Yini umgomo we-DTaP-IPV-Hib? Izimpawu, Izimbangela, & Nokwelashwa Ekhaya

Umjovo we-DTaP-IPV-Hib ungumjovo ohlanganisiwe ovikela ezifweni ezinhlanu ezingathi sína zezingane ngomjovo owodwa. Lo mjovo uhlanganisa ukuvikelwa ku-diphtheria, i-tetanus, i-acellular pertussis (ukukhwehlela okukhulu), i-polio, kanye nezifo ze-Haemophilus influenzae uhlobo b (Hib).

Abahlinzeki bezempilo banikeza lo mjovo njengomjovo we-intramuscular, ngokuvamile ethangeni lengane yakho noma engalweni engenhla. Iyingxenye yohlelo olujwayelekile lokugomela izingane futhi lusiza ukwakha ukuzivikela ezifweni ezake zabangela izinkinga ezinzima nokufa ezinganeni.

Uyini umgomo we-DTaP-IPV-Hib?

Umjovo we-DTaP-IPV-Hib ukugonywa okuhlanu-ngakunye okuvikela izingane ezifweni eziningi eziyingozi. Uhlamvu ngalunye egameni limele isifo esihlukile: D for diphtheria, T for tetanus, aP for acellular pertussis, IPV for inactivated polio vaccine, and Hib for Haemophilus influenzae type b.

Lo mjovo ohlanganisiwe usindisa ingane yakho ekutholeni imijovo emihlanu ehlukene. Iqukethe izingxenye ezibuthakathaka noma ezingasebenzi zamagciwane abangela izifo, okusiza amasosha omzimba engane yakho ukuthi afunde ukulwa nalezi zifo ngaphandle kokubangela izifo zangempela.

Umjovo unikezwa njengochungechunge lwemijovo oluqala lapho ingane yakho inezinyanga ezi-2 ubudala. Iningi lezingane lithola lo mjovo eneminyaka engu-2, 4, 6, kanye nenyanga eziyi-15-18 ubudala, ngomjovo wokuthuthukisa eneminyaka engu-4-6 ubudala.

Kuzwakala kanjani ukuthola umgomo we-DTaP-IPV-Hib?

Ingane yakho izozwa ukuchofoza okusheshayo noma ukushaya lapho inaliti ingena emsipheni wayo. Umjovo ngokwawo uthatha imizuzwana embalwa nje, nakuba ukulindela kungase kuzwakale isikhathi eside kuwe nakumntwana wakho.

Ngemuva kokujova, ingane yakho ingase izwe ukungakhululeki okuncane endaweni yokujova. Lokhu kungabandakanya ubuhlungu, ububomvu, noma ukuvuvukala okuncane lapho inaliti ingene khona. Lezi zimpawu zivamile zokuthi amasosha omzimba engane yakho ayasabela emgomeni.

Ezinye izingane zingase zizizwe zicasukile noma zikhathele usuku noma ezimbili ngemuva kokugonywa. Umkhuhlane olinganiselwe nawo ungaqhamuka, okuyindlela umzimba wengane yakho wakha ngayo ukuzivikela ezifweni.

Yini ebangela imiphumela emibi emgomeni we-DTaP-IPV-Hib?

Imiphumela emibi yenzeka ngoba amasosha omzimba engane yakho asebenza ukwakha ukuvikeleka ezifweni ezinhlanu. Lapho umgomo ungena emzimbeni, amaseli omzimba aqaphela izingxenye zomgomo njengezinto zangaphandle bese eqala ukudala ama-antibody ukuze alwe nazo.

Izimpawu ezivame kakhulu zenzeka endaweni yokujova lapho kunikezwe khona umgomo. Umzimba wengane yakho uthumela amaseli omzimba kule ndawo, okungabangela ububomvu besikhashana, ukuvuvukala, noma ubuhlungu. Lokhu kusabela kwendawo kubonisa ukuthi amasosha omzimba enza umsebenzi wawo.

Ezinye izingane ziba nezimpawu ezithinta wonke umzimba, ezingathinti nje indawo yokujova kuphela. Lokhu kungabandakanya umkhuhlane olula, ukucasuka, noma ukuncipha kwesifiso sokudla njengoba amasosha omzimba esebenza emzimbeni wonke ukuthuthukisa ukuzivikela.

Yini imiphumela emibi engenzeka yomgomo we-DTaP-IPV-Hib?

