Health and Illness in Children

Prepared By : Supervised by:

Faisal Al Aaraj Prof. Sohair Abd-Rabou
Prof. Houda Hussain
Dr. Asma Mahfouz
Objevtives
 Outline
Introduction
Definition of Health
Definition of Illness
Health and illness perceived by different developmental stages
Health Promotion
Health Problems by different developmental stages
Role of Pediatric Nurse Related to Health and Illness
Research and Evidence-Based Practice
References
 Introduction
Health and illness in children are critical aspects of their well-
being.
Children's health encompasses physical, mental, and social
well-being, while illness can range from minor ailments to
more serious conditions.
This exploration focuses on understanding children's health
and addressing common health issues, emphasizing the role of
caregivers and healthcare professionals in promoting their
well-being.
 Introduction
Children's health encompasses not only the absence of
disease but also the attainment of optimal physical, mental,
and social well-being.
It involves a delicate balance of growth, nutrition, physical
activity, and preventive care, all designed to foster the
flourishing of young lives.
 • According to World Health Organization
Definition of (WHO) Health is a state of complete
Health physical, mental, social, and Spiritual well-
being, and not merely the absence of
disease or infirmity.
• This definition is reflects the holistic nature
of health, encompassing not only the
absence of illness but also the overall state
of well-being in an individual or a
community.
 Meaning of Illness

• Illness is a condition of physical or mental

malfunction, discomfort, or imbalance that
disrupts an individual's physiological or
psychological processes.
• Illness can cause pain, weakness, exhaustion,
fever, or cognitive impairments can be caused
by microorganisms, injuries, genetic
predisposition, environmental variables, or
lifestyle choices.
 Meaning of Illness

• Illness is a subjective term referring to an

individual’s experience of mental and
physical sensations or states, and may not
necessarily indicate the presence of
disease.
• Illness affects people differently and often
leads them to seek medical care,
treatment, or self-care to recover.
Health and Illness Perceived by
Different Developmental Stages
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Newborns

Newborns communicate their health and illness primarily

through their behavior, gestures, and bodily cues. Here
are some ways newborns express their health and illness
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Newborns

Crying
Crying is the most common way newborns communicate
their discomfort or distress. It can indicate various needs,
such as hunger, tiredness, discomfort, or pain. Parents
usually learn to differentiate different cries over time.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Newborns

Facial expressions
Newborns can exhibit various facial expressions that may
indicate their comfort or uneasiness. Content and relaxed
expressions often suggest good health, while grimacing,
furrowing of the brows, or a distressed expression may
indicate illness or discomfort.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Newborns

Body movements
Observe your newborn's body movements. Healthy
babies usually have smooth and fluid movements. Lack of
movement, stiffness, or unusual jerky motions may signal
a potential health issue.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Newborns

Sleep patterns
Newborns require a lot of sleep, often around 16-17
hours a day. Changes in sleep patterns, such as excessive
sleepiness, difficulty in falling or staying asleep, or
increased irritability during sleep, may be indicators of
illness.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Newborns

Breathing patterns
Observe your baby's breathing patterns. Normal
breathing for newborns is usually regular, quiet, and
without any unusual sounds. Rapid or labored breathing,
wheezing, gasping, or grunting could be signs of
respiratory issues.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Newborns

Feeding patterns
Pay attention to how your baby feeds. Healthy newborns
typically have a good appetite, and their feeding sessions
are coordinated and satisfying. A sudden decrease in
feeding, aversion to feeding, or difficulties in swallowing
may be signs of illness.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Newborns

Skin color and appearance
Notice the color and appearance of your newborn's skin.
A healthy baby will have a pinkish complexion and even
skin tone. Pale skin, yellowing of the skin and eyes
(jaundice), or rashes may signify health concerns.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Newborns

Body temperature
A newborn's body temperature is an important indicator
of their well-being. Fever or significant changes in body
temperature, such as feeling very warm or cold to the
touch, should be noted as they could indicate an
underlying illness.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Newborns

Body temperature
A newborn's body temperature is an important indicator
of their well-being. Fever or significant changes in body
temperature, such as feeling very warm or cold to the
touch, should be noted as they could indicate an
underlying illness.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Toddler

