Ukutholakala kwe-Tetralogy of Fallot? Izimpawu, Izimbangela, & Ukwelashwa

I-Tetralogy of Fallot iyinhlanganisela yeziphene ezine zehliziyo ezingane ezelwe nazo, okwenza kube yisimo esivame kakhulu sehliziyo esiyinkimbinkimbi esizalwa naso. Lesi simo sithinta indlela igazi eligeleza ngayo ehlinzweni lomntwana wakho nakwimiphunga yabo, okusho ukuthi umzimba wabo awutholi igazi elinokulinganisela lokufakwa komoya.

Nakuba ukuzwa leli bika kungase kubonakale kukukhathaza, kubalulekile ukwazi ukuthi i-tetralogy of Fallot iyahlolwa kahle ochwepheshe behliziyo zabantwana. Ngokunakekelwa okufanele nokuphathwa, abantwana abaningi abanesimo esinjalo bayaqhubeka bephila impilo egcwele, esebenzayo.

Iyini i-Tetralogy of Fallot?

I-Tetralogy of Fallot yisimo senhliziyo esifaka izinkinga ezine ezithile ezisebenza ndawonye. Igama livela kudokotela waseFrance u-Étienne-Louis Arthur Fallot, owachaza okokuqala zonke iziphambeko ezine ezivela ndawonye ngo-1888.

Lezi ziphene ezine zehliziyo yingxube yindawo ehlanganiswe phakathi kwamagumbi angaphansi ehlinzweni, indlela ecindezelekile eya emathunjini, umsipha wehliziyo olukhulu olukhulu, kanye nomthambo omkhulu obekwe phezu kwengxube esikhundleni sokubeka nje phezu kwegumbi elingakwesobunxele. Uma lezi ziphambeko zihlangana, zivimbela inhliziyo yengane yakho ukupompa igazi elinokulinganisela lokufakwa komoya ngokuphumelelayo emzimbeni wayo.

Lesi simo sithuthukela phakathi kwamasonto ayisishiyagalombili okuqala okukhulelwe uma inhliziyo yengane yakho yakhiwa. Kwenzeka cishe ku-3 kuya ku-5 kwaba-10,000 abantwana abazalwayo, okwenza kube yinto engavamile kodwa hhayi eyinqaba kakhulu.

Ziyini izimpawu ze-Tetralogy of Fallot?

Isimpawu esiyinhloko oyibonayo ngumbala oluhlaza okwesibhakabhaka kwesikhumba, ezindebeni, nasezinzipeni zomntwana wakho, okuthiwa yi-cyanosis. Lokhu kwenzeka ngoba igazi labo alithwali oksijini elanele ukwanelisa izidingo zomzimba wabo.

Ngizokusihamba ngezimpawu ongazibona, ukhumbula ukuthi wonke umntwana uhlukile futhi izimpawu zingase zibe zimanzi noma zibonakale kakhulu:

• Isikumba esiluhlaza okwesibhakabhaka, ikakhulukazi ezindebeni, eminweni, nasezinzipeni
• Ubunzima bokudla noma ukudla, lapho abantwana bavame ukudinga ukuphumula njalo
• Ukukhula okungalungile kobunzima naphezu kokuthanda ukudla okuvamile
• Ukuqeda amandla kalula ngesikhathi sokudlala noma umsebenzi womzimba
• Ukuphefumula okunzima, ikakhulukazi ngesikhathi sokulila noma umzamo
• Izikhathi eziqubukelayo lapho umntwana wakho ehlala phansi ngesikhathi sokudlala (lokhu empeleni kuyasiza ukuba azizwe kangcono)
• Ukuhlupheka, nakuba lokhu kungavamile
• Ukuqina kweminwe nezinzipi, lapho ziqala khona zibe zinobukhulu futhi zikhulu ngokuhamba kwesikhathi

Abanye abantwana bathuthukisa lokho odokotela abakubiza ngokuthi “izikhathi ze-tet” - izikhathi eziqubukelayo lapho beba luhlaza okwesibhakabhaka kakhulu futhi bangase babonakale behluphekile. Ngalesi sikhathi, ungase uqaphele ukuthi umntwana wakho uhlala phansi ngokuzithoba, okusiza ekuthuthukiseni ukugcwala kwegazi emathunjini abo.

