Prevention and care of common childhood diseases

The optimal prevention and care logic for common children's diseases is actually to "prioritize the basic prevention and control of living habits, classify the disease first and then provide symptomatic care after it occurs, and do not blindly use medication or over-medicalize." There is no universal formula that is universally applicable, and it must be flexibly adjusted based on the child's individual constitution.

Last week, I went to the Children's Research Institute to meet an old classmate for dinner. It happened to coincide with the high incidence of respiratory infections in autumn. The infusion area was full of people. Many parents held their babies with red faces. As soon as they entered the clinic, they asked, "Can I prescribe some antibiotics?" Can I give an infusion to quickly reduce the fever? ”It makes people anxious and helpless.

I have been working in pediatric nursing for 12 years, and I have seen too many parents get confused when their children are sick, and even forget the most basic nursing knowledge. Take the most common fever as an example. Many people always think that they need to take medicine when the fever reaches 38°C. In fact, according to the standards of Western medicine, acetaminophen should be used when the armpit temperature exceeds 38.5°C for babies over 3 months old. Ibuprofen can be used for babies over 6 months old. If the temperature is lower than this, physical cooling should be prioritized. Just put antipyretic patches on the neck, armpits, and groin with warm water. There is no need to mess around.

Regarding whether you should cover your sweat when you have a fever, Chinese and Western medicine have always had different opinions: Western medicine believes that covering your sweat during high fever will affect heat dissipation and even induce febrile convulsions, which is absolutely prohibited.； However, many traditional Chinese medicine doctors and experienced elderly people will say that if it is the early stage of a cold and cold and the child is cold all over, with cold hands and feet, and is shivering, it is appropriate to cover the child with a thin blanket for a while. When the child is sweating and the hands and feet are warm, the child can be removed in time to dissipate heat, which can shorten the course of the disease. Both statements are actually correct. The core is to distinguish which stage of fever the child is in, and cannot generalize. Last year, I treated a 3-year-old boy. As soon as his mother found out that he had a fever, he wrapped him in two layers of thick quilts. The temperature reached 39.8 degrees Celsius and he convulsed. His lips were purple when he was sent to the emergency room. Later, I repeatedly emphasized to her every time I did a follow-up visit. When the baby's body temperature rises, he should cover himself with a thin blanket. Once his hands and feet warm up and the body temperature reaches a stable period, he must immediately loosen the blanket to dissipate heat. Later, the baby had no problem if he had a fever again.

Oh, by the way, there is another pitfall that parents are particularly likely to fall into, which is to rush to stop the cough whenever their child coughs. The U.S. FDA clearly does not recommend that children under 4 years old take over-the-counter cough medicines. Coughing is a self-protective response of the body to expel phlegm. Forcibly suppressing a cough will block phlegm in the respiratory tract, which can easily induce pneumonia. However, many clinicians believe that if a child coughs and cannot sleep for two or three days in a row, or even coughs to the point of vomiting, it is not a bad idea to use some mild cough medicine to relieve the symptoms, without having to bear the burden completely. For babies over 1 year old who usually have a slight cough, drinking two sips of warm honey water is more effective than any cough syrup. Pat the back with hollow palms from bottom to top to help him expel phlegm. The cough will be better by itself in three to five days. There is no need to run to the hospital as soon as he coughs.

If your baby's fever suddenly subsides after three or four days, and a small light red rash appears on his body, don't panic. It's an acute rash in young children. Our department often says, "When the fever subsides and the rash appears, it's nothing." There is no need to apply medicine or dietary restrictions. The rash will go away on its own in two days. Don't blindly apply hormonal ointments to the baby.

Speaking of which, I remembered that a mother brought her baby for a follow-up consultation last month. She said that her baby caught a cold and contracted diarrhea just two days later. Her buttocks were so red that she cried when she touched them. This is also a problem that occurs frequently after autumn. The core of diarrhea care is never to stop diarrhea, but to prevent dehydration. Western medicine first recommends oral rehydration salt III, which should be mixed in a small amount and fed multiple times in proportion to avoid electrolyte imbalance. It can be combined with probiotics and montmorillonite powder. No fasting is required. Light porridge or noodles can be given to the baby if he wants to. However, there are also schools of traditional Chinese medicine that believe that if the baby has diarrhea due to overeating, the baby's mouth will have a sour smell, and the stools will be ridiculously smelly, a proper meal or two to empty the stomach will help the baby get better faster. As for whether to avoid cold or raw food, it also depends on the baby's constitution: if a baby usually drinks cold yogurt and is fine, it is perfectly fine if a baby wants to eat some steamed apples at room temperature during diarrhea. ； Children who usually have diarrhea when exposed to cold food must drink warm food obediently. Don't do this. When my baby got whorls last year, he refused to drink the rehydration salt because of the weird taste. My mother-in-law tried adding a little salt to the boiled millet oil. He actually drank half a bowl while holding the bowl. He didn't become dehydrated after drinking it for two days. He gradually got better on his own. Sometimes the old method is not necessarily wrong.

After all, prevention is really much less worrying than staying up all night to take care of yourself after you get sick. When I do missionary work in the community, I always tell parents, don’t always pay the IQ tax to buy those health care products and probiotics that claim to “increase immunity”, they are useless. Your child's immunity is like a training ground. If you usually let him run outdoors for two hours a day to bask in the sun, eat a little more miscellaneous meals, including fine white rice and flour every meal, and a balanced mix of meat, eggs, milk and vegetables, it will be more effective than taking any supplements.

As for whether to use no-rinse disinfectant gel for children and whether to mop the floor with disinfectant every day at home, there has been a lot of controversy in the past two years: one group believes that we should disinfect frequently to keep viruses out.； The other group believes that an environment that is too clean will make the baby's immune cells "unable to fight", making it easier for children to become allergic and sick. In fact, there is no need to go to extremes. Washing hands with running water and soap is enough when you go out and go home. If you go to crowded places such as hospitals and amusement parks, you can use no-rinse gel to disinfect. At home, you can just mop the floor with clean water. There is no need to spray disinfectant every day. Getting some normal flora on your hands can actually help your child develop a stronger immunity.

In fact, there is no standard answer when it comes to raising babies. I have been working for so many years, and I have seen sensitive babies who catch a cold even if they blow a little wind, and I have also seen skinny babies who can chew popsicles in the middle of winter without any problems. Don’t always follow the standard answers on the Internet. Observe your own baby’s reactions more than anything else. If you are really unsure and your baby's mental state is particularly bad, go directly to the hospital to see a doctor instead of blindly giving medicine to your baby. It's safer than anything else.