He aha ka Tetralogy of Fallot? Nā Hōʻailona, Nā Kumu, & Lapaʻau

ʻO ka Tetralogy of Fallot ka hui ʻana o nā hemahema naʻau ʻehā i hānau ʻia nā pēpē me ia, ʻo ia hoʻi ka maʻi naʻau pilikia maʻamau loa. Hoʻopili kēia maʻi i ke ʻano o ke kahe koko ma o ka naʻau o kāu keiki a i ko lākou mau māmā, ʻo ia hoʻi ʻaʻole lawa ka koko momona oxygen i ko lākou kino.

ʻOiai hiki ke manaʻo nui ka lohe ʻana i kēia ʻike, he mea nui ia e ʻike ʻia ua maopopo loa ka tetralogy of Fallot i nā poʻe loea naʻau kamaliʻi. Me ka mālama pono a me ka lapaʻau, nui nā keiki me kēia maʻi e ola i nā ola piha a hana nui.

He aha ka Tetralogy of Fallot?

ʻO ka Tetralogy of Fallot kahi maʻi naʻau e komo pū ana i nā pilikia ʻehā kūikawā e hana pū ana. Mai ka kauka Farani ʻo Étienne-Louis Arthur Fallot ka inoa, nāna i wehewehe mua i nā hemahema ʻehā a pau e hana pū ana i ka makahiki 1888.

ʻO kēia mau hemahema naʻau ʻehā he puka ma waena o nā keʻena naʻau haʻahaʻa, kahi ala i hoʻonui ʻia i nā māmā, kahi ʻiʻo naʻau ʻākau mānoanoa, a me ke kumu moku nui i kau ʻia ma luna o ka puka ma mua o ka keʻena hema wale nō. Ke hui pū kēia mau hemahema, pale lākou i ka naʻau o kāu keiki mai ka puʻunaue ʻana i ke koko momona oxygen i ko lākou kino.

Hoʻomohala ʻia kēia maʻi i loko o nā hebedoma ʻewalu mua o ka hāpai ʻana i ka wā e hoʻokumu ana i ka naʻau o kāu pēpē. Hana ʻia ia ma kahi o 3 a 5 paha i nā pēpē 10,000 i hānau ʻia, ʻo ia hoʻi he mea maʻamau ʻole akā ʻaʻole maʻamau loa.

He aha nā hōʻailona o ka Tetralogy of Fallot?

ʻO ka hōʻailona nui āu e ʻike ai he kala uliuli i ka ʻili, nā lehelehe, a me nā kui o kāu pēpē, i kapa ʻia ʻo cyanosis. Hana ʻia kēia no ka mea ʻaʻole lawa ka oxygen i lawe ʻia e ko lākou koko e hoʻokō i nā pono o ko lākou kino.

E ʻae mai iaʻu e hele pū me ʻoe i nā hōʻailona āu e ʻike ai, e hoʻomanaʻo ana he ʻokoʻa kēlā me kēia keiki a hiki ke ʻokoʻa nā hōʻailona mai ka māmā a i ʻoi aku ka ʻike ʻia:

• ʻIli uliuli, ʻoi loa ma kahi o nā lehelehe, nā manamana lima, a me nā manamana wāwae
• Paʻakikī ka hānai ʻana a i ʻole ka ʻai ʻana, me nā pēpē e pono pinepine ai nā hoʻomaha pinepine
• Lohi ka hoʻonui ʻana o ke kaumaha ʻoiai he maikaʻi ka makemake
• Luhi koke i ka wā o ka pāʻani a i ʻole ka hana kino
• Pōkole o ka hanu, ʻoi loa i ka wā e uwe ai a i ʻole ka hoʻoikaika
• Nā hanana koke kahi e kūlou ai kāu keiki i ka wā e pāʻani ai (kōkua kēia iā lākou e ʻoluʻolu)
• Nā hiʻohiʻona hāʻule, ʻoiai he mea maʻamau ʻole kēia
• Clubbing o nā manamana lima a me nā manamana wāwae, kahi e puni a hoʻonui ʻia ai lākou i ka manawa