Kubalulekile ukuphawula ukuthi izimpawu zingase zihluke kakhulu kusuka kwingane kwenye. Abanye abantwana babonisa izimpawu ezicacile ngemuva nje kokuzalwa, kanti abanye bangase bangathuthuki izimpawu ezibonakalayo kuze kube yilapho beba namandla njengabantwana abancane.

Ziyini izimbangela ze-Tetralogy of Fallot?

I-Tetralogy of Fallot kwenzeka uma inhliziyo yengane yakho ingathuthuki kahle phakathi nezinyanga ezimbili zokuqala zokukhulelwa. Isizathu esiqondile sokuthi lokhu kwenzeke asiqondakali ngokuphelele, futhi kubalulekile ukwazi ukuthi akukho lutho olukwenzile noma awukwenzanga ngesikhathi sokukhulelwa okubangele lesi simo.

Nazi izici ezingase zikhulise amathuba alesiphephe senhliziyo, nakuba abantwana abaningi abane-tetralogy of Fallot bazalwa kubazali abangenazo izici ezingozi nhlobo:

• Ukuba nomzali onenkinga yenhliziyo ezelwe nayo
• Izimo ezithile zezinto eziphathekayo njenge-Down syndrome noma i-DiGeorge syndrome
• Ukugula komzali ngesikhathi sokukhulelwa, njengesihlalo noma i-phenylketonuria
• Ubudala bomzali obungaphezu kweminyaka engama-40
• Ukusetshenziswa kotshwala ngesikhathi sokukhulelwa
• Ukondleka okungalungile ngesikhathi sokukhulelwa
• Imithi ethile ethathwe ngesikhathi sokukhulelwa

Kwezinye izimo ezingavamile, i-tetralogy of Fallot ingaba ingxenye yesimo se-genetic. Abanye abantwana bangase babe nezici ezengeziwe njengokuhluka kokufunda noma ukubambezeleka kokukhula, kodwa abantwana abaningi abane-tetralogy of Fallot bathuthuka ngokuphelele ngaphandle kwesimo sabo senhliziyo.

Khumbula ukuthi iziphephe zehliziyo ezelwe nazo zivame kakhulu ngokujwayelekile, zithinta cishe ingane engu-1 kuya ku-100 ezelwe. Okubalulekile ukuthi isimo sengane yakho siye saqaphelwa ukuze ithole ukunakekelwa okudingekayo.

Nini okufanele ubone udokotela nge-Tetralogy of Fallot?

Uma uqaphela noma yiluphi ubukhazikhazi obuluhlaza okwesibhakabhaka esikhuneni, ezindebeni, noma ezinzipeni zomntwana wakho, xhumana nodokotela wakho wezingane ngokushesha. Lokhu kubaluleke kakhulu uma umbala oluhlaza okwesibhakabhaka uvela ngesikhathi sokulila, ukuncelisa, noma umsebenzi.

Kufanele ufuna ukunakekelwa kwezokwelapha ngokushesha uma ingane yakho ihlupheka ngokungaqondakali okukhulu, ukuphefumula okunzima, ukuhlupheka, noma ibonakala ikhathazekile noma ivila kakhulu. Lokhu kungase kube izimpawu “zesikhathi se-tet” ezidinga ukunakekelwa kwezokwelapha ngokushesha.

Lokhu kushiwo, abantwana abaningi abane-tetralogy of Fallot baqaphelwa ngesikhathi sokuhlolwa okuvamile kokukhulelwa noma ngokushesha ngemuva kokuzalwa ngesikhathi sokuhlolwa okuvamile kwabantwana abasanda kuzalwa. Uma ingane yakho isiqaphelwe kakade, udokotela wakho wehliziyo yabantwana uzokukhokhela izimpawu okufanele uzibheke nokuthi nini okufanele ubhale.

Ziyini izici ezingozi ze-Tetralogy of Fallot?

Abantwana abaningi abazalwa beTetralogy of Fallot abanawo ama-risk factors aqondakalayo, okusho ukuthi lesi simo singase senzeke kunoma yimuphi umndeni. Noma kunjalo, ukuqonda izici ezingozi ezingaba khona kungakusiza ukuba ube nezingxoxo ezilwemi neqembu lakho lezokunakekelwa kwezempilo.

