What does a pediatrician do?

Pediatrics is aimed at the prevention and treatment of diseases in children of any age.

Pediatricians observe newborns from the first day of life and give parents recommendations on feeding and caring for the baby. Regular examinations by a pediatrician allow you to monitor the physical and neuropsychic development of the child, and timely detect and correct disorders of various types.

Pediatrics is divided into several areas:

preventive: aimed at preventing disorders in the development of the child. The main methods used: screening tests to detect genetic abnormalities, vaccinations according to the calendar, counseling parents on physical education and a balanced diet, and so on;
clinical: deals with the diagnosis of pathologies and their effective treatment. For this purpose, modern laboratory and instrumental examinations are used, as well as drug therapy and physiotherapy;
scientific: focused on building scientific paradigms that explain the development of children at different ages;
social: aimed at studying social factors affecting the health of the child and creating a suitable sanitary and hygienic environment in children's institutions;
environmental: studies the influence of natural factors on the formation of a child’s body.

Parents most often encounter clinical and preventive pediatrics.

What does the pediatrician look for?

The pediatrician provides scheduled and unscheduled consultations.

Scheduled inspections are carried out according to the following schedule:

1 month: the doctor monitors weight gain and growth, checks reflexes, hearing and vision, symmetry of the folds in the newborn;
monthly until the child reaches one year of age: regular visits are necessary for early detection of pathologies and counseling parents on nutrition, sleep, strengthening the muscle corset, and early development;
after one year: according to the vaccination calendar for immunizing the child.

The pediatrician also advises parents when children have teething problems. It is also necessary to undergo a routine examination by a pediatrician before entering kindergarten and school. The pediatrician checks the readiness of children to increase physical and intellectual stress, and gives a conclusion about the child’s compliance with one of the health groups. If a young patient has chronic diseases or congenital anomalies, the doctor develops a long-term therapy plan aimed at relieving symptoms and maintaining health.

An unscheduled visit to the pediatric department is necessary if the child has become lethargic, apathetic, or has symptoms of the disease.

For children under 3 years of age, the danger signs are:

delay in physical and mental development;
forced (unnatural) position of the neck during feeding;
increased tearfulness;
refusal to eat and poor weight gain;
restless sleep;
crying too loudly;
chaotic eye movements (the child does not focus on the faces of the parents or other objects).

You should also seek medical help if you notice the following symptoms (regardless of the child’s age):

complaints of pain in any part of the body;
frequent headaches;
temperature increase;
lethargy and apathy, increased fatigue;
nightmares and problems sleeping;
urinary incontinence (for children over 3 years old);
presence of impurities in stool or urine, or changes in the frequency of bowel movements and urination (constipation or diarrhea);
the appearance of skin rashes;
tumors and swelling on the body;
nausea and vomiting;
shortness of breath after exercise.

Poor coordination in a child is also a warning sign: if you notice that he often falls, does not participate in active games, runs and jumps with caution (or tries to avoid exertion), this may be a reason to visit a pediatrician. You should also make an appointment with a doctor if your child is having difficulty adapting to school workloads: perhaps problems with concentration and perseverance are caused by a hormonal imbalance, vitamin deficiency, or another disorder.

The examination in the pediatrician's office takes place in the presence of adults: parents or guardians. The doctor weighs the child, measures the height and volume of certain parts of the body (in young children), checks reflexes and body temperature. The pediatrician also examines the skin, listens to the heartbeat, and kneads the abdomen. After collecting anamnesis, additional tests may be prescribed. Most often, this is a general analysis of urine and blood, sputum culture (if an infection is suspected), and ultrasound of organs. Based on the results of the research, appropriate therapy is prescribed.

During treatment, you must be examined again by a pediatrician. The doctor monitors recovery and, if necessary, adjusts the dosage of medications.

What does the pediatrician treat?

A pediatrician diagnoses and treats a wide range of disorders of various organ systems.

