Training content on prevention and management of common childhood diseases

There is no universal formula for the prevention and control of common childhood diseases. The core principle is "prevention first, hierarchical treatment, and individualized adaptation." There is no need to be overly anxious and rush to the hospital as soon as symptoms appear, nor can you insist on delaying treatment. All treatment plans must be adjusted based on the actual condition of the child, rather than standard guidelines.

I have been working in community child care for eight years. Every time I hold a training, I encounter a room full of parents holding up their mobile phones to take notes. Last time, a father wrote the words 38.5°C on his hand and said that he would give medicine as soon as the child's fever reaches this point. In fact, there is really no need to get hung up on this number. I have seen a 3-year-old baby running around the clinic area chasing balloons when the fever reached 39°C, and I have also seen a baby with a fever of 37.8°C that lay so weak in his mother’s arms that he couldn’t open his eyes. The latter could have been given antipyretics in advance instead of having to carry him until the temperature reached the temperature line. There has always been a great controversy about fever care. The mainstream of Western medicine is to wear less clothes to dissipate heat and not cover sweat to avoid febrile convulsions. However, there is also a school of traditional Chinese medicine in pediatrics that believes that if the fever is in the early stages of a cold and cold, and the child is shivering from the cold, it is completely appropriate to cover the child with a thin cover for a while, and then slowly reduce the clothes after sweating. There are clinically effective cases for both methods. The core is to observe whether the child is comfortable.

Oh, by the way, many parents tend to treat coughs as illnesses and rush to give them cough medicine as soon as they hear their babies cough. Last month, a grandmother came with her 2-year-old baby in her arms and said that after feeding her 2-year-old baby cough syrup for three days, the baby only coughed more violently and was wheezing. In fact, coughing is a protective reaction of the respiratory tract to discharge secretions. It is like having a "scavenger" in the throat. If you force it to stop, phlegm blocking the trachea can easily induce pneumonia. Regarding the use of cough medicines for children, the consensus at home and abroad is that over-the-counter cough medicines are not recommended for children under 6 years old. Drinking more warm water and spraying the nose with saline to dilute the secretions is more effective than taking medicine.

Let’s talk about the grandma who just gave me medicine indiscriminately. Her baby still had a constant problem of constipation. The grandma always said that eating more bananas would cure the problem. However, after only half a year of taking it, the baby only had a bowel movement every three or four days and cried every time. In fact, the dietary fiber content of ripe bananas is not as good as dragon fruit. If you buy unripe bananas, the tannic acid in them will actually aggravate constipation. Regarding the prevention of digestive tract problems, many parents have a blind spot: it is normal for children to have acute diarrhea 2-3 times a year, and there is no need to give antibiotics every time they have diarrhea. Here we also want to talk about different intervention ideas: Evidence-based medicine currently only confirms that two specific strains of Lactobacillus rhamnosus GG and Saccharomyces boulardii can help alleviate acute viral diarrhea. Whether daily consumption of ordinary probiotics can prevent diarrhea is not recommended by mainstream Western medicine for fear of disturbing the intestinal flora environment. ； However, the point of view of traditional Chinese medicine in child care is that for children who usually have a weak spleen and stomach and have diarrhea when eating cold things, taking some probiotics appropriately and combining with chiropractic adjustment can indeed reduce the frequency of the disease. You can choose based on the child's acceptance. There is no absolute right or wrong.

Don’t blame me for being verbose. I have to carry out hand hygiene repeatedly in every training. I am not just shouting slogans. Last month, three kindergartens in our jurisdiction conducted a comparison. The classes that required children to strictly follow the seven-step handwashing method before eating and after using the toilet had a 62% lower incidence rate of hand, foot, and mouth, and herpangina in the entire quarter than classes that did not impose mandatory requirements. This data was collected by us from door to door, and it is not empty words in books. There are also many parents who ask whether they should vaccinate their children at their own expense. To be honest, as long as the financial conditions permit, all the vaccines that can be vaccinated are available. My own child has just turned 4 years old and received all self-funded vaccines for pneumonia, pentavalent pneumonia, hand, foot and mouth, and influenza. Last winter, half of the children in the kindergarten got the flu, and his nose only lasted for two days.

Oh, by the way, there is another misunderstanding that must be mentioned: Don’t regard “the baby not getting sick” as the goal of raising a baby. A child's immune system is like a new employee who has just joined the job. It needs to constantly deal with germs and practice in order to upgrade. Under normal circumstances, it is completely normal for a child under 6 years old to have 6-8 colds and 2-3 diarrhea a year. On the contrary, a child who does not get sick all year round may have more severe symptoms once he does get sick. I have seen too many parents wear two layers of masks when going out and wipe the floor with disinfectant every day in order to prevent their children from getting sick. As a result, as soon as their children go to kindergarten, they take half a semester off to see a doctor because their immune system has never had a chance to "practice".

Finally, I would like to give you a general guideline. You don’t need to memorize any care guidelines. If your baby has the following conditions, don’t read popular science posts at home and go directly to the hospital: lack of energy for more than 24 hours, breathing much faster than usual, rash and fever, frequent vomiting, diarrhea and scant urine, headache and neck hardness that makes vomiting come out. We talk so much about prevention and home management, not to let you become a barefoot doctor, but to help you reduce unnecessary anxiety, and don't give medicines to your baby indiscriminately. When you are really unsure, it is better to find a professional than anything else.