Cervical Cancer Prevention with Cervarix / VACCINE

Introduction

Cervari is a vaccine for cervical cancer in Indonesia, which is intended for both young girls and adult women (aged 10 years s / d 55 years) for the prevention of cervical cancer.

The vaccine contains antigens for HPV types 16 and 18 cause more than 70% of cervical cancer cases in the world.

GSK's cervical cancer vaccine provides 100% protection against human papillomavirus (HPV) types 16 and 18 are associated with lesions of pre-kanker.

Cervarix also provide additional protection against other oncogenic HPV types are HPV types 45, 31 and 52.

Cervarix is ​​formulated with an adjuvant system technology ASO4. ASO4 encourage the formation of a stronger immune response and durable than the aluminum adjuvant tradisional.

All women are at risk of cervical cancer during their lifetime, regardless of age and lifestyle

HPV is a common virus, easily passed through genital skin contact. Both teenage girls and adult women at risk for cervical cancer is caused by repeated infection of HPV cause kanker.

Estimated that up to 50-80% of women will have an HPV infection in their lifetime, 7-9 and up to 50% percent of these infections could potentially cause cancer. 9-11 The risk of infection since the first sexual contact.

Most HPV infections go away on its own, but some will stay. 13 Unlike other viruses, when a woman has been infected with HPV, does not mean she will have immunity to this virus. 7.14-19 Therefore, even if a woman has been exposed to HPV, she still has the risk of recurrent infection of HPV types are the same or different, and remain at risk for cervical cancer.

Indications Cervarix

In Indonesia, GSK's cervical cancer vaccine aimed at teenage girls and adult women to prevent cervical cancer by protecting from infection and the incidence of persistent infection at the stage of CIN 2 and more severe lesions caused by human papillomavirus (HPV) types 16 and 18. This vaccine has demonstrated efficacy against persistent infection caused by oncogenic HPV types other than HPV 16 and HPV 18.

Vaccination schedule for GSK's cervical cancer vaccine consists of three doses, given at months 0, the 1st and the 6th.

Cervarix has been tested on 40,000 study subjects and has demonstrated a good level of tolerance.

In the world, every two minutes a woman dies of cervical cancer.

In Indonesia, cervical cancer is the number one cancer that most commonly affects women in Indonesia.

Cervical cancer is a cancer that can affect women with diverse backgrounds and different ages all over the world. Starting with the cervix - the part of the uterus (or womb) and then reach the vagina - and gradually will spread if not given treatment.

Cervical cancer can often infect and kill women in the productive age (30-50 years of age), often at the time they still have social and economic responsibilities towards children and other family members.

Pap smears can detect early-stage cervical cancer by identifying the cell changes on the cervix.

In general, will not be visible symptoms in the early stages of cancer serviks.

The risk of developing cervical cancer in women who are not screened regularly is five times higher than the teratur.

Screening is important because it can help detect cervical cancer development, but it can not prevent HPV infection.

There are 15 types of cancer-causing HPV types can lead to cervical cancer; HPV 16 and 18, causing more than 70% of cervical cancer in the Asia Pacific region and the world.

HPV is a common virus.

HPV easily transmitted through genital skin contact

Both teenage girls and adult women at risk for cervical cancer is caused by infection or recurrent infection caused by HPV causes cancer.

Most HPV infections go away on its own, but some will stay. 26 Unlike other viruses, when a woman infected with HPV virus, does not mean she will have immunity to this virus. 3.27-32 Therefore, although a woman has been exposed to HPV, she is still at risk for recurrent infection of HPV types are the same or different, and remain at risk of developing cancer serviks.

The vaccine targets HPV types 16 and 18 have the potential to prevent more than 70% of cervical cancer incidence 19

In the future, vaccination with screening can reduce the risk of cervical cancer compared with screening alone and can reduce the number of abnormal screening that require follow-up significantly.

HPV and Cervical Cancer

In the world, about 500,000 women are diagnosed with cervical cancer and an average of 270,000 deaths annually. Women who are sexually active are infected risk of cervical cancer or early stage disease regardless of age or lifestyle. 

