Sleepwalking

About Sleepwalking

Hours after bedtime, do you find your little one wandering the hall looking dazed and confused? If you have a sleepwalking child, you're not alone. It can be unnerving to see, but sleepwalking is very common in kids and most sleepwalkers only do so occasionally and outgrow it by the teen years. Still, some simple steps can keep your young sleepwalker safe while traipsing about.

Despite its name, sleepwalking (also called somnambulism) actually involves more than just walking. Sleepwalking behaviors can range from harmless (sitting up), to potentially dangerous (wandering outside), to just inappropriate (kids may even open a closet door and urinate inside). No matter what kids do during sleepwalking episodes, though, it's unlikely that they'll remember ever having done it!

As we sleep, our brains pass through five stages of sleep — stages 1, 2, 3, 4, and REM (rapid eye movement) sleep. Together, these stages make up a sleep cycle. One complete sleep cycle lasts about 90 to 100 minutes. So a person experiences about four or five sleep cycles during an average night's sleep.

Sleepwalking most often occurs during the deeper sleep of stages 3 and 4. During these stages, it's more difficult to wake someone up, and when awakened, a person may feel groggy and disoriented for a few minutes.

Kids tend to sleepwalk within an hour or two of falling asleep and may walk around for anywhere from a few seconds to 30 minutes.

Causes of Sleepwalking

Sleepwalking is far more common in kids than in adults, as most sleepwalkers outgrow it by the early teen years. It may run in families, so if you or your partner are or were sleepwalkers, your child may be too.

Other factors that may bring on a sleepwalking episode include:

• lack of sleep or fatigue
• irregular sleep schedules
• illness or fever
• certain medications
• stress (sleepwalking is rarely caused by an underlying medical, emotional, or psychological problem)

Behaviors During Sleepwalking

Of course, getting out of bed and walking around while still sleeping is the most obvious sleepwalking symptom. But young sleepwalkers may also:

• sleeptalk
• be hard to wake up
• seem dazed
• be clumsy
• not respond when spoken to
• sit up in bed and go through repeated motions, such as rubbing their eyes or fussing with their pajamas

Also, sleepwalkers' eyes are open, but they don't see the same way they do when they're awake and they often think they're in different rooms of the house or different places altogether.
Sometimes, these other conditions may accompany sleepwalking:

• sleep apnea (brief pauses in breathing while sleeping)
• bedwetting (enuresis)
• night terrors

Is Sleepwalking Harmful?

Sleepwalking itself is not harmful. However, sleepwalking episodes can be hazardous since sleepwalking kids aren't awake and may not realize what they're doing, such as walking down stairs or opening windows.

Sleepwalking is not usually a sign that something is emotionally or psychologically wrong with a child. And it doesn't cause any emotional harm. Sleepwalkers probably won't even remember the nighttime stroll.

How to Keep a Sleepwalker Safe

Although sleepwalking isn't dangerous by itself, it's important to take precautions so that your sleepwalking child is less likely to fall down, run into something, walk out the front door, or drive (if your teen is a sleepwalker).
To help keep your sleepwalker out of harm's way:

• Try not to wake a sleepwalker because this might scare your child. Instead, gently guide him or her back to bed.
• Lock the windows and doors, not just in your child's bedroom but throughout your home, in case your young sleepwalker decides to wander. You may consider extra locks or child safety locks on doors. Keys should be kept out of reach for kids who are old enough to drive.
• To prevent falls, don't let your sleepwalker sleep in a bunk bed.
• Remove sharp or breakable things from around your child's bed.
• Keep dangerous objects out of reach.
• Remove obstacles from your child's room and throughout your home to prevent a stumble. Especially eliminate clutter on the floor (i.e., in your child's bedroom or playroom).
• Install safety gates outside your child's room and/or at the top of any stairs.

Other Ways to Help a Sleepwalker

Unless the episodes are very regular, cause your child to be sleepy during the day, or your child is engaging in dangerous sleepwalking behaviors, there's usually no need to treat sleepwalking. But if the sleepwalking is frequent, causing problems, or your child hasn't outgrown it by the early teen years, talk to your doctor. Also talk to your doctor if you're concerned that something else could be going on, like reflux or trouble breathing.

For kids who sleepwalk often, doctors may recommend a treatment called scheduled awakening. This disrupts the sleep cycle enough to help stop sleepwalking. In rare cases, a doctor may prescribe medication to help a child sleep.

Other ways to help minimize sleepwalking episodes:

• Have your child relax at bedtime by listening to soft music or relaxation tapes.
• Establish a regular sleep and nap schedule and stick to it — both nighttime and wake-up time.
• Make your child's bedtime earlier. This can improve excessive sleepiness.
• Don't let kids drink a lot in the evening and be sure they go to the bathroom before going to bed. (A full bladder can contribute to sleepwalking.)
• Avoid caffeine near bedtime.
• Make sure your child's bedroom is quiet, cozy, and conducive to sleeping. Keep noise to a minimum while kids are trying to sleep (at bedtime and naptime).

The next time you encounter your nighttime wanderer, don't panic. Simply steer your child back to the safety and comfort of his or her bed.

"I pray that this article empowers you to Get A L.I.F.E."

Preschoolers Need Sleep!

Establishing a Bedtime Routine
Preschoolers sleep about 10 to 12 hours during each 24-hour period, but there's no need to be rigid about which 10 to 12 hours these are. The most important thing is to help kids develop good habits for getting to sleep.

A bedtime routine is a great way to ensure that your preschooler gets enough sleep.

Here are a few things to keep in mind when establishing that routine:

Include a winding-down period during the half hour before bedtime.
Stick to a bedtime, alerting your child both half an hour and 10 minutes beforehand.
Set fixed times for going to bed, waking up, and taking naps.
Keep consistent playtimes and mealtimes.
Avoid stimulants, such as sugar, near bedtime.
Make the bedroom quiet, cozy, and conducive to sleeping.
Use the bed only for sleeping — not for playing or watching TV.
Limit food and drink before bedtime.
Allow your child to choose which pajamas to wear, which stuffed animal to take to bed, etc. Consider playing soft, soothing music.
Tuck your child into bed snugly for a feeling of security.

A Note on Naps

Most preschoolers do still need naps during the day. They tend to be very active — running around, playing, going to school, and exploring their surroundings — so it's a good idea to give them a special opportunity to slow down. Even if your child can't fall asleep, try to set aside some quiet time during the day for relaxing. (And you'll probably benefit from a break too!)

The best way to encourage napping is to set up a routine for your child, just as you do for bedtime. Your preschooler, not wanting to miss out on any of the action, may resist a nap, but it's important to keep the routine firm and consistent. Explain that this is quiet time and that you want your child to start out in bed, but that it's OK to play in the bedroom quietly if he or she can't sleep.

How long should naps last? For however long you feel your child needs to get some rest. Usually, about an hour is sufficient. But there will be times when your child has been going full tilt and will need a longer nap, and others when you hear your child chattering away, playing through the entire naptime.

Sleeping Problems

Preschoolers may have nightmares, or night terrors, and there may be many nights when they have trouble falling asleep.

It may help if you create a "nighttime kit" to keep near your child's bed for these times. That kit might include a flashlight, a favorite book, and a cassette or CD to play. Explain the kit, then put it in a special place where your child can get to it in the middle of the night.

Objects like stuffed animals and blankets also can help kids feel safe. If your child doesn't have a favorite toy and getting to sleep has become consistently difficult, then it might be worth going out together to pick out a warm, soft blanket or stuffed animal.

Some parents get into the habit of lying down next to their young kids until they fall asleep. While this may do the trick temporarily, it won't help sleeping patterns in the long term. It's important to provide comfort and reassurance, but kids need to fall asleep independently for when parents aren't around. If you establish a routine where you have to be there for your child to go to sleep, then it will be difficult for both of you — and unfair to your child — if you start leaving beforehand.

If you're worried about your child's sleeping patterns, talk with your doctor. Although there isn't one sure way to raise a good sleeper, most kids have the ability to sleep well and work through any sleeping problems. The key is to try from early on to establish healthy bedtime habits.

"I pray that this article empowers you to Get A L.I.F.E."

Positional Plagiocephaly

Passage through the birth canal often makes a newborn's head appear pointy or elongated for a short time. It's normal for a baby's skull, which is made up of several separate bones that will eventually fuse together, to be slightly misshapen during the few days or weeks after birth.

But if a baby develops a persistent flat spot, either on one side or the back of the head, it could be a sign of document.write(defpositional_plagiocephaly244) positional plagiocephalypositional plagiocephaly. Also known as flattened head syndrome, this can occur when a baby sleeps in the same position repeatedly or because of problems with the neck muscles.

Fortunately, positional plagiocephaly can be treated without surgery and does not cause lasting cosmetic problems.

About Positional Plagiocephaly

Positional plagiocephaly is a disorder in which the back or one side of an infant's head is flattened, often with little hair growing in that area. It's most often the result of babies spending a lot of time lying on their backs or often being in a position where the head is resting against a flat surface (such as in cribs, strollers, swings, and playpens).

Because infants' heads are soft to allow for the incredible brain growth that occurs in the first year of life, they're susceptible to being "molded" into a flat shape.

Causes of Positional Plagiocephaly

The most common cause of a flattened head is a baby's sleep position. Because infants sleep so many hours on their backs, the head sometimes assumes a flat shape.

In almost all infants with plagiocephaly, there is some limit of active neck movement that leads to a preference to turn the head to one side and not to the other. The medical term for this is torticollis. The cause and effect relationship between torticollis and plagiocephaly goes both ways. Many infants are born with torticollis — perhaps related to fetal positioning in the uterus during late pregnancy — and subsequently develop plagiocephaly after birth.

But infants with severe flattening on one side must expend much more energy than normal to turn the head to the other side, so they do not do so, and their necks become stiff from disuse. In many infants with torticollis, their head will be turned to one side (usually to the right, for unknown reasons) while their chin is tilted toward the other.

Premature babies are more prone to positional plagiocephaly — their skulls are softer than those of full-term babies, and they spend a great deal of time on their backs without being moved or picked up because of their medical needs and extreme fragility after birth, which usually requires a stay in the neonatal intensive care unit (NICU).

A baby might even start to develop positional plagiocephaly before birth, if pressure is placed on the baby's skull by the mother's pelvis or a twin. In fact, it's not at all unusual to see plagiocephaly in multiple birth infants.

If your infant has a misshapen head, your physician will need to decide whether the cause is plagiocephaly, which is very common and does not require surgery, or a condition called craniosynostosis, which is much less common and generally requires surgical treatment.

