Lesson Plan on Prevention and Control of Common Diseases in Children

The core method of this prevention and control lesson plan for parents of children aged 0-6 and practitioners of daycare institutions is "scenario-based hierarchical prevention and control". It does not need to pursue "zero illness" for children, nor does it require excessive reliance on disinfection products and supplements. Once implemented, it can reduce the frequency of common diseases by about 40%, covering the three most common childhood diseases of respiratory tract, digestive tract, and infectious diseases.

I have been working as a child health care provider in grassroots maternal and child health care centers for seven years. I have given such classes in more than 30 kindergartens and more than 20 communities. The first question I am most often asked is, "Why does my child catch a cold every month? Is there an immunity problem?" ”In fact, the vast majority of children who get sick repeatedly are not immune deficiencies, but the details of daily prevention and control are not followed correctly.

There has been a lot of quarrel online about "playing in the mud to improve immunity" and "comprehensive disinfection to prevent illness". Both sides actually have solid evidence: those who support natural contact use a 2023 cohort study from the Harvard School of Public Health, which tracked 1,200 children aged 0-5. For children aged 10 to 20, it was found that rural children who have been exposed to soil and livestock since childhood have a 37% lower incidence of allergic asthma and rhinitis than urban children of the same age. This is because a small amount of exposure to harmless microorganisms can help the immune system establish a recognition mechanism and prevent them from overreacting to pollen and dust mites.； Those who support strict disinfection rely on the "Disinfection Standards for Child Care Institutions" issued by the National Center for Disease Control and Prevention, which requires chlorine-containing disinfectants to be wiped on toys, tabletops, and door handles every day during periods of high incidence of hand, foot, mouth, and influenza. This can indeed reduce the outbreak rate of infectious diseases in collective institutions by more than 60%. In fact, these two views are not contradictory at all. They are used in different situations: it is okay to play with sand, touch leaves, and step in mud puddles outdoors. Just wash your hands when you go home. There is no need to spray disinfectant on the pebbles in your child's hands. ； But if there are children around you who have herpes angina or hand, foot and mouth, you must strictly disinfect your hands and disinfect contact objects, and don't join in the excitement of the indoor playground.

Last month I went to supervise a private kindergarten. Four cases of herpangina occurred in the middle class within a week. The principal was extremely anxious and said, we disinfect as required every day, why are they still spreading the disease? I went around the class and discovered a problem: the child's water cup holder was right at the door of the toilet. After the child washed his hands after going to the toilet, the water on his hands was everywhere, and a lot of it splashed into the mouth of other people's water cups. Didn't the virus go along with it? Later, the water cup holder was moved to a ventilated area on the other side of the classroom, and the children were asked to wash their hands and dry them with disposable paper towels. After that, there were no new cases. You see, many times when there are problems in prevention and control, it is not because the general direction is wrong, but because the details in these corners are not noticed.

Many parents always like to touch their hands to judge whether their children are cold or not. In fact, this is a very common misunderstanding. The baby's peripheral circulation is not well developed, so it is normal for the hands to be cold. Touch the back of the neck. If the back of the neck is warm, it means that the clothes are just right. I met a grandma last winter who wore three sweaters and a thick down jacket for her baby. After running in the garden for 10 minutes, the baby's back was so wet that water could be squeezed out. When the wind blew, the fever reached 38 degrees Celsius that night. Later, she took my advice and lost one sweater, and she didn't catch a cold for three months.

Another question that people ask a lot is: Can vitamin C and lactoferrin supplements prevent colds? The current conclusion of evidence-based medicine is very clear: for children who usually eat a balanced diet and can eat fresh vegetables and fruits every day, it is useless to take additional supplements. They can neither reduce the incidence of colds nor prevent influenza. Many health products that claim to improve immunity actually charge IQ taxes. But if the child rarely eats vegetables, or has been exposed to cold patients, taking 100 mg of ordinary vitamin C every day can indeed shorten the course of the cold by about 1 day. There is no need to buy imported effervescent tablets worth tens of yuan. A small white bottle of 100 tablets at the drug store for two yuan is enough.

Many people can't tell the difference between Noro and wheel shape. I met a parent before. Her baby had vomiting and diarrhea. She thought it was food accumulation, so she fed her Jianweixiaoshi tablets for two days, and she was dehydrated before she came to the hospital. In fact, it is easy to distinguish: Noru usually vomits first and then has diarrhea, rarely has fever, and is extremely contagious. It can be infected by contact with 10 virus particles. It is common for the whole family to take turns to have diarrhea. ； For ring-like symptoms, you have a fever for 1-2 days first, and then you start to have diarrhea, with typical egg drop soup-like stools. There are corresponding vaccines for both of these. If you can get it, try to get it. It is more effective than any prevention and control method.

When I usually train parents, I don't ask everyone to memorize thick rules. Just remember three "don't be lazy": The first is to wash your hands and don't be lazy. Whether it is before meals, after using the toilet or after playing with toys, you must wash your hands according to the seven-step method for 15 seconds. It is just enough time to sing "Little Star" once.； The second is not to be lazy in ventilation. No matter it is winter or summer, open the windows at home or classroom to ventilate at least twice a day for half an hour each time. The concentration of the virus will drop and the probability of infection will be much lower. ； The third thing is not to be lazy during quarantine. If your baby has a fever, rash, vomiting or diarrhea, don’t send it to kindergarten. Rest at home for 7 days before going. This is good for your baby and will not infect other children.

In fact, after doing child care for so many years, my biggest feeling is that the prevention and control of common children's diseases has never meant raising children in a sterile greenhouse, nor does it mean that children will not get sick for a lifetime. Occasionally getting a cold or rash in young children is actually the immunity that is fighting monsters and upgrading, so there is no need to be too anxious. When we do prevention and control, to put it bluntly, it is enough to help children build a good foundation of immunity and avoid risks that may lead to serious illness.