Izici ezingozi eziye zaqaphelwa odokotela zifaka kokubili izinto eziphathekayo nezemvelo:

• Umlando womndeni weziphene zehliziyo ezelwe nazo
• Izimo zezinto eziphathekayo ezinjenge-Down syndrome, i-DiGeorge syndrome, noma i-Alagille syndrome
• Ubudala bomzali obukhulu (ngaphezu kweminyaka engama-35-40)
• Isihlalo somzali noma i-phenylketonuria
• Ukusetshenziswa komzali wemithi ethile ngesikhathi sokukhulelwa
• Ukusetshenziswa kotshwala ngumzali ngesikhathi sokukhulelwa
• Ukutheleleka kwamagciwane komzali ekuqaleni kokukhulelwa
• Ukondleka okungalungile komzali ngesikhathi sokukhulelwa

Kwezinye izimo ezingavamile, i-tetralogy of Fallot ivela njengengxenye yesimo se-genetic esikhulu. Abantwana abanesimo esinjalo bangase babe nezinkinga ezengeziwe zezempilo ngaphandle kwesimo sabo senhliziyo, kodwa isimo sangane ngayinye sihlukile.

Kubalulekile ukuqonda ukuthi ukuba nezici ezingozi akusho ukuthi ingane yakho ngokuqinisekile izoba nezinkinga zenhliziyo, futhi ukungabi nezici ezingozi akusho ukuthi ngeke ibe nazo. Izimo eziningi zenzeka ngaphandle kwanoma yisiphi isizathu esicacile.

Ziyini izinhlanganisela ezingaba khona ze-Tetralogy of Fallot?

Ngaphandle kokwelashwa, i-tetralogy of Fallot ingabangela izinhlanganisela ezinkulu njengoba ingane yakho ikhula. Izindaba ezinhle ukuthi ngokunakekelwa kwezokwelapha okufanele, izinhlanganisela eziningi zingaqalekiswa noma ziphathwe ngokuphumelelayo.

Ngizokucacisela izinhlanganisela eziqaphelwa odokotela, ukuze wazi ukuthi iqembu lakho lezokwelapha lisebenza ukukuvimbela:

• Izinkinga zesilinganiso senhliziyo (arrhythmias) ezingathinta ukuthi inhliziyo iphompa kangcono kangakanani
• Ukwehluleka kwenhliziyo, lapho inhliziyo ihluleka ukupompa igazi elanele ukwanelisa izidingo zomzimba
• Ukufa kwenhliziyo okuzumayo, nakuba lokhu kuyinqaba ngokwelashwa okufanele
• Izingxube zegazi ezingahamba ziye ebuchosheni futhi zibangele izifo eziqhumayo
• Ama-abscesses ebuchosheni, okuyizifo ezimbi kodwa ezinkulu
• I-Endocarditis, ukutheleleka kwesikhumba sangaphakathi senhliziyo
• Ukubambezeleka kokukhula ngenxa yezinga eliphansi lokufakwa komoya
• Izinkinga zezinkalweni ngenxa yokugcwala kwegazi okuncane

Ezinye izinhlanganisela zivame kakhulu ukwenzeka kubantwana abangakahlinzwa, kanti ezinye zingase zithuthuke ngisho nangemuva kokwelashwa okuphumelelayo. Kungakho ukunakekelwa okuqhubekayo okuvamile nodokotela wehliziyo yabantwana kubalulekile ekuphileni kwengane yakho.

Ubungozi bezinhlanganisela buyahluka kakhulu kusuka kwingane kwenye. Udokotela wakho uzokusiza ukuqonda izinga lobungozi lengane yakho ethile nezinyathelo ongazithatha ukuze unciphise izinkinga ezingaba khona.

I-Tetralogy of Fallot ihlonishwa kanjani?

Izimo eziningi ze-tetralogy of Fallot ziqaphelwa okokuqala ngesikhathi sokuhlolwa okuvamile kokukhulelwa, ngokuvamile phakathi kwamasonto angu-18 kuya kwangu-22. Uma kungenjalo kutholakala ngaphambi kokuzalwa, odokotela ngokuvamile bayakuqaphela phakathi nezinsuku ezimbalwa zokuqala noma amasonto okuqala okuphila uma beqaphela izimpawu.