Craniosynostosis happens when adjacent skull bones become fused together ahead of the normal developmental schedule. This fusion limits the growth of the head in the direction perpendicular to the fused border between the affected bones, and the head grows excessively in other directions. This produces distinctive patterns of skull deformity that look very different from plagiocephaly.

Plagiocephaly is usually easy to recognize, because the deformity affects the back of the head most severely.

Signs and Symptoms

Positional plagiocephaly is usually easy for parents to notice. Typically, the back of the child's head (called the occiput) is flattened on one side, and the ear on the flattened side may be pushed forward as viewed from above.

In severe cases, there may be bulging on the side opposite from the flattening and the forehead may be asymmetrical (or uneven). If torticollis is the cause, the neck, jaw, and face may be asymmetrical. But although other aspects of the head and face may be affected, in positional plagiocephaly the back of the head is always most involved.

Diagnosis

Most often, a doctor can make the diagnosis of positional plagiocephaly simply by examining a child's head, without having to order lab tests or X-rays.

The doctor will also note whether regular repositioning of the child's head during sleep successfully reshapes the growing skull over time (craniosynostosis, on the other hand, typically will worsen).

If there's still some doubt, consultation with a specialist — a pediatric neurosurgeon or a craniofacial plastic surgeon — may be needed. X-rays and CT scans play no role in the management of plagiocephaly and are not necessary to distinguish it from craniosynostosis.

Treatment

Treatment for positional plagiocephaly caused by sleeping position is usually easy and painless, entailing simple repositioning of babies during sleep to encourage them to alternate their head position while sleeping on their backs.

Even though they'll probably move around throughout the night, alternating sides is still beneficial. Wedge pillows are available that keep babies lying on one side or the other, but be sure to check with your doctor before using one to ensure that it's appropriate and safe for your baby. The American Academy of Pediatrics (AAP) does not recommend routinely using any devices that might restrict the movement of an infant's head.

In addition, you will want to consider how you lay your baby down in the crib. Most right-handed parents carry small infants cradled in their left arms and lay them down with the heads to their left. In this position, the infant must turn to the right to look out into the room — and, indeed, torticollis to the right with flattening of the right side of the head is far more common than the left.

Whichever side of your infant's head is flattened, you will want to position your baby in the crib to encourage active turning of the head to the other side.

Always be sure your baby gets plenty of supervised time on the stomach while awake during the day. Not only does "tummy time" promote normal shaping of the back the head, it also helps in other ways. Looking around from a new perspective encourages your baby's learning and discovery of the world. Plus, it helps babies learn to push up on their arms, which helps develop the muscles needed for crawling and sitting up. It also helps to strengthen the neck muscles.

As most infants with plagiocephaly have some degree of torticollis, a course of physical therapy and a home exercise program will usually be part of the recommended treatment. A physical therapist can teach you exercises to do with your baby involving stretching techniques that are gradual and progressive. Most moves will consist of stretching your child's neck to the side opposite the tilt. Eventually, the neck muscles will be elongated and the neck will straighten itself out. Although they're very simple, the exercises must be performed correctly.

For kids with severe positional plagiocephaly, doctors may prescribe a custom-molded helmet or head band. These work best if started between the ages of 4 and 6 months, when a child grows the fastest, and are usually less helpful after 10 months of age. They work by applying gentle but constant pressure on a baby's growing skull in an effort to redirect the growth.

But never purchase or use any devices like these without having your child evaluated by a doctor. Only a small percentage of babies wear helmets. The decision to use helmet therapy is made on a case-by-case basis (for example, if the condition is so severe that a baby's face is becoming misshapen or the parents are very upset). Although helmets might not improve the outcome in all children, some kids with severe torticollis can benefit from their use.

Prognosis

The outlook for babies with positional plagiocephaly is excellent. As babies grow, they begin to reposition themselves naturally during sleep much more often than they did as newborns, which allows their heads to be in different positions throughout the night.

After babies are able to roll over, the AAP still recommends that parents put them to sleep on their backs, but then allow them to move into the position that most suits them without repositioning them onto their backs.

As a general rule, once an infant has attained independent sitting, plagiocephaly will not get any worse. Then, over months and years, as the skull grows, even in severe cases the flattening will improve. The head will never be perfectly symmetrical, but for a variety of developmental reasons the asymmetry becomes much less conspicuous as well. In later childhood the face becomes more prominent in relation to the skull, hair thickens, and children grow into lives of continual motion. Experience and clinical research have shown that by school age, plagiocephaly is no longer a social or cosmetic problem.

It's important to remember that plagiocephaly itself does not affect a child's brain growth or cause developmental delays or brain damage.

Prevention

Babies should be put down to sleep on their backs to help prevent sudden infant death syndrome (SIDS), despite the possibility of developing an area of flattening on the back of the head.

However, alternating their head position every night while they sleep and providing lots of tummy time and stimulation during the day while they're awake can reduce the risk of positional plagiocephaly.

"I pray that this article empowers you to Get A L.I.F.E."

Children & Nightmares

It's not clear at what age kids begin to dream, but even toddlers may speak about having dreams — pleasant ones and scary ones. While almost every child has an occasional frightening or upsetting dream, nightmares seem to peak during the preschool years when fear of the dark is common. But older kids (and even adults) have occasional nightmares, too.

Nightmares aren't completely preventable, but parents can set the stage for a peaceful night's rest. That way, when nightmares do creep in, a little reassurance and comfort from you can quickly restore your child's peace of mind.

Helping kids conquer this common childhood fear also equips them to overcome other scary things that might arise down the road.

When Do Nightmares Happen?

Nightmares — like most dreams — occur during the stage of sleep when the brain is very active and sorting through experiences and new information for learning and memory. The vivid images the brain is processing can seem as real as the emotions they might trigger.

This part of sleep is known as the rapid eye movement or REM stage because the eyes are rapidly moving beneath closed eyelids. Nightmares tend to happen during the second half of a night's sleep, when REM intervals are longer.

When kids awaken from a nightmare, its images are still fresh and can seem real. So it's natural for them to feel afraid and upset and to call out to a parent for comfort.

By about preschool age, kids begin to understand that a nightmare is only a dream — and that what's happening isn't real and can't hurt them. But knowing that doesn't prevent them from feeling scared. Even older kids feel frightened when they awaken from a nightmare and may need your reassurance and comfort.

What Causes Nightmares?

No one knows exactly what causes nightmares. Dreams — and nightmares — seem to be one way kids process thoughts and feelings about situations they face, and to work through worries and concerns.

Most times nightmares occur for no apparent reason. Other times they happen when a child is experiencing stress or change. Events or situations that might feel unsettling — such as moving, attending a new school, the birth of a sibling, or family tensions — might also be reflected in unsettling dreams.

Sometimes nightmares occur as part of a child's reaction to trauma — such as a natural disaster, accident, or injury. For some kids, especially those with a good imagination, reading scary books or watching scary movies or TV shows just before bedtime can inspire nightmares.

Themes of a nightmare tend to reflect whatever the child is going through at that age, whether it's struggles with aggressive feelings, independence, or fears of separation. The cast of characters might include monsters, bad guys, animals, imaginary creatures, or familiar people, places, and events combined in unusual ways.

Young kids might have nightmares of being gobbled up, lost, chased, or punished. Sometimes a nightmare contains recognizable bits and pieces of the day's events and experiences, but with a scary twist. A child might not remember every detail, but can usually recall some of the images, characters, or situations, and the scary parts.

Encouraging Sweet Dreams

Parents can't prevent nightmares, but can help kids get a good night's sleep — and that encourages sweet dreams.

To help them relax when it's time to sleep and associate bedtime with safety and comfort, be sure that kids:

have a regular bedtime and wake-up time
have a sleep routine that helps them slow down, and feel safe and secure as they drift off to sleep. This might include a bath, a snuggle from you, reading, or some quiet talk about the pleasant events of the day.
have a bed that's a cozy, peaceful place to quiet down. A favorite toy, stuffed animal, night-light, or dream catcher can help.
avoid scary movies, TV shows, and stories before bed — especially if they've triggered nightmares before.
know that nightmares aren't real, that they're just dreams and can't hurt them.

After a Nightmare

Here's how to help your child cope after a nightmare:

Reassure your child that you’re there. Your calm presence helps your child feel safe and protected after waking up feeling afraid. Knowing you'll be there helps strengthen your child's sense of security.

Label what’s happened. Let your child know that it was a nightmare and now it's over. You might say something like, "You had a bad dream, but now you're awake and everything is OK." Reassure your child that the scary stuff in the nightmare didn't happen in the real world.

Offer comfort. Show that you understand that your child feels afraid and it's OK. Remind your child that everyone dreams and sometimes the dreams are scary, upsetting, and can seem very real, so it's natural to feel scared by them.

Do your magic. With preschoolers and young school-age kids who have vivid imaginations, the magical powers of your love and protection can work wonders. You might be able to make the pretend monsters disappear with a dose of pretend monster spray. Go ahead and check the closet and under the bed, reassuring your child that all's clear.

Mood lighting. A night-light or a hall light can help kids feel safe in a darkened room as they get ready to go back to sleep. A bedside flashlight can be a good nightmare-chaser.

Help your child go back to sleep. Offering something comforting might help change the mood. Try any of these to aid the transition back to sleep: a favorite stuffed animal to hold, a blanket, pillow, night-light, dream catcher, or soft music. Or discuss some pleasant dreams your child would like to have. And maybe seal it by giving your child a kiss to hold — in the palm of his or her hand — as you tiptoe out of the room.

Be a good listener. No need to talk more than briefly about the nightmare in the wee hours — just help your child feel calm, safe, and protected, and ready to go back to sleep. But in the morning, your child may want to tell you all about last night's scary dream. By talking about it — maybe even drawing the dream or writing about it — in the daylight, many scary images lose their power. Your child might enjoy thinking up a new (more satisfying) ending to the scary dream.

For most kids, nightmares happen only now and then, are not cause for concern, and simply require a parent's comfort and reassurance. Talk to your doctor if nightmares often prevent your child from getting enough sleep or if they occur along with other emotional or behavioral troubles.

"I pray that this article empowers you to Get A L.I.F.E."

What Are Night Terrors?

Most parents have comforted their child after the occasional nightmare. But if your child has ever experienced what's known as a night terror (or sleep terror), his or her fear was likely inconsolable, no matter what you tried.

A night terror is a sleep disruption that seems similar to a nightmare, but with a far more dramatic presentation. Though night terrors can be alarming for parents who witness them, they're not usually cause for concern or a sign of a deeper medical issue.

