam memahami bahasa dan berkomunikasi secara verbal. Disamping itu seringkali (prilaku stimulasi diri) seperti berputar-putar, mengepak-ngepakan tangan seperti sayap, berjalan berjinjit dan lain sebagainya.Gejala autisme sangat bervariasi. Sebagian anak berperilaku hiperaktif dan agresif atau menyakiti diri, tapi ada pula yang pasif. Mereka cenderung sangat sulit mengendalikan emosinya dan sering tempertantrum (menangis dan mengamuk). Kadang-kadang mereka menangis, tertawa atau marah-marah tanpa sebab yang jelastis memiliki spektrum yg lebar. Dari yg autis ringan sampai yg terberat. Termasuk di dalamnya adalah hyper-active, attention disorder, dan sebagainya. Anak autis dapat hidup normal dan mandiri, tentunya butuh kesabaran dan ketekunan orang tua dalam menghadapi perilaku-pelaku tidak normal sang anak.

Penyebab Autis

Autis adalah gangguan perkembangan pervasif pada anak yang ditandai dengan adanya gangguan dan keterlambatan dalam bidang kognitif, bahasa, perilaku, komunikasi dan interaksi sosial.Penyebab autisme adalah gangguan neurobiologis yang mempengaruhi fungsi otak sedemikian rupa sehingga anak tidak mampu berinteraksi dan berkomunikasi dengan dunia luar secara efektif. Jumlah penderita autis diberbagai Negara terus meningkat, termasuk Indonesia.  Menyebab dari autis sendiri belum diketahui secara pasti dan masih menjadi bahan perdebatan dikalangan para ahli.

Kebanyakan anak autis adalah laki-laki.  Anak perempuan memiliki hormon estrogen yg dapat menetralisir autisme, sedangkan  hormon testoteronnya pada anak laki-laki justru memperparah keadaannya.

Berikut beberapa hal yang diduga menjadi penyebab-penyakit autis:
Beberapa peneliti mengungkapkan terdapat gangguan biokimia
Sebagian peneliti lain berpendapat bahwa autisme disebabkan oleh gangguan psikiatri/jiwa.
Ahli lainnya berpendapat bahwa autisme disebabkan oleh karena kombinasi makanan yang salah atau lingkungan yang terkontaminasi zat-zat beracun yang mengakibatkan kerusakan pada usus besar yang mengakibatkan masalah dalam tingkah laku dan fisik termasuk autis.
Perdebatan yang terjadi akhir akhir ini berkisar pada kemungkinan penyebab autis yang disebabkan oleh vaksinasi anak, namun hal ini dibantah oleh ahli yang lain.

Bagaimana Mengetahui Gejala Autis Sejak Dini?
Tentunya bila gejala autisme dapat dideteksi sejak dini dan kemudian dilakukan penanganan yang tepat dan intensif, kita dapat membantu anak autis untuk berkembang secara optimal.

Ada beberapa cara yang dapat digunakan untuk mengetahui gejala autis.
1.      Metode M-Chat

Salah satunya dengan metode yang dinamakan M-CHAT (Modified Checklist for Autism in Toddlers).  Orang tua harus mengamati 6 pertanyaan penting berikut :

1. Apakah anak anda tertarik pada anak-anak lain?
2. Apakah anak anda dapat menunjuk untuk memberitahu ketertarikannya pada  sesuatu?
3. Apakah anak anda pernah membawa suatu benda untuk diperlihatkan pada orangtua?
4. Apakah anak anda dapat meniru tingkah laku anda?
5. Apakah anak anda berespon bila dipanggil namanya?
6. Bila anda menunjuk mainan dari jarak jauh, apakah anak anda akan melihat ke arah mainan tersebut?

Bila jawaban anda TIDAK pada 2 pertanyaan atau lebih, maka sebaiknya berkonsultasi dengan profesional yang ahli dalam perkembangan anak dan mendalami bidang autisme.