Hoʻomohala kekahi mau keiki i ka mea i kapa ʻia e nā kauka ʻo "tet spells" - nā hanana koke kahi e lilo ai lākou i uliuli loa a me ka manaʻo kaumaha paha. I kēia mau manawa, e ʻike paha ʻoe i kāu keiki e kūlou iho, kahi e kōkua ai e hoʻomaikaʻi i ke kahe koko i ko lākou māmā.

He mea kūpono ke hoʻomaopopo ʻia he ʻokoʻa loa nā hōʻailona mai ke keiki a i ke keiki. Hōʻike kekahi mau pēpē i nā hōʻailona maopopo ma hope koke o ka hānau ʻana, ʻoiai ʻaʻole paha e hoʻomohala kekahi i nā hōʻailona ʻike ʻia a hiki i ko lākou lilo ʻana i mea hana ma ke ʻano he mau kamaliʻi.

He aha ka mea e hoʻokumu ai i ka Tetralogy of Fallot?

Hana ʻia ka Tetralogy of Fallot i ka wā ʻaʻole i hoʻomohala maʻamau ka naʻau o kāu pēpē i loko o nā mahina ʻelua mua o ka hāpai ʻana. ʻAʻole maopopo loa ke kumu kikoʻī o kēia, a he mea nui ia e ʻike ʻaʻole ʻoe i hana a i ʻole ʻaʻole i hana i ka wā hāpai i kēia kūlana.

Eia nā kumu e hoʻonui ai i ka hiki ke loaʻa kēia hemahema naʻau, ʻoiai ka nui o nā pēpē me ka tetralogy of Fallot i hānau ʻia i nā mākua me nā kumu pilikia ʻole.

• Loaʻa i ka mākua ka maʻi naʻau congenital
• Nā kūlana genetic like me ka Down syndrome a i ʻole DiGeorge syndrome
• Ka maʻi o ka makuahine i ka wā hāpai, e like me ka maʻi diabetes a i ʻole phenylketonuria
• ʻO ka makahiki o ka makuahine ma luna o 40 mau makahiki
• Hoʻohana ʻawaʻawa i ka wā hāpai
• ʻAi maikaʻi ʻole i ka wā hāpai
• Nā lāʻau lapaʻau i lawe ʻia i ka wā hāpai

I nā hihia maʻamau ʻole, hiki i ka tetralogy of Fallot ke lilo i ʻāpana o kahi syndrome genetic. Hiki i kekahi mau keiki ke loaʻa nā hiʻohiʻona hou e like me nā ʻokoʻa aʻo a i ʻole nā ​​hoʻopaneʻe ulu, akā nui nā keiki me ka tetralogy of Fallot e ulu maʻamau loa ma waho o ko lākou kūlana naʻau.

E hoʻomanaʻo he mea maʻamau loa nā hemahema naʻau congenital, e pili ana i kahi kokoke i 1 i 100 mau pēpē. ʻO ka mea nui, ua ʻike ʻia ke kūlana o kāu keiki i hiki iā lākou ke loaʻa ka mālama e pono ai.

I ka wā e ʻike ai i ke kauka no ka Tetralogy of Fallot?

Inā ʻike ʻoe i kekahi kala uliuli i ka ʻili, nā lehelehe, a i ʻole nā ​​manikū o kāu pēpē, e kelepona koke i kāu pediatrician. He mea nui loa kēia inā ʻike ʻia ke kala uliuli i ka wā e uē ai, e hānai ai, a i ʻole ka hana.