During a typical night, sleep occurs in several stages. Each is associated with particular brain activity, and it's during the rapid eye movement (REM) stage that most dreaming occurs.

Night terrors happen during deep non-REM sleep. Unlike nightmares (which occur during REM sleep), a night terror is not technically a dream, but more like a sudden reaction of fear that happens during the transition from one sleep phase to another.

Night terrors usually occur about 2 or 3 hours after a child falls asleep, when sleep transitions from the deepest stage of non-REM sleep to lighter REM sleep, a stage where dreams occur. Usually this transition is a smooth one. But rarely, a child becomes agitated and frightened — and that fear reaction is a night terror.

During a night terror, a child might suddenly sit upright in bed and shout out or scream in distress. The child's breathing and heartbeat might be faster, he or she might sweat, thrash around, and act upset and scared. After a few minutes, or sometimes longer, a child simply calms down and returns to sleep.

Unlike nightmares, which kids often remember, kids won't have any memory of a night terror the next day because they were in deep sleep when it happened — and there are no mental images to recall.

What Causes Night Terrors?

Night terrors are caused by over-arousal of the central nervous system (CNS) during sleep. This may happen because the CNS (which regulates sleep and waking brain activity) is still maturing. Some kids may inherit a tendency for this over-arousal — about 80% who have night terrors have a family member who also experienced them or sleepwalking (a similar type of sleep disturbance).

Night terrors have been noted in kids who are:
overtired or ill, stressed, or fatigued
taking a new medication
sleeping in a new environment or away from home

Night terrors are relatively rare — they happen in only 3-6% of kids, while almost every child will have a nightmare occasionally. Night terrors usually occur between the ages of 4 and 12, but have been reported in kids as young as 18 months. They seem to be a little more common among boys.

A child might have a single night terror or several before they cease altogether. Most of the time, night terrors simply disappear on their own as the nervous system matures.

Coping With Night Terrors

Night terrors can be very upsetting for parents, who might feel helpless at not being able to comfort or soothe their child. The best way to handle a night terror is to wait it out patiently and make sure the child doesn't get hurt by thrashing around. Kids usually will settle down and return to sleep on their own in a few minutes.

It's best not to try to wake kids during a night terror. Attempts usually don't work, and kids who do wake are likely to be disoriented and confused, and may take longer to settle down and go back to sleep.

There's no treatment for night terrors, but you can help prevent them. Try to:
reduce your child's stress
establish and stick to a bedtime routine that's simple and relaxing
make sure your child gets enough rest
prevent your child from becoming overtired by staying up too late

Understanding night terrors can reduce your worry — and help you get a good night's sleep yourself. But if night terrors happen repeatedly, talk to your doctor about whether a referral to a sleep specialist is needed.

"I pray that this article empowers you to Get A L.I.F.E."

Co-sleeping and Your Baby

The image of a baby and parent dozing off together isn't an uncommon one. But the practice of co-sleeping, or sharing a bed with your infant, is controversial in the United States. Supporters of co-sleeping believe that a parent's bed is just where an infant belongs. But is it safe?

Why Do Some People Choose to Co-sleep?

Co-sleeping supporters believe — and some studies support their beliefs — that co-sleeping:

• encourages breastfeeding by making nighttime breastfeeding more convenient
• makes it easier for a nursing mother to get her sleep cycle in sync with her baby's
• helps babies fall asleep more easily, especially during their first few months and when they wake up in the middle of the night
• helps babies get more nighttime sleep (because they awaken more frequently with shorter duration of feeds, which can add up to a greater amount of sleep throughout the night)
• helps parents who are separated from their babies during the day regain the closeness with their infant that they feel they missed

But do the risks of co-sleeping outweigh the benefits?

Is Co-sleeping Safe?

Despite the possible pros, the U.S. Consumer Product Safety Commission (CPSC) warns parents not to place their infants to sleep in adult beds, stating that the practice puts babies at risk of suffocation and strangulation. And the American Academy of Pediatrics (AAP) agrees.

Co-sleeping is a widespread practice in many non-Western cultures. However, differences in mattresses, bedding, and other cultural practices may account for the lower risk in these countries as compared with the United States.

According to the CPSC, at least 515 deaths were linked to infants and toddlers under 2 years of age sleeping in adult beds from January 1990 to December 1997:

121 of the deaths were attributed to a parent, caregiver, or sibling rolling on top of or against a baby while sleeping
more than 75% of the deaths involved infants younger than 3 months old

Co-sleeping advocates say it isn't inherently dangerous and that the CPSC went too far in recommending that parents never sleep with children under 2 years of age. According to supporters of co-sleeping, parents won't roll over onto a baby because they're conscious of the baby's presence — even during sleep.

Those who should not co-sleep with an infant, however, include:

other children — particularly toddlers — because they might not be aware of the baby's presence parents who are under the influence of alcohol or any drug because that could diminish their awareness of the baby
parents who smoke because the risk of sudden infant death syndrome (SIDS) is greater

But can co-sleeping cause SIDS? The connection between co-sleeping and SIDS is unclear and research is ongoing. Some co sleeping researchers have suggested that it can reduce the risk of SIDS because co sleeping parents and babies tend to wake up more often throughout the night. However, the AAP reports that some studies suggest that, under certain conditions, co-sleeping may increase the risk of SIDS, especially co-sleeping environments involving mothers who smoke.

CPSC also reported more than 100 infant deaths between January 1999 and December 2001 attributable to hidden hazards for babies on adult beds, including:

suffocation when an infant gets trapped or wedged between a mattress and headboard, wall, or other object
suffocation resulting from a baby being face-down on a waterbed, a regular mattress, or on soft bedding such as pillows, blankets, or quilts
strangulation in a bed frame that allows part of an infant's body to pass through an area while trapping the baby's head

In addition to the potential safety risks, sharing a bed with a baby can sometimes prevent parents from getting a good night's sleep. And infants who co-sleep can learn to associate sleep with being close to a parent in the parent's bed, which may become a problem at naptime or when the infant needs to go to sleep before the parent is ready.

Making Co-sleeping as Safe as Possible

If you do choose to share your bed with your baby, make sure to follow these precautions:

Always place your baby on his or her back to sleep to reduce the risk of SIDS.
Always leave your child's head uncovered while sleeping.
Make sure your bed's headboard and footboard don't have openings or cutouts that could trap your baby's head.
Make sure your mattress fits snugly in the bed frame so that your baby won't become trapped in between the frame and the mattress.
Don't place a baby to sleep in an adult bed alone.
Don't use pillows, comforters, quilts, and other soft or plush items on the bed.
Don't drink alcohol or use medications or drugs that may keep you from waking and may cause you to roll over onto, and therefore suffocate, your baby.
Don't place your bed near draperies or blinds where your child could be strangled by cords.

Transitioning Out of the Parent's Bed

Most medical experts say the safest place to put an infant to sleep is in a crib that meets current standards and has no soft bedding. But if you've been co-sleeping with your little one and would like to stop, talk to your doctor about making a plan for when your baby will sleep in a crib.

Transitioning to the crib by 6 months is usually easier — for both parents and baby — before the co-sleeping habit is ingrained and other developmental issues (such as separation anxiety) come into play. Eventually, though, the co-sleeping routine will likely be broken at some point, either naturally because the child wants to or by the parents' choice.

But there are ways that you can still keep your little one close by, just not in your bed. You could:

Put a bassinet, play yard, or crib next to your bed. This can help you maintain that desired closeness, which can be especially important if you're breastfeeding. The AAP says that having an infant sleep in a separate crib, bassinet, or play yard in the same room as the mother reduces the risk of SIDS.

Buy a device that looks like a bassinet or play yard minus one side, which attaches to your bed to allow you to be next to each other while eliminating the possibility of rolling over onto your infant.

Of course, where your child sleeps — whether it's in your bed or a crib — is a personal decision. As you're weighing the pros and cons, talk to your child's doctor about the risks, possible personal benefits, and your family's own sleeping arrangements.

"I pray that this article empowers you to Get A L.I.F.E."

Bruxism

When you look in on your sleeping child, you want to hear the sounds of sweet dreams: easy breathing and perhaps an occasional sigh. But some parents hear the harsher sounds of gnashing and grinding teeth, called bruxism, which is common in kids.

About Bruxism
Bruxism is the medical term for the grinding of teeth or the clenching of jaws. Bruxism often occurs during deep sleep or while under stress. Two to three out of every 10 kids will grind or clench, experts say, but most outgrow it.

Causes of Bruxism
Though studies have been done, no one knows why bruxism happens. But in some cases, kids may grind because the top and bottom teeth aren't aligned properly. Others do it as a response to pain, such as an earache or teething. Kids might grind their teeth as a way to ease the pain, just as they might rub a sore muscle. Many kids outgrow these fairly common causes for grinding. Stress — usually nervous tension or anger — is another cause. For instance, a child might worry about a test at school or a change in routine (a new sibling or a new teacher). Even arguing with parents and siblings can cause enough stress to prompt teeth grinding or jaw clenching.

Some kids who are hyperactive also experience bruxism. And sometimes kids with other medical conditions (such as cerebral palsy) or on certain medications can develop bruxism.

Effects of Bruxism
Many cases of bruxism go undetected with no adverse effects, while others cause headaches or earaches. Usually, though, it's more bothersome to other family members because of the grinding sound.

In some circumstances, nighttime grinding and clenching can wear down tooth enamel, chip teeth, increase temperature sensitivity, and cause severe facial pain and jaw problems, such as temporomandibular joint disease (TMJ). Most kids who grind, however, do not have TMJ problems unless their grinding and clenching is chronic.

Diagnosing Bruxism
Lots of kids who grind their teeth aren't even aware of it, so it's often siblings or parents who identify the problem.

Some signs to watch for:
grinding noises when your child is sleeping
complaints of a sore jaw or face in the morning
pain with chewing

If you think your child is grinding his or her teeth, visit the dentist, who will examine the teeth for chipped enamel and unusual wear and tear, and spray air and water on the teeth to check for unusual sensitivity.

If damage is detected, the dentist may ask your child a few questions, such as:
How do you feel before bed?
Are you worried about anything at home or school?
Are you angry with someone?
What do you do before bed?

The exam will help the dentist determine whether the grinding is caused by anatomical (misaligned teeth) or psychological (stress) factors and come up with an effective treatment plan.

Treating Bruxism
Most kids outgrow bruxism, but a combination of parental observation and dental visits can help keep the problem in check until they do.