2. Melakukan Konsultasi dengan Para Ahli

Jika berdasarkan metode diatas buah hati anda menunjukkan tanda-tanda autis, segera konsultasikan dengan ahli atau dokter.Karena karakteristik dari penyandang autis ini banyak sekali ragamnya (sepektrum yang sangat luas) sehingga cara diagnosa yang paling ideal adalah dengan memeriksakan anak pada beberapa tim dokter ahli seperti ahli neurologis, ahli psikologi anak, ahli penyakit anak, ahli terapi bahasa, ahli pengajar dan ahli profesional lainnya dibidang autis. Diagnosis yang paling baik adalah dengan cara seksama mengamati perilaku anak dalam berkomunikasi, bertingkah laku dan tingkat perkembangannya.

Cara Menghadapi Anak Autis:

1. Melatih Komunikasi Verbal dan Non verbal

Disini orangtua harus berperan aktif terhadap anak. Orangtua harus bisa mengajarkan komunikasi verbal dan non verbal kepada anak dengan cara menemaninya bermain, atau yang lainnya. Contohnya, pada saat si anak mengambil sesuatu misalnya mainan bola, jangan biarkan dia hanya mengambil barang itu tanpa mengucapkan nama barang tersebut.

2. Sesuaikan Keinginan Anda

Jangan paksakan anak anda mengikuti apa yang orangtua mau. Bersabar adalah kunci utama dalam menghadapi anak autis. Apabila anak anda tidak mau diatur misal dalam hal makan. Usahakan anda tidak memaksakan keinginan anda kepada anak untuk duduk diam selama makan. Ajaklah dia untuk duduk diam dalam beberapa menit, memegang sendok dan menyuapkan makan menggunakan sendok. Apabila dia sudah merasa bosan, biarkan dia melakukan apa yang dia inginkan namun dalam batas wajar. Kemudian, ajak lagi anak anda melakukan hal tesebut.

3. Interaksi Sosial

Jangan biarkan anak anda bermain sendirian. Ajaklah dia keluar rumah bertemu dengan orang-orang dan anak-anak seumuran dia. Ajak anak anda bermain hal yang dia sukai. Apabila anak anda sedang bermain mobil-mobilan, ikutlah dalam bermain mobil-mobilan kemudian contohkan pada anak anda bagaimana cara bermain dan menyusun mobil-mobilan agar rapi.

4. Emosi dan Perasaan

Jangan mudah terpancing emosi dalam menghadapi anak autis. Usahakan hindari emosi dan perasaan sedih ketika bermain dengan anak anda. Apabila anak anda mengamuk, menangis, menjerit, dan melempar sesuatu biarkan saja dia melakukan hal itu. Setelah dia tenang ajak lagi untuk bermain sesuatu yang dapat melatih anak autis.

5. Kasih Sayang

Anak autis sangat membutuhkan kasih sayang dari orangtua nya. Perlakukannlah anak yang menderita autis sebaik mungkin. Anggap mereka seperti anak-anak normal lainnya yang sangat senang apabila dipeluk dan dicium oleh orangtua mereka. Nikmatin kebersamaan anda dengan semua kebahagiaan. Memberikan pelukan dengan menceritakan dongen yang lucu kemudian tertawa bersama akan menjadi hal menyenangkan bagi anak penderita autis

Ubah Keinginan Anda Terhadap Anak Anda
Orang tua Anda mungkin mengajarkan Anda untuk duduk diam selama waktu makan. Akan tetapi itu bukan keinginan yang wajar bagi kebanyakan anak autis. Cobalah memulai dengan tujuan yang lebih kecil, seperti duduk diam selama tiga menit, makan dengan sendok, atau apa pun yang Anda pikir dia bisa menangani. Kemudian barulah membangun tujuan yang lebih besar, seperti duduk diam selama waktu makan.