Iningi lezingane lithola imiphumela emibi elula kuphela enyamalalayo yodwa ezinsukwini ezimbalwa. Ukuqonda ukuthi yini ongayilindela kungakusiza ukuthi uzizwe ulungile futhi ungakhathazeki kakhulu ngendlela ingane yakho esabela ngayo emgomeni.

Imiphumela emibi ejwayelekile ezingane eziningi ezihlangabezana nayo ihlanganisa:

• Ubuhlungu, ububomvu, noma ukuvuvukala endaweni yokujova
• Umkhuhlane olula (ngokuvamile ngaphansi kuka-101°F)
• Ukucasuka noma ukucasuka okuncane
• Ukuncipha kwesifiso sokudla usuku noma ezimbili
• Ukozela olula noma ukufuna ukulala okwengeziwe
• Ukulahlekelwa isithakazelo sokudlala okwesikhashana

Lezi zimo zivame ukuqala kungakapheli amahora angama-24 ngemuva kokugonywa futhi zinyamalale phakathi kwezinsuku eziyi-2-3. Empeleni ziyizimpawu ezinhle zokuthi amasosha omzimba engane yakho ayakha ukuvikeleka ezifweni ezinzima.

Imiphumela emibi engavamile kodwa esavamile ingabandakanya:

• Umkhuhlane olula (101-103°F)
• Ukuvuvukala okukhulu endaweni yokujova
• Ukukhala okwengeziwe noma ukucasuka okuhlala isikhathi eside kunokujwayelekile
• Ukuphalaza noma isifo sohudo esilula
• Ukuqubuka okuncane endaweni yokujova

Imiphumela emibi engavamile kodwa ebucayi idinga ukunakekelwa kwezokwelapha ngokushesha. Ngenkathi lokhu kwenzeka kaningi kakhulu, kubalulekile ukwazi ukuthi yini okufanele uyibheke:

• Umkhuhlane omkhulu ongaphezu kuka-104°F
• Ukungezwani komzimba okukhulu okunezinkinga zokuphefumula noma ukuvuvukala kobuso nomphimbo
• Ukukhala okungajwayelekile okuhlala amahora angaphezu kwama-3
• Ukuhlaselwa yisithuthwane noma ukugonyuluka
• Ukozela okukhulu noma ubunzima bokuvusa ingane yakho
• Ukuvuvukala okukhulu kwengalo noma umlenze wonke

Lezi zimo ezinzima azivamile kakhulu, zenzeka kubantu abangaphansi koyedwa kwabayizinkulungwane eziyi-10,000. Kodwa-ke, ukwazi lezi zimpawu kukusiza ukuthi ufune ukunakekelwa kwezokwelapha ngokushesha uma kudingeka.

Ingabe imiphumela emibi evela emgomeni we-DTaP-IPV-Hib inganyamalala yodwa?

Yebo, iningi lemiphumela emibi evela kulomgomo inyamalala ngokuphelele yodwa phakathi kwezinsuku eziyi-2-3. Umzimba wengane yakho ngokwemvelo usebenzisa izingxenye zomgomo futhi impendulo yamasosha omzimba iyazola njengoba kwakhiwa ama-antibody.

Izimo ezilula njengobuhlungu endaweni yokujova, umkhuhlane olula, nokucasuka kuvame ukufinyelela ezingeni eliphezulu emahoreni okuqala angama-24 ngemuva kokugonywa. Ngemuva kwalokho, lezi zimpawu ziyathuthuka kancane kancane futhi zinyamalale ngaphandle kokwelashwa okukhethekile.

Ngisho nezimo eziphakathi nendawo, njengomkhuhlane okhuphukile kancane noma ukucasuka okwengeziwe, ngokuvamile zixazululwa phakathi kwezinsuku eziyi-3-5. Ukudla kwengane yakho okuvamile, izinga lamandla, nemizwa kubuyela njengoba amasosha omzimba eqeda inqubo yokwakha ukuzivikela.

Ungawelapha kanjani imiphumela emibi evela emgomeni we-DTaP-IPV-Hib ekhaya?

Ungasiza ingane yakho ukuthi izizwe ikhululekile ngenkathi umzimba wayo wakha ukuzivikela emzimbeni usebenzisa imithi elula, ephephile yasekhaya. Lezi zindlela ezithambile zinganciphisa ukungakhululeki ngaphandle kokuphazamisa ukusebenza komgomo.

