home Calculators About the stages of child brain development and their impact on social and emotional life. Maturation of the cerebral cortex

About the stages of child brain development and their impact on social and emotional life. Maturation of the cerebral cortex

The brain is one of the most important organs in the human body. To understand the processes of human growth, maturation, the ability of a child/teenager/adult to perform any actions, assessments, behavior, etc. (for “mature behavior” - in general) It is necessary to understand how the brain works, which parts of it mature and when, for what, for what processes different subsections of the brain are responsible.

Such knowledge is especially important for parents of high-frequency children and high-frequency teenagers, so as not to burden the child with their high expectations, the press of phrases “and you should already be at the age of X years...” (and a series of demands follows that the child is not able to fulfill, because the brain has not yet “matured”).

According to research in particular by Dr. Gordon Neufeld (G. Neufeld Institute, Vancouver, Canada), The development of some parts of the brain in high-frequency children (and therefore the development of brain functions) occurs more slowly, the stages are required large quantity time, and the brain matures longer.

Interactive illustration demonstrating the stages of brain tissue maturation (click to play)

Different areas of the brain mature at different times. Knowing this helps explain the emotional and intellectual changes in children, adolescents and young adults. Despite the fact that no two children develop identically, scientists, using magnetic resonance imaging performed on the same children over several years, have established a relationship between certain stages of child development and changes in brain tissue.

To see how the brain matures, click on flash animation. The color scale indicates the maturation of brain tissue, from red, orange and yellow to green, blue and violet.

0 – 4 years

Early development – In the first few years of life, the areas of the brain associated with basic functions change most quickly. By the age of 4, the areas responsible for basic senses and gross motor skills are almost fully developed. The child can walk, hold a pencil and eat independently.

Feel – areas responsible for sensations, for example, tactile, are almost fully developed.

Vision – The areas of the brain that control vision are fully mature.

6 years

Language – the area of the brain responsible for speech is immature and orange, but continues to develop rapidly in children up to 10 years of age. The brain is already beginning the process of “thinning”, destroying unnecessary connections. This process will intensify in subsequent years, which may be one of the explanations why young children, unlike adults, learn a new language so easily.

Intelligence – Yellow and red areas of the prefrontal cortex indicate that these parts of the brain responsible for abstract thinking, rational thinking and emotional maturity have not yet developed. Their lack of maturity is one of the reasons why young children find it difficult to absorb large amounts of information and when they are presented with too much information. big choice, children have tantrums.

9 years

Fine motor skills – If general motor skills are well developed by the age of 5, then development fine motor skills It develops most actively between 8 and 9 years. It becomes easier for children to write, and in crafts they achieve new level accuracy.

Mathematics – By the age of 9, the parietal lobes of the brain begin to mature. Their development allows children master mathematics and geometry skills. The speed of learning at this age is very fast.

13 years

Discretion – The prefrontal cortex is one of the last areas of the brain to mature. Until it developed, children lack the ability to adequately assess risk or make long-term plans.

Emotions – deep in the limbic system, the ability to experience emotions grows. But this ability is not inhibited by the prefrontal cortex, which lags behind in development. This is why teenagers often find it so difficult to control their emotions.

Logics – At this age, the parietal lobes, which are indicated in blue in the figure, develop very quickly. The child’s intelligence and analytical abilities are growing.

15 years

Specialization - V adolescence the abundance of nerve connections continues to decrease. Underutilized connections will die to help more active connections develop. As a result, the child's brain becomes more specialized and efficient.

17 years

Abstract thinking – Dark blue and purple mature areas of the prefrontal cortex shows why children in late adolescence are able to deal with much more complicated things than in childhood. The development of these areas leads to a surge in social activity and expression of emotions among older adolescents. Planning, risk assessment and self-control become possible.

21 years old

Higher mental functions – Although, at first glance, the brain appears to be almost fully developed during adolescence, The areas of dark blue and purple in this picture show that there is a strong lack of emotional maturity, Impulse control and decision-making are impacted well into adulthood.

Maturity – the brain of a 21 year old young man almost ripe. But the green areas indicate that even after reaching the official “adult” age, our brains there are still areas with potential for development. Emotional maturity and decision-making will continue to develop in subsequent years.

This is the result of disturbances in the formation of individual cerebral structures or the brain as a whole that occur in the prenatal period. Often have nonspecific clinical symptoms: predominantly epileptic syndrome, mental and mental retardation. The severity of the clinical picture directly correlates with the degree of brain damage. They are diagnosed antenatally during obstetric ultrasound, after birth - using EEG, neurosonography and MRI of the brain. Treatment is symptomatic: antiepileptic, dehydration, metabolic, psychocorrective.

ICD-10

Q00 Q01 Q02 Q04

General information

Anomalies of brain development - defects consisting of abnormal changes anatomical structure cerebral structures. The severity of neurological symptoms accompanying cerebral anomalies varies significantly. IN severe cases defects are the cause of antenatal fetal death; they account for up to 75% of cases of intrauterine death. In addition, severe cerebral anomalies account for about 40% of newborn deaths. Timing of manifestation clinical symptoms may be different. In most cases, cerebral abnormalities appear in the first months after the birth of the child. But, since the formation of the brain lasts until the age of 8, a number of defects make their clinical debut after the 1st year of life. In more than half of the cases, cerebral defects are combined with defects of somatic organs. Prenatal detection of cerebral anomalies is an urgent task in practical gynecology and obstetrics, and their postnatal diagnosis and treatment are priority issues of modern neurology, neonatology, pediatrics and neurosurgery.

Causes

The most significant cause of disruptions in intrauterine development is the influence on the pregnant woman’s body and the fetus of various harmful factors that have a teratogenic effect. The occurrence of an anomaly as a result of monogenic inheritance occurs only in 1% of cases. The most influential cause of brain defects is considered to be an exogenous factor. Many active chemical compounds, radioactive contamination, certain biological factors. Of no small importance here is the problem of pollution of the human environment, which causes toxic substances to enter the body of a pregnant woman. chemical substances.

Various embryotoxic effects can be associated with the lifestyle of the pregnant woman herself: for example, smoking, alcoholism, drug addiction. Dysmetabolic disorders in a pregnant woman, such as diabetes mellitus, hyperthyroidism, etc., can also cause cerebral abnormalities in the fetus. Many medications that a woman can take in the early stages of pregnancy, unaware of the processes occurring in her body, also have a teratogenic effect. Infections suffered by a pregnant woman or intrauterine infections of the fetus have a powerful teratogenic effect. The most dangerous are cytomegaly, listeriosis, rubella, and toxoplasmosis.