Behavior
Changes in behavior can be an indicator of a toddler's
health. A healthy toddler is typically active, playful,
curious, and engaged in their surroundings. However, if a
toddler becomes unusually irritable, lethargic, or
withdrawn, it may suggest illness or discomfort.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Toddler

Appetite
A toddler's eating patterns can provide insight into their
health. Normal appetites can vary, but a sudden loss of
appetite, refusal to eat, or significant changes in eating
habits may indicate illness or discomfort.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Toddler

Communication
While toddlers may not have mastered verbal
communication fully, they still attempt to express
themselves. They may use words, gestures, or sounds to
convey discomfort or pain. Pay attention if your child
points to specific body parts or expresses discomfort
through non-verbal cues.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Toddler

Body language
Observe your toddler's body language. Clues such as
limpness, rubbing or holding a specific body part,
constant fidgeting or restlessness, or avoiding particular
activities or movements may suggest potential health
concerns or discomfort.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Toddler

Bathroom habits
Pay attention to your toddler's bathroom habits.
Significant changes in urination or bowel movements,
such as prolonged diarrhea, constipation, blood in stool or
urine, or discomfort during bathroom trips, could suggest
a health concern.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Toddler

Sleep patterns
Most toddlers require around 11-14 hours of sleep in a
day. If a toddler experiences significant changes in sleep
patterns, such as excessive sleepiness,or staying asleep, or
frequent awakenings, it may be worth considering if there
is an underlying health issue.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Preschool Age

Similar to toddlers
Behavior change
Appetite change
Sleep pattern
Body Language
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Preschool Age

Verbal communication
Preschool-aged children can articulate their feelings
and symptoms to a certain extent. They may use
words to describe physical discomfort or pain, such as
"my tummy hurts" or "my head is pounding."
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Preschool Age

Emotional state
Pay attention to the emotional well-being of
preschoolers. Feeling unusually sad, anxious, or
depressed might be an indication of underlying health
issues.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in School Age

Verbal communication
School-age children can express their symptoms and
feelings quite clearly. They are usually able to
describe specific sensations, such as headaches,
stomachaches, sore throat, or muscle pain.
Encourage open and honest communication, and
actively listen to their concerns.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in School Age

Behavior
Changes in behavior can still indicate a school-age
child's health condition. They may appear fatigued,
lethargic, or irritable when they are unwell. On the
other hand, some children may become excessively
hyperactive or restless due to discomfort.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in School Age

School performance
Health issues can sometimes impact a child's ability to
concentrate, participate, or perform well
academically. If you notice a sudden decline in their
school performance, it might indicate an underlying
health concern.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Adolescents

Verbal expression:
Adolescents possess advanced language skills,
allowing them to articulate their symptoms and
feelings in more detail. They can often accurately
describe physical discomfort or pain, as well as
emotional symptoms they may experience.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Adolescents

Self-awareness
Adolescents may have an increased level of self-
awareness when it comes to their health. They can
recognize changes in their physical, mental, and
emotional states, and may actively seek out
information to understand their symptoms.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Adolescents

Emotional well-being
Adolescents are often more in tune with their
feelings and emotions. They may experience mood
changes, anxiety, or depression related to their health
concerns or illness.
 Health and Illness Perceived by Different Developmental Stages

Health and Illness Perceived in Adolescents

Internet and media influence
With easy access to the internet and social media,
adolescents may gather information about health
and illness from various sources. It's important to
guide them toward reliable and accurate sources of
information.
 Health Promotion
and
Health Problems by Different
Developmental Stages
 Health Promotion
Education and Awareness
Behavioral Change
Access to Healthcare
Community Engagement
Policy Advocacy
Health Promotion • Encourage breastfeeding for the first 6
for Newborns months as it provides essential nutrients
and strengthens the infant's immune
system.
• Promote skin-to-skin contact for bonding
and temperature regulation.
• Ensure vaccinations according to the
recommended schedule.
• Promote a safe sleeping environment to
prevent Sudden Infant Death Syndrome
(SIDS).
• Educate parents about recognizing signs of
illness and seeking timely medical care.
 Common Health Problems of Newborns
• Common Health Problems of Newborns (Global Prevalence):

• Preterm Birth: Globally, approximately 10% of births are preterm (WHO, 2021).