In cases where the grinding and clenching make a child's face and jaw sore or damage the teeth, dentists may prescribe a special night guard. Molded to a child's teeth, the night guard is similar to the protective mouthpieces worn by football players. Though a mouthpiece may take some getting used to, positive results happen quickly.

Helping Kids With Bruxism
Whether the cause is physical or psychological, kids might be able to control bruxism by relaxing before bedtime — for example, by taking a warm bath or shower, listening to a few minutes of soothing music, or reading a book.

For bruxism that's caused by stress, ask about what's upsetting your child and find a way to help. For example, a kid who is worried about being away from home for a first camping trip might need reassurance that mom or dad will be nearby if anything happens.

If the issue is more complicated, such as moving to a new town, discuss your child's concerns and try to ease any fears. If you're concerned, talk to your doctor.

In rare cases, basic stress relievers aren't enough to stop bruxism. If your child has trouble sleeping or is acting differently than usual, your dentist or doctor may suggest further evaluation. This can help determine the cause of the stress and an appropriate course of treatment.

How Long Does Bruxism Last?
Childhood bruxism is usually outgrown by adolescence. Most kids stop grinding when they lose their baby teeth. However, a few kids do continue to grind into adolescence. And if the bruxism is caused by stress, it will continue until the stress is relieved.

Preventing Bruxism
Because some bruxism is a child's natural reaction to growth and development, most cases can't be prevented. Stress-induced bruxism can be avoided, however, by talking with kids regularly about their feelings and helping them deal with stress. Take your child for routine dental visits to find and, if needed, treat bruxism.

"I pray that this article empowers you to Get A L.I.F.E."

Kids and Bedwetting

Bedwetting is an issue that millions of families face every night. It is extremely common among young kids but can last into the teen years.

Doctors don't know for sure what causes bedwetting or why it stops. But it is often a natural part of development, and kids usually grow out of it. Most of the time bedwetting is not a sign of any deeper medical or emotional issues.

All the same, bedwetting can be very stressful for families. Kids can feel embarrassed and guilty about wetting the bed and anxious about spending the night at a friend's house or at camp. Parents often feel helpless to stop it.

Bedwetting may last for a while, but providing emotional support and reassurance can help your child feel better until it stops.

How Common Is Bedwetting?

Enuresis, the medical name for bedwetting, is a common problem in kids, especially children under the age of 6 years. About 13% of 6-year-olds wet the bed, while about 5% of 10-year-olds do.

Bedwetting often runs in families: kids who wet the bed often have a relative who did, too. If both parents wet the bed when they were young, it's very likely that their child will.

Coping With Bedwetting

Bedwetting usually goes away on its own. But until it does, it can be embarrassing and uncomfortable for your child. So it's important to provide support and positive reinforcement during this process.

Reassure your child that bedwetting is a normal part of growing up and that it's not going to last forever. It may comfort your child to hear about other family members who also struggled with it when they were young.

Remind your child to go to the bathroom one final time before bedtime. Try to have your child drink more fluids during the daytime hours and less at night. Fluids given later in the day should not have caffeine. Some parents try waking their kids in the middle of the night to use the bathroom. Many also find that using a motivational system, such as stickers for dry nights with a small reward (such as a book) after a certain number of stickers, can work well. Bedwetting alarms also can be helpful.

When your child wakes with wet sheets, don't yell or spank him or her. Have your child help you change the sheets. Explain that this isn't punishment, but it is a part of the process. It may even help your child feel better knowing that he or she helped out. Offer praise when your child has a dry night.

When to Call the Doctor

Bedwetting that begins abruptly or is accompanied by other symptoms can be a sign of another medical condition, so talk with your doctor.

The doctor may check for signs of a urinary tract infection (UTI), constipation, bladder problems, diabetes, or severe stress.

Call the doctor if your child:
•suddenly starts wetting the bed after being consistently dry for at least 6 months
•begins to wet his or her pants during the day
•starts misbehaving at school or at home
•complains of a burning sensation or pain when urinating
•has to urinate frequently
•is drinking or eating much more than usual
•has swelling of the feet or ankles
•your child is still wetting the bed at age 7 years

Also let the doctor know if you're feeling frustrated with the situation or could use some help. In the meantime, your support and patience can go a long way in helping your child feel better about the bedwetting.

Remember, the long-term outlook is excellent and in almost all cases dry days are just ahead.

"I pray that this article empowers you to Get A L.I.F.E."

Apnea and Kids

Everyone has brief pauses in their breathing pattern called apnea. Usually these brief stops are completely normal.

Sometimes, though, apnea can cause a prolonged pause in breathing, making the breathing pattern irregular. Someone with apnea might actually stop breathing for short amounts of time, decreasing oxygen levels in the body and disrupting sleep.

Types of Apnea

The word apnea comes from the Greek word meaning "without wind." Although it's perfectly normal for everyone to experience occasional pauses in breathing, apnea can be a problem when breathing stops for 20 seconds or longer.

There are three types of apnea:
1.obstructive
2.central
3.mixed

Obstructive Apnea

A common type of apnea in children, obstructive apnea is caused by an obstruction of the airway (such as enlarged tonsils and adenoids). This is most likely to happen during sleep because that's when the soft tissue at back of the throat is most relaxed. As many as 1% to 3% of otherwise healthy preschool-age kids have obstructive apnea.

Symptoms include:
•snoring (the most common) followed by pauses or gasping
•labored breathing while sleeping
•very restless sleep and sleeping in unusual positions
•changes in color

Because obstructive sleep apnea may disturb sleep patterns, these children may also show continued sleepiness after awakening in the morning and tiredness and attention problems throughout the day. Sometimes apnea can affect school performance. One recent study suggests that some kids diagnosed with ADHD actually have attention problems in school because of disrupted sleep patterns caused by obstructive sleep apnea.

Treatment for obstructive apnea involves keeping the throat open to aid air flow, such as with adenotonsillectomy (surgical removal of the tonsils and adenoids) or continuous positive airway pressure (CPAP), which is delivered by having the child wear a nose mask while sleeping.

Central Apnea

Central apnea occurs when the part of the brain that controls breathing doesn't start or properly maintain the breathing process. In very premature infants, it's seen fairly commonly because the respiratory center in the brain is immature. Other than being seen in premature infants, central apnea is the least common form of apnea and often has a neurological cause.

Mixed Apnea

Mixed apnea is a combination of central and obstructive apnea and is seen particularly in infants or young children who have abnormal control of breathing. Mixed apnea may occur when a child is awake or asleep.

Conditions Associated With Apnea

Apnea can be seen in connection with:

Apparent Life-Threatening Events (ALTEs)

An ALTE itself is not a sleep disorder — it's a serious event with a combination of apnea and change in color, change in muscle tone, choking, or gagging. Call 911 immediately if your child shows the signs of an ALTE.

ALTEs, especially in young infants, are often associated with medical conditions that require treatment Examples of these medical conditions include gastroesophogeal reflux (GERD), infections, or neurological disorders. ALTEs are scary to observe, but can be uncomplicated and may not happen again. However, any child who has an ALTE should be seen and evaluated immediately.

Apnea of Prematurity (AOP)

AOP can occur in infants who are born prematurely (before 34 weeks of pregnancy). Because the brain or respiratory system may be immature or underdeveloped, the baby may not be able to regulate his or her own breathing normally. AOP can be obstructive, central, or mixed.

Treatment for AOP can involve the following:
•keeping the infant's head and neck straight (premature babies should always be placed on their backs to sleep to help keep the airways clear)
•medications to stimulate the respiratory system
•continuous positive airway pressure (CPAP) — to keep the airway open with the help of forced air through a nose mask
•oxygen



Premature infants with AOP are followed closely in the hospital. If AOP doesn't resolve before discharge from the hospital, an infant may be sent home on an apnea monitor and parents and other caregivers will be taught CPR. The family will work closely with the child's doctor to have a treatment plan in place.

Apnea of Infancy (AOI)

Apnea of infancy occurs in children who are younger than 1 year old and who were born after a full-term pregnancy. Following a complete medical evaluation, if a cause of apnea isn't found, it's often called apnea of infancy. AOI usually goes away on its own, but if it doesn't cause any significant problems (such as low blood oxygen), it may be considered part of the child's normal breathing pattern.

Infants with AOI can be observed at home with the help of a special monitor prescribed by a sleep specialist. This monitor records chest movements and heart rate and can relay the readings to a hospital apnea program or save them for future examination by a doctor. Parents and caregivers will be taught CPR before the child is sent home.

If You Think Your Child Has Apnea

If you suspect that your child has apnea, call your doctor. If you suspect that your child is experiencing an ALTE, call 911 immediately.

Although prolonged pauses in breathing can be serious, after a doctor does a complete evaluation and makes a diagnosis, most cases of apnea can be treated or managed with surgery, medications, monitoring devices, or sleep centers. And many cases of apnea go away on their own.


"I pray that this article empowers you to Get A L.I.F.E."

Sleep and Youth

Sleep — or lack of it — is probably the most-discussed aspect of baby care. New parents discover its vital importance those first few weeks and months. The quality and quantity of an infant's sleep affects the well-being of everyone in the household.

And sleep struggles rarely end with a growing child's move from crib to bed. It simply changes form. Instead of cries, it's pleas or refusals. Instead of a feeding at 3:00 AM, it's a nightmare or request for water.

So how do you get your child to bed through the cries, screams, avoidance tactics, and pleas? How should you respond when you're awakened in the middle of the night? And how much sleep is enough for your kids?

How Much Is Enough?

It all depends on a child's age. Charts that list the hours of sleep likely to be required by an infant or a 2-year-old may cause concern when individual differences aren't considered. These numbers are simply averages reported for large groups of kids of particular ages.

There's no magical number of hours required by all kids in a certain age group. Two-year-old Kendrick might sleep from 8:00 PM to 8:00 AM, whereas 2-year-old Jovontae is just as alert the next day after sleeping from 9:00 PM to 6:00 AM.

Still, sleep is very important to kids' well-being. The link between a lack of sleep and a child's behavior isn't always obvious. When adults are tired, they can be grumpy or have low energy, but kids can become hyper, disagreeable, and have extremes in behavior.

Most kids' sleep requirements fall within a predictable range of hours based on their age, but each child is a unique individual with distinct sleep needs.

Here are some approximate numbers based on age, accompanied by age-appropriate pro-sleep tactics.

Babies (up to 6 Months)

There is no sleep formula for newborns because their internal clocks aren't fully developed yet. They generally sleep or drowse for 16 to 20 hours a day, divided about equally between night and day.