Pathogenesis

Construction nervous system the fetus begins literally from the first week of pregnancy. Already by the 23rd day of gestation, the formation of the neural tube ends, incomplete fusion of the anterior end of which entails serious cerebral anomalies. By approximately the 28th day of pregnancy, the anterior cerebral vesicle is formed, which subsequently divides into 2 lateral ones, which form the basis of the cerebral hemispheres. Next, the cerebral cortex, its convolutions, corpus callosum, basal structures, etc. are formed.

Differentiation of neuroblasts (germinal nerve cells) leads to the formation of neurons that form gray matter, and glial cells composing the white matter. Gray matter is responsible for higher processes of nervous activity. The white matter contains various pathways that connect cerebral structures into a single functioning mechanism. A full-term newborn has the same number of neurons as an adult. But the development of his brain continues, especially intensively in the first 3 months. life. There is an increase in glial cells, branching of neuronal processes and their myelination.

Failures can occur at various stages of brain formation. If they occur in the first 6 months. pregnancy, they can lead to a decrease in the number of formed neurons, various disorders in differentiation, and hypoplasia of various parts of the brain. At a later date, damage and death of normally formed cerebral substance may occur.

Types of brain abnormalities

Anencephaly- absence of the brain and acrania (absence of skull bones). The place of the brain is occupied by connective tissue growths and cystic cavities. May be covered with skin or bare. The pathology is incompatible with life.

Encephalocele- prolapse of cerebral tissues and membranes through a defect in the bones of the skull, caused by its non-fusion. As a rule, it is formed along the midline, but it can also be asymmetrical. A small encephalocele may mimic a cephalohematoma. In such cases, skull radiography helps determine the diagnosis. The prognosis depends on the size and content of the encephalocele. If the protrusion is small in size and there is ectopic nerve tissue in its cavity, surgical removal of the encephalocele is effective.

Microcephaly- reduction in the volume and weight of the brain due to a delay in its development. Occurs with a frequency of 1 case per 5 thousand newborns. Accompanied by a reduced head circumference and a disproportionate ratio of the facial/cranial skull with a predominance of the former. Microcephaly accounts for about 11% of all cases of mental retardation. With severe microcephaly, idiocy is possible. Often there is not only mental retardation, but also a lag in physical development.

Macrocephaly- increase in brain volume and mass. Much less common than microcephaly. Macrocephaly is usually combined with disorders of brain architecture, focal heterotopia white matter. Basics clinical manifestation - mental retardation. Convulsive syndrome may occur. Partial macrocephaly occurs with enlargement of only one of the hemispheres. As a rule, it is accompanied by asymmetry of the cerebral part of the skull.

Cystic cerebral dysplasia- characterized by multiple cystic cavities of the brain, usually connected to the ventricular system. Cysts can vary in size. Sometimes they are localized only in one hemisphere. Multiple brain cysts present with epilepsy that is resistant to anticonvulsant therapy. Single cysts, depending on their size, may have a subclinical course or be accompanied by intracranial hypertension; their gradual resorption is often noted.

Holoprosencephaly- absence of separation of the hemispheres, as a result of which they are represented by a single hemisphere. The lateral ventricles are formed into a single cavity. Accompanied by severe dysplasias facial skull and somatic defects. Stillbirth or death occurs on the first day.

Focal cortical dysplasia(FCD) - the presence in the cerebral cortex of pathological areas with giant neurons and abnormal astrocytes. Favorite location is the temporal and frontal areas of the brain. A distinctive feature of epileptic seizures during FCD is the presence of short-term complex paroxysms with rapid generalization, accompanied in their initial phase by demonstrative motor phenomena in the form of gestures, stomping in one place, etc.

Heterotopias- accumulations of neurons that, at the stage of neuronal migration, were delayed along their path to the cortex. Heterotopions can be single or multiple, have a nodular or ribbon form. Their main difference from tuberous sclerosis is the lack of the ability to accumulate contrast. These anomalies of brain development are manifested by episyndrome and mental retardation, the severity of which directly correlates with the number and size of heterotopions. With single heterotopia, epileptic seizures, as a rule, debut after 10 years of age.

Diagnostics

Severe brain abnormalities can often be diagnosed by visual examination. In other cases, cerebral anomaly can be suspected by cerebral retardation, muscle hypotonia in the neonatal period, and the occurrence of convulsive syndrome in children in the first year of life. The traumatic or hypoxic nature of brain damage can be excluded if there is no history of birth trauma of the newborn, fetal hypoxia or asphyxia of the newborn. Prenatal diagnosis of fetal malformations is carried out by screening ultrasound during pregnancy. Ultrasound in the first trimester of pregnancy can prevent the birth of a child with severe cerebral anomaly.

One of the methods for identifying brain defects in infants is neurosonography through the fontanel. Much more accurate data in children of any age and in adults is obtained using MRI of the brain. MRI allows you to determine the nature and localization of the anomaly, the size of cysts, heterotopias and other abnormal areas, and carry out differential diagnosis with hypoxic, traumatic, tumor, and infectious brain lesions. Diagnostics convulsive syndrome and the selection of anticonvulsant therapy is carried out using EEG, as well as prolonged EEG video monitoring. If there are familial cases of cerebral anomalies, consultation with a geneticist with genealogical research and DNA analysis may be useful. In order to identify combined anomalies, examination of somatic organs is carried out: ultrasound of the heart, ultrasound abdominal cavity, radiography of the chest cavity, ultrasound of the kidneys, etc.

Treatment of brain abnormalities

Treatment of brain malformations is predominantly symptomatic, carried out by a pediatric neurologist, neonatologist, pediatrician, and epileptologist. In the presence of convulsive syndrome, anticonvulsant therapy is carried out (carbamazepine, levetiracetam, valproate, nitrazepam, lamotrigine, etc.). Since epilepsy in children, which accompanies abnormalities of brain development, is usually resistant to anticonvulsant monotherapy, a combination of 2 drugs is prescribed (for example, levetiracetam with lamotrigine). For hydrocephalus, dehydration therapy is carried out, and shunt operations are used according to indications. In order to improve the metabolism of normally functioning brain tissue, to some extent compensating for the existing congenital defect, it is possible to conduct a course of neurometabolic treatment with the administration of glycine and vitamins. B, etc. Nootropic drugs used in treatment only in the absence of episyndrome.

For moderate and relatively mild cerebral anomalies, comprehensive psychological support for the child and education for older children in specialized schools are recommended. These techniques help to instill self-care skills, reduce the severity of mental retardation and, if possible, socially adapt children with cerebral defects.