Pono ʻoe e ʻimi i ka mālama ola kino koke inā loaʻa i kāu keiki ka uliuli nui koke, ka pilikia hanu, ka hiolo ʻana, a i ʻole ke ʻano huhū a luhi paha. Hiki i kēia mau mea ke hōʻailona o kahi

• Mōʻaukala ʻohana o nā hemahema puʻuwai i hānau ʻia
• Nā kūlana genetic e like me ka Down syndrome, DiGeorge syndrome, a i ʻole Alagille syndrome
• Ka makahiki makua wahine holomua (ma luna o 35-40 mau makahiki)
• Ka maʻi diabetes makua a i ʻole phenylketonuria
• Ke hoʻohana ʻana o ka makuahine i kekahi mau lāʻau lapaʻau i ka wā hāpai
• Ke inu ʻawaʻawa ʻana o ka makuahine i ka wā hāpai
• Nā maʻi viral makua i ka wā hāpai mua
• Ka ʻai ʻole maikaʻi o ka makuahine i ka wā hāpai

I kekahi mau hihia kakaikahi, hele mai ka tetralogy of Fallot ma ke ʻano he hapa o kahi syndrome genetic nui aʻe. Hiki i nā keiki me kēia mau syndromes ke loaʻa nā pilikia olakino hou aku ma mua o ko lākou kūlana puʻuwai, akā ʻokoʻa ka kūlana o kēlā me kēia keiki.

He mea nui e hoʻomaopopo ʻaʻole ʻo ka loaʻa ʻana o nā kumu pilikia ʻaʻole ia e manaʻo e loaʻa i kāu keiki nā pilikia puʻuwai, a ʻaʻole ka loaʻa ʻole ʻana o nā kumu pilikia ʻaʻole ia e hōʻoia ʻaʻole lākou e loaʻa. ʻO ka hapa nui o nā hihia e hele mai me ke kumu maopopo ʻole.

He aha nā pilikia hiki ke loaʻa i ka Tetralogy of Fallot?

Me ka ʻole o ka mālama ʻana, hiki i ka tetralogy of Fallot ke alakaʻi i nā pilikia koʻikoʻi i ka ulu ʻana o kāu keiki. ʻO ka lono maikaʻi, me ka mālama lapaʻau kūpono, hiki ke pale ʻia a mālama ʻia paha ka nui o kēia mau pilikia.

E wehewehe wau i nā pilikia a nā kauka e nānā ai, i ʻike ʻoe i ka mea e hana nei kāu hui lapaʻau e pale aku ai:

• Nā pilikia rhythm puʻuwai (arrhythmias) e hiki ke hoʻopilikia i ka hana maikaʻi ʻana o ka puʻuwai
• Ka hāʻule ʻana o ka puʻuwai, kahi e hakakā ai ka puʻuwai e hoʻopuka i ka koko lawa e hoʻokō i nā pono o ke kino
• Ka make puʻuwai koke, ʻoiai he mea kakaikahi kēia me ka mālama kūpono
• Nā clots koko e hiki ke hele i ka lolo a hoʻokumu i nā hahau
• Nā abscesses lolo, he mau maʻi kakaikahi akā koʻikoʻi
• Endocarditis, kahi maʻi o ka papa o loko o ka puʻuwai
• Nā hoʻopaneʻe hoʻomohala ma muli o nā pae oxygen haʻahaʻa lōʻihi
• Nā pilikia kidney mai ka emi ʻana o ke kahe koko

Hiki ke nui aku ka nui o nā pilikia i nā keiki i loaʻa ʻole ka ʻoki kino hoʻoponopono, ʻoiai hiki ke ulu kekahi mau mea ʻē aʻe ma hope o ka mālama kūleʻa. ʻO ia ke kumu o ka pono nui o ka mālama mālama mau me ka cardiologist pediatric ma ke ola holoʻokoʻa o kāu keiki.

He ʻano like ʻole ka pilikia o nā pilikia mai ke keiki a ke keiki. E kōkua kāu kauka iā ʻoe e hoʻomaopopo i ka pae pilikia o kāu keiki a me nā hana āu e hiki ai ke hana e hoʻemi i nā pilikia.