Ukuxilongwa kwengane yakho kuzofaka ukuhlolwa okuhlukene okusisiza odokotela ukuqonda ukuthi inhliziyo yabo isebenza kanjani. Lokhu kuhlolwa kwenzelwe ukuba kube lula ngangokunokwenzeka engwaneni yakho:

• I-Echocardiogram - i-ultrasound engenazinkinga yenhliziyo ebonisa ubukhulu nendlela yayo yokusebenza
• I-Electrocardiogram (ECG) - ilinganisa umsebenzi womgogodla wenhliziyo usebenzisa izitikha ezincane esifubeni
• I-X-ray yesifuba - inikeza izithombe zenhliziyo namathumbu
• I-Pulse oximetry - iklip encane eminweni noma esinzipeni eilinganisa amazinga oksijini
• I-Cardiac catheterization - ukuhlolwa okuningiliziwe okusetshenziswa kwezinye izimo ngaphambi kokuhlinzwa
• I-MRI noma i-CT scan - izifundo eziningiliziwe zokuthola izithombe ezingase zidingeke ekuhleleni ukuhlinzwa

I-echocardiogram ngokuvamile iyisivivinyo esibaluleke kakhulu ngoba ibonisa odokotela zonke iziphambeko ezine ngokucacile. Lesi sivivinyo esingenazinkinga sisebenzisa amaza omsindo ukwenza izithombe ezihambayo zenhliziyo yengane yakho, futhi singenziwa ngenkathi ingane yakho ilele.

Ngesinye isikhathi odokotela badinga ukuhlolwa okuqhubekayo ukuhlela indlela engcono yokwelapha. Udokotela wakho wehliziyo yabantwana uzokucacisela ukuthi yiziphi izivivinyo ingane yakho ezidingayo nokuthi kungani ngayinye ibalulekile ekunakekelweni kwayo.

Ukuphathwa kwe-Tetralogy of Fallot kuyini?

Ukuhlinzwa yikona ukwelashwa okuyinhloko kwe-tetralogy of Fallot, futhi izindaba ezinhle ukuthi izindlela zokuhlinzwa ziye zathuthuka kakhulu phakathi neminyaka. Abantwana abaningi badinga ukuhlinzwa okulungisayo, ngokuvamile kwenziwa phakathi nonyaka wokuqala noma emibili yokuphila.

Uhlelo lokwelapha lengane yakho luzoxhomeka ekuthini isimo sabo sibukhulu kangakanani. Ngizokusihamba ngezindlela eziyinhloko zokwelapha:

• Ukuhlinzwa okulungisayo okuphelele - ukwelashwa okuthandwa kakhulu okulungisa zonke iziphambeko ezine ngesikhathi esisodwa
• Ukuhlinzwa okwesikhashana (shunt) - kudala indlela ehlukile yegazi ukufinyelela emathunjini kuze kube yilapho kulungiswa okuphelele kungenzeka
• I-Balloon valvuloplasty - inqubo engathinta kancane engase isize ezimweni ezithile
• Imithi yokusekela umsebenzi wenhliziyo ngaphambi kokuhlinzwa
• Ukwelashwa ngoksijini uma kudingeka
• Ukusekelwa kokondleka ukusisiza ekukhuleni nasekuthuthukiseni

Ukuhlinzwa okulungisayo okuphelele ngokuvamile kuhilela ukuvala ingxube phakathi kwamagumbi enhliziyo, ukwandisa indlela ecindezelekile eya emathunjini, futhi ngezinye izikhathi ukufaka i-pulmonary valve. Lokhu kuhlinzwa okukhulu ngokuvamile kuthatha amahora amaningana futhi kudinga ukuhlala eyunithi yokunakekelwa okukhulu yabantwana ngemuva kwalokho.

Abanye abantwana bangase badinge ukuhlinzwa okwesikhashana kuqala, ikakhulukazi uma bencane kakhulu noma banezinye izinkinga zezempilo. Lokhu kudala uxhumano olulodwa olulodwa oluvumela igazi eliningi ukuba ligeleze emathunjini kuze kube yilapho belungele ukulungiswa okuphelele.

Udokotela wakho wehliziyo yabantwana uzoxoxa ngesikhathi esifanele nendlela engcono yesimo sengane yakho ethile. Bazobheka izici ezinjengobusuku bengane yakho, impilo yonke, nobunzima bezimpawu zabo.

Unganakekela kanjani ekhaya ngesikhathi sokwelashwa kwe-Tetralogy of Fallot?