- New cases of cervical cancer 40-45 / 9-10 days

- The number of deaths due to cervical cancer is 20-25 / hari9-10

- Every one hour, one woman died of cancer serviks9-10

How to detect cervical cancer?

HPV - the virus that causes cervical cancer

- HPV types 16, 18, 45, 52 and 31 are responsible for more than 80% of cervical cancer cases in Asia Pasifik

Every woman at risk of contracting cervical cancer during their lifetime, regardless of age and lifestyle. An estimated 50-80% of women were infected with HPV through sexual contact in their lives, 3,21,22 and potentially cause cancer by 50%. 22-24 The risk of infection since the first sexual contact. 

Prevention by HPV vaccination

The vaccine will enhance the ability of the immune system to recognize and destroy the virus when it enters the body, before the infection.

source:http://www.pro-vclinic.web.id/news/pencegahan-kanker-serviks

PNEUMONIA

What is pneumonia?

Pneumonia is an infection of one or both lungs which is usually caused by bacteria, viruses, or fungi. Prior to the discovery of antibiotics, one-third of all people who developed pneumonia subsequently died from the infection. Currently, over 3 million people develop pneumonia each year in the United States. Over a half a million of these people are admitted to a hospital for treatment. Although most of these people recover, approximately 5% will die from pneumonia. Pneumonia is the sixth leading cause of death in the United States.

What are pneumonia symptoms and signs?

Most people who develop pneumonia initially have symptoms of a cold (upper respiratory infection, for example, sneezing,sore throat, cough), which are then followed by a high fever ,shaking chills, and a cough with sputum production. The sputum is usually discolored and sometimes bloody. Depending on the location of the infection, certain symptoms are more likely to develop. When the infection settles in the air passages, cough and sputum tend to predominate the symptoms. In some, the spongy tissue of the lungs that contain the air sacs is more involved. In this case, oxygenation of the blood can be impaired, along with stiffening of the lung, which results in shortness of breath. At times, the individual's skin color may change and become dusky or purplish (a condition known as "cyanosis") due to their blood being poorly oxygenated.

The only pain fibers in the lung are on the surface of the lung, in the area known as the pleura. Chest pain may develop if the outer aspects of the lung close to the pleura are involved in the infection. This pain is usually sharp and worsens when taking a deep breath and is known as pleuritic pain or pleurisy. In other cases of pneumonia, depending on the causative organism, there can be a slow onset of symptoms. A worsening cough, headaches, and muscle aches may be the only symptoms.

Children and babies who develop pneumonia often do not have any specific signs of a chest infection but develop a fever, appear quite ill, and can become lethargic. Elderly people may also have few symptoms with pneumonia.

How is pneumonia diagnosed?

Your doctor will ask you about your symptoms and do a physical exam. He or she may order a chest X-ray and a blood test. This is usually enough for your doctor to know if you have pneumonia. You may need more tests if you have bad symptoms, are an older adult, or have other health problems. In general, the sicker you are, the more tests you will have.

Pneumonia may be suspected when the doctor examines the patient and hears coarse breathing or crackling sounds when listening to a portion of the chest with a stethoscope. There may be wheezing or the sounds of breathing may be faint in a particular area of the chest. A chest X-ray is usually ordered to confirm the diagnosis of pneumonia. The lungs have several segments referred to as lobes, usually two on the left and three on the right. When the pneumonia affects one of these lobes, it is often referred to as lobar pneumonia. Some pneumonias have a more patchy distribution that does not involve specific lobes. In the past, when both lungs were involved in the infection, the term "double pneumonia" was used. This term is rarely used today.

Sputum samples can be collected and examined under the microscope. Pneumonia caused by bacteria or fungi can be detected by this examination. A sample of the sputum can be grown in special incubators, and the offending organism can be subsequently identified. It is important to understand that the sputum specimen must contain little saliva from the mouth and be delivered to the laboratory fairly quickly. Otherwise, overgrowth of noninfecting bacteria from the mouth may predominate. As we have used antibiotics in a broader uncontrolled fashion, more organisms are becoming resistant to the commonly used antibiotics. These types of cultures can help in directing more appropriate therapy.