Pehea ka hōʻoia ʻana o ka Tetralogy of Fallot?

Ua ʻike mua ʻia nā hihia he nui o ka tetralogy of Fallot i ka wā o nā ultrasound hāpai maʻamau, ma waena o 18 a me 22 mau pule. Inā ʻaʻole i loaʻa ma mua o ka hānau ʻana, maʻamau ka hōʻoia ʻana o nā kauka i loko o nā lā mua a i ʻole nā ​​pule o ke ola ke ʻike lākou i nā hōʻailona.

E komo ana ka hōʻoia ʻana o kāu keiki i nā hoʻokolohua he nui e kōkua i nā kauka e hoʻomaopopo pono i ka hana ʻana o ko lākou naʻau. Ua hoʻolālā ʻia kēia mau hoʻokolohua e hōʻoluʻolu loa i kāu ʻōpiopio:

• Echocardiogram - kahi ultrasound ʻeha ʻole o ka naʻau e hōʻike ana i kona ʻano a me ka hana
• Electrocardiogram (ECG) - ke ana i ka hana uila o ka naʻau me ka hoʻohana ʻana i nā kāpili liʻiliʻi ma ka umauma
• X-ray umauma - hāʻawi i nā kiʻi o ka naʻau a me nā māmā
• Pulse oximetry - kahi klipu liʻiliʻi ma ka manamana lima a i ʻole ka manamana wāwae e ana i nā pae oxygen
• Cardiac catheterization - kahi hoʻokolohua kikoʻī hou aʻe i hoʻohana ʻia i kekahi mau hihia ma mua o ka ʻoki kino
• MRI a i ʻole CT scan - nā haʻawina kiʻi kikoʻī e pono ai no ka hoʻolālā ʻoki kino

ʻO ka echocardiogram ka hoʻokolohua nui loa ma ka mea maʻamau no ka mea e hōʻike ana i nā kauka i nā hemahema ʻehā āpau. Hoʻohana kēia hoʻokolohua ʻeha ʻole i nā nalu leo ​​e hana i nā kiʻi neʻe o ka naʻau o kāu keiki, a hiki ke hana ʻia ʻoiai e hiamoe ana kāu pēpē.

I kekahi manawa, pono nā kauka i nā hoʻokolohua hou aʻe e hoʻolālā i ke ala mālama maikaʻi loa. E wehewehe kāu cardiologist pediatric i nā hoʻokolohua e pono ai kāu keiki a me ke kumu o kēlā me kēia mea nui no ko lākou mālama.

He aha ka lāʻau lapaʻau no ka Tetralogy of Fallot?

ʻO ka ʻoki kino ka lāʻau lapaʻau nui no ka tetralogy of Fallot, a ʻo ka mea maikaʻi, ua holomua nui nā ʻano ʻoki kino i nā makahiki i hala. Pono ka hapa nui o nā keiki i ka ʻoki kino hoʻoponopono, maʻamau i hana ʻia i loko o ka makahiki mua a ʻelua paha o ke ola.

E hilinaʻi kāu papa hana lapaʻau no kāu keiki i ka nui o kona ʻano maʻi. E ʻae mai iaʻu e alakaʻi iā ʻoe ma nā ala lapaʻau nui:

• ʻOki kino hoʻoponopono piha - ka lāʻau lapaʻau makemake ʻia e hoʻoponopono i nā hemahema ʻehā a pau i hoʻokahi hana ʻoki
• ʻOki kino manawa pōkole (shunt) - hana i kahi ala ʻē aʻe no ke koko e hiki ai i nā māmā a hiki i ka hoʻoponopono piha
• Balloon valvuloplasty - kahi hana ʻoki ʻoi aku ka liʻiliʻi e kōkua paha i nā kūlana kikoʻī
• Nā lāʻau lapaʻau e kākoʻo i ka hana naʻau ma mua o ka ʻoki kino
• Lāʻau lapaʻau oxygen i ka wā e pono ai
• Kākoʻo meaʻai e kōkua i ka ulu ʻana a me ka hoʻomohala ʻana