Ubah Lingkungan Tempatnya Berada
 Keamanan adalah kuncinya. Demi menangani anak autis, menciptakan lingkungan yang aman adalah sebuah tantangan. Karena begitu banyak perilaku anak Anda mungkin memiliki potensi yang membahayakan dirinya, sangatlah penting untuk mengambil tindakan pencegahan, seperti membaut rak pada dinding dan/atau lantai dengan kencang, atau memastikan lemari berdiri dengan aman. Atau bisa juga menutupi dengan benda lain yang bisa mencegahnya untuk memanjat.

Pertimbangkan Kemungkinan Sumber Perilaku
Banyak anak autis sangat menginginkan, atau sebaliknya “over-respond” terhadap Input Sensorik. Sebagian lagi berganti-ganti diantara keduanya. Sangat sering perilaku “buruk” anak autis sebenarnya adalah reaksi terhadap Input Sensorik berlebih, atau terlalu sedikit. Dengan hati-hati mengamati anak Anda, Anda mungkin dapat mengetahui penyebabnya.

Hilangkan Input Sensorik Berlebih Untuk Menangani Anak Autis
Jika reaksi anak Anda berlebih terhadap Input Sensorik, ada banyak cara untuk mengubah situasi ini. Tentu saja, pilihan pertama adalah hanya menghindari penyebab Input sensorik berlebih seperti parade, taman hiburan dan sejenisnya. Ketika itu tidak bisa dilakukan, Anda bisa menggunakan sumbat telinga, mainan yang bisa mengalihkan, atau cara membujuk lainnya untukmenangani anak autis Anda sementara waktu.

Menyediakan Input Sensorik Untuk Menangani Anak Autis
Jika anak Anda menabrakkan diri di sofa, memanjat dinding atau berputar-putar, kemungkinan dia sedang membutuhkan “Input Sensorik”. Anda dapat menyediakan Input Sensorik dalam beberapa cara yang tepat. Beberapa orang menyarankan menangani anak autis dengan pelukan hangat, lainnya menyarankan menghimpitnya menggunakan bantal sofa dengan hati-hati, menggulung mereka seperti “hot dog” dalam selimut, atau memberi mereka rompi atau selimut yang diberi pemberat.

Cari Jalan Keluar Positif Untuk Perilaku Tidak Biasa
Sementara memanjat di pusat hiburan mungkin adalah perilaku “buruk”, memanjat di tempat olahraga bisa menjadi cara yang bagus untuk membangun otot dan persahabatan, pada saat yang sama. Sementara berputar-putar di toko kelontong mungkin aneh, adalah hal wajar untuk berputar di ayunan ban. Yang menjadi masalah di satu tempat, mungkin menjadi manfaat jika dilakukan di tempat lain!

Nikmati Keberhasilan Anak Anda
Anda, sebagai orang tua, adalah yang seharusnya memberi semangat atas keberhasilan pertama anak Anda. Anda senang ketika ia mengatakan “ya” untuk sebuah ajakan bermain, melengkapi kalimat, atau menendang bola bolak balik beberapa kali. Dia mungkin tidak akan menjadi kapten tim sepak bola, tetapi dia berhasil menjadi dirinya sendiri.

Kurangi Kekhawatiran Terhadap Opini Orang Lain
Anak Anda benar-benar melakukan pekerjaan dengan baik di toko kelontong. Dia mungkin mengepakkan tangannya sedikit, tapi itu bukan masalah besar. Sampai Anda menangkap mata seorang ibu, dari gadis kecil yang sempurna, menatap anak Anda. Tiba-tiba kepakan anak Anda tampak seperti masalah yang sangat besar, dan Anda menemukan diri membentak anak Anda, “..letakkan tangan ke bawah…!”. Ini tidak mudah, tetapi penting untuk diingat bahwa dia autis, dia tidak dengan sengaja mempermalukan Anda!