A blood test that measures white blood cell count (WBC) may be performed. An individual's white blood cell count can often give a hint as to the severity of the pneumonia and whether it is caused by bacteria or a virus. An increased number of neutrophils, one type of WBC, is seen in most bacterial infections, whereas an increase in lymphocytes, another type of WBC, is seen in viral infections, fungal infections, and some bacterial infections (like tuberculosis).

Bronchoscopy is a procedure in which a thin, flexible, lighted viewing tube is inserted into the nose or mouth after a local anesthetic is administered. Using this device, the doctor can directly examine the breathing passages (trachea and bronchi). Simultaneously, samples of sputum or tissue from the infected part of the lung can be obtained.

Sometimes, fluid collects in the pleural space around the lung as a result of the inflammation from pneumonia. This fluid is called a pleural effusion. If a significant amount of fluid develops, it can be removed. After numbing the skin with local anesthetic a needle is inserted into the chest cavity and fluid can be withdrawn and examined under the microscope. This procedure is called a thoracentesis. Often ultrasound is used to prevent complications from this procedure. In some cases, this fluid can become severely inflamed (parapneumonic effusion) or infected (empyema) and may need to be removed by more aggressive surgical procedures. Today, most often, this involves surgery through a tube or thoracoscope. This is referred to as video-assisted thoracoscopic surgery or VATS.

What are some of the organisms that cause pneumonia? What is the treatment for pneumonia? Can pneumonia be prevented?

The most common cause of a bacterial pneumonia is Streptococcus pneumoniae. In this form of pneumonia, there is usually an abrupt onset of the illness with shakingchills, fever, and production of a rust-colored sputum. The infection spreads into the blood in 20%-30% of cases (known assepsis), and if this occurs, 20%-30% of these patients die.

Two vaccines are available to prevent pneumococcal disease: the pneumococcal conjugate vaccine (PCV13) and the pneumococcal polysaccharide vaccine (PPV23; Pneumovax). The pneumococcal conjugate vaccine is part of the routine infant immunization schedule in the U.S. and is recommended for all children < 2 years of age and children 2-4 years of age who have certain medical conditions. The pneumococcal polysaccharide vaccine is recommended for adults at increased risk for developing pneumococcal pneumonia including the elderly, people who havediabetes, chronic heart, lung, or kidney disease, those with alcoholism, cigarette smokers, and in those people who have had their spleen removed. This vaccination should be repeated every five to seven years, whereas the flu vaccine is given annually.

Antibiotics often used in the treatment of this type of pneumonia includepenicillin, amoxicillin and clavulanic acid (Augmentin, Augmentin XR), and macrolide antibiotics including erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone), azithromycin (Zithromax, Z-Max), and clarithromycin(Biaxin). Penicillin was formerly the antibiotic of choice in treating this infection. With the advent and widespread use of broader-spectrum antibiotics, significant drug resistance has developed. Penicillin may still be effective in treatment of pneumococcal pneumonia, but it should only be used after cultures of the bacteria confirm their sensitivity to this antibiotic.

Klebsiella pneumoniae and Hemophilus influenzae are bacteria that often cause pneumonia in people suffering from chronic obstructive pulmonary disease (COPD) or alcoholism. Useful antibiotics in this case are the second- and third-generation cephalosporins, amoxicillin and clavulanic acid, fluoroquinolones (levofloxacin [Levaquin], moxifloxacin-oral [Avelox], and sulfamethoxazole/trimethoprim [Bactrim, Septra]).

Mycoplasma pneumoniae is a type of bacteria that often causes a slowly developing infection. Symptoms include fever, chills, muscle aches,diarrhea, and rash. This bacterium is the principal cause of many pneumonias in the summer and fall months, and the condition often referred to as "atypical pneumonia." Macrolides (erythromycin, clarithromycin, azithromycin, and fluoroquinolones) are antibiotics commonly prescribed to treat Mycoplasma pneumonia.