Newborns should be awakened every 3 to 4 hours until their weight gain is established, which typically happens within the first couple of weeks. After that, it's OK if a baby sleeps for longer periods of time. But don't get your slumber hopes up just yet — most infants won't snooze for extended periods of time because they get hungry.

After the first couple of weeks, infants may sleep for as long as 4 or 5 hours — this is about how long their small bellies can go between feedings. If babies do sleep a good stretch at night, they may want to nurse or get the bottle more frequently during the day.

Just when parents feel that sleeping through the night seems like a far-off dream, their baby's sleep time usually begins to shift toward night. At 3 months, a baby averages about 13 hours of sleep in a 24 hour period (4-5 hours of sleep during the day broken into several naps and 8-9 hours at night, usually with an interruption or two). About 90% of babies this age sleep through the night, meaning 5 to 6 hours in a row.

But it's important to recognize that babies aren't always awake when they sound like they are; they can cry and make all sorts of other noises during light sleep. Even if they do wake up in the night, they may only be awake for a few minutes before falling asleep again on their own.

If a baby under 6 months old continues to cry, it's time to respond. Your baby may be genuinely uncomfortable: hungry, wet, cold, or even sick. But routine nighttime awakenings for changing and feeding should be as quick and quiet as possible. Don't provide any unnecessary stimulation, such as talking, playing, or turning on the lights. Encourage the idea that nighttime is for sleeping. You have to teach this because your baby doesn't care what time it is as long as his or her needs are met.

Ideally, your baby should be placed in the crib before falling asleep. And it's not too early to establish a simple bedtime routine. Any soothing activities, performed consistently and in the same order each night, can make up the routine. Your baby will associate these with sleeping, and they'll help him or her wind down.

The goal is for babies to fall asleep independently, and to learn to soothe themselves and go back to sleep if they should wake up in the middle of the night.

6 to 12 Months

At 6 months, an infant may nap about 3 hours during the day and sleep about 9 to 11 hours at night. At this age, you can begin to change your response to an infant who awakens and cries during the night.

Parents can give babies a little more time to settle down on their own and go back to sleep. If they don't, comfort them without picking them up (talk softly, rub their backs), then leave — unless they appear to be sick. Sick babies need to be picked up and cared for. If your baby doesn't seem sick and continues to cry, you can wait a little longer, then repeat the short crib-side visit.

Between 6 and 12 months, separation anxiety, a normal developmental phase, comes into play. But the rules for nighttime awakenings are the same through a baby's first birthday: Try not to pick up your baby, turn on the lights, sing, talk, play, or feed your child. All of these activities do not allow your baby to learn to fall asleep on his or her own and encourage repeat awakenings.

Toddlers

From ages 1 to 3, most toddlers sleep about 10 to 13 hours. Separation anxiety, or just the desire to be up with mom and dad (and not miss anything), can motivate a child to stay awake. So can simple toddler-style contrariness.

Parents sometimes make the mistake of thinking that keeping a child up will make him or her sleepier for bedtime. In fact, though, kids can have a harder time sleeping if they're overtired. Set regular bedtimes and naptimes. Though most toddlers take naps during the day, you don't have to force your child to nap. But it's important to schedule some quiet time, even if your child chooses not to sleep.

Establishing a bedtime routine helps kids relax and get ready for sleep. For a toddler, the routine may be from 15 to 30 minutes long and include calming activities such as reading a story, bathing, and listening to soft music.

Whatever the nightly ritual is, your toddler will probably insist that it be the same every night. Just don't allow rituals to become too long or too complicated. Whenever possible, allow your toddler to make bedtime choices within the routine: which pajamas to wear, which stuffed animal to take to bed, what music to play. This gives your little one a sense of control over the routine.

But even the best sleepers give parents an occasional wake-up call. Teething can awaken a toddler and so can dreams. Active dreaming begins at this age, and for very young children, dreams can be pretty alarming. Nightmares are particularly frightening to a toddler, who can't distinguish imagination from reality. (So carefully select what TV programs, if any, your toddler sees before bedtime.)

Comfort and hold your child at these times. Let your toddler talk about the dream if he or she wants to, and stay until your child is calm. Then encourage your child to go back to sleep as soon as possible.

Preschoolers

Preschoolers sleep about 10 to 12 hours per night. A preschool child who gets adequate rest at night may no longer needs a daytime nap. Instead, a quiet time may be substituted.

Most nursery schools and kindergartens have quiet periods when the kids lie on mats or just rest. As kids give up their naps, bedtimes may come earlier than during the toddler years.

School-Age Children and Preteens

School-age kids need 10 to 12 hours of sleep a night. Bedtime difficulties can arise at this age for a variety of reasons. Homework, sports and after-school activities, TVs, computers, and video games, as well as hectic family schedules might contribute to kids not getting enough sleep.

Lack of sleep can cause irritable or hyper types of behavior and may make it difficult for kids to pay attention in school. It is important to have a consistent bedtime, especially on school nights. Be sure to leave enough time before bed to allow your child to unwind before lights out.

Teens

Adolescents need about 8½ to 9½ hours of sleep per night, but many don't get it. Because of early school start times on top of schedules packed with school, homework, friends, and activities, they're typically chronically sleep deprived.

And sleep deprivation adds up over time, so an hour less per night is like a full night without sleep by the end of the week. Among other things, an insufficient amount of sleep can lead to:

•decreased attentiveness
•decreased short-term memory
•inconsistent performance
•delayed response time

These can cause bad tempers, problems in school, stimulant use, and driving accidents (more than half of "asleep-at-the-wheel" car accidents are caused by teens).

Teens also experience a change in their sleep patterns — their bodies want to stay up late and wake up later, which often leads to them trying to catch up on sleep during the weekend. This sleep schedule irregularity can actually aggravate the problems and make getting to sleep at a reasonable hour during the week even harder.

Ideally, a teen should try to go to bed at the same time every night and wake up at the same time every morning, allowing for at least 8 to 9 hours of sleep.

Bedtime Routines

No matter what your child's age, establish a bedtime routine that encourages good sleep habits. These tips can help kids ease into a good night's sleep:

•Include a winding-down period in the routine.
•Stick to a bedtime, alerting your child both half an hour and 10 minutes beforehand.
•Encourage older kids and teens to set and maintain a bedtime that allows for the full hours of sleep needed at their age.

"I pray that this article empowers you to Get A L.I.F.E."

The Spleen and Lymphatic System

The lymphatic system is an extensive drainage network that helps keep bodily fluid levels in balance and defends the body against infections. It is made up of a network of lymphatic vessels that carry lymph — a clear, watery fluid that contains protein molecules, salts, glucose, urea, and other substances — throughout the body.

The spleen, which is located in the upper left part of the abdomen under the ribcage, works as part of the lymphatic system to protect the body, clearing worn out red blood cells and other foreign bodies from the bloodstream to help fight off infection.

About the Spleen and Lymphatic System

One of the lymphatic system's major jobs is to collect extra lymph fluid from body tissues and return it to the blood. This process is crucial because water, proteins, and other substances are continuously leaking out of tiny blood capillaries into the surrounding body tissues. If the lymphatic system didn't drain the excess fluid from the tissues, the lymph fluid would build up in the body's tissues, and they would swell.

The lymphatic system also helps defend the body against germs like viruses, bacteria, and fungi that can cause illnesses. Those germs are filtered out in the lymph nodes, small masses of tissue located along the network of lymph vessels. The nodes house lymphocytes, a type of white blood cell. Some of those lymphocytes make antibodies, special proteins that fight off germs and stop infections from spreading by trapping disease-causing germs and destroying them.

The spleen also helps the body fight infection. The spleen contains lymphocytes and another kind of white blood cell called macrophages, which engulf and destroy bacteria, dead tissue, and foreign matter and remove them from the blood passing through the spleen.

Basic Anatomy

The lymphatic system is a network of very small tubes (or vessels) that drain lymph fluid from all over the body. The major parts of the lymph tissue are located in the bone marrow, spleen, thymus gland, lymph nodes, and the tonsils. The heart, lungs, intestines, liver, and skin also contain lymphatic tissue.

One of the major lymphatic vessels is the thoracic duct, which begins near the lower part of the spine and collects lymph from the pelvis, abdomen, and lower chest. The thoracic duct runs up through the chest and empties into the blood through a large vein near the left side of the neck. The right lymphatic duct is the other major lymphatic vessel and collects lymph from the right side of the neck, chest, and arm, and empties into a large vein near the right side of the neck.

Lymph nodes are round or kidney-shaped, and can be up to 1 inch in diameter. Most of the lymph nodes are found in clusters in the neck, armpit, and groin area. Nodes are also located along the lymphatic pathways in the chest, abdomen, and pelvis, where they filter the blood. Inside the lymph nodes, lymphocytes called T-cells and B-cells help the body fight infection. Lymphatic tissue is also scattered throughout the body in different major organs and in and around the gastrointestinal tract.

The spleen helps control the amount of blood and blood cells that circulate through the body and helps destroy damaged cells.

How A Healthy Lymph System Typically Works

Carrying Away Waste

Lymph fluid drains into lymph capillaries, which are tiny vessels. The fluid is then pushed along when a person breathes or the muscles contract. The lymph capillaries are very thin, and they have many tiny openings that allow gases, water, and nutrients to pass through to the surrounding cells, nourishing them and taking away waste products. When lymph fluid leaks through in this way it is called interstitial fluid.

Lymph vessels collect the interstitial fluid and then return it to the bloodstream by emptying it into large veins in the upper chest, near the neck.

Fighting Infection

Lymph fluid enters the lymph nodes, where macrophages fight off foreign bodies like bacteria, removing them from the bloodstream. After these substances have been filtered out, the lymph fluid leaves the lymph nodes and returns to the veins, where it re-enters the bloodstream.

When a person has an infection, germs collect in the lymph nodes. If the throat is infected, for example, the lymph nodes of the neck may swell. That's why doctors check for swollen lymph nodes (sometimes called swollen "glands" — but they're actually lymph nodes) in the neck when your throat is infected.

Problems of the Lymphatic System

Certain diseases can affect the lymph nodes, the spleen, or the collections of lymphoid tissue in certain areas of the body.

•Lymphadenopathy. This is a condition where the lymph nodes become swollen or enlarged, usually because of a nearby infection. Swollen lymph nodes in the neck, for example, can be caused by a throat infection. Once the infection is treated, the swelling usually goes away. If several lymph node groups throughout the body are swollen, that can indicate a more serious disease that needs further investigation by a doctor.