Prognosis and prevention

The prognosis is largely determined by the severity of the cerebral anomaly. An unfavorable symptom is the earlier onset of epilepsy and its resistance to therapy. The prognosis is complicated by the presence of concomitant congenital somatic pathology. An effective preventive measure is the exclusion of embryotoxic and teratogenic effects on a woman during pregnancy. When planning a pregnancy, future parents should get rid of bad habits, undergo genetic counseling, screening for chronic infections.

Some data demonstrating the stages of maturation of brain tissue. Different areas of the brain mature at different times. Knowing this helps explain the emotional and intellectual changes in children, adolescents and young adults. Despite the fact that no two children develop identically, scientists, using magnetic resonance imaging performed on the same children over several years, have established a relationship between certain stages of child development and changes in brain tissue.

0 - 4 years
Early Development - In the first few years of life, areas of the brain associated with basic functions change most rapidly. By the age of 4, the areas responsible for basic senses and gross motor skills are almost fully developed. The child can walk, hold a pencil and eat independently.

Sensations - areas responsible for sensations, for example, tactile, are almost fully developed.

Vision - The areas of the brain that control vision are fully mature.

6 years

Language, the area of the brain responsible for speech, is immature but continues to develop rapidly in children up to age 10. The brain is already beginning the process of “thinning”, destroying unnecessary connections. This process will intensify in subsequent years, which may be one of the explanations why young children, unlike adults, learn a new language so easily.

The mind, the part of the brain responsible for abstract thinking, rational thinking, and emotional maturity, has not yet developed. Their lack of maturity is one of the reasons why young children have difficulty absorbing large amounts of information and have tantrums when presented with too many choices.

9 years

Fine motor skills - If gross motor skills are well developed by the age of 5, then the development of fine motor skills is most active between 8 and 9 years. It becomes easier for children to write, and their crafts reach a new level of accuracy.

Mathematics. By the age of 9, the parietal lobes of the brain begin to mature. Their development allows children to master mathematics and geometry skills. The speed of learning at this age is very fast.

13 years

Judgment - The prefrontal cortex is one of the last areas of the brain to mature. Until it develops, children lack the ability to adequately assess risk or make long-term plans.

Emotions - Deep in the limbic system, the ability to experience emotions grows. But this ability is not inhibited by the prefrontal cortex, which lags behind in development. This is why teenagers often find it so difficult to control their emotions.

Logic - At this age, the parietal lobes, which are indicated in blue in the figure, develop very quickly. The child’s intelligence and analytical abilities are growing.

15 years

Specialization - During adolescence, the abundance of nerve connections continues to decrease. Underutilized connections will die to help more active connections develop. As a result, the child's brain becomes more specialized and efficient.

17 years

Abstract thinking - in late adolescence, children are able to deal with much more complex things than in childhood. The development of these areas leads to a surge in social activity and expression of emotions among older adolescents. Planning, risk assessment and self-control become possible.

21 years old

Higher mental functions. Although, at first glance, the brain appears to be almost fully developed during adolescence, severe deficits in emotional maturity, impulse control, and decision-making affect well into adulthood.

Maturity - The brain of a 21-year-old young man is almost mature. Even after we reach formal adulthood, there are still areas of our brains that have the potential for development. Emotional maturity and decision-making will continue to develop in subsequent years.

During the prenatal period, the brain develops by 70%. Another 30% of development occurs from infancy to preschool age. The first 12 months of a baby’s life are associated with his rapid and comprehensive development, when he grows literally every day, gains weight and muscle mass. The brain also gains enormous speed of development during this period.

Intrauterine brain development of a child

The formation of the medulla begins in the first weeks of pregnancy. During this period of time, the birth of neurons occurs, which do not stand still, but move to their permanent “place of residence” and exist separately from each other. After the second month, the baby's brain begins to divide into several parts. And already at 35 weeks, the baby’s cerebral cortex can be completely compared in structure to the adult’s cortex.

Rules for your baby's brain development after birth

Since the baby is born with a practically formed brain, the period from birth to 3 years is a period of improvement. Neurons grow and communicate with each other every minute. In one second, up to 2 million synapses connecting neurons are created in brain cells. Throughout life, the quantitative level of neurons does not change. Numerous skills, abilities and reflexes, including vital ones, are embedded in the brain from birth. During the first three years, the connection between neurons becomes incredibly strong, synapses grow like trees with a huge number of branches. By the age of three, the brain volume of children and adults differs by only 15%.

After three years, the formation of the baby’s brain slows down. Formation ends after 6 years of age. Therefore, at this age, the brain’s abilities are practically in no way inferior to the capabilities of the adult brain.

The influence of the environment on brain formation

In order for the brain to have the opportunity to develop harmoniously, the baby needs to create a certain environment that will be saturated only with positive impressions and emotions. In such an environment, brain development is stimulated, and it begins active work. Since in the first years of a child’s life the development of the future foundations of adaptation to life and thinking, health and various skills occurs, the task of parents becomes to organize assistance in the formation of the brain. The baby should be surrounded by various sounds and images, smells and touches. All this stimulates the brain to form as quickly as possible.

Factors that negatively affect brain formation

In 2008, scientists Harvard University conducted studies that made it possible to identify several negative factors that interfere with the normal development of the human brain. These include:

the mother’s educational level is below average;
single-parent family (divorce or death of one of the parents);
mental problems in parents;
family poverty and lack of funds for basic necessities;
cruel or indifferent treatment of children by adults.

If there is more than one in a family negative factor, then brain development baby is coming with some lag. When all five factors are present together, a child's brain develops 70% slower.

You can see the difference between children as early as three years of age. The main sign of trouble in the family is poor lexicon. If both parents have a low level of education, lead an antisocial lifestyle and do not have the opportunity to spend enough time with the child, the child may lag significantly behind his peers in mental abilities. There are exceptions when a child from a dysfunctional family already from the age of 3 realizes the “abnormality” of the existence of his family and strives to receive his first education from the social environment (kindergarten, peers and their parents, etc.).

Not the least role in the development nutrition also plays a role in the brain. During pregnancy and breastfeeding physical and mental development The baby is completely dependent on the mother’s lifestyle and nutrition. Now there is a lot of data about which products and what they contain.
substances affect the formation of the child’s brain. Therefore, mothers should study the information in detail and exclude foods with negative effects from their diet. After introducing the first complementary foods, you should pay attention to healthy eating baby. A special role in proper development and the formation of the brain and nervous system are played by “smart lipids”, which are found in vegetable oils, nuts, seafood, etc.

Early child development

Today, more and more parents are studying the rules of early childhood development, approving latest research scientists who talk about the need to lay the first “building blocks” of future knowledge. To do this, experts recommend creating a stimulating environment from birth, which includes two factors:

Organizing a continuous stream of new tasks that require effort from the child.
Communication between parents and child and assistance in mastering new information.