ʻO ka ʻoki kino hoʻoponopono piha maʻamau e komo pū ana i ka pani ʻana i ka puka ma waena o nā keʻena naʻau, ka hoʻonui ʻana i ke ala ʻāpana i nā māmā, a i kekahi manawa e pani ana i ka puka pulmonary. ʻO kēia ʻoki kino nui maʻamau e lawe i nā hola he nui a pono i kahi noho ma ka ʻāpana mālama koʻikoʻi pediatric ma hope.

Pono paha kekahi mau pēpē i ka ʻoki kino manawa pōkole ma mua, ʻoiai inā he liʻiliʻi loa lākou a i ʻole nā ​​pilikia olakino ʻē aʻe. Hana kēia i kahi pilina pūpū liʻiliʻi e ʻae ai i ka nui o ke koko e kahe i nā māmā a hiki i ka wā e mākaukau ai lākou no ka hoʻoponopono piha.

E kūkākūkā kāu kauka naʻau pediatric i ka manawa kūpono a me ke ala kūpono no ke kūlana kikoʻī o kāu keiki. E noʻonoʻo lākou i nā mea e like me ka nui o kāu keiki, ke olakino holoʻokoʻa, a me ka nui o kā lākou mau hōʻailona.

Pehea e hāʻawi ai i ka mālama home i ka wā o ka mālama ʻana i ka Tetralogy of Fallot?

ʻO ka mālama ʻana i ke keiki me ka tetralogy of Fallot ma ka home, ʻo ia ka nānā pono ʻana i kā lākou mau pono, me ka kōkua ʻana iā lākou e ola maʻamau e like me ka hiki. E hāʻawi mai kāu hui lapaʻau i nā kuhikuhi kikoʻī, akā eia nā kumu nui e kōkua ai.

ʻO ka mālama i kēlā me kēia lā, ʻo ia ka nānā ʻana i ke olakino o kāu keiki a me ke kākoʻo ʻana i kā lākou ulu ʻana:

• E nānā i nā loli i ke kala o ka ʻili, ʻoi aku ka uliuli nui ʻana
• E ʻae i nā manawa hoʻomaha pinepine i ka wā e hānai ai a pāʻani ai
• E hōʻoia i ka ʻai maikaʻi me nā meaʻai kiʻekiʻe i ka calorie inā paipai ʻia
• E pale aku i nā maʻi me ka hoʻomaʻemaʻe lima maikaʻi a me ka pale ʻana i nā mea hoʻopili maʻi
• E hāʻawi i nā lāʻau lapaʻau e like me ke kauoha
• E mālama i nā papa hoʻomaha mau
• E paipai i nā hana kūpono i ka makahiki, ʻoiai e mahalo ana i nā palena o kāu keiki

Inā loaʻa i kāu keiki nā "tet spells" kahi e lilo koke ai lākou i uliuli loa, e kōkua iā lākou i ka kūlana kuli-umauma (e like me ka kūlou ʻana) a e noho mālie ʻoe i ka wā e kāhea ai i kāu kauka. Hoʻoponopono koke ka hapa nui o nā spells, akā pono mau lākou i ka nānā ʻana o nā kauka.

E hoʻomanaʻo he nui nā keiki me ka tetralogy of Fallot e hiki ke komo i nā hana kamaliʻi maʻamau, ʻoiai paha e pono lākou e hoʻomaha pinepine. E alakaʻi aku kāu cardiologist iā ʻoe ma nā palena hana ma muli o ke kūlana kikoʻī o kāu keiki.

Pehea ʻoe e hoʻomākaukau ai no kāu mau hālāwai kauka?