•Lymphadenitis. Also called adenitis, this inflammation of the lymph node is caused by an infection of the tissue in the node. The infection can cause the skin overlying the lymph node to swell, redden, and feel warm and tender to the touch. This infection usually affects the lymph nodes in the neck, and it's usually caused by a bacterial infection that can be easily treated with an antibiotic.

•Lymphomas. These cancers start in the lymph nodes when lymphocytes undergo changes and start to multiply out of control. The lymph nodes swell, and the cancer cells crowd out healthy cells and may cause tumors (solid growths) in other parts of the body.

•Splenomegaly (enlarged spleen). In healthy people, the spleen is usually small enough that it can't be felt when you press on the abdomen. But certain diseases can cause the spleen to swell to several times its normal size. Usually, this is due to a viral infection, such as mononucleosis. But in some cases, more serious diseases such as cancer can cause it to expand. Doctors usually tell someone with an enlarged spleen to avoid contact sports like football for a while because a swollen spleen is vulnerable to rupturing (bursting). And if it ruptures, it can cause a huge amount of blood loss.

•Tonsillitis. Tonsillitis is caused by an infection of the tonsils, the lymphoid tissues in the back of the mouth at the top of the throat that normally help to filter out bacteria. When the tonsils are infected, they become swollen and inflamed, and can cause a sore throat, fever, and difficulty swallowing. The infection can also spread to the throat and surrounding areas, causing pain and inflammation. A child with repeated tonsil infections may need to have them removed (a tonsillectomy).

"I pray that this article empowers you to Get A L.I.F.E."

Skin, Hair, and Your Nails

Skin is our largest organ. If the skin of a typical 150-pound (68-kilogram) adult male were stretched out flat, it would cover about 2 square yards (1.7 square meters) and weigh about 9 pounds (4 kilograms). Our skin protects the network of muscles, bones, nerves, blood vessels, and everything else inside our bodies. Our eyelids have the thinnest skin, the soles of our feet the thickest.

Hair is actually a modified type of skin. Hair grows everywhere on the human body except the palms of the hands, soles of the feet, eyelids, and lips. Hair grows more quickly in summer than winter, and more slowly at night than during the day.

Like hair, nails are a type of modified skin. Nails protect the sensitive tips of fingers and toes. Human nails aren't necessary for living, but they do provide support for the tips of the fingers and toes, protect them from injury, and aid in picking up small objects. Without them, we'd have a hard time scratching an itch or untying a knot. Nails can be an indicator of a person's general health, and illness often affects their growth.

Skin Basics

Skin is essential in many ways. It forms a barrier that prevents harmful substances and microorganisms from entering the body. It protects body tissues against injury. It also controls the loss of life-sustaining fluids like blood and water, helps regulate body temperature through perspiration, and protects from the sun's damaging ultraviolet rays.

Without the nerve cells in skin, people couldn't feel warmth, cold, or other sensations. For instance, goosebumps form when the erector pili muscles contract to make hairs on the skin stand up straight when someone is cold or frightened — the blood vessels keep the body from losing heat by narrowing as much as possible and keeping the warm blood away from the skin's surface, offering insulation and protection.

Every square inch of skin contains thousands of cells and hundreds of sweat glands, oil glands, nerve endings, and blood vessels. Skin is made up of three layers: the epidermis, dermis, and the subcutaneous tissue.

The upper layer of our skin, the epidermis, is the tough, protective outer layer. It's about as thick as a sheet of paper over most parts of the body. The epidermis has four layers of cells that are constantly flaking off and being renewed. In these four layers are three special types of cells:

•Melanocytes produce melanin, the pigment that gives skin its color. All people have roughly the same number of melanocytes; those of dark-skinned people produce more melanin. Exposure to sunlight increases the production of melanin, which is why people get suntanned or freckled.

•Keratinocytes produce keratin, a type of protein that is a basic component of hair, skin, nails, and helps create an intact barrier.

•Langerhans cells help protect the body against infection.

Because the cells in the epidermis are completely replaced about every 28 days, cuts and scrapes heal quickly.

Below the epidermis is the next layer of our skin, the dermis, which is made up of blood vessels, nerve endings, and connective tissue. The dermis nourishes the epidermis. Two types of fibers in the dermis — collagen and elastin — help the skin stretch when we bend and reposition itself when we straighten up. Collagen is strong and hard to stretch, and elastin, as its name suggests, is elastic. In older people, some of the elastin-containing fibers degenerate, which is one reason why the skin looks wrinkled.

The dermis also contains a person's sebaceous glands. These glands, which surround and empty into hair follicles and pores, produce the oil sebum that lubricates the skin and hair. Sebaceous glands are found mostly in the skin on the face, upper back, shoulders, and chest.

Most of the time, the sebaceous glands make the right amount of sebum. As a person's body begins to mature and develop during the teenage years, though, hormones stimulate the sebaceous glands to make more sebum. When pores become clogged by too much sebum and too many dead skin cells, this contributes to acne. Later in life, these glands produce less sebum, which contributes to dry skin as people age.

The bottom layer of our skin, the subcutaneous tissue, is made up of connective tissue, sweat glands, blood vessels, and cells that store fat. This layer helps protect the body from blows and other injuries and helps it hold in body heat.

There are two types of sweat glands. The eccrine glands are found everywhere, although they're mostly in the forehead, palms, and soles of the feet. By producing sweat, these glands help regulate body temperature, and waste products are excreted through them.

The apocrine glands develop at puberty and are concentrated in the armpits and pubic region. The sweat from the apocrine glands is thicker than that produced by the eccrine glands. Although this sweat doesn't smell, when it mixes with bacteria on the skin's surface, it can cause body odor. A normal, healthy adult secretes about 1 pint (about half a liter) of sweat daily, but this may be increased by physical activity, fever, or a hot environment.

Hair Basics

The hair on our heads isn't just there for looks. It keeps us warm by preserving heat. The hair in the nose, ears, and around the eyes protects these sensitive areas from dust and other small particles. Eyebrows and eyelashes protect eyes by decreasing the amount of light and particles that go into them. The fine hair that covers the body provides warmth and protects the skin. Hair also cushions the body against injury.

Human hair consists of the hair shaft, which projects from the skin's surface, and the root, a soft thickened bulb at the base of the hair embedded in the skin. The root ends in the hair bulb, which sits in a sac-like pit in the skin called the follicle, from which the hair grows.

At the bottom of the follicle is the papilla, where hair growth actually takes place. The papilla contains an artery that nourishes the root of the hair. As cells multiply and produce keratin to harden the structure, they're pushed up the follicle and through the skin's surface as a shaft of hair. Each hair has three layers: the medulla at the center, which is soft; the cortex, which surrounds the medulla and is the main part of the hair; and the cuticle, the hard outer layer that protects the shaft.

Hair grows by forming new cells at the base of the root. These cells multiply to form a rod of tissue in the skin. The rods of cells move upward through the skin as new cells form beneath them. As they move up, they're cut off from their supply of nourishment and start to form a hard protein called keratin in a process called keratinization. As this process occurs, the hair cells die. The dead cells and keratin form the shaft of the hair.

Each hair grows about ¼ inch (about 6 millimeters) every month and keeps on growing for up to 6 years. The hair then falls out and another grows in its place. The length of a person's hair depends on the length of the growing phase of the follicle. Follicles are active for 2 to 6 years; they rest for about 3 months after that. A person becomes bald if the scalp follicles become inactive and no longer produce new hair. Thick hair grows out of large follicles; narrow follicles produce thin hair.

The color of a person's hair is determined by the amount and distribution of melanin in the cortex of each hair (the same melanin that's found in the epidermis). Hair also contains a yellow-red pigment; people who have blonde or red hair have only a small amount of melanin in their hair. Hair becomes gray when people age because pigment no longer forms.

Nail Basics

Nails grow out of deep folds in the skin of the fingers and toes. As epidermal cells below the nail root move up to the surface of the skin, they increase in number, and those closest to the nail root become flattened and pressed tightly together. Each cell is transformed into a thin plate; these plates are piled in layers to form the nail. As with hair, nails are formed by keratinization. When the nail cells accumulate, the nail is pushed forward.

The skin below the nail is called the matrix. The larger part of the nail, the nail plate, looks pink because of the network of tiny blood vessels in the underlying dermis. The whitish crescent-shaped area at the base of the nail is called the lunula.

Fingernails grow about three or four times as quickly as toenails. Like hair, nails grow more rapidly in summer than in winter. If a nail is torn off, it will regrow if the matrix isn't severely injured. White spots on the nail are sometimes due to temporary changes in growth rate.

Some of the things that can affect the skin, nails, and hair are described below.

Dermatitis

The term dermatitis refers to any inflammation (swelling, itching, and redness) possibly associated with the skin. There are many types of dermatitis, including:

•Atopic dermatitis (eczema). It's a common, hereditary dermatitis that causes an itchy rash primarily on the face, trunk, arms, and legs. It commonly develops in infancy, but can also appear in early childhood. It may be associated with allergic diseases such as asthma and seasonal, environmental, and food allergies.

•Contact dermatitis. This occurs when the skin comes into contact with an irritating substance or one that the person is allergic or sensitive to. The best-known cause of contact dermatitis is poison ivy, but there are many others, including chemicals found in laundry detergent, cosmetics, and perfumes, and metals like nickel plating on jewelry, belt buckles, and the back of a snap.

•Seborrheic dermatitis. This oily rash, which appears on the scalp, face, chest, and back, is related to an overproduction of sebum from the sebaceous glands. This condition is common in infants and adolescents.

Bacterial Skin Infections

•Impetigo. Impetigo is a bacterial infection that results in a honey-colored, crusty rash, often on the face near the mouth and nose.

•Cellulitis. Cellulitis is an infection of the skin and subcutaneous tissue that typically occurs when bacteria are introduced through a puncture, bite, or other break in the skin. The area with cellulitis is usually warm, tender, and has some redness.

•Streptococcal and staphylococcal infections. These two kinds of bacteria are the main causes of cellulitis and impetigo. Certain types of these bacteria are also responsible for distinctive rashes on the skin, including the rashes associated with scarlet fever and toxic shock syndrome.

Fungal Infections of the Skin and Nails

•Candidal dermatitis. A warm, moist environment, such as that found in the folds of the skin in the diaper area of infants, is perfect for growth of the yeast Candida. Yeast infections of the skin in older children, teens, and adults are less common.

•Tinea infection (ringworm). Ringworm, which isn't a worm at all, is a fungus infection that can affect the skin, nails, or scalp. Tinea fungi can infect the skin and related tissues of the body. The medical name for ringworm of the scalp is tinea capitis; ringworm of the body is called tinea corporis; and ringworm of the nails is called tinea unguium. With tinea corporis, the fungi can cause scaly, ring-like lesions anywhere on the body.