In the first case, it is important to find a “golden” mean when implementing tasks. It shouldn’t be very difficult or very easy for a child. Here, parents must take into account the level of development of the baby at every stage of his life.

In the second case, communication means complete mutual understanding between the child and adults. Moreover, parents should express not only their approval, but also criticism. This way the baby will be able to understand that different situations There may be several lines of behavior.

According to the latest data, early development implies educational a process that must begin in the womb. That is, the expectant mother, being in an “interesting” position, should already take this issue seriously. During pregnancy, you need not only to eat right, supplying the baby with the substances necessary for brain development, but also to introduce him to the “great”. Reading, handicrafts, listening to music, painting, etc. - all this leads to the formation of the baby’s brain. By following the rules of brain development for your child, you can raise a real genius!

How can parents understand whether their child is healthy and has only age-related and personal behavioral characteristics? Or does the child have MMD (ADHD, ADD), and is it worth seeking advice on raising such a child and possibly treatment from specialists: neurologists, psychologists, speech pathologists, psychiatrists? After all, timely assistance from specialists can help parents in proper education child and quickly overcome problems in his behavior and learning ability.

One of modern definitions Minimal brain dysfunction (ADHD, ADD) is a condition manifested by behavioral and learning disorders, in the absence of intellectual impairment, and occurs as a result of impaired maturation of the main regulatory systems of the brain (primarily the prefrontal regions frontal lobes, parts of the brain that control emotions and motor activity).

Minimal brain dysfunction(MMD) - in another way: attention deficit hyperactivity disorder(ADHD) or without it (ADD) is a painful condition of the central nervous system with a certain set of signs (symptoms), but different in severity. Therefore, when making a diagnosis, they write about the syndrome.

Why is the manifestation of ADD (ADHD) so varied and individual? No two children with MMD syndrome (ADHD, ADD) are alike; the reason is related to the origin (etiopathogenesis) of this condition.

MRI studies have revealed changes in the brain with MMD:

decrease in the volume of brain matter in the left frontoparietal, left cingulate, bilateral parietal and temporal cortex;
as well as a reduction in cerebellar volume in children with ADHD;
Focal damage to the medial and orbital PFC (prefrontal cortex) has also been associated with ADHD features.

Positron emission tomography of the brain revealed functional insufficiency of the neurons (nerve cells) of the prefrontal parts of the frontal lobes and disruption of their connections with the mesencephalic parts (areas of the brain located under the cerebral cortex) and upper sections brain stem. This is manifested in a decrease in the production of neurotransmitter substances by the cells of these parts of the brain: dopamine and norepinephrine. Deficiencies in the functioning of these neurotransmitter systems lead to manifestations of MMD (ADHD or ADD).

Thus, modern research methods (neuroimaging methods) identify areas of brain damage in MMD syndrome in all examined children from the moment of birth and in subsequent years of life.

The central nervous system continues to develop in a child from the moment of birth until the age of 12-14 years, therefore, areas of brain damage that occur during the period of birth of a child can disrupt the normal development of the child’s brain not only immediately after birth, but also in subsequent years of life, while development is ongoing central nervous system (CNS).

The main reason for damage to areas of a child’s brain is hypoxia during childbirth, that is, a decrease in the supply of sufficient oxygen to the brain. Moreover, hypoxia is dangerous if it occurs quickly within a few minutes (acute hypoxia or fetal distress), with which the fetal defense mechanisms cannot cope. Acute hypoxia can cause suffering and death of areas of the white matter of the brain. Such hypoxia can occur primarily during childbirth.

Chronic fetal hypoxia, which develops during pregnancy due to reasons usually related to maternal health and placental insufficiency, does not lead to brain damage, since the fetal defense mechanisms have time to adapt. The nutrition of the entire fetal body is disrupted, but no damage to the fetal brain occurs. Fetal malnutrition develops - low birth weight (not corresponding to the height of the child and the gestational age at which he was born). If childbirth takes place without acute hypoxia, then a child born with malnutrition, with sufficient nutrition, will quickly gain weight. normal weight, and will not have problems with the development of the central nervous system.

During cerebral hypoxia during childbirth, the cells of the cerebral cortex (neurons of the cerebral cortex) are the least affected, since they begin to work only after the birth of the child; during childbirth they need a minimum of oxygen.

During hypoxia during childbirth, blood is redistributed and primarily goes to the cells of the brain stem, where the most important centers for life are located - the center for regulating blood circulation and the center for regulating breathing. (From it, after the birth of the child, a signal will come to take a breath.) Thus, the most sensitive to hypoxia in the fetus are the neuroglial cells (oligodendrocytes) located in large quantities between the cortex and the brain stem, in the subcortical zone - the area of the White Matter of the brain (WM).

Neuroglial cells after the birth of a child must ensure the process of myelination. Each cell of the cerebral cortex - a neuron - has processes that connect it with other neurons, and the longest process (axon) goes to the neurons of the brain stem. As soon as myelination occurs - the covering of these processes with a special membrane, the neurons of the cerebral cortex can send signals to the subcortex and brain stem and receive response signals.

The more neuroglial cells that suffer from hypoxia during childbirth, the greater the difficulty for the neurons of the cerebral cortex in establishing connections with the subcortex and brain stem, since the myelination process is disrupted. That is, the neurons of the cerebral cortex cannot fully and in time (according to the program recorded in their genes) regulate and control the underlying parts of the brain. Some cortical neurons simply die when they are unable to perform their functions.

Regulation of muscle tone and reflexes is disrupted. By the age of 1-1.5 years, cortical neurons usually establish enough connections for muscle tone and reflexes to normalize and the child to walk on his own feet (as written in the genetic program for the development of the body). Not only the frontal, but also other parts of the brain are involved in the development of movements, which provides greater compensatory capabilities for normalizing movement disorders.

From 1.5 to 2 years old, the social development of the child begins. A child has a genetically based fear of adults (parents), a desire to repeat the actions and words of adults, obey the comments of adults, understand the word “no” (even if not always obey), be afraid of punishment and rejoice in praise from adults (parents). That is, the possibility of raising a child is ensured at the genetic level in the development program of the child’s central nervous system. Moreover, this genetic program for the development of social maturation (social adaptation and behavior) is evolutionarily honed and selected, otherwise the child would not be able to survive in the world around him, full of real dangers for the preservation of health and life itself.

If there are insufficient connections in the cortical neurons responsible (according to the gene program) for this social development, behavioral disorders that do not correspond to the age norm appear - violations of social adaptation. Behavioral disorders may in some cases simply be inherent to this child, in connection with his individual characteristics or be a reflection certain periods child development.