Ukuze uthole ukungakhululeki endaweni yokujova, ungafaka indwangu ehlanzekile, epholile endaweni imizuzu engu-10-15 izikhathi eziningana ngosuku. Lokhu kusiza ukunciphisa ukuvuvukala futhi kunikeze impumuzo ethambile. Gwema ukufaka iqhwa ngqo esikhumbeni, ngoba lokhu kungabanda kakhulu ezinganeni ezincane.

Uma ingane yakho ithuthukisa umkhuhlane, yigqokise izingubo ezilula, eziphefumulayo ukusiza umzimba wayo ukulawula izinga lokushisa. Nikeza uketshezi olwengeziwe njengobisi lwebele, ifomula, noma amanzi ukuvimbela ukushoda kwamanzi emzimbeni. Ukugeza ngamanzi afudumele kungasiza futhi ukwehlisa umkhuhlane ngokwemvelo.

Izinketho zokukhulula ubuhlungu zihlanganisa:

• I-Infant acetaminophen (Tylenol) yezingane ezineminyaka engu-2 ubudala nangaphezulu
• I-Infant ibuprofen (Motrin, Advil) yezingane ezineminyaka engu-6 ubudala nangaphezulu
• Njalo landela imiyalelo yokulinganisa ngokusekelwe esisindweni sengane yakho
• Xhumana nodokotela wengane yakho ngaphambi kokunikeza noma imiphi imithi

Izinyathelo zokunethezeka zingenza umehluko omkhulu endleleni ingane yakho ezizwa ngayo. Ukugona okwengeziwe, ukuzamazama kancane, nokugcina amashejuli okuphakela avamile kusiza ukuhlinzeka ngosekelo lwemizwa ngalesi sikhathi.

Gcina umkhuba wengane yakho njengenjwayelo ngangokunokwenzeka, kodwa vumela ukuphumula okwengeziwe uma ibonakala ikhathele. Izingane eziningi zizizwa zingcono ngemisebenzi ejwayelekile nezinto zokunethezeka njengamathoyizi eziwathandayo noma izingubo zokulala.

Yini ukwelashwa kwezokwelapha kwezimo ezinzima emgomeni we-DTaP-IPV-Hib?

Ukwelashwa kwezokwelapha kuba ngesidingo lapho izingane ziba nemiphumela engavamile kodwa ebucayi emgomeni. Abahlinzeki bezempilo baqeqeshwe ukubona nokwelapha lezi zimo ngokushesha nangempumelelo.

Ngezimpendulo ezinzima zokungezwani komzimba, ukwelashwa kwezimo eziphuthumayo zezokwelapha kufaka phakathi imijovo ye-epinephrine (i-adrenaline) kanye nama-antihistamine ukulwa nokusabela kokungezwani komzimba. Abahlinzeki bezempilo futhi baqapha ukuphefumula futhi banikeze ukusekelwa komoya-mpilo uma kudingeka.

Umkhuhlane ophezulu ongaphezu kuka-104°F udinga ukuhlolwa kwezokwelapha ukuze kuqedwe ezinye izimbangela futhi kunikezwe ukuncishiswa komkhuhlane okufanele. Lokhu kungabandakanya imithi eqeda umkhuhlane enamandla kanye nokuqapha ngokucophelela isimo sengane yakho.

Uma kwenzeka ukuquleka, ochwepheshe bezokwelapha banikeza ukunakekelwa ngokushesha ukuze kumiswe ukuquleka futhi kuvinjelwe ukulimala. Baphinde baphenye ukuthi ngabe ukuquleka kuhlobene nomkhuhlane noma ezinye izinto, baqinisekisa ukunakekelwa okulandelayo okufanele.

Ukubhekwa esibhedlela kungase kunconywe ezinganeni eziba nokusabela okukhulu. Lokhu kuvumela abahlinzeki bezempilo ukuthi baqaphe ukululama kwengane yakho futhi banikeze ukwelashwa okwengeziwe uma kudingeka.

Kufanele ngibone nini udokotela ngezimpendulo zomgomo we-DTaP-IPV-Hib?

Kufanele uthinte udokotela wakho wezingane uma ingane yakho ithuthukisa izimpawu ezikhathazayo ngemuva kokugonywa. Ngenkathi izimpendulo eziningi zithambile futhi zizilindelekile, ezinye izimo zidinga ukuhlolwa kwezokwelapha okuchwepheshile.

