Prevention and management of common childhood diseases

The core of the prevention and management of common childhood diseases has never been to "prevent children from getting sick at all", but to reduce the probability of infection and the risk of severe illness through scientific and layered protection methods, while using correct home care methods to shorten the course of the disease and minimize the pain of the child and the cost of care for the entire family.

I just told this to a mother who came for consultation last week. Her baby had just started a small class and had already had fever twice in the first 10 days of school. She was so anxious that she even quit work and just stared at the baby's temperature, wishing she could weld the baby at home and not go out. In fact, our pediatricians often say that 6-8 upper respiratory tract infections a year for children in kindergarten are within the normal range. There is really no need to deny yourself just because your child gets sick twice. Nowadays, the opinions on child protection on the Internet are completely divided into two extremes. One group is a "disinfection party" that is meticulous to the core: turn on ultraviolet lights at home every day, children must wear N95 when going out, spray no-rinse disinfectant gel on everything after touching it, and even hang coats outside the door for half an hour when they return home for disinfection. ； The other group is the "rough care group" who are completely resigned. They say that sooner or later they will be infected anyway, so it is better to actively contact the virus to build up antibodies. There are even parents who deliberately take their children to the "Influenza Bureau" and "Hand, Foot and Mouth Bureau" to seek infection. Both of these approaches actually went astray: I treated a 5-year-old girl before. She was never allowed to touch the soil at home. When she went to the park to sit on a bench, she had to put three layers of disinfectant towels on her. As a result, she contracted hand, foot and mouth after touching a public slide during her first spring outing in elementary school. She had a high fever that did not go away for 4 days, and her symptoms were much more severe than those of a rough baby who usually rolls around on the floor. ； Last winter, I also took in a child who took the initiative to join the flu bureau. He was fine at first, but ended up with a fever and pneumonia, and spent a week in the ICU. The parents regretted that their intestines were blue.

In fact, the baby's immune system is like the operating system of a new mobile phone. You have to let it receive different weak virus signals so that it can be continuously patched and upgraded. If you put it in a sterile box every day, it will be directly infected by the virus and crash when connected to the Internet, which will be more troublesome. For daily protection, just "keep key parts safe and let go of other places": wash your hands carefully before meals, after using the toilet, and when you come home from outside, wear a mask when going to hospitals and crowded closed places, and run in the park when you need to, and play in the sand when you need to. There is really no need to overdo it.

Oh, by the way, there is another pitfall that many parents easily fall into, which is that the prevention of digestive tract diseases is always inadequate. Everyone knows that we should wash our hands frequently, but few people actually wash their hands for 15 seconds. Last time, a grandmother brought her Denoro baby to the doctor and said that she washes her hands every time she comes back from going out. When I asked, I found out that what she meant by washing her hands was washing her hands for 3 seconds. Just apply soap and rinse, which is equivalent to washing in vain. As for whether to give your baby probiotics to prevent diarrhea, there is currently no unified conclusion in the academic community: Most European and American guidelines do not recommend that healthy children take probiotics to prevent digestive tract diseases. Some colleagues in the domestic gastroenterology department will suggest that if your baby is going to a crowded place in the near future, or if you want to travel far away to change the environment, you can take ordinary bifidobacteria probiotics 3 days in advance. You don’t need to buy imported health products that cost hundreds of dollars. A small box of OTC products in pharmacies is enough.

There are even more controversies about symptom management. The most common one is when to take antipyretics when you have a fever. Many people stick to the 38.5°C line and never give medicine until the temperature reaches 37.5°C. Others quickly feed Motrin as soon as their body temperature exceeds 37.5°C. Neither approach is necessary. The last time my baby had a fever, it was 38.2°C and he was so weak that he didn’t even want to watch his favorite Peppa Pig cartoon. I gave him antipyretics directly before the fever reached 38.5°C.℃ ； On the other hand, if the baby has a fever of 38.8℃ and is still jumping around on the ground to play with building blocks, you can give him some warm water electrolytes first, wipe the neck and armpits with warm water, and observe him for half an hour. There is really no need to rush to give medicine. There is another cliché: don’t give your baby antibiotics when he catches a cold. 90% of upper respiratory tract infections are caused by viruses. Antibiotics are useless against viruses. Instead, they will destroy the baby’s intestinal flora. Unless a blood test is done to confirm bacterial infection, don’t eat them randomly.

Oh, yes, there is also the question of vitamin D supplementation, which has been asked by many parents recently. Some guidelines say that supplementation is enough until the age of 2, some say that supplementation is required until adolescence, and others say that as long as the sun is enough, there is no need to supplement. In fact, there is really no need to worry about it. If your child seldom goes out to bask in the sun and is picky about food and doesn’t like to drink milk, then there is no harm in supplementing it until he is in elementary school. ； As long as the child runs outside for two or three hours every day and eats a balanced diet, it will be no problem if he stops after the age of 2. There is no standard answer that must be followed.

To put it bluntly, there is no way to raise a baby without getting sick. Don’t pursue zero infection, and don’t lie down and do nothing. Pay more attention to your baby’s condition and slowly figure out your baby’s physical condition - some babies have diarrhea when they eat something cold, and some babies don’t catch a cold even after playing crazy and sweating. These individual differences are much more useful than the general standards on the Internet. If you are really unsure about your baby's condition, don't frighten yourself by searching online. Go directly to a regular hospital to see a pediatrician, which is more reliable than anything else.