Common Problems
The child is more prone to any kind of infection as compared to an adult because of low body defence mechanisms. For the first two years diarrhoeal disorders are a major problem, whereas in the 2 to 5 years age group respiratory infections take the lead. Cough and cold are the commonest illnesses encountered in the metros especially during changing seasons. As most of them are viral in nature, antibiotics are seldom required. They however need medical attention when the cough becomes very noisy or is associated with breathing difficulty and/or high fever. Viral fever has no specific treatment and only management of symptoms is required. Fortunately it cures by itself in
Four to five days.
About 5 per cent of all children are prone to developing convulsions at the onset of fever. Do not panic. Remove all extra clothes, sponge the whole body with tap water. Give Paracetamol or any other fever medicine immediately after the convulsions have stopped. Consult your doctor at the earliest, specially after the first episode. Children usually grow out of it by the age of 3 years and there are no long-term brain defects.
Stomach infections are characterized by vomiting, loose motions stomach ache and sometimes fever. Give some medicine to stop the vomiting and start with plenty of fluids like electrolyte solutions, coconut water, dal water, etc. Do not give glucose water. Stomach-ache should be suspected when the baby cries uncontrollably and is relieved by abdominal massage. Anti-spasmodic drops are all that is required. Some babies have pain at a particular time of the day daily and is popularly known as evening colic. Its exact cause is not known but proper feeding, burping and colic drops help. Hygiene is the cornerstone in prevention of stomach infrequently and keep washing the toddler’s hands frequently and keep the nails short and clean. Take care that the baby does not put floor litter in his mouth. Bottle-feeding is best avoided, but if you must, the bottle should be boiled foe at-least 10 minutes before each feed. Soothers and teething rings are not to be used. Thrush is the white coating over the tongue seen in bottle-fed infant or after antibiotics. Local application of anti-fungal lotion is required for 5-7 days.
Eye flu or conjunctivitis is a common problem during changing seasons. The eyes are swollen, red and eyelids get stuck together because of thick pus-like discharge. Wash the eye with cotton swabs soaked in boiled and cooled water and start putting antibiotic eye drop, 1 drop in each eye three-hourly for 5 to 7 days. Ear discharge is a serious problem for which you must consult your pediatrician or an ENT surgeon at the earliest. Do not self-medicate by using any eardrops. Dandruff-like greasy scales and peeling of the scalp skin is common in the first six months especially in winters. Severe forms lead to formation of a ‘cradle cap’ Gentle washing and cleaning with Cetavelon shampoo followed by brushing prevents its worsening to eczema. Urine infection is more common in girls than boys. It can present as unexplained fever or can be associated with increased frequency of urination and excessive crying while passing urine. However, babies, especially boys, may cry before and after passing urine, which is normal. In suspected urinary infection, urine culture and an appropriate antibiotic is required.
With the arrival of a newborn the older child feels emotionally threatened and may show behavior disturbances leading to sibling rivalry. To avoid such a situation prepare the child before delivery itself. Involve the older child in the care of the sibling, so that he can relate to him with love, responsibility and feeling of belonging. Breath holding spells usually occur between the ages of 6 months and 3 years. The child starts crying after he is hurt, frustrated or frightened. Breath is held for a few seconds and the child becomes blue. Measures should be taken to avoid precipitating factors. The attack can be aborted by using a strong physical stimulus like a pinch, applied at the onset of the spell. It is essential that there is consistency in both the parents’ behavior and they do not reinforce the child’s actions after the recovers from the spell. Over-anxiety of parents may lead the child to use it as an attention-seeking disorder. Head banging and rocking in the bed gives the child a pleasurable sensation. Thumb-sucking and nail-biting are also examples of similar self-stimulation although thumb-sucking is normal during 3 to 9 months. These habits, if persist, can be due to a feeling of insecurity. Patient explanation along with physical prevention can be of help. Teeth-grinding result from tension origination in unexpressed anger or resentments (It is definitely not related to intestinal worms). Helping the child to find ways to express resentment may relieve the problem. Bedtime can be made more enjoyable permitting re-experience and review of some of the fears or angers experienced during the day.
An important aspect in medical care is the parent-doctor relationship. The doctor contributes invaluable technical advice and the parents provide insight into their children. Choose the right physician who is willing to provide you the best care possible. Besides being qualified in paediatrics and having a convenient office location and office hours, he should be responsible, sympathetic and accessible-willing to listen to your concerns, encourage your questions, offer explanations and not grudge the extra time that may be necessary. Of course he has to be good with your children. On your end you should always try and follow the protocol, tell the whole truth, follow the doctor’s instructions or clearly explain why you can’s. If in doubt, ask for explanation, discuss conflicting advice and when you are unhappy talk directly. The right physician will not mind your calling up even for silly queries and concerns, but unless it is an emergency wait for the office time he also has a family and some commitment towards it. Whether it is mid-afternoon or midnight, paediatricians spend more time in phone consultations than any other specialty, so prepare yourself before calling. The child’s symptoms, temperature, weight, medicines given last time, questions about diet etc. You should be ready along with a working pen and paper. Phone immediately if the child develops fever above 104 c, or it is associated with convulsions, limpness, inconsolable crying, whimpering, purple spots on the body, severe headache, neck stiffness, difficulty in breathing or swallowing, In a newborn, a subnormal temperature is more alarming than fever. Also call urgently if there is bleeding from any site, severe diarrhea and vomiting, abnormal behavior or if the child has swallowed any object or medicine.