Legionnaire's disease is caused by the bacterium Legionella pneumoniaethat is most often found in contaminated water supplies and air conditioners. It is a potentially fatal infection if not accurately diagnosed. Pneumonia is part of the overall infection, and symptoms include high fever, a relatively slow heart rate, diarrhea, nausea, vomiting, and chest pain. Older men, smokers, and people whose immune systems are suppressed are at higher risk of developing Legionnaire's disease. Fluoroquinolones (see above) are the treatment of choice in this infection. This infection is often diagnosed by a special urine test looking for specific antibodies to the specific organism.

Mycoplasma, Legionnaire's, and another infection, Chlamydia pneumoniae, all cause a syndrome known as "atypical pneumonia." In this syndrome, the chest X-ray shows diffuse abnormalities, yet the patient does not appear severely ill. In the past, this condition was referred to as "walkingpneumonia," a term that is rarely used today. These infections are very difficult to distinguish clinically and often require laboratory evidence for confirmation.

Recently, a study performed in the Netherlands demonstrated that adding a steroid medication, dexamethasone (Decadron), to antibiotic therapy shortens the duration of hospitalization. This medication should be used with caution in patients whom are critically ill or already have a compromised immune system.

Pneumocystis carinii (now known as Pneumocystis jiroveci) pneumonia is another form of pneumonia that usually involves both lungs. It is seen in patients with a compromised immune system, either from chemotherapy forcancer, HIV/AIDS, and those treated with TNF (tumor necrosis factor), such as for rheumatoid arthritis. Once diagnosed, it usually responds well to sulfa-containing antibiotics. Steroids are often additionally used in more severe cases.

Viral pneumonias do not typically respond to antibiotic treatment. These infections can be caused by adenoviruses, rhinovirus, influenza virus (flu),respiratory syncytial virus (RSV), and parainfluenza virus (that also causescroup). These pneumonias usually resolve over time with the body's immune system fighting off the infection. It is important to make sure that a bacterial pneumonia does not secondarily develop. If it does, then the bacterial pneumonia is treated with appropriate antibiotics. In some situations, antiviral therapy is helpful in treating these conditions. More recently, H1N1, swine-origin influenza A, has been associated with very severe pneumonia often resulting in respiratory failure. This disease often requires the use of mechanical ventilation for breathing support. Death is not uncommon when this infection involves the lungs.

Fungal infections that can lead to pneumonia include histoplasmosis, coccidiomycosis, blastomycosis, aspergillosis, and cryptococcosis. These are responsible for a relatively small percentage of pneumonias in the United States. Each fungus has specific antibiotic treatments, among which are amphotericin B, fluconazole (Diflucan), penicillin, and sulfonamides.

Major concerns have developed in the medical community regarding the overuse of antibiotics. Most sore throats and upper respiratory infections are caused by viruses rather than bacteria. Though antibiotics are ineffective against viruses, they are often prescribed. This excessive use has resulted in a variety of bacteria that have become resistant to many antibiotics. These resistant organisms are commonly seen in hospitals and nursing homes. In fact, physicians must consider the location when prescribing antibiotics (community-acquired pneumonia, or CAP, versus hospital-acquired pneumonia, or HAP).

The more virulent organisms often come from the health-care environment, either the hospital or nursing homes. These organisms have been exposed to a variety of the strongest antibiotics that we have available. They tend to develop resistance to some of these antibiotics. These organisms are referred to as nosocomial bacteria and can cause what is known as nosocomial pneumonia when the lungs become infected.

Recently, one of these resistant organisms from the hospital has become quite common in the community. In some communities, up to 50% of Staph aureus infections are due to organisms resistant to the antibiotic methicillin. This organism is referred to as MRSA (methicillin-resistant Staph aureus) and requires special antibiotics when it causes infection. It can cause pneumonia but also frequently causes skin infections. In many hospitals, patients with this infection are placed in contact isolation. Their visitors are often asked to wear gloves, masks, and gowns. This is done to help prevent the spread of this bacteria to other surfaces where they can inadvertently contaminate whatever touches that surface. It is therefore very important to wash your hands thoroughly and frequently to limit further spread of this resistant organism. The situation with MRSA continues to evolve. The community-acquired strain of MRSA tends to be responsive to some of the more commonly used antibiotics whereas the hospital-acquired strains require stronger, more aggressive antibiotic therapies. As this evolution occurs, patients are arriving in the hospital with the community-acquired strains as well as a previous hospital-acquired strain. This further necessitates performing bacterial cultures to determine the best course of action.

