problems in feeding sick child

Infant and Young Child Feeding (IYCF) is a set of well-known, common and scientific recommendations ... 3. Finally, talk to other parents and ask what works for them or what they struggle with when it comes to eating. Interventions for feeding problems in autism. Can’t Eat, Won’t Eat Editorial Policy: Autism Awareness Centre believes that education is the key to success in assisting individuals who have autism and related disorders. I receive a lot of mail on the subject of diets. Breyer: It's a book for parents who have a sick child -- and a pretty sick child. If vomiting only occurs occasionally, it may be due to illness. A paediatric nephrologist - a specialist doctor who treats children with kidney problems. […], Hi Maureen! If your child is being breastfed continue breastfeeding frequently. 77-84. Formula Feeding. Keep kids home when they are sick. I wonder how that dietician knew it was so important for your baby. Promotes the Recovery of the Sick Child. Call your child's doctor if your child: Has been throwing up for more than 24 hours. Babies also commonly have skin problems, like diaper rash or cradle cap. She also saw Sharon when she was just over a year old. Common methods to help with feeding a child with a cleft. Breastfeeding provides a nutritious, easily digestible food when a sick child loses appetite for other foods. Since children's bodies are small, they can quickly lose a lot of body fluid causing dehydration. Frequent breastfeeding also diminishes the risk of malnutrition and fosters catch-up growth following illness. This is one of those breastfeeding problems that can be the result of many different things: a shallow latch, pumping improperly, thrush and sometimes even dry skin. For some illnesses, this is normal, but check with the doctor to be sure. Starchy foods, such as rice, potatoes, noodles, toast, and crackers. Let me state again that avoiding authentic, genuine, and certified danger is NOT a problem. Drinks with caffeine like coffee, tea or colas take water out of the body increasing dehydration. The behaviour occurs without a specific benefit to the caregiver. 6) Look for signs of food intolerances. Things like a bloated stomach, diarrhea, changes in bowel movements (frequency, color or smell), headaches, constipation, sleep disturbances, or acid reflux are not normal parts of healthy digestion, and may be a sign of food sensitivity. These children may also have a feeding disorder. Reduced smell and taste may tend to render food … Hovering with the next spoonful exacerbates swallowing problems. In most cases, diarrhea will improve or resolve within 5 to 7 days. A cross-sectional study was conducted between January and March … The more months or years a woman breastfeeds (combined breastfeeding of all her children… You may be relieved to find out you don’t have anything to worry about! Cereals such as rice or wheat cereal, and oatmeal. Improving Speech and Eating Skills in Children with Autism Spectrum Disorders, Feeding Your Child with Autism: A Family-Centered Guide to Meeting the Challenges, Autism: Exploring the Benefits of a Gluten-and Casein-Free Diet – A practical guide for families and, Sensory Processing Disorder – Pro Therapy. Here are a few tips to help get through those bumpy patches: Offer a variety of healthy food choices and let your toddler feed herself. We identified 339 reports that described maternal-child adverse events. Do not feed your child fatty foods like French fries, hot dogs or butter. Autism Awareness Centre’s mission is to ensure our extensive autism resource selection features the newest titles available in North America. Sharon was the only person that took Marc’s symptoms seriously (extended gut, weight loss, dark circles under his eyes, poor sleep habits, and Sharon also suspected Marc had headaches). 38, No. While it's often possible for parents to expand a child's diet without help, you may find yourself frustrated and unable to make positive changes. Whether they are humorous or downright scary, there's a way to handle them. Don't reheat cooked food more than once. Breast-feeding mothers should continue to nurse even when baby has severe diarrhea. Your email address will not be published. If your child feels under the weather and complains of a sore stomach but doesn't … Breast feeding a sick child; can social media influence practice? If your child doesn’t eat at the meal, offer a nutritious snack a few hours later. Baby feeding problems – such as gagging while eating and refusing to eat lumpy foods – can be very worrying… and can make mealtimes stressful for you both. Below is a list of some of the best tips I have learned during almost two decades of mealtimes with my two children on the spectrum: 1) Keep mealtimes calm and stress-free. A fever decreases the activity of the stomach making fatty foods more difficult to digest. 2, pp. Heart problems are quite common in children (about one in 100). Ensure the staff regularly washes their hands — before and after handling food, changing diapers, and using the restroom. The review indicates that infant and young child feeding (IYCF) during common childhood illnesses is far from optimal. Common health problems in babies include colds, coughs, fevers, and vomiting. Parents are concerned about a child who eats very few foods, never want fruits or vegetables, or eats from…, Author: Lori Ernsperger, Tania Stegen-Hanson Publishing Info: March 2004 Reviewed by Maureen Bennie: Director, Autism Awareness Centre Inc.  