Experience on the prevention and treatment of common childhood diseases

There is no universal "prevention and treatment template" for common childhood diseases. The core principle is always that prevention is better than cure, with observation and care as the core and evidence-based medication as supplement, and resolutely avoid over-medical treatment. Rather than copying parenting strategies online, understanding your own children's body signals is the most useful "special medicine".

To be honest, I have seen too many parents panic when their children have a fever. The older generation said that it is better to cover the sweat and let it go. Some online popular science says that the fever must reach 38.5℃ before taking antipyretics. Some bloggers say that as long as the child is uncomfortable, it is okay to give antipyretic medicine at 38℃. Each has its own reasons, and there is no need to take sides. According to the latest "Evidence-Based Guidelines for the Diagnosis and Treatment of Certain Issues in Acute Fever of Unknown Cause in Children Aged 0 to 5 Years Old in China", it is indeed the priority to look at the mental state rather than the body temperature value: the 3-year-old child who was admitted last month had a fever of 39.2°C. He chased the nurse for cartoon stickers to play with, and gnawed an apple until it made a crunching sound. I just asked the parents to give more warm electrolyte water instead of rushing to give medicine. The fever went away on its own the next day. ； There is also a 2-year-old baby whose temperature is only 37.9°C. He wilted in his mother's arms and shed tears. He even pushed aside his favorite strawberries. So it is perfectly fine to give him some acetaminophen to relieve the discomfort. As for the controversy over physical cooling, there is no need to get entangled. Evidence-based medicine does not recommend alcohol baths or ice pack cold compresses to avoid irritating children's delicate skin. If the elderly at home are accustomed to using warm towels to wipe large blood vessels such as armpits and groins, there is no harm in giving it a try as long as the child does not resist.

Compared with menacing problems like fever, "irritating little problems" such as coughs and runny noses are the ones that test the mentality of parents the most. Many people take out cephalosporins and amoxicillin when their children cough. Some parents have heard people say that antibiotics are harmful to the body, and they still carry it when their children cough and wheeze. Both of these are considered extremes. The objective fact is that 90% of acute upper respiratory tract infections are caused by viruses, and antibiotics are of no use. However, if the child has a cough that does not improve for more than 7 days, or vomits yellow purulent sputum, or has a high fever that does not go away, and the blood test shows bacterial or mycoplasma infection, then the medication must be used for the full course of treatment, and do not force it. My child got mycoplasma pneumonia last winter. He coughed twice at first. I thought it was a common cold. He still had an intermittent fever for 3 days. When I went for a X-ray, he showed signs of mild pneumonia. After taking azithromycin for 3 days, he was jumping around without any infusion. ； I have encountered cases in the past where parents refused to take medicine. The child coughed until midnight and could not lie down. When he came to check for severe pneumonia, he had to stay in the hospital for a week. It was really not worth the gain. Oh, by the way, if a baby over 1 year old only has a dry cough and no other symptoms, drinking two sips of warm honey water is more effective than feeding a bunch of cough syrup. This is a method recommended by the WHO and has been personally tested to be effective.

Speaking of prevention, I also stepped into the trap of "over-cleaning" in the past two years. When my child first entered kindergarten, I stuffed his school bag with disposable disinfectant gel every day, and told him to wipe his hands after touching the slides and toys. I used disinfectant on the floor of the house every week. As a result, my child caught colds every day, and got infected at the slightest sign of trouble. On the contrary, the little boy in the same class was rolling around in the community every day, playing on the sand and rolling grass, and grandma didn't care. He didn't get sick a few times throughout the year. These are actually two directions that are highly controversial right now: One group advocates creating a sterile environment for children as much as possible to avoid contact with germs. ； Another school of thought, the "hygiene hypothesis," believes that children's appropriate exposure to microorganisms in the environment can help the immune system develop normally. My own experience is that I just need to stick to the bottom line of washing hands with running water before eating and after using the toilet, and washing my hands with running water after going out. There is no need to stop me from playing in the sand or touching leaves. Just don’t rub your eyes and touch your mouth directly after playing. Of course, when Norovirus and hand, foot and mouth are most common, you should go to closed indoor playgrounds less often, and change your coat promptly when you get home. Don’t go too extreme.

As for minor problems such as eczema and diarrhea, I have also accumulated a lot of practical experience: many parents avoid hormone ointments as soon as they see them, fearing that they will become dependent on them. In fact, weak hormone ointments such as desonide are very safe if used continuously for less than one week, and are much more reliable than indiscriminate use of folk ointments and "pure plant" ointments with unknown ingredients.； If your baby has diarrhea, don’t rush to give him anti-diarrheal medicine first. Add oral rehydration salt first to avoid dehydration. I have seen too many parents give their baby anti-diarrheal medicine, and the toxins cannot be expelled and cause high fever.

To be honest, my biggest feeling after raising children for so many years is that there is really no one-size-fits-all approach. Some children are born with thick skin, and it’s okay to sweat and get blown out of the wind when they go out to play in autumn and winter. Some children are born with allergies and get rashes when exposed to pollen. There is no need to copy other people’s experiences. Pay more attention to the little signs before your child gets sick, such as whether he suddenly rubs his eyes, has a worse appetite than usual, and sleeps tossing and turning. Drinking more warm water and adjusting his diet in advance is much more useful than panicking and checking for advice after he gets sick. If you are really unsure about your condition, it is much better to find a reliable doctor in time than to scare yourself by checking it on your mobile phone for a long time.