• Low Birth Weight: Around 15% of newborns worldwide have low birth weight
(UNICEF, 2020).

• Respiratory Distress Syndrome (RDS): RDS affects up to 1% of newborns,

primarily preterm infants, and is characterized by breathing difficulties due to
underdeveloped lungs.

• Infections: Neonatal infections, including sepsis, affect a significant number of

newborns, often due to exposure during birth or through postnatal transmission.
 Common Health Problems of Newborns
• Common Health Problems of Newborns (Middle East):
• Neonatal Jaundice: Prevalent in the Middle East due to genetic factors and
is one of the leading causes of hospital readmissions (Al-Biltagi et al., 2020).
• Respiratory Distress Syndrome: Occurs in a significant proportion of
newborns in Middle Eastern countries, often linked to maternal factors
(Asad, 2019).
• Infections: Neonatal infections, including sepsis, can impact newborns in
the Middle East, emphasizing the importance of aseptic delivery practices.

• Birth Injuries: Birth injuries may occur in cases of difficult deliveries, and
prompt medical attention is crucial to address these injuries effectively.
• Congenital Heart Defects: Some Middle Eastern countries report cases of
congenital heart defects, necessitating specialized pediatric cardiac care.
 • Promote breastfeeding to enhance nutrition
Health Promotion for and immune system development.
Infants • Encourage routine immunizations according
to the recommended schedule.
• Educate parents on safe sleeping practices to
reduce the risk of SIDS.
• Emphasize the importance of hygiene,
including handwashing and clean water.
• Provide guidance on introducing age-
appropriate, nutritious solid foods.
 • Common Health Problems of Infants (Global Prevalence)

Conti… • Pneumonia: Globally, pneumonia is a leading cause of

infant mortality, responsible for approximately 15% of
all deaths in infants under five (UNICEF, 2020).
• Diarrheal Diseases: Diarrhea remains a major concern,
contributing to around 8% of infant deaths worldwide
(WHO, 2021).
• Neonatal Infections: Infections acquired during the
neonatal period, such as sepsis and meningitis, are a
significant concern, particularly for newborns.
• Anemia: Iron-deficiency anemia is prevalent among
infants and can affect their physical and cognitive
development.
Conti…
• Common Health Problems of Infants (Middle East):
• Malnutrition: In some Middle Eastern countries, malnutrition remains a
challenge, particularly in conflict-affected areas (Save the children, 2021).
• Acute Respiratory Infections: These infections are common in the Middle
East, often linked to factors like air pollution and overcrowded living
conditions (Ghanem et al., 2020).
• Gastrointestinal Infections: Diarrheal diseases caused by various
pathogens, including contaminated water sources, can lead to infant
morbidity in some Middle Eastern regions.
• Malnutrition: Some parts of the Middle East face issues related to infant
malnutrition, with stunting and growth delays being of particular concern.
• Immunization-Preventable Diseases: Vaccine coverage can vary, and in
some areas, infants remain susceptible to preventable diseases like polio,
measles, and pertussis.
Health Promotion for Toddlers

• Encourage a diet rich in fruits, vegetables, and whole

grains for healthy growth.
• Promote active play to develop motor skills and
maintain a healthy weight.
• Emphasize regular toothbrushing and dental check-
ups to prevent cavities.
• Educate parents about childproofing homes to prevent
accidents.
• Encourage social interaction for language and
emotional development.
Conti…
• Common Health Problems of Toddlers (Global Prevalence):
• Childhood Obesity: Globally, over 40 million children under the
age of five are overweight or obese (WHO, 2021).
• Dental Caries: Dental caries (tooth decay) affects nearly 20% of
children aged 2 to 4 worldwide (World Dental Federation, 2020).
• Gastrointestinal Infections: Diarrheal diseases, often caused by
pathogens, are common among toddlers and can result in
dehydration and malnutrition.
• Behavioral Issues: Behavioral concerns like temper tantrums and
defiance are typical in toddlers as they develop independence.
Conti…
• Common Health Problems of Toddlers (Middle East):
• Malnutrition: In certain Middle Eastern regions, malnutrition and
stunting continue to affect toddler health (UNICEF, 2021).
• Accidental Injuries: Accidental injuries are a significant health
concern for toddlers, necessitating better safety measures (Ghaffari
et al., 2019).
• Immunization-Preventable Diseases: Ensuring that toddlers receive
recommended vaccines is crucial to protect them from preventable
diseases, including measles, mumps, and rubella.
• Gastrointestinal Infections: Diarrheal diseases caused by factors like
contaminated water sources can affect toddlers, resulting in
dehydration and malnutrition in some regions.
 Health Promotion for Preschoolers