Behavioral disorders include: problems with education, communication, behavioral discipline, eating, sleeping, difficulty acquiring neatness skills, hyperactivity. High degree activity and a tendency to noisy games are typical for children from 2 to 4 years old, and it is considered age norm. But hyperactivity in combination with inattention and impulsivity, which persist in a child after 4 years, indicates the presence of MMD syndrome (ADHD, ADD).

First of all, the regulation of one’s emotions and sensations is disrupted. Children are emotionally labile (unstable), irritable, and quick-tempered. But, on the other hand, they are characterized by increased vulnerability and low self-esteem.

Intelligence usually develops successfully, but its implementation is hampered by poor concentration: children cannot fully listen to the conditions of the task and impulsively make rash decisions. They quickly get bored with monotonous work, mechanical memorization of a large volume of material, they often do not finish the things they start...

Main signs of MMD (ADHD, ADD)

The main signs of MMD (ADHD, ADD) primarily include:

Inattention - easy distractibility, difficulty concentrating on tasks that require prolonged attention.
Impulsivity - a tendency to rash actions, difficulties in switching, difficulties in organizing work. constant transitions from one type of activity to another.
Hyperactivity, which is understood as excessive mobility, the inability to stay in one place or sit quietly. In general, hyperactive children are children who are “constantly on the move.”

The US Psychiatric Association has identified 14 signs attention deficit disorder, the presence of any 8 of which makes it possible to diagnose this disorder. So baby:

makes constant movements with his arms and legs, fidgets in his chair;
cannot sit still for a long time when necessary;
easily distracted by external stimuli;
finds it difficult to tolerate the situation of waiting for changes in games or group activities;
often begins to answer without hearing the question to the end;
when completing tasks, experiences difficulties that are not related to negativism or insufficient understanding of the essence of the request;
is not able to concentrate for a long time both in games and when performing tasks;
often moves from one unfinished task to another;
unable to play calmly and quietly;
excessively talkative;
often interrupts others, is annoying;
gives the impression of not hearing the speech addressed to him;
often loses things needed (for classes), both at school and at home;
often engages in (and independently engages in) risky activities that threaten physical well-being, without awareness of their possible consequences.

Other symptoms (signs) of MMD (ADHD, ADD):

increased mental fatigue, distractibility, difficulty remembering new material, poor tolerance to noise, bright light, heat and stuffiness, motion sickness in transport with the appearance of dizziness, nausea and vomiting. Possible headaches, overexcitement of the child at the end of the day of stay in kindergarten in the presence of choleric temperament and lethargy in the presence of phlegmatic temperament. Sanguine people are excited and inhibited almost simultaneously.

There are significant fluctuations due to deterioration or improvement of physical condition, time of year, and age.

To the maximum extent, signs of MMD appear in primary school schools.

A.I. Zakharov describes ADHD as the following complex of disordered behavior: “ increased excitability, restlessness, scatteredness, disinhibition of drives, lack of restraining principles, feelings of guilt and worries, as well as age-appropriate criticality. Often these children, as they say, “without brakes,” cannot sit still for a second, jump up, run, “without understanding the road,” are constantly distracted, and interfere with others. They easily switch from one activity to another without finishing the job they start. Fatigue occurs much later and is less pronounced than in children with ADD. Promises are easily made and immediately forgotten; playfulness, carelessness, mischief, and low intellectual development are characteristic (?!).”

The weakened instinct of self-preservation is expressed in frequent falls, injuries, and bruises of the child.

Childhood injuries (age from 0 to 17 years), “Children in Russia” Unicef, Rosstat, 2009.

:	1995	2000	2005	2008
Child population	38,015 thousand	33,487 thousand	27,939 thousand	26,055 thousand
Intracranial trauma	59 thousand	84 thousand	116 thousand	108.8 thousand
Fractures: - hands - legs	288 thousand 108 thousand	304 thousand 111 thousand	417 thousand 168 thousand	411 thousand 168 thousand
Dislocations and sprains of the limbs	263 thousand	213 thousand	395 thousand	400 thousand
Superficial injuries of children			4013 per 1 million	4326 per 1 million
All injuries			10.9 thousand per 100 thousand.	11.5 thousand per 100 thousand

The conclusion from the statistics of childhood trauma is terrible; the increase in injuries, taking into account the decrease in the number of children in the population over 13 years, amounted to a 3-4 fold increase. What happened to the children? Fewer and fewer children are involved in sports, which means the sports injury has not grown. The number of cars on the roads is growing from year to year, but it is not due to an increase in accidents that such an increase in child injuries has occurred!

The constant increase in childhood injuries in our country is due to the constant increase in children with MMD syndrome (ADHD, ADD).

Causes of minimal brain dysfunction

In the literature you can find several similar terms:

MMN - minimal brain impairment;
MMD - minimal brain dysfunction;
MDM - minimal brain dysfunction.

A.I. Zakharov attributes the minimum brain failure(dysfunction) to the most common type of neuropsychiatric disorders.

A set of official, usually listed causes of MMD (ADHD, ADD):

70-75% of cases of brain development disorders in MMD are, according to leaders of domestic medicine, genetic causes. Moreover, this conclusion is voiced without any scientific evidence.
In other cases the following are listed:
- severe pregnancy, especially the first half: toxicosis, threat of miscarriage.
- harmful effects on the body of a pregnant woman from the environment: chemicals, radiation, vibration.
- harmful effects on the fetus during pregnancy of infectious diseases: microbes and viruses.
- premature and post-term birth, weakness of labor and its prolonged course, lack of oxygen (hypoxia) due to compression of the umbilical cord, entanglement around the neck.
- After childbirth, the brain is adversely affected poor nutrition, frequent or severe illnesses and infections in newborns and infants, accompanied by various kinds of complications, helminthic infestations and giardiasis, brain contusions, poisoning and the environmental situation in the region.
- A number of authors (B.R. Yaremenko, A.B. Yaremenko, T.B. Goryainova) consider damage to the cervical spine during childbirth to be the main cause of MMD. A completely unsubstantiated and unscientific opinion!

In fact, muscle tone is regulated by the brain. With hypoxic damage to the brain, muscle tone is disrupted, including in the neck muscle group, which causes displacement of the cervical vertebrae. That is, changes in the position of the vertebrae are secondary. Primary – brain damage, causing disturbances in muscle tone and reflexes in the neck, torso and limbs of the newborn child.

