Insights on the prevention and treatment of common childhood diseases

The core of the prevention and control of common diseases in children has never been to pursue "zero disease", but to use a layered response to minimize the damage of the disease - prevention focuses on daily diet, work and rest, and exercise rather than taking supplements for miraculous effects; management focuses on dynamically observing the child's overall condition rather than blindly taking medication and rushing to the emergency room. Most self-limiting diseases such as common colds, diarrhea, and childhood rashes do not require excessive intervention. Once abnormal signs such as listlessness, shortness of breath, and persistent high fever occur, seek medical treatment decisively and do not bear it.

I went through a lot of trouble when I first became a mother. My baby's first fever was only 38 degrees Celsius. I rushed to the emergency room in the middle of the night wrapped in a thick blanket and waited in line for two and a half hours. The doctor lifted up my clothes and looked at my throat and listened to my lungs. He didn't even prescribe any medicine. He just told me to go home and drink more water. If my body temperature exceeded 38.5, I would just take prescribed antipyretics. At that time, I thought the doctor was perfunctory, so I went back and read half of the "American Academy of Pediatrics Parenting Encyclopedia" before I realized that 90% of common colds are caused by viruses. There is no specific medicine at all. It takes about a week to recover without taking medicine. Taking medicine randomly will increase the burden on the child's liver and kidneys.

Later, people around me always recommended lactoferrin, immune globulin, and various imported vitamin combinations to me, saying that taking them would keep the baby "free from colds all year round." I bought two cans for a fever that cost me less than 2,000. Later, I asked my friends who are evidence-based pediatricians and they said that there is not enough large-scale clinical evidence to prove that this type of supplement can reduce the incidence of common diseases in healthy children. On the contrary, some high-dose vitamin supplements can cause diarrhea and increase metabolic burden if taken too much. Of course, I also asked a colleague who works in children's nutrition. Her opinion is that if the child is usually very picky about eating and cannot touch a few bites of vegetables for a week or two, then supplementing with vitamin C within 100 mg per day can indeed help shorten the course of the cold. There is no need to kill all supplements at once. The key is to look at the actual needs of the child.

When my baby first started primary school, he had three consecutive fevers in the first month. There was a huge quarrel in the group of mothers. One group said, "As long as a child in the class catches a cold, the child should be taken off immediately. He must not be infected." I struggled with it for a long time, and then I tried a flexible approach: if the baby only had a runny nose and could run, jump, and eat well, he would be sent to kindergarten as normal. If the baby was coughing so much that he couldn't sleep well, and his head was droopy and he didn't even want to touch his favorite Ultraman, he would rest at home. After one semester, the number of times my child gets sick is actually less than that of a child who asks for leave whenever there is any trouble. Later, when I asked the child care doctor, they said that the immunity of young children is gradually improved through contact with common pathogens. As long as they are not serious infectious diseases such as hand, foot, and mouth, and norovirus, there is no need to raise the child in a sterile box.

Speaking of treatment, what impressed me the most was the time when my baby got rash. The fever lasted for three days and nights, reaching a maximum temperature of 39.9 degrees. My mother-in-law would always talk about covering the baby’s sweat and giving him anti-inflammatory drugs. I had done my homework in advance and knew that the rash in young children is caused by heat, so there is no need to take antibiotics. I asked a relative who is a traditional Chinese medicine practitioner. They said that if a child has cold hands and feet and is shivering when he has a fever, he can cover himself with a thin quilt for a while. When his hands and feet are hot and his whole body feels hot, he must loosen his clothes to dissipate the heat and don't cover it. At that time, I kept an eye on the baby's mental health. I used acetaminophen for those who were over 3 months old and ibuprofen for those who were over 6 months old. The dosage was calculated based on the baby's weight. After the fever subsided, he could play and drink water. I didn't go to the hospital. On the third day, the fever subsided and he had a rose-colored rash. Nothing happened. Of course, I have to make it clear that not all fevers can be treated at home. Babies under 3 months old must go to the hospital immediately if their fever exceeds 37.5 degrees Celsius. If the fever subsides or the baby is still wilted, breathing much faster than usual, or has a red rash that does not fade, don’t hesitate to go to the emergency room. This is the bottom line and cannot be touched.

Speaking of which, there is another interesting thing. Two pediatricians I met before, one is a pure evidence-based school, and the other is a combination of traditional Chinese and Western medicine. They argued for half an hour over whether children with colds should drink boiled green onion water, but in the end they couldn’t agree. To put it bluntly, as long as the child does not feel uncomfortable after drinking it, it is a good thing to drink more water. There is also the issue of whether to fast for diarrhea that was discussed in the group before. The old view is that the child should be hungry to rest the stomach. The current evidence-based view is that as long as the child can eat, give normal porridge and rotten noodles that are light and easy to digest, and do not give high sugar and oil. The first priority is to supplement oral rehydration salt III to avoid dehydration. My child had rotavirus diarrhea last time based on this. He did not fast, and he was completely fine in three days. He recovered faster than the first time he had diarrhea in one day. Of course, some Chinese medicine friends say that if the diarrhea is caused by food accumulation, one or two moderately hungry meals can indeed alleviate it. I think it is no problem. The key is to see if the child has an appetite.

After raising a baby for so long, my biggest feeling is that there is no 100% correct nursing formula. The "one trick to cure a child's fever" and "the secret recipe to never catch a cold again" posted on the Internet are basically gimmicks. Every child's body is different. What others use that works well may not apply to your baby. The most practical skill is actually to learn to observe the child's state. If he can play, laugh and chew chicken legs, don't panic even if the temperature reaches 39 degrees. If he doesn't even want to touch his favorite strawberries, he should give him more snacks even if the temperature is only 37.5 degrees. After all, as parents, we are not to be our children's "bulletproof vests" to keep out all germs, but to be his "safety valves" so that we can be stable when problems do arise and know when to wait and when to ask for help. That's enough.