Temukan Cara Bergembira Bersama
Tidaklah mudah untuk menyatukan autisme dan kegembiraan. Tetapi jika Anda berpikir, ketika sedang menangani anak autis; menggulung anak Anda hingga seperti “hot dog”, memantul di trampolin atau bahkan duduk dan berpelukan bersama-sama dapat menjadi sangat menyenangkan. Daripada mengkhawatirkan tentang hasil terapis dari setiap tindakan, cobalah saja menikmati kekonyolan, gelitikkan, pelukan … dan anak Anda sendiri. Setidaknya untuk sementara waktu!

Perlu diketahui:

• Mengajar anak autis merupakan tugas yang menantang, terutama bagi yang belum pernah memiliki pengalaman menangani anak-anak dengan ketidakmampuan belajar.

• Meskipun lambat, anak autis bisa dilatih untuk membaca, menulis, dan belajar.

• Autisme mempengaruhi kemampuan seseorang untuk berkomunikasi dan berinteraksi secara efektif.

• Autisme merupakan kelainan genetik dan tidak dapat disembuhkan.

• Namun tidak berarti anak autis tidak dapat menjalani kehidupan normal.

• Pengaruh autisme akan bervariasi antara satu anak dengan yang lainnya.

• Ada yang hanya sedikt berbicara, sementara yang lainnya menunjukkan perilaku kompulsif yang ekstrim.

• Di sekolah khusus, anak-anak autis juga belajar aritmatika, tata bahasa, dan lain-lain sama seperti anak lainnya.

• Berbagai teknik dilakukan untuk mengajar anak-anak autis di sekolah khusus.

• Diperlukan kesabaran dan ketekunan ketika menghadapi anak-anak dengan autisme.

• Perilaku agresi, agitasi, dan mudah marah dari guru akan berpengaruh negatif terhadap proses pengajaran.

Perkembangan anak 16-18 Bulan

Pada usia ini si anak sudah dapat berjalan dengan lancar. Perbendaharaan kata-katanya pun semakin banyak. Dan di usianya yang ke-18 bulan dia akan berjalan dengan berjinjit-jinjit dan mulai belajar berlari. Untuk ucapan kata-katanya pun semakin jelas. Satu hal yang aku coba untuk mengurangi kebiasaan buruk anakku yaitu bila dia masuk ke dalam lingkungan baru dan bertemu dengan orang-orang baru maka dia akan takut dan menangis. Untuk itu aku daftarkan dia ke sekolah Tumble Tots agar dia dapat bersosialisasi dengan teman-teman seusianya dan juga gurunya dan saraf motoriknya lebih terasah lagi. Sejauh ini dia sangat menikmatinya.

Pada usia ini si anak sudah dibiasakan untuk bisa mengkomunikasikan keinginannya. Termasuk bila dia mau minum susu. Sekarang bila dia mau minum susu dia sudah bisa bilang “Ma…mau susu”. Ataupun bila dia mau pipis dia akan bilang “mau pis” ataupun “mau pup”.

Pada usia 17 bulan konsumsi susu nya MORINAGA CHIL MIL nya berkurang untuk itu saya berkonsultasi dengan pihak MORINAGA dan akhirnya si kecil sudah bisa diganti susu nya menjadi MORINAGA CHIL KID yang tersedia dengan rasa vanila dan rasa madu. Untuk proses penggantian ini saya melakukannya dengan mencampurkan CHIL MIL tersebut dengan CIL KID dengan komposisi yang seimbang terlebih dahulu kemudian perlahan-lahan menjadi hanya CHIL KID. Contohnya susunya harusnya 2 sendok maka saya campur CHIL MIL 1 sendok kemudian CHIL KID nya 1 sendok. Setelah dilakukan beberapa minggu untuk penyesuaian usus nya terhadap susu CHIL KID barulah dia mengkonsumsi murni CHIL KID 2 sendok. Sekarang konsumsi susunya sudah kembali normal dan mengikuti petunjuk aturan yang ada pada dus susu.