Source: http://www.medicinenet.com/pneumonia/

IRON DFICIENCY ANEMIA

Anaemia is a condition where the amount of haemoglobin in the blood is below the normal level, or there are fewer red blood cells than normal.

Symptoms of iron deficiency anaemia

• shortness of breath (dyspnoea)

• changes in your appearance, such as a pale complexion and dry nails

What causes iron deficiency anaemia?

• non-steroidal anti-inflammatory drugs (NSAIDs)

• a peptic ulcer

• stomach cancer or bowel cancer

• heavy periods

• pregnancy - because your body needs extra iron for your baby

Treating iron deficiency anaemia
Iron-rich foods

• dark-green leafy vegetables, such as watercress and curly kale

• beans

• nuts

• meat

• dried fruit

• tea and coffee

• calcium, found in dairy products such as milk

• antacids (medication to help relieve indigestion) 

Diagnosis 

• The diagnosis of iron-deficiency anemia will be suggested by appropriate history (eg, anemia in a menstruating woman or an athlete engaged in long-distance running), the presence of occult blood (ie, hidden blood) in the stool, and often by other history.  
• Body-store iron deficiency is diagnosed by diagnostic tests, such as a low serum ferritin, a low serum iron level, an elevated serum transferrin and a high total iron binding capacity . 
• Serum iron levels (ie, iron not part of the hemoglobin in red cells) may be measured directly in the blood, but these levels increase immediately with iron supplementation (the patient must stop supplements for 24 hours), and pure blood-serum iron concentration in any case is not as sensitive as a combination of total serum iron, along with a measure of the serum iron-binding protein levels (TIBC).
• The ratio of serum iron to TIBC (called iron saturation or transferrin saturation index or percent) is the most specific indicator of iron deficiency, when it is sufficiently low. The iron saturation (or transferrin saturation) of < 5% almost always indicates iron deficiency, while levels from 5% to 10% make the diagnosis of iron deficiency possible but not definitive. Saturations over 12% (taken alone) make the diagnosis unlikely. Normal saturations are usually slightly lower for women (>12%) than for men (>15%), but this may indicate simply an overall slightly poorer iron status for women in the "normal" population.

source: 1. http://en.wikipedia.org/wiki/Iron_deficiency_anemia
             2. http://www.nhs.uk/conditions/Anaemia-iron-deficiency-/Pages/Introduction.aspx

How to Ear Care

Cleaning your ears

• Clean your ears with extra care. Wipe the outer ear with a washcloth or tissue. Do not put anything into your ear smaller than your elbow. Do not use Q-tips, bobby pins or sharp pointed objects to clean your ears. These objects may injure the ear canal or eardrum.
• Earwax is the ear's mechanism for self cleaning. If you have a build-up of wax that is blocking your hearing, see your ear physician to have it removed.
• If you experience itching or pain in your ears, consult with your ear physician to determine the appropriate treatment.
• If you have pierced ears, clean your earrings and earlobes regularly with rubbing alcohol.

Illness and Medications

• Reduce the risk of ear infections by treating upper respiratory infections promptly.
• Some illnesses and medical conditions can affect your hearing. If you experience sudden hearing loss or persistent noise in your ears or head, see an ear physician immediately.
• Drainage from the ear is not normal and should be evaluated promptly.
• Some medications can affect hearing. Take medications only as directed, and consult your physician if you experience unusual hearing, balance symptoms, or ringing in the ears.

Noise

• At home or work, wear hearing protection during exposure to loud levels of noise. This includes mowing the lawn, leaf blowing or using power tools. By law, a noisy work environment will require the use of hearing protection.
• When using stereos and home theater systems, avoid excessive volume. If you think it is too loud, it probably is.
• When using personal sound systems, the volume should be comfortable. If someone else can hear what you are listening to, the volume is too high. Remove the headphones from time to time to give your ears a rest.
• Wear earplugs at rock concerts, nightclubs and motor sporting events.
• Keep automobile sound systems at sensible volumes. This can help you avoid hearing damage and allow you to hear and yield to emergency vehicles.