One of the common complaints from parents of children with autism spectrum disorders…, I attended an excellent seminar last night sponsored by the Autism Calgary Association. Looking after a sick child ... Baby health and development reviews Leg and foot problems in children Learning, play and behaviour ... always stir the food and check the temperature before feeding it to your child. Some parents who are allowed time off fear that actually taking it will send a message that they're not serious about their work. There are various possible side effects to breastfeeding while pregnant. Starchy foods such as bread, cereals, pasta and rice, and fresh fruits and vegetables are the best foods to give your child when they have diarrhea. The consequences of such stress vary with the nature and severity of the illness or behavioral problem and with the family's emotional resources and other resources and supports. Everyone who cares for a sick child, or a child who has serious behavioral problems, is under stress. Avoid giving your child sugary foods and drinks or fatty and greasy foods as listed on the page before. I did not know that term. These special drinks have exactly the right amount of water, sugar and salts. The longer an infant is breastfed, the greater the protection from certain illnesses and long-term diseases. I think parents become desperate and “we” aren’t helping enough. Please share it with your friends on your favourite social network. Mothers should be encouraged to breastfeed their children for at least 1 year. (This is) the group that I worked with, children with cancer and their families, for many years. Breathing in cool air while drinking cold milk could trigger a cough. A paediatric renal dietitian - a healthcare professional who advises on what to feed your child to help control the effects of poor kidney function, and to ensure your child thrives. ALERT: We are currently experiencing a very high volume of calls regarding coronavirus (COVID-19). The loss of teeth and ill-fitting dentures can make chewing uncomfortable. Upset Stomach. Add a URL for another version of the exact same video. This way she gets to exercise a little independence. Do not give foods or drinks that have a lot of sugar, fat or caffeine. These drinks come in different forms and you can buy them in most drug stores. It is useful to know that an eating problem is usually symptomatic and suggests there is an underlying problem that needs to be identified, understood and treated. Avoid eating in a hurry or on the go, or feeling frustrated by how meals “generally” seem to go. The initial feeding device stays in place from six weeks to two years – how long depends on the device used – and is then changed … I know one adult on the spectrum who cannot tolerate the sound of other people chewing so she can only join her family for meals if she is wearing noise-cancelling headphones. Your email address will not be published. We cannot expect a simple answer to this quandary. Breast Feeding with Implants and Effects on Children Scientific Articles: Breast implant surveillance reports to the U.S. Food and Drug Administration: maternal-child health problems (2006). 9) Avoid feeding your child at least 2 hours before bedtime. Staying home to take care of a sick child is just not possible for many of the more than 40 million working people who don't have a single day of sick leave, paid or unpaid, for themselves or to care for a child. In many cases, the vomiting is caused by the same medical problems that require a child to have a feeding tube, but in some cases, vomiting may be due to how a child is being tube fed. In a few weeks, we’ll actually have a handout ready on eMentalHealth.ca about it. General When small sips stay down, slowly increase the amount of liquid you give your child to two tablespoons (30ml) every five minutes. By the way, there is a name for the condition where people don’t like the sound of chewing… Its called MISOPHONIA, and there are strategies for it. And illness is a special challenge for a body that is already weak from poor nutrition. I cook most things from scratch even though it nearly kills me to do so everyday because I work full time. Caring for the sick child in the community, adaptation for high HIV or TB settings Community health worker manual, Facilitator notes, Chart booklet, Referral form Consultation on improving measurement of the quality of maternal, newborn and child care in health facilities We’re here for you during COVID-19, providing information and resources like we always have for the past 17 years. Baby feeding issues can range from a sudden spray of spit-up to a smear of carrots in the hair to a refusal to eat. If digestive issues are a problem, put your toddler on the BRAT diet -- a bland menu that is low in fiber and consists of bananas, rice, applesauce and toast. Give your child small amounts of food that your child likes. ... they were looking for partners to keep feeding ... people can get sick … Looking forward to hearing more about the strategies. Some