Often specialists encounter infections:

flu. An upper respiratory tract disease caused by viruses of different strains. Manifests itself in the form of high body temperature and chills, cough, mucous discharge from the nose;
measles. Another viral disease that affects the entire body as a whole. The child develops a fever, conjunctivitis appears, and experiences general symptoms of intoxication: nausea, weakness, headache;
ARVI. Pathology of the upper respiratory tract with a milder course than influenza. The main symptoms: nasal congestion, redness of the sclera, frequent sneezing and lacrimation. Most often, infection occurs in the cold season against the background of general hypothermia of the body;
scarlet fever. A common childhood disease with a high risk of severe complications. The first sign of scarlet fever is the appearance of a bright red rash on the skin and mucous membrane of the oral cavity;
bronchitis. Inflammation of the bronchi, leading to a convulsive cough with difficult to clear sputum. Usually accompanied by increased body temperature and general weakness. If the disease spreads to neighboring tissues and organs, rhinitis develops;
chickenpox. A viral infection that affects the skin with the formation of a characteristic itchy rash. The disease is quite common in children and is highly contagious.

A pediatrician is one of the first doctors you should contact if your child is unwell. Therefore, he is faced with diseases of various organ systems. For example, he can diagnose sore throat and otitis media, dysbacteriosis or pyelonephritis. In some cases, consultation with highly specialized doctors is required: pediatric otolaryngologists, urologists, nephrologists, dermatologists, and so on. In this case, the doctor refers the patient to the right specialist for further treatment.

Story

The profession of a pediatrician as a separate specialization in Russia appeared in the 19th century. The starting point of its development is considered to be the publication in 1847 of the manual “Pediatrik” by S. F. Khotovitsky. The scientific work highlights the physiological features of the child’s body and describes the so-called infant diseases. In the second half of the 19th century, N. F. Filatov became known as a talented pediatrician. He described acute infections common to children - measles, scarlet fever, diphtheria, chicken pox, and made a significant contribution to the study of the latent form of malaria. He authored textbooks that are fundamental in quality and breadth of knowledge.

The formation of pediatrics as an independent medical science lasted for decades, but the official opening of faculties for training pediatric doctors in Leningrad (St. Petersburg) and Moscow took place only in 1935. Before and after this date, the study of pressing topics continued (for example, the course of pathologies with rashes and fever, the use of vaccines), and in modern Russia, in every medical university there are departments of pediatrics and its numerous branches - narrow specializations (for example, neonatology).

Do I need to go to the pediatrician after a year?

A pediatrician not only diagnoses and treats various pathologies in children, he also monitors their physical and neuropsychic development. Scheduled visits to a specialist allow you to monitor the main changes occurring in the child’s body, identify various deviations in time and correct them.

Examinations by a pediatrician are necessary to detect developmental delays.

Various signs may indicate this:

lethargy and low physical activity of the child;
uncertain, stiff gait, frequent falls (for children over one and a half years old);
slurred speech;
undeveloped hand motor skills.

Such a clinical picture may indicate a genetic disease or hormonal imbalance. With early diagnosis, most pathologies can be cured or corrected. But a late visit to a specialist reduces the child’s chances of full development.

Also, a routine examination by a pediatrician is necessary before the first visit to kindergarten and school. The doctor not only prepares documents, but also checks how ready the child is for socialization and increased physical and mental stress. If a child develops more slowly than his peers, suffers from chronic diseases, or his immune system is not strong enough, the pediatrician may recommend postponing entry into first grade.

Do I need to see a pediatrician before vaccination?

The Ministry of Health of Ukraine has developed and approved a national vaccination calendar, according to which it is recommended to vaccinate children. Before vaccination, you must bring your child to be examined by a pediatrician.

The doctor will determine whether there are any contraindications to the procedure.

Vaccinations are not given if children:

increased body temperature;
there is an exacerbation of a chronic disease;
weakened immune system after recent injury or surgery;
in the past there was an acute reaction to immunization - fever, swelling.

In this case, the doctor recommends postponing the procedure to a more favorable period. Also, each vaccine has its own list of contraindications. For example, the tuberculosis vaccine is not given to children with an insufficient mass index, as well as in the presence of a keloid scar. The DTP vaccine is not given to patients with progressive diseases of the nervous system. An examination by a pediatrician before immunization allows you to take into account all existing risks and make vaccination effective and safe for the child.