Safety Issues

• Always wear a helmet when you bike, ski, and roller blade or in any other activity that puts you at risk for head and ear injuries.
• If you scuba dive, learn and practice proper underwater techniques to avoid potentially damaging changes in pressure inside your ears.
• When flying in an airplane, swallow and yawn frequently when the plane is ascending and descending to equalize pressure in your ears. If you have an upper respiratory problem such as a cold or sinus infection, take a decongestant a few hours before descending, or use a decongestant spray just prior to descent and on landing.
• Earplugs with special filters can be purchased to help equalize air pressure in ears during air travel.

General Care

• Have your ears checked regularly by your primary care physician and your hearing checked regularly by an audiologist. Consult an ear physician as necessary.
• When outdoors in sunny weather, remember to use a sunscreen on your ears.
• If you notice unusual bumps or scaly areas on the exterior ear, consult your physician immediately.
• Know the warning signs of hearing loss:
  • Difficulty hearing conversations, especially in the presence of background noise
  • Frequently asking others to repeat what they have said
  • Misunderstanding what other people say and answering inappropriately
  • Difficulty hearing on the telephone
  • Requiring the television or radio volume to be louder than others in the room prefer
  • Feeling that people are mumbling or have marbles in their mouth when they talk
  • Difficulty hearing environmental sounds, such as birds chirping
  • Agreeing, nodding your head, or smiling during conversations when you are not sure what has been said
  • Withdrawing from conversations and social situations because it is too difficult to hear
  • Reading lips so you can try to follow what people are saying
  • Straining to hear or keep up with conversations
  • Noise within your ears or head called tinnitus not caused by an external sound source
• See an ear physician immediately if you injure your ears, experience ear pain, or notice changes in your ears or hearing.

source:http://my.clevelandclinic.org/healthy_living/ear_care/hic_ear_care_tips.aspx

Reasons Babies Cry and How to Soothe Them

Here are the most common reasons babies cry. If your little one is wailing and you don't know why, work your way down the list. Chances are you'll find something that helps.

Learn the most common reasons babies cry and how to soothe a crying baby.

1. Hunger

This is probably the first thing you think of when your baby cries.

Learning to recognize the signs of hunger will help you start your baby's feedings before the crying stage. Some signs to watch for in newborns: fussing, smacking of lips, rooting (a newborn reflex that causes babies to turn their head toward your hand when you stroke their cheek), and putting  their hands to their mouth.

2. A dirty diaper

Some babies let you know right away when they need to be changed. Others can tolerate a dirty diaper for quite a while.

Either way, this one is easy to check and simple to remedy.

3. Needs sleep

Aren't babies lucky? When they're tired they can simply go to sleep – anytime, anywhere. Or so adults like to think.

In reality, it's harder for them than you might think. Instead of nodding off, babies may fuss and cry, especially if they're overly tired.

We thought our daughter was colicky for the first five weeks of life, until we read about how babies get really cranky if they're exhausted. After we started putting her to sleep as soon as she yawned the first time at any time of the day, she cried a lot less and had fewer problems with gas.

— Anonymous

I've noticed that if my baby starts crying after being played with, fed, and changed, and she's been up for a while, she is overtired! I just hold her close, talk to her in a soft voice, and let her cry. She doesn't cry hard when I hold her like that. She makes funny fussy noises with her eyes closed. Before long, she's sound asleep.

— Stefanie

A loud shhhhhh sound works incredibly well. I had to make a recording because I was getting lightheaded from doing it so much for my daughter. My recording lasts for 48 minutes, and it works every time! 

— Rob

My 2 ½-month-old is so interested in everything that she doesn't want to stop being part of it by falling asleep. Yet she's tired and cranky at the same time. Minimizing sensory input sometimes helps her feel like she's not "missing something" by settling down. (And then there are the times when she's just going to cry no matter what I do.)

— Anonymous

4. Wants to be held

Babies need a lot of cuddling. They like to see their parents' faces, hear their voices, and listen to their heartbeats, and can even detect their unique smell. Crying can be their way of asking to be held close.