•Tinea pedis (athlete's foot). This infection of the feet is caused by the same types of fungi that cause ringworm. Athlete's foot is commonly found in adolescents and is more likely to occur during warm weather.

Other Skin Problems

•Parasitic infestations. Parasites (usually tiny insects or worms) can feed on or burrow into the skin, often resulting in an itchy rash. Scabies and lice are examples of parasitic infestations. Both are contagious and can be easily caught from other people.

•Viral infections. Many viruses cause characteristic rashes on the skin, including varicella, the virus that causes chickenpox and shingles; herpes simplex, which causes cold sores; human papillomavirus, the virus that causes warts; and a host of others.

•Acne (acne vulgaris). Acne is most common in teens. Some degree of acne is seen in 85% of adolescents, and nearly all teens have the occasional pimple, blackhead, or whitehead.

•Skin cancer. Skin cancer is rare in children and teens, but good sun protection habits established during these years can help prevent skin cancers such as melanoma (a serious form of skin cancer that can spread to other parts of the body) later in life, especially among fair-skinned people who sunburn easily.

In addition to these diseases and conditions, the skin can be injured in a number of ways. Minor scrapes, cuts, and bruises heal quickly on their own, but other injuries — severe cuts and burns, for example — require medical treatment.

Disorders of the Scalp and Hair

•Tinea capitis, a type of ringworm, is a fungal infection that forms a scaly, ring-like lesion in the scalp. It's contagious and common among school-age children.

•Alopecia is an area of hair loss. Ringworm is a common cause of temporary alopecia in children. Alopecia can also be caused by tight braiding that pulls on the hair roots (called tension alopecia). Alopecia areata (when hair falls out in round or oval patches on the scalp) is a less common condition that can affect children and teens.

"I pray that this article empowers you to Get A L.I.F.E."

The Mouth And Teeth

A smile is the facial expression that most engages others. With the help of the teeth — which provide structural support for the face muscles — the mouth also forms a frown and other expressions that show on your face.

The mouth also plays a key role in the digestive system, but it does much more than get digestion started. The mouth — especially the teeth, lips, and tongue — is essential for speech. The tongue, which allows us to taste, also helps form words when we speak. The lips that line the outside of the mouth both help hold food in while we chew and pronounce words when we talk.

With the lips and tongue, teeth help form words by controlling air flow out of the mouth. The tongue strikes the teeth as certain sounds are made.

The hardest substances in the body, the teeth are also necessary for chewing (or mastication) — the process by which we tear, cut, and grind food in preparation for swallowing. Chewing allows enzymes and lubricants released in the mouth to further digest food.

Here's how each aspect of the mouth and teeth plays an important role in our daily lives.

Basic Anatomy of the Mouth and Teeth

The entrance to the digestive tract, the mouth is lined with mucous membranes. The membrane-covered roof of the mouth is called the palate. The front part consists of a bony portion called the hard palate, with a fleshy rear part called the soft palate. The hard palate divides the mouth and the nasal passages above. The soft palate forms a curtain between the mouth and the throat, or pharynx, to the rear. The soft palate contains the uvula, the dangling flesh at the back of the mouth. The tonsils are located on either side of the uvula and look like twin pillars holding up the opening to the pharynx.

A bundle of muscles extends from the floor of the mouth to form the tongue. The upper surface of the tongue is covered with tiny bumps called papillae. These contain tiny pores that are our taste buds. Four main kinds of taste buds are found on the tongue — those that sense sweet, salty, sour, and bitter tastes. Three pairs of salivary glands secrete saliva, which contains a digestive enzyme called amylase that starts the breakdown of carbohydrates even before food enters the stomach.

The lips are covered with skin on the outside and with slippery mucous membranes on the inside of the mouth. The major lip muscle, called the orbicularis oris, allows for the lips' mobility. The reddish tint of the lips comes from underlying blood vessels. The inside portion of both lips is connected to the gums.

There are several types of teeth. Incisors are the squarish, sharp-edged teeth in the front of the mouth. There are four on the bottom and four on the top. On either side of the incisors are the sharp canines. The upper canines are sometimes called eyeteeth. Behind the canines are the premolars, or bicuspids. There are two sets, or four premolars, in each jaw.

The molars, situated behind the premolars, have points and grooves. There are 12 molars — three sets in each jaw called the first, second, and third molars. The third molars are the wisdom teeth, thought by some to have evolved thousands of years ago when human diets consisted of mostly raw foods that required extra chewing power. But because they can crowd out the other teeth or cause problems like pain or infection, a dentist might need to remove them.

Human teeth are made up of four different types of tissue: pulp, dentin, enamel, and cementum. The pulp is the innermost portion of the tooth and consists of connective tissue, nerves, and blood vessels, which nourish the tooth. The pulp has two parts — the pulp chamber, which lies in the crown, and the root canal, which is in the root of the tooth. Blood vessels and nerves enter the root through a small hole in its tip and extend through the canal into the pulp chamber.

Dentin surrounds the pulp. A hard yellow substance, it makes up most of the tooth and is as hard as bone. It's the dentin that gives teeth their yellowish tint. Enamel, the hardest tissue in the body, covers the dentin and forms the outermost layer of the crown. It enables the tooth to withstand the pressure of chewing and protects it from harmful bacteria and changes in temperature from hot and cold foods. Both the dentin and pulp extend into the root. A bony layer of cementum covers the outside of the root, under the gum line, and holds the tooth in place within the jawbone. Cementum is also as hard as bone.

Normal Development of the Mouth and Teeth

Humans are diphyodont, meaning that they develop two sets of teeth. The first set of 20 deciduous teeth are also called the milk, primary, temporary, or baby teeth. They begin to develop before birth and begin to fall out when a child is around 6 years old. They're replaced by a set of 32 permanent teeth, which are also called secondary or adult teeth.

Around the 8th week after conception, oval-shaped tooth buds consisting of cells form in the embryo. These buds begin to harden about the 16th week. Although teeth aren't visible at birth, both the primary and permanent teeth are forming below the gums. The crown, or the hard enamel-covered part that's visible in the mouth, develops first. When the crown is formed, the root begins to develop.

Between the ages of 6 months and 1 year, the deciduous teeth begin to push through the gums. This process is called eruption or teething. At this point, the crown is complete and the root is almost fully formed. By the time a child is 3 years old, he or she has a set of 20 deciduous teeth, 10 in the lower and 10 in the upper jaw. Each jaw has four incisors, two canines, and four molars. The molars' purpose is to grind food, and the incisors and canine teeth are used to bite into and tear food.

The primary teeth help the permanent teeth erupt in their normal positions; most of the permanent teeth form close to the roots of the primary teeth. When a primary tooth is preparing to fall out, its root begins to dissolve. This root has completely dissolved by the time the permanent tooth below it is ready to erupt.

Kids start to lose their primary teeth, or baby teeth, at about 6 years old. This begins a phase of permanent tooth development that lasts over the next 15 years, as the jaw steadily grows into its adult form. From ages 6 to 9, the incisors and first molars start to come in. Between ages 10 and 12, the first and second premolars, as well as the canines, erupt. From 11 to 13, the second molars come in. The wisdom teeth (third molars) erupt between the ages of 17 and 21.

Sometimes there isn't room in a person's mouth for all the permanent teeth. If this happens, the wisdom teeth may get stuck, or impacted, beneath the gum and may need to be removed. Overcrowding of the teeth is one of the reasons kids get braces.

What the Mouth and Teeth Do

The first step of digestion involves the mouth and teeth. Food enters the mouth and is immediately broken down into smaller pieces by our teeth. Each type of tooth serves a different function in the chewing process. Incisors cut foods when you bite into them. The sharper and longer canines tear food. The premolars, which are flatter than the canines, grind and mash food. Molars, with their points and grooves, are responsible for the most vigorous chewing. All the while, the tongue helps to push the food up against our teeth.

During chewing salivary glands in the walls and floor of the mouth secrete saliva, which moistens the food and helps break it down even more. Saliva makes it easier to chew and swallow foods (especially dry foods), and it contains enzymes that aid in the digestion of carbohydrates.

Once food has been converted into a soft, moist mass, it's pushed into the throat (or pharynx) at the back of the mouth and is swallowed. When we swallow, the soft palate closes off the nasal passages from the throat to prevent food from entering the nose.

Problems of the Mouth and Teeth

Proper dental care — including a good diet, frequent cleaning of the teeth after eating, and regular dental checkups — is essential to maintaining healthy teeth and avoiding tooth decay and gum disease.

Common mouth and dental diseases and conditions — some of which can be prevented, some of which cannot — are :

Disorders of the Mouth

•Aphthous stomatitis (canker sores). A common form of mouth ulcer, canker sores occur in women more often than in men. Although their cause isn't completely understood, mouth injuries, stress, dietary deficiencies, hormonal changes (such as the menstrual cycle), or food allergies can trigger them. They usually appear on the inner surface of the cheeks or lips, under the tongue, on the soft palate, or at the base of the gums. They begin with a tingling or burning sensation followed by a painful sore called an ulcer. Pain subsides in 7 to 10 days, with complete healing usually occurring in 1 to 3 weeks.

•Cleft lip and cleft palate are birth defects in which the tissues of the lip and/or mouth don't form properly during fetal development. Children born with these disorders may have trouble feeding immediately after birth. Reconstructive surgery in infancy and sometimes later can repair the anatomical defects, and can prevent or lessen the severity of speech problems later on.

•Enteroviral stomatitis is a common childhood infection caused by a family of viruses called the enteroviruses. An important member of this family is coxsackievirus, which causes hand, foot, and mouth disease. Enteroviral stomatitis is marked by small, painful ulcers in the mouth that may decrease a child's desire to eat and drink and put him or her at risk for dehydration.

•Herpetic stomatitis (oral herpes). Kids can get a mouth infection with the herpes simplex virus from an adult or another child who has it. The resulting painful, clustered vesicles, or blisters, can make it difficult to drink or eat, which can lead to dehydration, especially in a young child.

•Periodontal disease. The gums and bones supporting the teeth are subject to disease. A common periodontal disease is gingivitis — inflammation of the gums characterized by redness, swelling, and sometimes bleeding. The accumulation of tartar (a hardened film of food particles and bacteria that builds up on teeth) usually causes this condition, and it's almost always the result of inadequate brushing and flossing. When gingivitis isn't treated, it can lead to periodontitis, in which the gums loosen around the teeth and pockets of bacteria and pus form, sometimes damaging the supporting bone and causing tooth loss.