Breastfeeding or baby food

Many women who want to use artificial feeding want to know what pediatricians think and say about infant formula ? The opinion of experts is clear. Breastfeeding is the best solution if the mother is in good health and has no contraindications or bad habits.

Why doctors recommend breast milk:

better immunity. Antibodies in the mother’s body protect the child from diseases that she has already had;
normal growth;
minimal risk of gaining excess weight. It is almost impossible to overfeed a baby with breast milk;
the baby burps less because less air enters the stomach;
the risk of rickets is reduced;
restoration of mother's health. The likelihood of developing breast cancer is minimized. Oxytocin produced during breastfeeding restores the previous state of the uterus. Accelerated metabolism makes it easier to return to your previous figure;
breast milk is sterile. This is more convenient than artificial feeding.

The disadvantages of artificial feeding include certain discomfort (spontaneous milk release, constant need to be near the baby) and difficulties in determining the amount of food eaten.

Is it possible to choose a pediatrician?

A pediatrician is the main doctor who monitors the health and development of a child until he reaches adulthood. Therefore, parents want to find not only an experienced and competent specialist, but also a doctor whom they can completely trust.

According to the National Campaign, carried out in Ukraine since April 2018, any resident of the country has the right to choose a doctor at his own discretion. This rule also applies to pediatricians. Initially, young patients are observed by pediatricians at the nearest polymedical center (at the place of registration). But parents can enter into an agreement for the provision of medical services with any specialist in their city, without being tied to their registration address or actual residential address.

To select a competent pediatrician, it is recommended:

study reviews about the selected specialist. This can be done on the official website of the medical center, or by talking with its patients;
make an appointment for a routine examination with your child. A competent pediatrician easily finds contact with young patients - this is an important condition that allows children to undergo medical procedures without fear;
ask the doctor any questions you are interested in, and after talking with specialists, make a decision about service with a specific doctor.

In the future, you can change your pediatrician if necessary.

Pediatrics

The concept of “pediatrics” is translated from Greek as “child treatment.” Doctors and healers have long understood that diseases in children and adults progress differently. But, nevertheless, for quite a long time pediatrics was part of obstetrics. Therefore, those doctors who delivered children subsequently treated newborn babies.

Pediatrics became an independent field in 1802, when the first children's hospital was built in Paris.

The question of the need to separate into an independent field of medicine was dealt with by many Russian scientists and doctors, among whom were A. N. Radishchev, M. V. Lomonosov, N. I. Novikov, I. I. Betsky, S. G. Zybelin.

The first children's hospital was built in 1834 in St. Petersburg, and the second in 1842 in Moscow. 1865 is the year of the establishment of the first department specializing in childhood diseases.

When science became an independent sphere, many narrow specializations arose in it. This is how various categories in the field of pediatrics emerged, for example preventive. They are the ones who are involved in the development and organization of certain actions and activities aimed at preventing morbidity among children.

The list of the main responsibilities of such a specialist includes the following:

Carrying out scheduled inspections.
Promotion of a healthy lifestyle and hardening.
Description of the need for vaccination and examination of children before it.
Providing information and conducting conversations about various ways and techniques for maintaining the health of young patients.

In addition, there are three main levels in the preventive direction:

primary;
secondary;
tertiary.

The first option involves prevention using various vaccinations and vitamin complexes.

The second involves early diagnosis and identification of symptoms of emerging diseases. For this purpose, routine screenings, examinations and tests are carried out.

The last area deals with the prevention of the development of childhood diseases, for which certain diets and other preventive measures are prescribed.

A pediatrician working in the clinical field deals with the diagnosis and treatment of various diseases in young patients.

A scientific specialist conducts innovative research and development to preserve the good health of children.

An environmental worker determines the degree of environmental impact on the condition of young organisms.

The social pediatric department specializes in approving various documentation on public health protection and medical statistics. This also includes interaction with other structures, as a result of which the maximum preservation of children’s health is observed.

Is it possible to change the local pediatrician?