Hiki i ka hoʻomākaukau ʻana no nā hālāwai cardiology ke kōkua iā ʻoe e hoʻohana pono i kou manawa me ka loea o kāu keiki. E hele mākaukau e kūkākūkā i ke ola o kēlā me kēia lā o kāu keiki a me nā hopohopo āu i ʻike ai.

Eia nā mea āu e lawe mai ai a hoʻomākaukau ai no kāu mau hālāwai:

• Papa inoa o nā lāʻau lapaʻau i kēia manawa me nā nui pololei a me ka manawa
• Ka pakuhi ulu o kāu keiki a me nā moʻolelo hānai
• Nā memo e pili ana i kekahi mau hōʻailona a i ʻole nā ​​hoʻololi āu i ʻike ai
• Nā nīnau e pili ana i nā pae hana, ulu, a i ʻole hoʻomohala
• Nā hopena hoʻokolohua mua a i ʻole nā ​​hōʻike mai nā kauka ʻē aʻe
• Nā kāleka ʻinikua a me ka hōʻike
• Kahi mea hōʻoluʻolu no kāu keiki i ka wā o nā hoʻokolohua

Mai kānalua e nīnau i nā nīnau e pili ana i nā mea āu i ʻike ʻole ai. Makemake kāu hui lapaʻau e ʻike ʻoe i ka hilinaʻi e pili ana i ka mālama ʻana i kāu keiki, no laila e hoʻolilo lākou i ka manawa e wehewehe ai i nā kaʻina hana, nā hopena hoʻokolohua, a me nā hoʻolālā mālama.

Hiki ke kōkua ke kākau i ka ʻike nui i ka wā o ka ʻaha kūkā, a i ʻole e nīnau inā hiki iā ʻoe ke hoʻopaʻa i nā ʻāpana nui o ke kūkākūkā. He nui nā ʻohana i ʻike he pono ke lawe mai i kahi hoa a hoa ʻohana paha no ke kākoʻo a e kōkua i ka hoʻomanaʻo ʻana i nā kikoʻī nui.

He aha ka mea nui e pili ana i ka Tetralogy of Fallot?

ʻO Tetralogy of Fallot kahi kūlana naʻau koʻikoʻi akā hiki ke mālama ʻia e pili ana i nā tausani o nā keiki i kēlā me kēia makahiki. Me nā holomua i ka ʻoki kino naʻau pediatric a me ka mālama lapaʻau mau, ʻo ka hapa nui o nā keiki me kēia kūlana e manaʻo ʻia e ola i nā ola piha a hana nui.

ʻO ka mea nui loa e hoʻomanaʻo ai, ʻo ka ʻike mua a me ka mālama kūpono e hana i kahi ʻokoʻa nui i nā hopena. Loaʻa i ka hui lapaʻau o kāu keiki ka ʻike nui me kēia kūlana a e hana pili pono me ʻoe e hāʻawi i ka mālama maikaʻi loa.

ʻOiai paha e paʻakikī ka huakaʻi i kekahi manawa, he nui nā ʻohana i ʻike ua aʻo lākou e pili ana i ka hoʻomanawanui, ka ʻōlelo aʻo lapaʻau, a me ke koʻikoʻi o ka hoʻolauleʻa ʻana i kēlā me kēia milepōhaku. Hiki i kāu keiki ke ulu e komo i nā haʻuki, alualu i ka hoʻonaʻauao, loaʻa nā ʻoihana, a hoʻomaka i nā ʻohana ponoʻī.

Nā nīnau pinepine e pili ana i ka Tetralogy of Fallot

E hiki anei i kaʻu keiki ke pāʻani i nā haʻuki a hana ikaika?