Official medicine also claims the heterogeneity (heterogeneity) of the causes of MMD (ADD, ADHD). The development of this syndrome is associated with organic brain lesions in the perinatal period, as well as with genetic and socio-psychological factors (so to speak, with bad upbringing, bad educators, dysfunctional social environment - “?”) - (Prof. Zavadenko N.N. ''Modern approaches to diagnostics and ADHD treatment" M., 2003)

About genetics as not proven cause of MMD, already written above. Socio-psychological factors and the social environment are very important for the social development and adaptation of a child with MMD syndrome, but are not the cause of the appearance of MMD in a child.

It remains to consider the most important period of life for maintaining a healthy central nervous system of a child - the perinatal period. Perinatal period – peripartum period – before, during and immediately after childbirth.

The perinatal period is divided into the prenatal (antenatal) period, the birth itself - the intranatal period and 7 days after birth - the postnatal period. The intra- and postnatal periods are a stable value.

Antenatal - the period from 28 weeks of pregnancy, which was considered the borderline period between childbirth and abortion. At the same time, the criterion remains not only the gestational age (pregnancy), but also the weight of the fetus - more than 1000 g. In the last twenty years, doctors in advanced countries have shown that the fetus can survive even at a shorter gestation period, and then the antenatal period in most developed countries began count from 22-23 weeks and fetal weight from 500 g. In our country, from January 1, 2012, children born weighing more than 500 grams also began to be counted as newborns (and not as late miscarriages).

What has changed during the perinatal period in our country (and in the world) over the past 40-50 years? Pregnancy in the antenatal period proceeds, as it did thousands of years ago, even better and more reliably, thanks to the observation of pregnant women in antenatal clinics. The postnatal period for newborns, thanks to the achievements of modern neonatology, has been constantly improving over the past 20-30 years. The intranatal period (the period of childbirth) has changed dramatically over the past 40 - 50 years.

In the hands of obstetricians appeared: 1) the most powerful means for induction and stimulation of labor, and, conversely, for inhibition and cessation of labor,
active programmed (according to a plan drawn up in advance (?!) by the obstetrician) management of childbirth,
monitoring the condition of the fetus (fetal heartbeat) using CTG (often used),
ultrasound devices for monitoring the state of uteroplacental blood flow and cerebral blood flow of the fetus (used extremely rarely),
means of labor pain relief (epidural analgesia), etc.

Over the past 40 years, has such modern provision of childbirth management improved the health status of Russian births?

No, it hasn't improved!

Judging by the statistics, there is a constant increase in children with cerebral palsy, with syndromes of social adaptation and behavioral disorders, including: MMD (ADHD and ADD) and autism syndrome, with problems in the development of the musculoskeletal system (when from 1-1.5 years of age are formed: stoop, scoliosis, valgus flatfoot and bowfoot, walking on toes, etc.), with speech development disorders, with autonomic dysfunction syndromes, sleep disorders, etc.

Domestic neurologists, neonatologists, pediatricians, orthopedists, kindergarten teachers, school teachers, speech therapists and speech pathologists, child psychiatrists and psychologists, do not try at all to understand the reasons for such a terrifying, catastrophic growth of children with MMD (ADD, ADHD) and other developmental pathologies CNS.

Various figures are given for our country, identifying MMD from 7.6% to 12% of school-age children, that is, from 76 to 120 children per 1000 children under 16 years of age. Autism syndrome has increased 1,500 times in our country from 1966 to 2001 and reaches 6.8 per 1,000 children under 14 years of age. Elements of autism syndrome—autism spectrum disorder (ASD)—are observed in many children with MMD syndrome (ADD, ADHD).

MMD syndrome (ADD, ADHD) and ASD syndrome occur in the majority of sick children with cerebral palsy, that is, in addition to severe motor disorders, they also suffer from areas of the brain on which social development and social adaptation depend, which makes the rehabilitation of such children even more difficult . The majority of children with MMD (ADD, ADHD), autism, and cerebral palsy have a syndrome of autonomic dysfunction (in modern terms, somatoform disorders of the autonomic nervous system).

And this proves the complete similarity of the causes of developmental disorders of the central nervous system in children: cerebral palsy, MMD and autism syndrome and ASD, autonomic dysfunction syndrome, disorders of the musculoskeletal system, syndromes of speech development disorders, syndromes of disorders in the brain centers of vision and hearing and other developmental disorders CNS in young children. What will be clinically more pronounced, and in what combination these syndromes will appear, depends only on the number and size of lesions of the white matter of the brain (WM) and their location (localization).

The importance of white matter cells of the brain (neuroglia) in establishing connections between brain neurons is described in detail above.

What is medicine doing to improve the diagnosis of brain damage in the fetus and newborn, in order to clarify what brain damage is at the root? neurological disorders in children?

Ultrasound methods (neurosonography - NSG) do not allow accurately determining the nature and extent of the pathological process.

Accurate diagnosis is provided by CTG (computed tomography), MRI (nuclear magnetic resonance tomography), positron emission tomography, etc. But there are very few publications on these methods for studying the brain of newborns and young children, which is in no way comparable to the colossal increase in the number of children with neurological problems.

There is not a single work with MRI (CT) data that would track changes in the brain from the moment of birth of a child (with suspicion of hypoxia during childbirth) and in subsequent periods of life, while the development of the central nervous system occurs. In clinical works describing neurological pathology in children (cerebral palsy, MMD, autism, etc.) that occurs during the perinatal period, there is no scientific basis for morphological changes in the brain.

This is clearly written in the unique work of V.V. Vlasyuk “Morphology and classification of strokes of the white matter of the cerebral hemispheres in fetuses and newborns.”

Why do strokes (infarctions) of the white matter of the brain occur in children?

Because, as written above, during fetal hypoxia, blood is redistributed towards the child’s brain stem, where the centers for regulating blood circulation and respiration are located. The cerebral cortex does not work at the time of childbirth, therefore, the neurons of the cortex consume a minimum of oxygen (they are in a “sleepy” state). The white matter of the brain (the so-called subcortex), which consists of neuroglial cells and processes of nerve cells, suffers from hypoxia, decreased blood circulation and poor circulation. White matter hypoxia can result in necrosis (death) of the white matter of the brain. Depending on the size, prevalence and severity of necrosis (infarction) of the white matter of the brain (WM), Vlasyuk V.V. publishes the Classification of necrosis (heart attacks, strokes) of the BVM:

single
multiple (common)

finely focal (1-2mm)
large-focal (more than 2mm)

coagulation (with the formation of scar tissue at the site of cells and tissues that died from a heart attack)
colliquation (with the formation of cysts, from small to large with liquid contents)
mixed (both cysts and scars)

incomplete (processes of loosening, encephalodystrophy, edematous-hemorrhagic leukoencephalopathy, telencephalopathy - when only neuroglial cells die)
complete (periventricular leukomalacia, when all glia, vessels and axons (neuron processes) die

D According to the location of the focus or foci of necrosis:

periventricular (PVL) - usually occur with hypoxia and ischemia due to arterial hypotension in the zone of border blood supply between the ventriculofugal and ventriculopetal arterial branches
subcortical (SL-subcortical leukomalacia)
central (TG - telencephalic gliosis)
mixed (for example: the presence of foci of necrosis in the periventricular and central parts of the semioval centers - indicates DFL - diffuse leukomalacia, widespread ischemia of the VVM.