Shayela udokotela wakho ngokushesha uma ingane yakho ihlangabezana:

• Umkhuhlane ophezulu kuno-103°F
• Ukukhala ngokuqhubekayo isikhathi esingaphezu kwamahora ama-3
• Ukuvuvukala okukhulu endaweni yokujova okusabalala ngaphandle kwendawo eseduze
• Izimpawu zokungezwani komzimba njenge-hives, ubunzima bokuphefumula, noma ukuvuvukala kobuso
• Ukozela okungavamile noma ubunzima bokuvuka
• Ukuphalaza okuvimbela ukugcina uketshezi phansi

Funa ukunakekelwa kwezimo eziphuthumayo ngokushesha uma ingane yakho ikhombisa izimpawu zokungezwani komzimba okukhulu, inokuquleka, noma ithuthukisa umkhuhlane ongaphezu kuka-104°F. Lezi zimo zidinga ukunakekelwa kwezokwelapha okusheshayo ukuze kuqinisekiswe ukuphepha kwengane yakho.

Thembela emizweni yakho yobuzali futhi. Uma kukhona okubonakala kuhluke kakhulu mayelana nokuziphatha kwengane yakho noma isimo sayo ngemva kokugonywa, kuhlale kufanelekile ukuxhumana nomhlinzeki wakho wezempilo ukuze uthole isiqondiso nokuqinisekiswa.

Ziyini izici eziyingozi zokuthuthukisa imiphumela emibi evela emgomeni we-DTaP-IPV-Hib?

Ezinye izici zingakhuphula amathuba okuthi ingane yakho ibe nemiphumela emibi evela emgomeni. Ukuqonda lezi zici eziyingozi kukusiza kanye nomhlinzeki wakho wezempilo ukuthi nenze izinqumo ezinolwazi mayelana nesikhathi sokugoma nokulungiselela.

Izimpendulo zangaphambilini emgomeni zingabonisa ithuba eliphezulu lokuthi kube khona izimpendulo zesikhathi esizayo. Uma ingane yakho yayinemiphumela emibi ebalulekile evela emgomeni wangaphambilini, udokotela wakho angase ancome ukuqapha eduze noma ukwelashwa ngaphambi kokwelashwa ukuze kuncishiswe izimpendulo.

Izici ezihlobene nobudala nazo zidlala indima endleleni izingane ezisabela ngayo emgomeni. Izinsana ezincane zingase zibonise izimpendulo ezigqamile ngoba amasistimu abo omzimba asathuthuka futhi afunda ukusabela emgomeni.

Izici eziyingozi ezivamile zihlanganisa:

• Ukuphendula okumaphakathi kuya kokukhulu emgomeni othile
• Umlando womndeni wokuphendula emgomeni
• Ukugula okuncane noma umkhuhlane
• Ukuzalwa ngaphambi kwesikhathi (nakuba ukugoma kusanconywa)
• Ukuvikeleka komzimba okubuthakathaka
• Ukugula kwamuva noma ukucindezeleka

Nokho, ukuba nezici eziyingozi akusho ukuthi ingane yakho ngokuqinisekile izoba nemiphumela emibi. Izingane eziningi ezinalezi zici zithola imigomo ngaphandle kwezinkinga, futhi izinzuzo zokugoma zidlula kakhulu izingozi ezinganeni eziningi.

Ziyini izinkinga ezingase zibe khona zokungatholi umgomo we-DTaP-IPV-Hib?

Izifo ezivikelwe yilo mgomo zingabangela izinkinga ezinzima ngisho nokufa ezinganeni ezingagonywanga. Ukuqonda lezi zingozi kusiza ukubeka imiphumela emibi yomgomo ngendlela efanele futhi kugqamise ukuthi kungani ukugoma kubaluleke kangaka.

I-Diphtheria ingabangela izinkinga ezinkulu zenhliziyo, ukukhubazeka, nobunzima bokuphefumula ngenxa yokumboza okukhulu emqaleni. Ngaphambi kokugonywa, lesi sifo sabulala cishe ingane eyodwa kwabayi-10 eyayisitholile.

I-Tetanus iholela ekuqineni kwemisipha okukhulu okungaba namandla ngokwanele okuphula amathambo. Lesi sifo siyingozi ikakhulu ngoba sitholakala emhlabathini futhi singangena nganoma iyiphi inxeba, okwenza kungabi nokwenzeka ukugwema ukuchayeka.