Selain dari konsumsi susu, dia sangat menyukai jus buah yang menjadi selingan di waktu-waktu makannya. Dia sangat suka Jus Strawberry dan Jus Terong Belanda. Kebetulan saya ibu yang kurang menyukai buah-buahan berharap anak ku nantinya akan menyukai buah-buahan dan sayuran.

Ternyata sekarang dia sudah tumbuh besar bukan bayi lagi ya bu…Sekarang setiap bangun pagi dia pasti memeluk dan mencium ku…

Hal ini menjadi semangat ku setiap hari…


-Friskila Damaris Silitonga, SKEP, NS, MPH

Manfaat Kasih Sayang Ibu Bagi Kesehatan Anak

Penelitian mendukung teori ini, studi terbaru menunjukkan ikatan antara ibu dan anak bisa mempengaruhi otak, jantung, tubuh dan bahkan kehidupan seks seseorang. Ini dia manfaatnya:

1. Bisa menjadi nutrisi bagi otak
Kasih sayang ibu tidak hanya baik untuk jantung dan jiwa, tapi juga nutrisi bagi otak. Peneliti di Washington University School of Medicine melakukan scan terhadap anak usia 7-10 tahun. Didapatkan anak yang mendapatkan asuhan dan dukungan dari ibu memiliki bagian otak hippocampus yang lebih besar dibanding anak yang kurang mendapat kasih sayang.

Hippocampus adalah daerah otak yang terlibat dalam memori dan pembelajaran, serta menjadi kunci perkembangan masa kanak-kanak dan juga prestasi akademisnya di sekolah.

Sedangkan bagi si ibu, kasih sayang yang diberikan pada anaknya membuat otaknya juga bertambah besar selama baru menjadi ibu, terutama di daerah yang berhubungan dengan kesenangan, penilaian, penalaran dan perencanaan.

2. Lebih sehat saat usia setengah baya
Orang-orang dengan ibu yang sangat mencintai dan mengasuh dengan tulus membuatnya berisiko lebih rendah terkena penyakit sindrom metabolik seperti diabetes tipe 2. Para peneliti berspekulasi, hal ini berhubungan dengan tingkat stres yang lebih rendah saat mendapat kasih sayang ibu sehingga risiko terjadi peradangan dan sensitivitas insulin juga menurun.

3. Menurunkan risiko obesitas
Studi dari Ohio State University menemukan ikatan emosional yang lemah antara ibu dan anak dikaitkan dengan kemungkinan anak memiliki kelebihan berat badan di kemudian hari. Bahkan dalam studi ini lebih dari 25 persen balita obesitas saat remaja karena memiliki hubungan yang buruk dengan ibunya.

Peneliti mengatakan area di otak yang mengontrol emosi dan stres turut membantu mengontrol nafsu makan dan keseimbangan energi, sehingga mengurangi risiko makan berlebih.

4. Memiliki kehidupan seks yang sehat
Penelitian menemukan ibu turut membantu mensosialisasikan anak-anaknya terhadap tanggung jawab seksual, sehingga bisa membantu anak memiliki pandangan yang tepat mengenai seks. Serta gadis yang memiliki ikatan emosional kuat dengan ibunya cenderung memiliki kehidupan seks yang lebih baik.

5. Hubungan romantis yang lebih stabil
Studi yang diterbitkan dalam jurnal Psychological Science mengungkapkan anak yang mendapatkan kasih sayang dan dukungan yang kurang dari orang tua terutama ibu cenderung memiliki hubungan romantis yang tidak stabil.

Meski begitu hasil ini bukanlah sebab akibat, karena itu bukan berarti jika tidak memiliki hubungan yang sehat dengan ibu, ia tidak akan memiliki hubungan yang baik dengan pasangan. - 5 Manfaat Kasih Sayang Ibu Bagi Kesehatan Anak.