• Encourage a balanced diet rich in fruits, vegetables, and

whole grains.
• Promote regular exercise to develop motor skills and
maintain a healthy weight.
• Emphasize proper toothbrushing and regular dental check-
ups.
• Foster emotional well-being through play and social
interactions.
• Teach about road safety, fire safety, and stranger awareness.
Conti…
• Common Health Problems of Preschoolers (Global Prevalence)
• Childhood Obesity: Globally, childhood obesity affects over
150 million children (World Health Organization, 2021).
• Dental Caries: Dental caries remains a significant issue,
impacting approximately 620 million children aged 5-11
worldwide (World Dental Federation, 2020).
• Respiratory Infections: Preschoolers are susceptible to colds,
flu, and other respiratory infections, which can be frequent
in childcare and school settings.
• Gastrointestinal Infections: Diarrheal diseases, often due to
pathogens in contaminated food or water, continue to affect
preschoolers and may lead to dehydration.
 • Common Health Problems of Preschoolers (Middle
East):
Conti… • Vitamin D Deficiency: Prevalent in Middle
Eastern countries due to limited sun exposure (Al-
Mutairi et al., 2017).
• Accidental Injuries: Accidental injuries,
especially from road traffic accidents, pose a
considerable threat to preschooler health (Hijar et
al., 2018).
• Behavioral and Emotional Challenges:
Preschoolers in the Middle East may experience
behavioral and emotional challenges as they
navigate social interactions and emotional
development.
• Developmental Delays: Some preschoolers may
exhibit developmental delays, such as speech or
motor skill issues, necessitating early intervention.
 Health Promotion for School-Age Children

Healthy Lifestyle: Encourage balanced nutrition and regular

physical activity.

Emotional Well-being: Promote mental health awareness and

stress management.

Oral Health: Stress the importance of regular dental check-ups

and proper hygiene.

Safety Education: Teach about injury prevention, online safety,

and substance abuse awareness.

Immunizations: Ensure children are up-to-date with

recommended vaccinations.
Conti…
Common Health Problems of School-Age Children (Global
Prevalence):

• Childhood Obesity: Worldwide, over 340 million children and adolescents aged 5-19 are
overweight or obese (World Obesity Federation, 2020).
• Dental Issues: Dental problems, including cavities and gum disease, affect a large percentage
of school-age children (American Dental Association, 2021).

Common Health Problems of School-Age Children (Middle

East):

• Vitamin D Deficiency: Prevalent in the Middle East due to limited sun exposure, affecting
child health (Al-Mutairi et al., 2017).
• Injury Due to Conflict: In conflict-affected Middle Eastern regions, injuries, and trauma can
significantly impact school-age children (United Nations, 2020).
 Health Promotion for Adolescents

• Healthy Lifestyle: Promote balanced nutrition, regular exercise, and stress

management.

• Mental Health Awareness: Encourage open conversations about mental well-

being and provide access to support.

• Safe Relationships: Teach about healthy relationships, consent, and sexual

health.

• Substance Abuse Prevention: Educate on the risks of substance use and

addiction.

