The severity of tics early in life does not predict their severity in later life. There is no reliable means of predicting the course of symptoms for a particular individual, but the prognosis is generally favorable. By the age of fourteen to sixteen, when the highest tic severity has typically passed, a more reliable prognosis might be made.Tics may be at their highest severity when they are diagnosed, and often improve as an individuals family and friends come to better understand the condition. Studies report that almost eight out of ten children with Tourettes experience a reduction in the severity of their tics by adulthood, and some adults who still have tics may not be aware that they have them. A study that used video to record tics in adults found that nine out of ten adults still had tics, and half of the adults who considered themselves tic-free displayed evidence of mild tics. Quality of life
People with Tourettes are affected by the consequences of tics and by the efforts to suppress them. Head and eye tics can interfere with reading or lead to headaches, and forceful tics can lead to repetitive strain injury. Severe tics can lead to pain or injuries; as an example, a rare cervical disc herniation was reported from a neck tic. Some people may learn to camouflage socially inappropriate tics or channel the energy of their tics into a functional endeavor.A supportive family and environment generally give those with Tourettes the skills to manage the disorder.
Candida infection (thrush) of the nipple can also occur, resulting in deep-pink, cracked, and sore nipples. Contraindications for breastfeeding
Because cracked nipples can result in the infant being exposed to blood, women with certain blood-borne diseases may be advised to stop breastfeeding if they have a cracked nipple. It has been found safe for breastfeeding mothers with hepatitis B and cracked nipples to breastfeed. In the event that a nursing woman experiences cracked and bleeding nipples or breast inflammation within one to two weeks immediately following an acute Toxoplasmosis infection (when the organism is still circulating in her bloodstream), it is theoretically possible that she could transmit Toxoplasma gondii to the infant through her breast milk. Immune suppressed women could have circulating Toxoplasma for even longer periods of time. However, the likelihood of human milk transmission is very small. Transmission risk of HIV increases if the mother has cracked and bleeding nipples An uncommon infection in the mother, Chagas disease, can be transmitted to the nursing infant via cracked nipples. Women with hepatitis C are advised to abstain from breastfeeding if their nipples are cracked or bleeding. Cause
Some studies indicate that cracked nipples are caused by poor latch. Yet other causes could be poor positioning, use of a feeding bottle, breast engorgement, inexperience, semi-protruding nipples, use of breast pumps and light pigmentation of the nipples. Breast engorgement is also a main factor in altering the ability of the infant to latch-on.