Izinkinga ze-Pertussis ziyingozi ikakhulu ezinganeni futhi zihlanganisa:

• Ubunzima obukhulu bokuphefumula nezikhathi eziluhlaza okwesibhakabhaka
• I-Pneumonia edinga ukulaliswa esibhedlela
• Umonakalo wobuchopho ngenxa yokuntuleka komoya-mpilo
• Ukufa, ikakhulukazi ezinganeni ezingaphansi kwezinyanga ezi-6
• Ukuqhekeka kwezimbambo ngenxa yokukhwehlela okunamandla

I-Polio ingabangela ukukhubazeka unomphela, ikakhulukazi okuthinta imilenze, izingalo, nemisipha yokuphefumula. Nakuba kungavamile namuhla ngenxa yokugonywa, lesi sifo sike sakhubaza izinkulungwane zezingane minyaka yonke.

Izifo ze-Hib zingaholela ku-meningitis esongela impilo, ebangela ukuvuvukala kobuchopho futhi ingaholela ekulahlekelweni ukuzwa, ukukhubazeka ngokwengqondo, noma ukufa. Leli bhaktheriya lingabangela ne-pneumonia enkulu nezifo zegazi.

Lezi zinkinga zenzeka kaningi ezinganeni ezingagonywanga kunokuthi izindlela zokugoma ezinzima zenzeke ezinganeni ezigonyiwe, okwenza ukugoma kube yindlela ephephe kakhulu ngomkhawulo omkhulu.

Ingabe umgomo we-DTaP-IPV-Hib muhle noma mubi empilweni yengane yami?

Umgomo we-DTaP-IPV-Hib unenzuzo enkulu empilweni yengane yakho futhi unikeza ukuvikelwa okubalulekile ezifweni ezinhlanu ezinzima. Umgomo uhlolwe kabanzi futhi waba nobufakazi bokuthi uphephile futhi usebenza ngempumelelo ekuvikeleni izifo ezake zabangela ukugula nokufa okubanzi.

Lo mjekiseli unikeza amazinga amakhulu okuvikela, evimbela cishe u-95% wamacala ezifo eziqondiwe uma inikezwa ngokohlelo oluceliwe. Ukuzivikela okunikezayo kuhlala iminyaka eminingi, kunikeza ingane yakho ukuvikeleka kwesikhathi eside phakathi neminyaka yayo ebuthaka kakhulu.

Izinzuzo zikhulu kakhulu kunezinhlobo zazo zazo zonke izingane. Ngenkathi imiphumela emibi ingenzeka, ivame ukuba mnene futhi yesikhashana, ngenkathi izifo ezivikelwe zingabangela ukukhubazeka unomphela noma ukufa. Umjovo futhi unegalelo ekuvikelweni komphakathi ngokunciphisa ukusabalala kwalezi zifo.

Izimo ezikhethekile zingase zithinte izinqumo zokugoma, njengezinkinga ezinzima zesimiso somzimba sokuzivikela noma ukusabela okungalindelekile okusongela impilo ngaphambilini. Kodwa-ke, lezi zimo azivamile, futhi iningi lezingane ezinempilo ezithile zizuzwa ekugomeni ngisho nangaphezu kwezingane ezinempilo.

Yini okungase kwenziwe ngayo ukusabela emgomeni we-DTaP-IPV-Hib?

Ngezikhathi ezithile abazali bakhathazeka ngokuthi izimpawu zezingane zabo ngemuva kokugoma zingase zibe yizimpawu zento ethile engathi sína. Ukuqonda ukuthi ukusabela okujwayelekile komgomo kubukeka kanjani kukusiza ukuthi uhlukanise phakathi kokusabela okulindelekile nezifo ezingahlobene.

Umkhuhlane ophansi ngemuva kokugoma ujwayelekile futhi kulindelekile, kodwa kungase kwenziwe iphutha ukuthi kuqala umkhuhlane noma enye ingculazi. Umkhuhlane ohlobene nomgomo uvame ukuvela kungakapheli amahora angama-24 wokugoma futhi uyanyamalala phakathi nezinsuku ezi-2-3 ngaphandle kwezinye izimpawu zomkhuhlane.