Until the patient has entered into an agreement with a pediatrician, he is assigned to the nearest polymedical center (at the place of registration) and is seen by a local doctor. In order to change a specialist, it is enough to choose another one and conclude an agreement with him. However, you should hurry up when choosing a pediatrician. According to the recommendations of the Ministry of Health of Ukraine, for each specialist there is a recommended number of patients, which should not be exceeded. For pediatricians, this threshold is 900 children.

Increasing the limit leads to increased workload on the specialist, which can lead to a deterioration in the quality of medical care. This issue is controlled by the state services of Ukraine. Therefore, the sooner you choose a doctor, the higher the likelihood that you can still conclude an agreement with him.

How to build a career

Many pediatricians start as local doctors and can, after acquiring a sufficient level of qualifications, become:

head of outpatient department (in large clinics);
Deputy for medical work;
chief physician

If desired, narrow specialists (for example, gastroenterologists) can also follow the same path.

In hospitals the scheme is similar:

Resident doctor.
Head of the department.
Deputy for medical work.
Chief physician.

You can also work in a department or Ministry of Health (for example, as a chief specialist in pediatrics).

If you have a penchant for scientific research or teaching, you can enroll in graduate school or work as an assistant in your chosen department, write or take part in writing research papers on topics of interest, give lectures and conduct practical classes for students. With successful career development, the position of head is not excluded; you can apply for the position of dean or rector of a medical educational institution.

Do I need to enter into an agreement with a pediatrician?

In accordance with the latest reforms carried out by the Ministry of Health of Ukraine, it is required to conclude a service agreement with the selected pediatrician.

For this, parents need to prepare the following documents:

passport;
TIN;
child's birth certificate.

You will also need your mobile phone number when signing the declaration. However, an agreement with a doctor can only be drawn up if the medical center where the specialist works is connected to the Electronic Health system. You can check this information at the registration desk.

The contract is drawn up electronically either by the pediatrician himself or by an authorized person (an employee of the medical center).

The procedure is carried out in several stages:

filling out an electronic version of the declaration;
entering a confirmation code (received as an SMS to the patient’s contact number). If the person who applies does not have a mobile phone, a specialist from the medical center scans the original documents and attaches them to the declaration;
printing of two copies of the contract, one of which remains in the medical institution, the second is given to the patient.

The declaration is automatically registered in the electronic database. In the future, if parents or guardians decide to change pediatricians, they will not need to terminate the agreement. It is enough to conclude a new agreement, and data about this will be displayed in the system.

Until the patient has signed a declaration with a specific specialist, he is served by a pediatrician at his place of registration.

Is a pediatrician in a private medical center expensive?

The possibility of concluding an agreement with any pediatrician in the city has increased the popularity of private clinics.

Private medical centers offer patients a number of advantages:

reception by appointment. The absence of queues allows you to undergo examination by a specialist and prescribed procedures without wasting time;
examination by highly specialized specialists. For example, pediatric orthopedists, pulmonologists, gastroenterologists, endocrinologists and other doctors are seen at the medical clinic. If the pediatrician needs to consult another doctor, you can undergo an examination at the same medical center, which is convenient for the patient;
24/7 support. Another important advantage of private medicine is support for patients at any time: you can reschedule a consultation or get specialist help when it is needed;
modern equipment. This applies to both diagnostic equipment and devices for physiotherapy. Modern ultrasound scanners with high image accuracy, X-ray machines with a minimum radiation dose, and so on are used;
having our own laboratory. Thanks to this, the diagnosis is made faster - you can get the result directly on the day of treatment.

Many consider the high cost of consultation to be the only disadvantage of seeing a private pediatrician. In reality, medical centers strive to keep prices affordable and offer patients comfortable service conditions. The final cost of treatment depends on the number of examinations completed, procedures and medications prescribed, and tests performed. You can check preliminary prices on the official website of the selected medical center, or at the reception by contact phone number.

Also, some medical centers offer special payment terms. For example, at ON Clinic staged payment is available without proof of income. This solution makes high-quality medicine accessible to a wide audience.

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Author: Syrbu Tatyana Vladimirovna

Head of the children's department, pediatrician. First category. Work experience 10 years.