Ukukhathalela ingane enesimo se-tetralogy of Fallot ekhaya kuhilela ukunaka izidingo zayo ngenkathi uyisiza ukuba iphile ngokujwayelekile ngangokunokwenzeka. Iqembu lakho lezokwelapha lizokunika imiyalo ethile, kodwa nazi izimiso ezijwayelekile ezingasiza.

Ukukhathalela kwansuku zonke kugxile ekuqapheleni impilo yengane yakho nasekusekeleni ukuthuthuka kwayo:

• Qaphela izinguquko emibalabala yesikhumba, ikakhulukazi ubukhazikhazi obuningi oluhlaza okwesibhakabhaka
• Vumela izikhathi zokuphumula njalo ngesikhathi sokudla nokudlala
• Qinisekisa ukondleka okuhle ngokudla okune-calorie eningi uma kunconywa
• Vivela ekuthintelweni kwezifo ngokuhlanza izandla okuhle nokugwema abantu abagulayo
• Nikeza imithi ngokuqondile njengoba kunqunyiwe
• Gcina izikhathi zokulala eziqondile
• Khuthaza imisebenzi efanele iminyaka ngenkathi uhlonipha imingcele yengane yakho

Uma ingane yakho inezikhathi ze-“tet” lapho ibe luhlaza okwesibhakabhaka kakhulu, yisize ibe sesimweni se-knee-chest (njengokuhlala phansi) futhi uhlale uzolile ngenkathi ubiza udokotela wakho. Izikhathi eziningi ziyaphela ngokushesha, kodwa zihlale zidinga ukunakekelwa kwezokwelapha.

Khumbula ukuthi abantwana abaningi abane-tetralogy of Fallot bangabamba iqhaza emisebenzini yabantwana evamile, nakuba bangase badinge ukuphumula njalo. Udokotela wakho wehliziyo uzokukhokhela noma yikuphi ukumisa imisebenzi ngokususelwa esimweni esithile sengane yakho.

Kufanele ulungiselele kanjani izikhathi zakho zokubona udokotela?

Ukulungiselela izikhathi zokubona ochwepheshe behliziyo kungakusiza ukuba wenze kakhulu isikhathi sakho nochwepheshe wehliziyo yengane yakho. Woza ulungele ukuxoxa ngokuphila kwansuku zonke kwengane yakho nanoma yikuphi ukukhathazeka okuye kwabonakala.

Nanku okufanele ukulethe nokulungiselela izikhathi zakho zokubona udokotela:

• Uhlu lwemithi yamanje ngamathani anembile nesikhathi
• Ishadi lokukhula lengane yakho nezirekhodi zokuncelisa
• Amanothi mayelana nanoma yiziphi izimpawu noma izinguquko oziqaphelayo
• Imibuzo mayelana namazinga omsebenzi, ukukhula, noma ukuthuthuka
• Imiphumela yokuhlolwa yangaphambili noma imibiko evela kwabanye odokotela
• Amakhadi yomshuwalense nokubona
• Into yokunethezeka yengane yakho ngesikhathi sokuhlolwa

Ungangabazi ukubuza imibuzo mayelana nanoma yini ongayiqondi. Iqembu lakho lezokwelapha lifuna uzizwe uqinisekile ngokunakekelwa kwengane yakho, ngakho bazokuthatha isikhathi sokuchaza izinqubo, imiphumela yokuhlolwa, nezinhlelo zokwelapha.

Kungasiza ukubhala ulwazi oluyinhloko ngesikhathi sokubona udokotela, noma ukubuza uma ungarekhoda izingxenye ezibalulekile zengxoxo. Imindeni eminingi ithol' ukuba kuwusizo ukuletha umlingani noma ilungu lomndeni ukusekela nokusiza ukukhumbula imininingwane ebalulekile.

Iyini into ebalulekile mayelana ne-Tetralogy of Fallot?

I-Tetralogy of Fallot yisimo senhliziyo esinzima kodwa esingaphatheka esithinta izinkulungwane zabantwana unyaka ngamunye. Ngokuthuthuka ekusebenzeni kwenhliziyo yabantwana nokukhathalelwa kwezokwelapha okuqhubekayo, iningi labantwana abanesimo esinjalo lingalindela ukuphila impilo egcwele, esebenzayo.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi ukuqaphela kwangaphambi kwesikhathi nokuphathwa okufanele kwenza umehluko omkhulu emiphumeleni. Iqembu lezokwelapha lengane yakho linolwazi olukhulu ngalesi simo futhi lizosebenza eduze nawe ukunikeza ukunakekelwa okuhle kakhulu.