• Safety Education: Address road safety, online safety, and risk-taking behavior.
 Conti…

Common Health Common Health

Problems of Problems of
Adolescents (Global Adolescents (Middle
Prevalence): East):

Mental Health Non-Communicable

Mental Health Issues:
Globally, mental health
disorders affect about
20% of adolescents
(World Health
Organization, 2021).
Obesity: Challenges:
Worldwide, over 12% of Adolescents in the
adolescents aged 5-19 Middle East face mental
are obese (World health issues,
Obesity Federation, exacerbated by societal
2020). stressors (Al-Jawaldeh,
2020).
Diseases:
Middle Eastern countries
are witnessing an
increase in non-
communicable diseases
among adolescents
(Agha, 2021).
Health Care for • The primary objective of pediatric nursing is to enhance
Children the quality of health care for children and their families.
• The US has about 74 million children aged 0-17 in 2016,
accounting for 24% of the population (Federal Interagency
Forum on Child and Family Statistics, 2017).
• The US has seen improvements in child health, including
increasing vaccination rates, lower adolescent birth rates,
and better child health outcomes.
• While the number of children living in poverty declined
marginally in 2015, the percentage remained high at 20%.
• Millions of children and families lack health insurance,
limiting access to care and health promotion programs.
 Role of Pediatric Nurse Related to
Health and Illness

• Pediatric nurses promote child and family health.

• Nursing roles vary by geography, education,
experience, and professional objectives.
• Just as patients (children and their families) have
varied histories, each nurse contributes unique
elements that impact the nurse-patient interaction.
• Pediatric nurses prioritize child and family welfare
wherever they work.
• Pediatric nurses can get further degrees to become
PNPs or CNSs.
 Therapeutic Relationship
• Therapeutic Relationship High-quality nursing care
starts with a therapeutic partnership.
• Pediatric nurses must connect with children and their
families while maintaining their own needs.
• Therapeutic relationships have clear, compassionate
boundaries between the nurse, child, and family.
• The nurse and family communicate and empower each
other.
• Identifying therapeutic or nontherapeutic patient
relationships helps nurses recognize issues early in
encounters with children and families.
Family Care and Advocacy
• Family Care and Advocacy Nurses are accountable to
themselves, the profession, and the employer, but they
are most responsible to the kid and family.
• The nurse must determine family objectives and needs
and create interventions to solve difficulties.
• As an advocate, the nurse helps the child and family
make educated decisions and act in their best interest.
• Nurses must show compassion and understanding
while treating children and families.
• Caring for the child and family's nontechnical needs is
seen as great nursing care by parents.
• Parents believe personal nursing care is essential to a
good relationship.
 Health promotion and Disease Prevention

• Health Promotion and Disease Prevention Every child-care nurse must

understand illness prevention and health promotion.
• A nurse care plan must evaluate child growth and development, including
nutrition, vaccines, safety, dental care, socializing, discipline, and education.
• If issues arise, the nurse addresses them or sends the family to other health
care providers.
• Education and foresight are ideal preventative methods.
• This text contains anticipatory information in each health promotion chapter.
• Understanding the risks and conflicts of each developmental phase allows
the nurse to advise parents on childrearing strategies to avoid issues.
 Health Teaching
• Health Education Advocacy and prevention for families
are integral to health education.
• Health teaching can be direct, like in parenting classes,
or indirect, like helping parents and children understand
a diagnosis or medical treatment, and providing
anticipatory guidance.
• Nurses need to perform health teaching with competent
role models because it entails communicating at the
child and family's level of knowledge and desire for
information.
• Effective nurses provide health education with liberal
feedback and evaluation to foster learning.
Injury Prevention

• Injury Prevention Each year, injuries kill or disable more

children older than 1 year old than all childhood diseases
combined.
• The nurse plays an important role in preventing injuries by
using a developmental approach to safety counseling for
parents of children of all ages.
• Realizing that safety concerns for a young infant are
completely different than injury risks of adolescents, the
nurse discusses appropriate injury prevention tips to
parents and children as part of routine patient care.
Support and Counseling
• Support and therapy are needed for
emotional needs.
• The tailored approach supports child
advocates and health teachers.
• The nurse may help by listening,
touching, and being there.
• It includes support, instruction, ways to
communicate feelings and thoughts,
and stress-reduction strategies for the
family.
 • As part of the health care team, the nurse
Coordination and coordinates nursing care with other experts.
Collaboration
• A nurse working alone seldom helps children.
• This united, multidisciplinary strategy can
provide holistic care by being conscious of
individual contributions and limits and working
with other professionals to give high-quality
health services.
• The nurse who feels competent in counseling
but is incompetent may inhibit the kid from
dealing with a problem and hinder future
success with a skilled expert.
• Nursing is crucial to delivering high-quality,
safe treatment by the health care team.
Ethical Decision • Alternatives with conflicting moralities are
ethical dilemmas.
Making
• Parents, nurses, doctors, and other health care
professionals can consider opposing moral
values to make ethically sound judgments.
• Collaboration in ethical decision-making
requires rigorous preparation for nurses.
• The nurse guides and self-regulates using the
professional code of ethics.
• Nurses can clarify their values when faced with
delicate topics with ethical arguments.
 RESEARCH AND EVIDENCE-BASED
PRACTICE