As can be seen from this classification of BVM strokes in newborns who died in childbirth or in the first weeks of life (neonatal period), without modern neuroimaging methods - CTG and MRI, it is very difficult to clinically establish an accurate diagnosis of brain damage. The NSG method is very inaccurate and uninformative for identifying small-focal and small-scale infarctions of the VVM. Moreover, as shown clinical researches, assessment of the condition on the Apgar scale also does not give an idea of possible damage BVM of a newborn. That is, assessing a newborn using the Apgar scale does not provide an assessment of the condition of the newborn’s brain.

Classic works by K. NELSON et al. to study the significance of the Apgar score for a correct understanding of the state of the newborn’s central nervous system.

49,000 children were examined, who were assessed by Apgar at 1 and 5 minutes after birth and by the state of the central nervous system later in life:

99 children had a score of 3 at 5-10-15-20 minutes, received intensive care and survived. 12 of these children developed cerebral palsy, 8 had less significant neurological impairment. The remaining 79%(!), after the intensive care, were healthy according to the central nervous system.

On the other hand, of the children who subsequently developed cerebral palsy, 55% had an Apgar score of 7-10 points at the 1st minute of life, and 73% of children with cerebral palsy had an Apgar score of 7-10 points at the 5th minute . Weinberg et al. believes that the Apgar score is not informative in the prognosis of hypoxic brain damage. In their opinion, it is important to assess the changes in the neurological status of the newborn over time.

Despite this, neonatologists, obstetricians and neurologists adopted in 2007 the Classification of PEP (perinatal encephalopathy), where only the presence of signs of asphyxia at birth, that is, an Apgar score below 7 points, suggests the need to examine the newborn’s brain.

Although the reflexes with which a child is born may be almost within normal limits. Since these reflexes reflect the state of the brain stem, and are not connected with higher parts of the central nervous system (subcortex, cerebral cortex) at the time of birth. These reflexes do not in any way reflect the state of the white matter of the brain, and VVM infacts are not diagnosed. Newborns born during labor with obstetric intervention, with induction and stimulation, do not even undergo a brain examination using ultrasound NSG, much less CT and MRI of the brain.

After birth, the child begins to develop acquired LUR (labyrinthine-setting) reflexes, which, according to the brain development program laid down in the genes, should help the child stand on his feet and begin to walk. The process of development of LUR depends on the establishment of connections between the cerebral cortex and the underlying parts of the brain. If a newborn has a stroke (heart attack) of the VVM, the development of the central nervous system is disrupted, but this can become noticeable only after some time. For example, the formation of cerebral palsy syndrome is noticeable by the age of one year, the formation of MMD syndrome (ADD, ADHD) from 1.5 years and later, autism syndrome and ASD after 2-2.5 years and later.

I repeat, there is still no work by radiologists on the development of the brain with different types of strokes of the VVM in children from the neonatal period to the end of development and formation of the brain.

To process CT and MRI data of the brain, children with cerebral palsy of different age groups, done incorrectly general conclusion about the alleged predominance of genetic disorders of brain development in children with cerebral palsy, MMD and autism. As evidence, in 50% of cases, macroscopically identified disturbances in the formation of the brain are described: “focal microgyria, reduction of individual lobes of the hemispheres, underdevelopment of the secondary and tertiary grooves of the cortex,” etc. Such conclusions would make sense if such children were examined with CT or MRI from birth and then regularly as the brain develops and grows. Since it is the WM infarctions that cause damage leading to disturbances in the development of neurons in the cerebral cortex and to disruptions in their connections with each other and the underlying parts of the brain. What leads to change normal structure and the location of the layers of neurons in the cerebral cortex and their pathways.

Works with dynamic observation Domestic doctors do not have any forms of VVM infarction from birth and further as the child develops.

However, categorical statements are published and voiced officially that in 75-80% of cases of brain development disorders in cerebral palsy, MMD, autism, these are genetic causes.

Over the past 30 years, there has been a marked increase in the number of children and grown-up adults with ADHD. This growth is noticed not only by medical specialists, but also by ordinary people. Official medicine spends public money on research into the causes of the increase in ADHD (ADD) in any direction, but only without connection with childbirth. Officially, several dozen genes, lead in exhaust gases, poor nutrition, ecology, poor upbringing, complex school program, bad teachers and parents, etc. and so on.

If only one obstetrician would have the conscience to admit that over the past 30 years we have almost no natural births left. Natural childbirth is the safest for preserving the fetus and newborn from brain damage.

Almost all births involve medical intervention through medical manipulations (punctures amniotic sac, perineal incisions, kelp and catheters (to “prepare” the cervix for childbirth, etc.) and medicinal methods for induction and stimulation of labor and contractions.

Such an insane scale of medical intervention in childbirth began abroad 40-50 years ago (immediately after the invention and use of oxytocin to stimulate labor, and then other drugs and medical methods). As a result, today more than 3 million American schoolchildren with ADHD are taking psychostimulants - amphetamines - daily before attending school.

Psychostimulants (amphetamines) make it possible for a child with ADHD to quietly sit through half a day of school lessons. And then at home, after the amphetamine wears off, you can “stand on your head.” According to Peter Gray, a professor of psychology at Boston College, “this is the machinations of teachers and the school curriculum, this is a conspiracy of psychiatrists,” who see in almost every child a mentally ill person with ADD (ADHD), or even ADHD with aggressiveness (this is in those who annually shoots classmates and teachers).

Why psychiatrists? Because the diagnosis of ADD (ADHD) refers to a group of mental illnesses associated primarily with impaired social development and social adaptation of the child.

Why conspiracy? Because in 1962 in the United States there were only 30 to 40 thousand children under 15 years of age diagnosed MMD syndrome(minor cerebral dysfunction - that’s what it was called in those days ADHD syndrome/ ADD). And now in the United States, about 8% of children aged 4 to 17 years (12% of boys and 6% of girls) are diagnosed with ADHD. P. Gray believes that the school curriculum has changed, teachers have become “stricter” and psychiatrists have become “more professionally evil”, and there has been an explosive increase in the number of children and schoolchildren with ADD (ADHD). “The reason for the diagnosis of ADHD lies, according to P. Gray, in the school’s intolerance of ordinary human diversity.”