Nakuba uhambo lungase lubonakale lukunzima ngezikhathi ezithile, imindeni eminingi ithol' ukuthi ukuba nengane enesimo se-tetralogy of Fallot kuyayifundisa ngokuqina, ukubukela izinto eziphathelene nempilo, nokubaluleka kokugubha yonke imiphumela. Ingane yakho ingakhula ibe yingxenye yemidlalo, ifune imfundo, ibe nemisebenzi, iqale imindeni yayo.

Imibuzo evame ukubuzwa mayelana ne-Tetralogy of Fallot

Ingane yami izokwazi ukudlala imidlalo futhi ibe namandla?

Abantwana abaningi abalungisiwe be-tetralogy of Fallot bangabamba iqhaza emidlalweni nasemisebenzini yomzimba, nakuba bangase badinge ezinye izinguquko. Udokotela wakho wehliziyo uzohlola umsebenzi wehliziyo ethile yengane yakho futhi anikeze imiyalo mayelana nemisebenzi ephephile. Abanye abantwana bangase badinge ukugwema imidlalo encintisana kakhulu noma enqamile, kanti abanye bangabamba iqhaza ngokugcwele ngokubekwa njalo.

Ingane yami izodinga ukunakekelwa okuqhubekayo kangakanani ngemuva kokuhlinzwa?

Abantwana abane-tetralogy of Fallot badinga ukulandelela kwehliziyo okuphila konke, ngisho nangemuva kokuhlinzwa okuphumelelayo. Ekuqaleni, izikhathi zokubona udokotela zingase zibe izinyanga ezimbalwa, bese ngokuvamile kanye noma kabili ngonyaka njengoba ingane yakho ikhula. Ukuvamile kuxhomeke ekuthini inhliziyo yabo isebenza kangcono kangakanani noma ngabe kukhona izinhlanganisela ezivela. Ukubheka njalo kusiza ekuqapheleni noma yiziphi izinkinga ngokushesha futhi kuqinisekisa ukuthi ingane yakho ihlala iphilile ngangokunokwenzeka.

I-Tetralogy of Fallot ingavikeleka?

Ngeshwa, ayikho indlela yokuvimbela i-tetralogy of Fallot ngoba ithuthukela ngokungahleliwe ngesikhathi sokukhulelwa kwasekuqaleni. Noma kunjalo, ukugcina ukunakekelwa okuhle kokukhulelwa, ukuthatha amavithamini okukhulelwa ane-folic acid, ukugwema utshwala nokubhema ngesikhathi sokukhulelwa, nokuphatha noma yiziphi izimo zezempilo zomzali kungasekele ukuthuthuka konke kwenhliziyo. Izimo eziningi zenzeka ngaphandle kwanoma yisiphi isizathu esiqondakalayo noma izici ezingozi ezingavikeleka.

Ingane yami izodinga ukuhlinzwa okwengeziwe njengoba ikhula?

Abanye abantwana bangase badinge izinqubo ezengeziwe njengoba bekhula, kodwa abaningi benza kahle ngokulungiswa kwabo okuqala. Isidingo sokuhlinzwa kwesikhathi esizayo sixhomeke ezintweni ezinjengokuthi ukulungiswa okuqala kugcinwa kangcono kangakanani, noma ngabe ama-valves enhliziyo adinga ukufakwa, nokuthi inhliziyo yengane yakho ikhula kanjani. Udokotela wakho wehliziyo uzolandelela umsebenzi wenhliziyo yengane yakho ngokuhamba kwesikhathi futhi axoxe nganoma yiziphi izinqubo zesikhathi esizayo ezingaba usizo.

Kufanele ngitshengiseni ingane yami ngesimo senhliziyo yayo?

Kubalulekile ukukhuluma nengane yakho ngesimo senhliziyo yayo ngezindlela ezifanele iminyaka. Abantwana abancinyane bangakuqonda ukuthi banenhliziyo ekhethekile eyayidinga ukulungiswa, futhi yingakho babona udokotela wehliziyo. Njengoba bekhula, unganikeza izincazelo eziningiliziwe. Ukuthembeka nokuhle kwenza abantwana bathuthukise ukuqonda okunempilo ngesimo sabo futhi bakhe ukuzethemba ekuqondeni impilo yabo njengoba bekhula.