• The increasing emphasis on quantifiable outcomes to establish

intervention success (often in connection to cost) requires nurses
to know if clinical treatments improve patient outcomes.
• This desire has led to the rise of evidence-based practice (EBP),
which questions why something works and whether there is a
better way.
• EBP also entails assessing and applying clinical studies to nursing
practice.
• When nurses base their clinical practice on science and research
and record their clinical results, they may legitimize their
contributions to health, wellness, and cure for patients, third-party
payers, institutions, and the nursing profession.
• Evidence-based nursing blends clinical experience, intuition, and
knowledge.
Conti…

• EBP enhances nursing through employing critical

thinking to create knowledge-based judgments.
• The conventional nursing process approach to
patient care may be utilized to conceptualize EBP in
nursing.
• After assessing the problem's knowledge and
unknowns, evidence-based nursing creates a
treatment plan.
• The nurse shortage and institutional changes have
made patient care, education, and training time
allocation difficult.
• As awareness of EBP's influence on patient care
outcomes grows, organizational culture may shift to
promote staff nurses' EBP engagement.
 Clinical Reasoning

• Clinical logic A career requires methodical thinking.

• Clinical reasoning and the nursing process are essential to
professional nursing because they solve problems
holistically.
• Developing clinical thinking requires reasonable and
intentional thought.
• This text's Critical Thinking Exercises emphasize clinical
thinking.
• These activities simulate a nurse practice setting and
need clinical reasoning to get the optimal result.
• These activities improve nurse clinical thinking.
 summery
• Children's health and illness encompass a wide range of physical,
mental, and social well-being factors.
• Children's health encompasses their overall well-being, including
physical, mental, and social dimensions, emphasizing growth,
nutrition, and preventive care, while child illness refers to physical or
mental imbalances, from minor ailments to chronic conditions,
requiring medical attention or self-care to restore well-being.
• These aspects of child health and illness involve a collective effort by
healthcare professionals, caregivers, and parents to ensure children
grow and thrive in a nurturing environment.
References
• World Health Organization. (2021).

• UNICEF. (2020). Pneumonia: The Forgotten Killer of Children.

• Al-Biltagi, M., Hassan, M., Abd-El Rahman, R. R., & Abdel-Hady, A. (2020). Prevalence and Risk Factors of Severe Neonatal Jaundice in a Tertiary Neonatal Unit.

• Asad, M. (2019). Risk factors for respiratory distress syndrome among neonates admitted to neonatal intensive care unit in Al-Najaf City.

• Cohn, L. N., Pechlivanoglou, P., Lee, Y., Mahant, S., Orkin, J., Marson, A., & Cohen, E. (2020). Health outcomes of parents of children with chronic illness: a systematic review and meta-analysis. The Journal of pediatrics, 218, 166-
177.

• Save the Children. (2021). Food and Nutrition Crisis in the Middle East.

• Ghanem, S., Elkholy, A., & Shaaban, R. (2020). Acute respiratory infections among young children in Egypt: prevalence and risk factors.

• World Dental Federation. (2020). Oral Health Atlas.

• UNICEF. (2021). Nutrition in the Middle East and North Africa.

• Ghaffari, M., Ansari, H., & Bastani, F. (2019). Risk factors for unintentional home injuries in children aged 1-5 years old: a case-control study.

• Meek, J. Y., Noble, L., & Section on Breastfeeding. (2022). Policy statement: breastfeeding and the use of human milk. Pediatrics, 150(1), e2022057988.

• Hockenberry, M. J., Wilson, D., & Rodgers, C. C. (2021). Wong's essentials of pediatric nursing-e-book. Elsevier Health Sciences.