The objection to this conclusion of P. Gray is obvious!

Could a child who did not obey adults, who did not adopt their experience, and did not imitate their actions, survive and maintain his health in a primitive communal society? Yes, humanity would have degenerated already at this uncivilized stage of its development. In our country, medical and obstetric active intervention in labor by induction and stimulation has begun everywhere over the past 30 years.

According to the report of Prof. O.R. Baeva at the All-Russian Obstetric Forum “Mother and Child 2010”, from 70 to 80% of women in all regions of our country in 2009 had a completely normal pregnancy and gave birth in the so-called low-risk birth group. But more than 65% of these women had childbirth with complications and medical interventions.

Over the past 30 years, there has been a sharp increase in the number of children with various developmental disorders of the central nervous system. Figures on child health (children under 15 years old):

for cerebral palsy in 1964 - 0.64 per 1000 children, in 1989 - 8.9 per 1000, in 2002 up to 21 per 1000;
on autism an increase from 1966 to 2001 by 1500 times to 6.4 per 1000 children;
even greater growth figures for children c ADHD- up to 28% of schoolchildren.

One of the authors of this article, when he came to school in 1964, had 46 students in his class, and one teacher from 1st to 4th grade did an excellent job teaching them. There were four such first classes, each with 44 to 46 children. What has happened to children over the past 30 years if teachers cannot maintain discipline in modern classes of 15-25 students?

If MRI scans show consequences of brain damage in all children with ADHD, what reasoning can there be that it is genes, nutrition or the environment that have damaged these areas of the brain of children with ADHD (cerebral palsy, autism, ASD, VSD, etc.)? Official medicine Don't take other people for simpletons.

Each case of damage to areas of the brain has specific causes. In the vast majority of cases, this is hypoxia of these areas of the brain during aggressive obstetric intervention in the process of childbirth (intrapartum period of childbirth)! But only small part Children get ADHD (ADD) from injuries and infections after birth.

If the medical and pedagogical community is silent, then the responsibility for preventing such violations lies on the shoulders of parents.

If you want more guarantees of the birth of healthy children without MMD (ADD, ADHD) and other neurological disorders of the central nervous system, do not allow induction and stimulation of your labor. If the fetus is suffering, then any induction and stimulation of labor will only increase the suffering (distress, hypoxia) of the fetus.

A modern example is indicative of changes in the attitudes of obstetricians towards the management of the birth of premature babies born before 32 weeks of pregnancy. According to the All-Russian Clinical Protocol “Premature Birth” of 2011, obstetricians were already prohibited from stimulating, only expectant management was recommended until the development of independent labor, or C-section, if the fetus or the woman in labor begins to suffer.

Why did this new protocol appear? premature birth. Because since 1992, when attending premature births, obstetricians acted according to the order of the Ministry of Health of the Russian Federation dated December 4, 1992 No. 318/190 “On the transition to the criteria for live births and stillbirths recommended by the World Health Organization.” The “Instructional and Methodological Recommendations” spelled out “rules for the management of premature birth during a pregnancy of 22 weeks or more” (Appendix 2).

In these instructions, when labor was weak, stimulation with oxytocin and prostaglandins was allowed. The question of delivery by cesarean section before 34 weeks of pregnancy was carried out according to vital indications on the part of the mother. In the interests of the fetus, CS was done: in case of breech presentation, transverse, oblique position of the fetus, in women with a burdened obstetric history (infertility, failure to carry a pregnancy), in the presence of intensive care neonatal service.

The official permission to stimulate labor during premature pregnancy led to the fact that the percentage of development of brain damage in premature babies during stimulation of labor was reflected in the colossal morbidity in the development of the central nervous system (for example, among those born prematurely in 2006, up to 92% of patients in terms of health were year of life).

And since 2012, according to a new order of the Ministry of Health, children born weighing from 500 g began to be nursed in incubators and on mechanical ventilation. Until January 1, 2012, a newborn weighing from 500 g to 1000 g was considered a newborn child, and not a late miscarriage, if he lived for more than 7 days (168 hours). If we continue the tactics of stimulating premature births, then we cannot avoid a sharp increase in infant mortality and disability due to the large group of newborn children (not late miscarriages) from 500 grams to 1000 grams of weight joining from January 1, 2012.

That's why a new one appeared Clinical protocol“Premature birth” from 2011, created by leading specialists from the National Center for Gynecology and Pediatrics named after. V.I. Kulakov and the Institute of Family Health. This protocol aims to improve the management of labor in preterm pregnancies in order to maximize the health of the fetus and preterm newborn.

In place of the criminal order No. 318 of 1992, which recommended the stimulation of premature labor before 32 weeks of pregnancy, the new 2011 protocol recommends: “In the absence of active labor and chances quick birth child, the method of choice is caesarean section.” The waiting time for labor to begin in case of premature rupture of membranes is no longer regulated. The waiting time for the independent development of labor can now be hours, days or weeks. The main thing is to ensure monitoring of the woman’s condition (prescribe antibiotics to prevent infection) and monitoring the condition of the fetus (listening to the fetal heartbeat and, if necessary, CTG).

Since the baby receives oxygen and nutrition through the umbilical cord, the presence of fetal fluid or its rupture does not affect his condition at all. But, everywhere, there is a common popular opinion that “a child without water suffers and suffocates.” This opinion exists among the “mass of citizens”, obviously not without the “hint” of obstetricians.

Therefore, for babies born after 32 weeks of gestation, induction and stimulation are still recommended as an option for active labor management. Otherwise, “suddenly a child without water will begin to choke”!

Thus, we cannot expect a reduction in the incidence of MMD (ADD, ADHD), autism, cerebral palsy and other central nervous system development disorders in our children, given this attitude towards childbirth on the part of official obstetrics!

The main cause of impaired development of the child’s central nervous system is damage (infarction) of the WM (white matter of the brain) during acute hypoxia (distress) and birth trauma of the fetus during childbirth (intrapartum period).

The main threat and cause of the development of acute hypoxia and birth trauma of the fetus during labor is induction (medicinal and mechanical “preparation” of the cervix) and stimulation of labor, contractions and pushing.

Only a strict, complete ban on obstetricians using “modern” equipment during childbirth. medications and medical manipulations for induction and stimulation of labor, will be able to reduce the threat of brain damage to newborn children, and dramatically reduce the number of newborns with brain damage.

Only the refusal of obstetricians from active aggressive management of labor will return our women to natural childbirth without induction and stimulation.

Natural birth is the only one safe birth, giving the greatest likelihood of preserving the intact central nervous system of the newborn child!