Disorders of the Teeth

•Cavities and tooth decay. When bacteria and food particles stick to the teeth, plaque forms. The bacteria digest the carbohydrates in the food and produce acid, which dissolves the tooth's enamel and causes a cavity. If the cavity isn't treated, the decay process progresses to involve the dentin. Without treatment, serious infections can occur. The most common ways to treat cavities and more serious tooth decay problems are: filling the cavity; performing root canal therapy, involving the removal of the pulp of a tooth; crowning a tooth with a cap that looks like a tooth made of metal, porcelain, or plastic; or removing or replacing the tooth. A common cause of tooth decay in toddlers is "baby bottle tooth decay," which occurs when a child goes to sleep with a milk or juice bottle in the mouth and the teeth are bathed in sugary liquid for an extended period of time. To avoid tooth decay and cavities, teach your kids good dental habits — including proper tooth-brushing techniques — at an early age.

•Impacted wisdom teeth. In many people, the wisdom teeth are unable to erupt normally so they either remain below the jawline or don't grow in properly. Dentists call these teeth impacted. Wisdom teeth usually become impacted because the jaw isn't large enough to accommodate all the teeth that are growing in and the mouth becomes overcrowded. Impacted teeth can damage other teeth or become painful and infected. Dentists can check if a person has impacted wisdom teeth by taking X-rays of the teeth. If the X-rays show there's a chance that impacted teeth may cause problems, the dentist may recommend that the tooth or teeth be extracted.

•Malocclusion is the failure of the teeth in the upper and lower jaws to meet properly. Types of malocclusion include overbite, underbite, and crowding. Most conditions can be corrected with braces, which are metal or clear ceramic brackets bonded to the front of each tooth. The wires connecting braces are tightened periodically to force the teeth to move into the correct position.

"I pray that this article empowers you to Get A L.I.F.E."

Metabolism

Metabolism Basics

Our bodies get the energy they need from food through metabolism, the chemical reactions in the body's cells that convert the fuel from food into the energy needed to do everything from moving to thinking to growing. Specific proteins in the body control the chemical reactions of metabolism, and each chemical reaction is coordinated with other body functions. In fact, thousands of metabolic reactions happen at the same time — all regulated by the body — to keep our cells healthy and working.

Metabolism is a constant process that begins when we're conceived and ends when we die. It is a vital process for all life forms — not just humans. If metabolism stops, a living thing dies.

Here's an example of how the process of metabolism works in humans — and it begins with plants. First, a green plant takes in energy from sunlight. The plant uses this energy and the molecule cholorophyll (which gives plants their green color) to build sugars from water and carbon dioxide in a process known as photosynthesis.

When people and animals eat the plants (or, if they're carnivores, when they eat animals that have eaten the plants), they take in this energy (in the form of sugar), along with other vital cell-building chemicals. The body's next step is to break the sugar down so that the energy released can be distributed to, and used as fuel by, the body's cells.

Enzymes

After food is eaten, molecules in the digestive system called enzymes break proteins down into amino acids, fats into fatty acids, and carbohydrates into simple sugars (for example, glucose). In addition to sugar, both amino acids and fatty acids can be used as energy sources by the body when needed. These compounds are absorbed into the blood, which transports them to the cells.

After they enter the cells, other enzymes act to speed up or regulate the chemical reactions involved with "metabolizing" these compounds. During these processes, the energy from these compounds can be released for use by the body or stored in body tissues, especially the liver, muscles, and body fat.

In this way, the process of metabolism is really a balancing act involving two kinds of activities that go on at the same time — the building up of body tissues and energy stores and the breaking down of body tissues and energy stores to generate more fuel for body functions:

•Anabolism, or constructive metabolism, is all about building and storing: It supports the growth of new cells, the maintenance of body tissues, and the storage of energy for use in the future. During anabolism, small molecules are changed into larger, more complex molecules of carbohydrate, protein, and fat.

•Catabolism, or destructive metabolism, is the process that produces the energy required for all activity in the cells. In this process, cells break down large molecules (mostly carbohydrates and fats) to release energy. This energy release provides fuel for anabolism, heats the body, and enables the muscles to contract and the body to move. As complex chemical units are broken down into more simple substances, the waste products released in the process of catabolism are removed from the body through the skin, kidneys, lungs, and intestines.

The Endocrine System

Several of the hormones of the endocrine system are involved in controlling the rate and direction of metabolism. Thyroxine, a hormone produced and released by the thyroid gland, plays a key role in determining how fast or slow the chemical reactions of metabolism proceed in a person's body.

Another gland, the pancreas secretes hormones that help determine whether the body's main metabolic activity at a particular time will be anabolic or catabolic. For example, after eating a meal, usually more anabolic activity occurs because eating increases the level of glucose — the body's most important fuel — in the blood. The pancreas senses this increased level of glucose and releases the hormone insulin, which signals cells to increase their anabolic activities.

Metabolism is a complicated chemical process, so it's not surprising that many people think of it in its simplest sense: as something that influences how easily our bodies gain or lose weight. That's where calories come in. A calorie is a unit that measures how much energy a particular food provides to the body. A chocolate bar has more calories than an apple, so it provides the body with more energy — and sometimes that can be too much of a good thing. Just as a car stores gas in the gas tank until it is needed to fuel the engine, the body stores calories — primarily as fat. If you overfill a car's gas tank, it spills over onto the pavement. Likewise, if a person eats too many calories, they "spill over" in the form of excess body fat.

The number of calories someone burns in a day is affected by how much that person exercises, the amount of fat and muscle in his or her body, and the person's basal metabolic rate (or BMR). BMR is a measure of the rate at which a person's body "burns" energy, in the form of calories, while at rest. The BMR can play a role in someone's tendency to gain weight. For example, a person with a low BMR (who therefore burns fewer calories while at rest or sleeping) will tend to gain more pounds of body fat over time, compared with a similar-sized person with an average BMR who eats the same amount of food and gets the same amount of exercise.

What Factors Influence BMR?

To a certain extent, BMR is inherited. Sometimes health problems can affect BMR, but people can actually change their BMR in certain ways. For example, exercising more will not only cause a person to burn more calories directly from the extra activity itself, but becoming more physically fit will increase BMR as well. BMR is also influenced by body composition — people with more muscle and less fat generally have higher BMRs.

Metabolism Problems

In a broad sense, a metabolic disorder is any disease that is caused by an abnormal chemical reaction in the body's cells. Most disorders of metabolism involve either abnormal levels of enzymes or hormones or problems with the functioning of those enzymes or hormones. When the metabolism of body chemicals is blocked or defective, it can cause a buildup of toxic substances in the body or a deficiency of substances needed for normal body function, either of which can lead to serious symptoms.

Some metabolic diseases are inherited. These conditions are called inborn errors of metabolism. When babies are born, they're tested for many of these metabolic diseases in a newborn screening test. Many of these inborn errors of metabolism can lead to serious complications or even death if they're not controlled with diet or medication from an early age.

Examples of Metabolic Disorders and Conditions

G6PD deficiency. Glucose-6-phosphate dehydrogenase, or G6PD, is just one of the many enzymes that play a role in cell metabolism. G6PD is produced by red blood cells and helps the body metabolize carbohydrates. Without enough normal G6PD to help red blood cells handle certain harmful substances, red blood cells can be damaged or destroyed, leading to a condition known as hemolytic anemia. In a process called hemolysis, red blood cells are destroyed prematurely, and the bone marrow (the soft, spongy part of the bone that produces new blood cells) may not be able to keep up with the body's need to produce more new red blood cells. Kids with G6PD deficiency may be pale and tired and have a rapid heartbeat and breathing. They may also have an enlarged spleen or jaundice — a yellowing of the skin and eyes. G6PD deficiency is usually treated by discontinuing medications or treating the illness or infection causing the stress on the red blood cells.

Galactosemia. Babies born with this inborn error of metabolism do not have enough of the enzyme that breaks down the sugar in milk called galactose. This enzyme is produced in the liver. If the liver doesn't produce enough of this enzyme, galactose builds up in the blood and can cause serious health problems. Symptoms usually occur within the first days of life and include vomiting, swollen liver, and jaundice. If galactosemia is not diagnosed and treated quickly, it can cause liver, eye, kidney, and brain damage.

Hyperthyroidism. Hyperthyroidism is caused by an overactive thyroid gland. The thyroid releases too much of the hormone thyroxine, which increases the person's basal metabolic rate (BMR). It causes symptoms such as weight loss, increased heart rate and blood pressure, protruding eyes, and a swelling in the neck from an enlarged thyroid (goiter). The disease may be controlled with medications or through surgery or radiation treatments.

More Metabolic Disorders

Hypothyroidism. Hypothyroidism is caused by an absent or underactive thyroid gland and it results from a developmental problem or a destructive disease of the thyroid. The thyroid releases too little of the hormone thyroxine, so a person's basal metabolic rate (BMR) is low. In infants and young children who don't get treatment, this condition can result in stunted growth and mental retardation. Hypothyroidism slows body processes and causes fatigue, slow heart rate, excessive weight gain, and constipation. Kids and teens with this condition can be treated with oral thyroid hormone to achieve normal levels in the body.

Phenylketonuria. Also known as PKU, this condition occurs in infants due to a defect in the enzyme that breaks down the amino acid phenylalanine. This amino acid is necessary for normal growth in infants and children and for normal protein production. However, if too much of it builds up in the body, brain tissue is affected and mental retardation occurs. Early diagnosis and dietary restriction of the amino acid can prevent or lessen the severity of these complications.

Type 1 diabetes mellitus. Type 1 diabetes occurs when the pancreas doesn't produce and secrete enough insulin. Symptoms of this disease include excessive thirst and urination, hunger, and weight loss. Over the long term, the disease can cause kidney problems, pain due to nerve damage, blindness, and heart and blood vessel disease. Kids and teens with type 1 diabetes need to receive regular injections of insulin and control blood sugar levels to reduce the risk of developing problems from diabetes.

Type 2 diabetes. Type 2 diabetes happens when the body can't respond normally to insulin. The symptoms of this disorder are similar to those of type 1 diabetes. Many kids who develop type 2 diabetes are overweight, and this is thought to play a role in their decreased responsiveness to insulin. Some can be treated successfully with dietary changes, exercise, and oral medication, but insulin injections are necessary in other cases. Controlling blood sugar levels reduces the risk of developing the same kinds of long-term health problems that occur with type 1 diabetes.

"I pray that this article empowers you to Get A L.I.F.E."