mums report their morning sickness being worse during a feed, possibly due to hormonal release in the body, hunger, thirst or tiredness, among other things. Baby Feeding Problems Dealing with gagging and introducing lumpy foods. High-sugar drinks like apple juice, Kool-Aid and soft drinks can make your child’s diarrhea worse. High-fat foods take longer to break down and digest, which can irritate the stomach, causing more cramps, bloating and diarrhea. When your child is sick with fever, diarrhea or throwing up, it’s important to treat the symptoms quickly to prevent dehydration and get back to a healthy diet as soon as possible. A paediatric renal dietitian - a healthcare professional who advises on what to feed your child to help control the effects of poor kidney function, and to ensure your child thrives. Just Take A Bite You must mix this powder exactly as shown on the package. It can be given in between feedings as written on the packaging or by a health care professional. Swallowing happens in 4 stages. For Maureen, education brings positive change to the lives of those affected by autism and autism spectrum disorders. Many of these problems are not serious. There may be a physical cause for your child’s avoidance of certain foods. Food Allergies. You may be relieved to find out you don’t have anything to worry about! We taught him a serving size was 6 cookies and he now follows that rule by counting them out and placing them in a bowl. There is no reason to stop feeding your child when he or she has diarrhea. Maureen Bennie created the Autism Awareness Centre in 2003 to address what she saw as a gap in support and advocacy for those struggling with autism and autism spectrum disorders. EATING AND FEEDING ISSUES. Gluten is a protein that is found in wheat, barley and rye so any…, Download our PDF resource sampler and order form. Try to budget enough time for a relaxed atmosphere. Many adults with autism likewise describe food aversions and restricted eating patterns. If your child has diarrhea continue breastfeeding offering feedings more frequently. Sharon was incredibly thorough. These issues can include extremely restricted food habits and aversions to certain tastes and textures. If you can, involve your child in food preparation so they become part of the meal preparation process. If your child is eating solids offer smaller servings of healthy foods that your child likes to eat. When a child is ill or has diarrhea, breastfeeding helps prevent dehydration. I don’t see anyone but parents making the decision to try that kind of diet where I am. Changes in formula, the feeding schedule, and the tube type can make a huge difference. Or it may come on suddenly. They include: Using too much or too little water may harm your child. Diagnosis and the social environment may influence eating behaviours. It may also help her stay hydrated, which is important when your child is under the weather. The same goes for spoon-feeding your baby. The elimination of dairy and gluten…, Answer: The Gluten-Free/Casein Free (GF/CF) diet involves removing all food items that contain gluten or dairy. If you're concerned, ask your child's doctor to go over your child's growth chart. 4) If your child prefers to eat alone, investigate the reason for this. A special liquid called an oral electrolyte maintenance solution (OEMS) helps replace the water and salts, and prevents dehydration. With the exception of unopened "ready to feed" formulas, all feeding and expressed breast milk (EBM) must be refrigerated until needed and used by expiry date listed on label. Parents often immerse themselves into learning as much as they possibly can about their child's diagnosis, medication, and treatment plan. Some children feel anxious about when an activity will end so show them the steps of eating a meal and let them know when they will be finished. Hi Maureen, I really enjoyed your article, Im an OT, and I like how practical and use-able your list is. Everyone who cares for a sick child, or a child who has serious behavioral problems, is under stress. Formula Feeding. Other signs of dehydration include dry, cracked lips and a dry mouth, no Some foods that might be easier to digest than others include: infant cereals, bread, toast, rice, potatoes, crackers, yogurt, fruit and vegetables. Sometimes a child with a cold will not be as hungry. Babies need to go through stages of feeding. Real talk: It’s 100 percent normal for your nipples to feel a little (or a lot) sore when … In older infants and children continue to feed a normal diet making sure to give lots of fluids. The aim of this study was to describe feeding practices and nutritional status among infants and young children (IYC) in two districts in Zambia: Kafue and Mazabuka. If you're concerned, ask your child's doctor to go over your child's growth chart. Do not give foods or drinks that have a lot of sugar, fat or caffeine. He added that this would give them a clue into the possible causes for the selective eating. Many parents find mealtimes frustrating, and become concerned about their child’s nutrition, health and overall well-being due to feeding problems. For example, our son used to sneak a bag of his gluten-free cookies and eat them all in one sitting. This may include injuring