He nui nā keiki me ka tetralogy of Fallot i hoʻoponopono ʻia e hiki ke komo i nā haʻuki a me nā hana kino, ʻoiai paha e pono ai kekahi mau hoʻololi. E loiloi kāu kauka naʻau i ka hana kikoʻī o ka naʻau o kāu keiki a hāʻawi i nā kuhikuhi e pili ana i nā hana palekana. Pono paha kekahi mau keiki e pale aku i nā haʻuki hoʻokūkū loa a i ʻole nā ​​​​haʻuki kiʻekiʻe, ʻoiai hiki i nā poʻe ʻē aʻe ke komo piha me ka nānā mau.

Ehia manawa e pono ai ka mālama hoʻomau o kaʻu keiki ma hope o ke ʻoki?

Pono nā keiki me ka tetralogy of Fallot i ka nānā mau ʻana o ka naʻau i ke ola a pau, ʻoiai ma hope o ka ʻoki kūleʻa. I ka hoʻomaka, hiki ke kipa i kēlā me kēia mau mahina, a laila maʻamau i hoʻokahi a ʻelua paha manawa i kēlā me kēia makahiki i ka wā e ulu ai kāu keiki. Ke hilinaʻi nei ka pinepine i ka maikaʻi o ka hana ʻana o ko lākou naʻau a inā paha e ulu ana kekahi mau pilikia. Ke kōkua nei nā nānā maʻamau e hopu i nā pilikia i ka wā mua a e hōʻoia i ka olakino o kāu keiki.

Hiki ke pale ʻia ka tetralogy of Fallot?

ʻAʻole maikaʻi, ʻaʻohe ala e pale ai i ka tetralogy of Fallot ʻoiai e ulu ana ia i ka wā hāpai mua. Eia naʻe, ʻo ka mālama pono ʻana i ka mālama hāpai, ka lawe ʻana i nā huaora hāpai me ka folic acid, ka pale ʻana i ka waiʻona a me ka puhipaka i ka wā hāpai, a me ka mālama ʻana i nā kūlana olakino makuahine hiki ke kākoʻo i ka hoʻomohala ʻana o ka naʻau. ʻO ka hapa nui o nā hihia e hana ʻia me ka ʻole o ke kumu i ʻike ʻia a i ʻole nā ​​​​kumu pilikia hiki ke pale ʻia.

E pono anei i kaʻu keiki nā ʻoki hou aʻe i ko lākou ulu ʻana?

Pono paha kekahi mau keiki i nā kaʻina hana hou aʻe i ko lākou ulu ʻana, akā nui ka poʻe e hana maikaʻi me ka hoʻoponopono mua wale nō. Ke hilinaʻi nei ka pono no nā ʻoki hou aʻe i nā mea e like me ka maikaʻi o ka hoʻoponopono mua, inā pono e hoʻololi i nā valve naʻau, a pehea ka ulu ʻana o ka naʻau o kāu keiki. E nānā kāu kauka naʻau i ka hana o ka naʻau o kāu keiki i ka manawa a kūkākūkā i nā kaʻina hana e hiki mai ana e pōmaikaʻi paha.

He aha kaʻu e haʻi aku ai i kaʻu keiki e pili ana i ko lākou kūlana naʻau?

He mea nui ke kamaʻilio me kāu keiki e pili ana i kona kūlana naʻau ma nā ʻano kūpono i ko lākou makahiki. Hiki i nā keiki ʻōpio ke hoʻomaopopo ua loaʻa iā lākou kahi naʻau kūikawā e pono ai ke hoʻoponopono, a ʻo ia ke kumu e ʻike ai lākou i ke kauka naʻau. I ko lākou ulu ʻana, hiki iā ʻoe ke hāʻawi i nā wehewehe kikoʻī hou aku. ʻO ka pololei a me ka maikaʻi e kōkua i nā keiki e hoʻomohala i kahi hoʻomaopopo olakino o ko lākou kūlana a kūkulu i ka hilinaʻi i ka mālama ʻana i ko lākou olakino i ko lākou ulu ʻana.