- Friskila Damaris Silitonga, SKEP, NS, MPH

The Foundation for Mother and Child Health Indonesia

Indonesia is the world’s largest archipelago consisting of around 18,000 islands. It is situated in South East Asia and includes such well known islands as Java, Sumatra, Bali, Komodo, Kalimantan and Timor.

It is the world’s fourth most populous nation in the world after China, India and the United States with an estimated population of 239 million (UNICEF, 2012).

Natural disasters such as earthquakes, tsunami and flooding frequently affect Indonesia. Aceh, situated on the northern tip of the island of Sumatra, was one of the worst affected regions in the world to suffer the devastating effects of the tsunami in December 2004 with around 200,000 Indonesians left dead or missing, and more recently, in 2013 severe flooding in Jakarta led the Indonesian government to declare a state of emergency.

West Timor in the rainy season – landslides make roads hazardous for travel.

As more and more people from rural areas move into urban areas, huge strains are put upon housing, water supplies, health care, education and employment.

More than 120 million Indonesians live on less than $2 per day (AUSAID, 2013) with the average income being $2,580 per year.

Indonesia’s Global hunger index – Serious (IFPRI, 2012) - This rating ranks countries on the basis of a combination of three indicators: level of child malnutrition, rates of child mortality, and the proportion of people who are calorie deficient. The ranking is updated annually.

Despite improvements in child malnutrition rates, 18% of all Indonesian children under the age of five suffer from malnutrition, and 37%  of the same age group have stunted growth (National Health Survey, Ministry of Health 2010; UNICEF, 2012).

Smoke house in West Timor

Micronutrient deficiencies: including iodine deficiency, vitamin A deficiency and iron deficiencies are prevalent. A lack of these micronutrients can lead to stunted growth, anaemia, night blindness, and a reduction of intellectual and physical capabilities in children making them much less likely to achieve their full potential, and more susceptible to illness and death.

Maternal mortality rates remain particularly high in Indonesia with 240 mothers dying from pregnancy related causes per 100,000 live births (UNICEF, 2012). The equivalent figure in the UK is 12 deaths per 100,000 live births.

Malaria is a major public health problem in Indonesia. It is estimated that over 105 million of Indonesia’s 239 million population are at risk for malaria infection, and recent research estimates that about 11,000 people die per year from this disease (Malaria Journal, 2013). The elimination of malaria is a primary aim of the Indonesian government who have stated that they wish to eliminate it by 2030.

What we do

The causes of malnutrition are complex. While poverty does play a major role, it is not merely a lack of food that plagues these families. A multifaceted problem demands a comprehensive solution, and the Foundation for Mother and Child Health in Indonesia is attacking undernutrition from its many different angles.

Under nutrition occurs when not enough food is eaten and the child is repeatedly ill from infectious diseases. Children who are undernourished have lowered resistance to infection and are more likely to die from common childhood diseases such as diarrhoea diseases and respiratory infections (UNICEF 2007). The ones who survive are likely to be caught up in a spiral of recurring sickness and slowed growth, often with irreversible damage to their mental and social development,

Well nourished women face fewer risks during pregnancy and childbirth and their children have a better start in life. Well nourished children perform better at school, grow into healthier adults and are able to give their own children a better start in life.

Children attending FMCH programmes in Jakarta are undernourished and come from impoverished families. Often their parents are unemployed or, if lucky enough to be employed, find work selling food on the streets of Jakarta or driving vans in their villages (kampungs). Most children attending FMCH live in very basic conditions with their family, often living in a one roomed house divided into two rooms by a curtain. Families share washing and bathroom facilities with several other families in their village. Parents have often had limited education: many of them only having had schooling up to the ages of 12 years old.

With these many problems facing families and their children, a multi faceted programme has been developed to try and alleviate the causes of undernutrition and poverty.  The Foundation for Mother and Child Health Indonesia provides health care, nutrition, education, pre school and skills training programmes for mothers, fathers and children; and provides train the trainer programmes for community health workers.