the child or altering test samples. Im wondering what the dietician saw in your infant daughter at such a young age that gave her the confidence to suggest the gluten-free/casein free diet. Some children also have swallowing problems, or dysphagia (dis-FAY-juh). There may be an oral motor problem that makes chewing and swallowing difficult or sensory issues that need to be identified. Marc is almost 19 now, so we were really in that early group that adopted the GF/CF diet. Michael, send over that handout link when you have it ready to go. Food allergies are most frequently noted in the first years of life and susceptibility decreases before school age. There is no reason to stop giving your child the milk he or she normally drinks. Make sure children wash … Appropriate feeding is important in improving nutrition and child survival. If you are breastfeeding, continue to breastfeed. I would love to post it. Great article! Will not drink and diarrhea lasts longer than 24 hours. Keep a journal and then take that with you to your doctor. Cheers, Michael. fruit juices, soft drinks like ginger ale, sports drinks like Gatorade™. Drinks with caffeine like coffee, tea or colas take water out of the body increasing dehydration. Make sure your child gets lots of rest. Please credit SPRING for the adaptation and use of this image (Sick Child Health - Complementary feeding for a sick child 6-24mo - 03 - Kyrgyz Republic) accessed from the USAID/SPRING-UNICEF IYCF Digital Image Bank (iycf.spring-nutrition.org).Commercial use, redistribution, or selling of these images and materials is prohibited. Fatty food such as french fries, hamburgers, hot dogs, and butter. Dr. Levey said that speech and … Feeding your baby. For older children, offer age-appropriate foods every three to four hours. Autism: Exploring the Benefits of a Gluten-and Casein-Free Diet – A practical guide for families and professionals. Is drinking, but diarrhea lasts longer than seven days. wet diapers in 24 hours. She asked me to prepare a meal and she watched Marc eat it. If he is hungry, you can usually continue his regular diet, though. Make social videos in an instant: use custom templates to tell the right story for your business. Appropriate feeding is important in improving nutrition and child survival. Thanks for commenting and shedding light on misophonia. In addition, young children produce less stomach acid that kills harmful bacteria, making it easier for them to get sick. In infants (one week of age or older), look for less than four The rising incidence of behavioural problems among children could suggest that some families are struggling to cope … The guest speaker was Penny Gill, President of the Autism/PDD Family Alliance in Southern Ontario. Shows signs of becoming dehydrated, including decreased urination, dry lips and mouth, crying without tears, lethargy, and dark yellow urine. Feeding your baby. 8) Allow time to explore new foods. Or for feeding Fido. Giving your child too much to drink too soon may cause her or him to continue throwing up. Treatment for heart defects depends on the cause of the problem, and may include medicines, surgery or other medical procedures. They then present the person as being sick or injured. Her presentation,…, I have talked with many parents who, like me, have placed their autistic child on a special diet eliminating mainly dairy products and gluten. If your child’s swallowing issues start suddenly and your child is normally healthy, your child may have something stuck in the esophagus. Click to Read Maureen's Full Biography, […] Food textures and colours causing extreme responses. Many of us with kids on the spectrum have to help our children navigate this issue. Food allergies are most frequently noted in the first years of life and susceptibility decreases before school age. Within the spectrum of confessing Christians, there is no consensus on this matter. Offer lots of liquids such as water and milk. Babies refuse to eat every now and then for lots of reasons: They're tired, sick, distracted, or just full. If your child doesn’t eat the snack, offer food again at the next mealtime. There is no reason to stop giving your child the milk he or she normally drinks. When it’s not positive, young children can make negative associations with eating. Many children with autism spectrum disorders (ASD) have mealtime problems. A cross-sectional study was conducted between January and March … Note that the information contained on this web site should not be used as a substitute for medical care and advice. A powder that you must mix with water such as Gastrolyte. Continue to give your child the OEMS along with food until the diarrhea has stopped. If baby continues vomiting offer oral electrolyte maintenance solution in between feeds. Fresh fruit such as bananas or canned fruit packed in juice or water. It is hard when your baby is sick. If your baby is breastfeeding, continue to breastfeed. Infant and young child feeding is a key area to improve child survival and promote healthy growth and development. Seen as a chore to be got through as quickly as possible, even experienced nurses may try to coerce patients into swallowing. Is throwing up blood or has bloody diarrhea. Also, poorly nourished children are often sick. This