Guidance on prevention of common childhood diseases

The core of prevention of common children's diseases has never been to prevent children from getting sick at all. Rather, it is to minimize the risk of serious illness through three practical directions: daily protection that is suitable for the age group, nutritional foundation that is suitable for the body's constitution, and scientific observation of the disease course, reducing unnecessary medication and medical visits, and helping children gradually build their own immunity barrier.

I have been working in a pediatric clinic for almost eight years, and I have seen the most anxious parents who want to keep their children in a "sterile cover": mop the floor with chlorine-containing disinfectant three times a day, rub public toys three times with no-rinse disinfectant gel as soon as their children touch them, and don't even dare to open the windows during the flu season. A mother complained to me before, saying that her baby had almost never been sick before he entered kindergarten at the age of 3. However, in the first month of kindergarten, he got bronchitis three times in a row. She cried and asked me if her baby had immunity problems. In the past few years, there was indeed a "comprehensive eradication" school of protection, which believed that cutting off all contact with pathogens as much as possible would reduce illness. However, in recent years, more and more clinical data show that the establishment of children's respiratory and intestinal flora requires moderate exposure to non-pathogenic microorganisms from the outside world. Excessive eradication will destroy the balance of the flora and make children more likely to get sick if they are exposed to even a little bit of pathogenic bacteria. Of course, this does not mean that you should not take any protection at all. For example, during the period when hand, foot, and mouth disease and noxious disease are most common, you should avoid going to crowded crowded places and wash your hands with the seven-step method before eating and after going to the toilet. It is enough to do these basic actions, and there is no need to put shackles on yourself and your baby.

Speaking of protection misunderstandings, in fact, there are many pitfalls in food. Last week I met a grandma who brought her 5-year-old grandson to see her for constipation. She said that she usually steams and heats fruits for her baby to eat, because she is afraid that eating them cold will cause diarrhea. As a result, the baby was not only constipated, but also had diarrhea twice that day after taking a sip of room-temperature yogurt in the kindergarten. Regarding "whether raw and cold food can induce gastrointestinal diseases in children", in fact, the views of Chinese and Western medicine have always been different: the core of Western medicine's judgment standard is whether the food is clean. As long as it has not deteriorated or been contaminated by germs, eating at room temperature or even a small amount of ice will not directly cause diarrhea. On the contrary, "excessive insulation" of the gastrointestinal tract for a long time will make the gastrointestinal tolerance very poor. ； Traditional Chinese medicine believes that children's spleen and stomach are delicate, and excessive raw and cold food will damage the spleen yang and easily cause food accumulation and diarrhea. In fact, both statements are not contradictory. The key point is not to go to extremes: don’t show off two or three popsicles to your baby as soon as summer comes, but there is no need to steam all room-temperature watermelons and oranges until they are soft and soft before giving them to your baby. Just adapt to your baby’s own tolerance.

Many parents also like to ask me whether they should buy lactoferrin and immune globulin supplements for their children, which cost several hundred yuan a jar, saying that they can prevent colds. Let’s be honest here: At the current level of evidence-based medicine, there is no large-scale clinical data that can prove that this type of supplement can clearly improve children’s immunity. To put it bluntly, if you spend thousands to buy a year’s worth of supplements, you might as well straighten out your child’s daily diet: ensure 300-500ml of milk, an egg, about 100g of lean meat or fish and shrimp every day, plus half a pound of dark green vegetables. The high-quality protein, vitamins and trace elements in these foods are the true foundation of immunity. Of course, if your child is really picky about food and cannot even eat a few bites of vegetables for half a month, then under the guidance of a pediatrician or child care doctor, it is no problem to take appropriate supplements of multivitamins, iron and zinc supplements. You don’t have to listen to others who say that “supplements are all IQ taxes” and reject them all.

As for the response after getting sick, it is an important part of prevention - don't think that prevention has nothing to do with getting sick. Wrong response will make the baby get sick repeatedly and even cause unnecessary side effects. Many parents feel weak in their legs when they see their baby has a fever, and run to the hospital as soon as the fever reaches 37.5. In fact, it is completely unnecessary. A father came to the emergency room with his baby in the middle of the night. The baby had a fever of 39.2 degrees Celsius, but he was still nibbling cookies in his arms and was in great spirits. I checked the blood test and found out that it was just a common viral cold, so I asked him to take antipyretics home for observation and give him plenty of water. The fever went away on the third day and he developed a rash all over his body. It was a common childhood rash. If he was rushed to infuse antibiotics at that time, it would not be good for the baby's health. Of course, we don’t want everyone to carry it. If your child is listless, has a headache, has projectile vomiting, has a significantly faster breathing rate, or has unexplained petechiae or rashes on his body when he has a fever, no matter how high the fever is, he should come to the hospital immediately. Don’t delay things by carrying it.

In fact, my own child, who is 4 years old this year, also suffered from the flu twice last year. The fever lasted three days before it went away. At that time, I also stayed up for two nights without sleeping. There is no magical way to raise a baby without getting sick. The essence of our prevention is not to fight against the germs and drive them away, but to help the baby lay a good foundation for the body. Even if he does get sick, he will know how to judge the severity and avoid detours. You see, those children who grow up running, jumping, crawling and rolling are less likely to get sick than children who stay at home every day and dare not touch anything. To put it bluntly, this is the truth - immunity is developed, not prevented.