You may wonder if you'll spoil your baby by holding him so much, but during the first few months of life that isn't possible. To give your arms some relief, try wearing your baby in a front carrier or sling.

I like to lightly wrap my daughter in a soft blanket, hold her in a nursing position and lightly stroke her face and head. She loves feeling my hands in her hair and calms down pretty quickly.

— Tiffany

My son loves to hear my voice, so when he cries uncontrollably, I hold him close to my chest and tell him that Mommy is here and will protect him. Within minutes, he is sleeping in my arms!

— Jey

5. Tummy troubles (gas, colic, and more)

Tummy troubles associated with gas or colic can lead to lots of crying. In fact, the rather mysterious condition called colic is defined as inconsolable crying for at least three hours a day, at least three days a week, at least three weeks in a row.

If your baby often fusses and cries right after being fed, he may be feeling some sort of tummy pain. Many parents swear by over-the-counter anti-gas drops for babies or gripe water (made from herbs and sodium bicarbonate). Get your doctor's okay before using either of these.

6. Needs to burp

Burping isn't mandatory. But if your baby cries after a feeding, a good burp may be all he needs.

Babies swallow air when they breastfeed or suck from a bottle, and if the air isn't released it may cause some discomfort. Some babies are intensely bothered by having air in their tummy, while others don't seem to burp or need to be burped much at all.

My little one often cries because he has a difficult time burping after a feed, even with back rubbing and patting. What I found helps is some "tummy time." He'll often let out a great big burp after a few minutes on his tummy.

7. Too cold or too hot

When your baby feels chilly, such as when you remove his clothes to change a diaper or clean his bottom with a cold wipe, he may protest by crying.

Newborns like to be bundled up and kept warm — but not too warm. As a rule, they’re comfortable wearing one more layer than you need to be comfortable. Babies are less likely to complain about being too warm than about being too cold, and they won't cry about it as vigorously.

8. Something small

Babies can be troubled by something as hard to spot as a hair wrapped tightly around a tiny toe or finger, cutting off circulation. (Doctors call this painful situation a "hair tourniquet," and it's one of the first things they look for if a baby seems to be crying for no reason.)

Some babies are extra sensitive to things like scratchy clothing tags or fabric.And they can be very picky (understandably) about subtleties ranging from the position they're held in to the bottle you offer.

9. Teething

Teething can be painful as each new tooth pushes through tender young gums. Some babies suffer more than others, but all are likely to be fussy and tearful at some point along the way.

If your baby seems to be in pain and you're not sure why, try feeling his gums with your finger. You may be surprised to discover the hard nub of a baby tooth on its way in.

On average, the first tooth breaks through between 4 and 7 months, but it can happen earlier. Find out more about teething and how to ease the pain.

10. Wants less stimulation

Babies learn from the stimulation of the world around them, but sometimes they have a hard time processing it all — the lights, the noise, being passed from hand to hand. Crying can be a baby's way of saying, "I've had enough."

Many newborns enjoy being swaddled. It seems to make them feel more secure when the world gets overwhelming. If your baby's too old for swaddling or doesn't like it, try retreating to a serene spot and letting your baby vent for a while to manage a meltdown.

Swaddling is a huge help, especially to infants. Being tightly wrapped mimics being in the womb and my daughter loved it.

11. Wants more stimulation

A "demanding" baby may be outgoing and eager to see the world. And often the only way to stop the crying and fussing is to stay active. This can be exhausting for you!

Try "wearing" your baby in a sling, front carrier, or backpack.  (Watch our video on baby carriers.) Plan plenty of activities. Hang out with other parents with babies. Go on regular outings to kid-friendly places, whether that's your local playground, a children's museum, or the zoo.

12. Not feeling well

If you've met your baby's basic needs and comforted him and he's still crying, he could be coming down with something. You may want to check his temperature to rule out a fever and be alert for other signs of illness.

The cry of a sick baby tends to be distinct from one caused by hunger or frustration. If your baby's crying "just doesn't sound right," trust your instincts and call or see a doctor.

Source : http://www.babycenter.com