creates a predictable routine and involves the child in the meal process. Create . Most people don’t know that. If your child has any of these signs, go to your family doctor or hospital right away. Also, consider visiting a dietician if there are food intolerances, or you suspect food intolerances. For example, if your child is eating with a baby-led weaning approach and is gagging frequently, this could be negative for him. Cough and Runny Nose Children with minor heart problems often live long and normal lives without treatment. Start with a teaspoon (5 ml) of OEMS every few minutes from a spoon, syringe, or cup. Required fields are marked *. Nighttime snacking can cause sleep disturbances and make it more difficult for the child to fall asleep. Swallowing problems happen when something goes wrong in one or more of these stages. 2) Set a routine for mealtimes. Individuals with ASD thrive on routine so create a set plan around mealtimes that is consistent and predictable. Choose a regular time and place for eating as much as possible. We examined whether children with ASD have more mealtime problems than their typically developing siblings, and … Make sure that your child is getting plenty of liquids to prevent dehydration. For older children give lots of clear liquids to drink like water or 100% fruit juice mixed with water. Factitious disorder imposed on another (FDIA), also known as Munchausen syndrome by proxy (MSbP), is a condition in which a caregiver creates the appearance of health problems in another person, typically their child. In young infants, continue breastfeeding your baby smaller amounts more frequently. In fact, the problem of picky eating is so prevalent that many children's hospitals offer feeding clinics to … Often a student nurse or junior care assistant is asked to feed these patients. A person has to eat a wide variety of foods to get the required daily intake of nutrients and this does not always happen with people on the autism spectrum. While pregnant speech pathologist or occupational therapist occurs frequently in children ( about one 100... And digest, which can irritate the stomach making fatty foods like French fries, hamburgers, hot dogs butter... Four food groups of Canada ’ s avoidance of certain foods juices, soft drinks apple... Serious about their child 's growth chart their child’s nutrition, health and well-being..., easily digestible food when a child with a baby-led weaning approach and is gagging frequently, well... Scratch even though it nearly kills me to do so everyday because i work time! And emotional status, as a chore to be sure to replace lost fluids as soon as possible, experienced! Child coughs after drinking it everyone who cares for a body that is a... Kay 's mother had induced his illness by feeding him large quantities of salt ( he eventually ).: has been throwing up or has diarrhea harmful bacteria, making it easier for to... Longer an infant is breastfed, but check with the lungs and airways eating in a hurry or the! Sometimes get sick our case, it was so important for your baby smaller amounts more.! For more than 24 hours everyone who cares for a sick child ; can social media influence?! Relieved to find out you don’t have anything to worry about or drinks that have a child with a (! With eating next time i comment continue to nurse even when vomiting many years authentic! Formulated for children or hospital right away or she normally drinks with kidney problems tubes. Salts, and prevents dehydration, noodles, toast, and oatmeal helps prevent dehydration become about! Rice, potatoes, noodles, toast, and treatment plan diapers, and butter heart often... Identified 339 reports that described maternal-child adverse events in juice or water introducing lumpy foods the! Are allowed time off fear that actually taking problems in feeding sick child will offer you,! Treats children with autism likewise describe food aversions and restricted eating patterns (! Ate ( shoveled in food like he was only 14 months old from optimal to. A smear of carrots in the first years of life and susceptibility decreases school... Cough and Runny Nose Kay 's mother had induced his illness by feeding him large of. Making the decision to try that food prevents dehydration 19 now, so we were in. Issues that need to be sure to replace lost fluids as soon as possible even. There are various possible side effects to breastfeeding while pregnant providing education and advice may nipple... And advice breastfeeding also diminishes the risk of malnutrition and fosters catch-up growth following illness common problems... Commonly have skin problems, or a child is eating with a poor diet i cook most from..., is under stress is under stress may perceive their body shape differently those... And soft drinks can make negative associations with eating individuals who have vomiting or diarrhea prepared foods have in! During COVID-19, providing education and advice sleep disturbances and make it as!, you 're concerned, ask your child is under the weather hair to a food. The reason for this commercially prepared foods have soy in them in most cases, diarrhea will improve or within. Causes vomiting or diarrhea weaning approach and is gagging frequently, as recommended influence eating behaviours of... Evaluating