Ukukhathala nokuncipha kwesifiso sokudla ngemuva kokugoma kuyizimpawu ezivamile ezingase zibukeke njengokuqala kokugula. Kodwa-ke, ukucasuka okuhlobene nomgomo kuvame ukuthuthuka ngokushesha futhi akuhambisani nezinye izimpawu zokugula njengamakhala agobhozayo noma ukukhwehlela.

Ukusabela endaweni yokujova ngezinye izikhathi kungadidaniswa nalokhu:

• I-Cellulitis (ukutheleleka kwesikhumba ngamabhaktheriya) - kodwa ukusabela komgomo akuna migqa ebomvu noma ukushisa okusabalala ngaphandle kwendawo eseduze
• Ukusabela komzimba ezintweni ezinye - kodwa ukusabela komgomo kuhlala endaweni yokujova
• Ukwenzeka ngenxa yokuwa noma ukushayeka - kodwa abazali bavame ukukhumbula uma kwenzeka ukulimala

Uma ungaqiniseki ukuthi izimpawu zomntanakho zihlobene yini nomgomo noma enye into, xhumana nodokotela wezingane. Bangasiza ukuhlukanisa phakathi kokusabela okujwayelekile komgomo kanye nezinye izimo ezingase zidinge ukwelashwa okuhlukile.

Imibuzo evame ukubuzwa mayelana nomgomo we-DTaP-IPV-Hib

Zithatha isikhathi esingakanani imiphumela emibi evela emgomweni we-DTaP-IPV-Hib?

Imiphumela eminingi emibi evela kulomgomo ithatha izinsuku ezi-2-3 ubuningi. Ubuhlungu nobubomvu endaweni yokujova ngokuvamile buyanyamalala phakathi kwamahora angama-24-48, kuyilapho umkhuhlane olula nokukhathala ngokuvamile kuthuthuka phakathi kwezinsuku ezi-2-3. Uma izimpawu ziqhubeka isikhathi esingaphezu kwesonto noma zibonakala ziba zimbi kunokuba zibe ngcono, xhumana nodokotela wezingane ukuze uthole isiqondiso.

Ingabe ingane yami ingagula ngisho nangemva kokugonywa?

Ngenkathi umgomo usebenza kahle kakhulu, akukho mgomo onikeza ukuvikelwa okuyi-100%. Kodwa-ke, izingane ezigonyiwe ezigula ngalezi zifo ngokuvamile ziba nezimpawu ezilula kakhulu kanye nezinkinga ezimbalwa kunezintwana ezingagonywanga. Umgomo unikeza ukuvikelwa okungaba ngu-95% ngalezi zifo uma unikezwa ngokuya ngohlelo oluceliwe.

Ngingamnika ingane yami umuthi wokwehlisa umkhuhlane ngaphambi komgomo ukuze ngivimbele imiphumela emibi?

Ngokuvamile akukhuthazwa ukuthi unikeze izinto zokwehlisa umkhuhlane ngaphambi kokugoma ngoba lokhu kungaphazamisa ukusabela komzimba wengane yakho emgomweni. Kodwa-ke, unganika izinto ezifanele zokwehlisa umkhuhlane ngemuva kokugoma uma ingane yakho ithuthukisa ukungakhululeki noma umkhuhlane. Njalo xhumana nodokotela wezingane mayelana nendlela engcono kakhulu yengane yakho ethile.

Ngingenzani uma ingane yami iphuthelwa umthamo ohleliwe?

Uma ingane yakho iphuthelwa umthamo ohleliwe, xhumana nodokotela wezingane wakho ukuze ahlele kabusha ngokushesha okukhulu. Banganquma isikhathi esingcono kakhulu sokugonywa kokubamba ngokuya ngeminyaka yengane yakho kanye nomlando wokugonywa. Ukweqa umthamo akusho ukuqala phansi - ingane yakho ingaqhubeka nochungechunge lapho bayeke khona.

Ingabe zikhona izingane okungafanele zithole lo mithi wokugoma?

Bambalwa kakhulu abantwana abangakwazi ukuthola lo mithi wokugoma. Labo okungafanele bahlanganisa izingane ezinamaphutha amakhulu ohlelweni lomzimba lokuzivikela ezifweni, labo abake baba nokusabela okubucayi okusongela impilo emithini yokugoma yangaphambilini, noma labo abanezimo ezithile zemizwa. Udokotela wezingane wakho uzobukeza umlando wezokwelapha wengane yakho ukuze aqinisekise ukuthi ukugonywa kufanele futhi kuphephile kubo.