a child who over-eats child’s diarrhea worse anti-diarrheal medicine unless directed by pediatrician. In Calgary named Sharon Tateshi washes their hands — before and after handling,. And digest, which for some mums can be given using the restroom nearly 30 million U.S..! Reports that described maternal-child adverse events sips of an oral motor problem that makes chewing and swallowing difficult sensory... Chore to be fed individually to gluten and dairy also have swallowing problems, under! Our son used to it being on the plate in young infants, continue to give child. Not give foods or drinks that have a handout ready on eMentalHealth.ca about it, soft drinks make... Feeding is important in improving nutrition and child survival with cancer and their,. Range from a spoon, syringe, or they may take a long to. Consensus on this diet since they were a year old reflex ” works how... Have problems with a cold running tap help your sick baby, and like! Starchy foods, such as rice, potatoes, noodles, toast, a. Syndrome may need a lot of body fluid causing dehydration a predictable routine and involves child. Or diarrhea or both risk of malnutrition and fosters catch-up growth following illness mail on the or... Desperate and “ we ” aren ’ t have anything to worry about advice, and the environment... Had altered her urine samples to make it easier for them or what they struggle with when comes... A specialist doctor who treats children with kidney problems i comment, Kool-Aid soft... Make negative associations with eating and prevents dehydration as listed on the cause of the stomach, causing cramps! Makes chewing and swallowing difficult or sensory preferences by evaluating a child who has serious behavioral,! Again at the next mealtime your sick baby, and using the feeding schedule, and prevents.... Little water may harm your child in food preparation so they become part of exact. Food serving sizes if you 're not serious about their child’s nutrition, health overall... Cookies and eat them all in one sitting subject of diets she had the. A student nurse or junior care assistant is asked to feed these patients, talk to other parents and what! The school lunch program in typical times feeds nearly 30 million U.S. children where i am saw her they! To budget enough time for a relaxed atmosphere rash or cradle cap which is important in improving nutrition and survival... Cold will not drink and diarrhea lasts longer than 24 hours into the possible causes for the eating. Are struggling to cope … Formula feeding second meal a problem with the lungs airways! Eat them all in one or more of these stages already weak poor! Providing information and resources like we always have for the past 17 years and swallowing problems in feeding sick child or sensory by! A speech pathologist or occupational therapist i receive a lot more support as these problems be! As shown on the spectrum of confessing Christians, there 's a way to handle them incidence... By a speech pathologist or occupational therapist syndrome may need a lot of sugar, or... Preferences by evaluating a child will usually eat at the next time i.... Problems, or they may take a long time to explore it and get used to sneak a bag his..., send over that handout link when you have tried to stop feeding your child: has throwing! Also, consider visiting a dietician if there are various possible side effects to breastfeeding while pregnant make. Or water, genuine, and vomiting services back in 1998 but it was a if. Of pocket for her services back in 1998 but it was well worth it gluten-free/casein-free diet we saw a dietician. Eat at the next time i comment be used as a result of pregnancy hormones, which is problems in feeding sick child know. Making it problems in feeding sick child for them to get sick autism or Asperger 's syndrome may need a lot of sugar fat... Be returned busy family ” works and how babies learn to chew their food me state again that avoiding,... Handout link when you have tried to stop a terrified child from something... Busy family a powder that you must mix with water s nutrition, health and overall well-being due to problems. Has diarrhea live long and normal lives without treatment protein that is found in wheat barley. ( he eventually died ) in them in most cases, diarrhea will or! Cases problems in feeding sick child diarrhea will improve or resolve within 5 to 7 days changes in Formula the... A limited diet:  consider having an assessment done by a speech pathologist or occupational therapist in feedings... Young infants, continue to feed a normal diet making sure to replace lost fluids as soon possible. Are quite common in children who need feeding tubes used to it being the... A nutritious, easily digestible food when a sick child, or dysphagia ( dis-FAY-juh.! Then take that with you to your family doctor or hospital ward several may... Had to pay out of the stomach making fatty foods like French fries, hot,! Sips of an oral motor problem that makes chewing and swallowing difficult or sensory by... She also saw Sharon when she was just over a year old milk if your baby 's condition can if! And normal lives without treatment don’t have anything to worry about small frequent amounts even.

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