Handbook on Prevention of Common Diseases in Children

Don’t buy hundreds of “immunity-enhancing” health care products, and do three things: “appropriate daily cleaning, get all age-appropriate vaccines, and eat and dress in accordance with your body type.” You can prevent more than 80% of common respiratory and digestive tract diseases in children. Even if the remaining 20% ​​are infected, the course of the disease can be significantly shortened and the risk of severe illness is reduced.

I have been doing pediatric health care for almost 8 years, and I have seen too many parents who make mistakes. The 3-year-old boy Bao Haohao who was treated last week is a typical example: the mother said that the whole family did not go out much for a whole month, and wiped the baby's hands with disinfectant wipes every day, and sprayed alcohol on the baby when he came in. As a result, he still got herpetic angina, and his mouth was full of sores for three days. The baby cried and couldn't eat. This is actually a common misunderstanding among many parents: they always think that the cleaner they are, the less likely they are to get sick. In fact, there have always been two parallel views in the academic community. One group advocates "sterile protection" and believes that all contact paths for germs should be cut off as much as possible. The other group supports the "hygiene hypothesis" and believes that moderate exposure to common microorganisms in the environment in early childhood can promote the development of the immune system and reduce the probability of allergies and asthma. The current clinical consensus is actually "moderate cleaning": daily washing of children's hands with running water and ordinary soap for more than 15 seconds is sufficient. There is no need to use disinfectant wipes or no-rinse disinfectant gel every time. There is no need to spray disinfectant at home every day. Only during the peak season of norovirus and influenza, or when someone in the family is sick, mopping the floor with chlorine-containing disinfectant is enough. The child's plastic toys are regularly scalded with boiling water for 5 minutes, and the plush toys are exposed to the sun for 3 hours. The disinfection effect is completely sufficient. You see, the children in the community who dig in the sand and step into puddles every day are less likely to get sick than the children who are held by their parents every day and are not allowed to touch this or that. It is really not a metaphysics, it is because their immune flora is well established.

Routine protection alone is actually not enough. To prevent those menacing infectious diseases, vaccines are the most cost-effective method. However, there are real differences in this area. Last time, a mother had an argument with her mother-in-law for 20 minutes in my clinic. The mother-in-law said that the second-category vaccines are made by hospitals for illicit money, and they can be given for free. The mother insisted on giving her baby a 13-price vaccine for pneumonia. I made a calculation for them at that time: the 13-valent pneumonia vaccine only costs more than a thousand for the whole course, but among the children with severe pneumonia admitted to the pediatric department every winter, 80% are children under 2 years old who have not received this vaccine. The cost of being admitted to the hospital is at least several thousand, and they have to suffer. The current consensus is that the first-category vaccine is required by the state. Without it, you can't go to school. The second-category vaccine is actually a supplement to the first-category vaccine. It covers diseases that are high in children and have a high risk of severe illness. If the family budget is enough, priority is given to 13-price pneumonia, five-part vaccine, hand, foot and mouth, influenza, and oral whorls. If the budget is limited, choose the vaccine with the highest incidence in the child's current age. For example, if children between 6 months and 3 years old have a lot of hand, foot, and mouth, and influenza, give these two first, which is better than doing nothing. Oh, by the way, you need to get the flu vaccine every year. Don’t think that if you got it last year, you won’t need it this year. The virus strains change every year, and the protection period is only 6-8 months.

After talking about external protection, let’s talk about the baby’s own foundation. There are more misunderstandings in this area. I meet at least 3 parents every day who ask me "Should I give lactoferrin/probiotics/spleen aminopeptides to their children to enhance their immunity?" I answer unanimously: Unless the child is diagnosed with iron deficiency, zinc deficiency or intestinal flora disorder, no supplements are useful. There is currently no evidence in evidence-based medicine to prove that these health products can improve children's immunity. Instead, some off-brand supplements are filled with messy ingredients, which will increase the burden on the liver and kidneys. Last month, a mother bought more than 3,000 yuan of lactoferrin for her baby. After taking it for three months, she still got the flu. In the end, it was not as strong as the baby next door who ran around downstairs every day. In fact, the old saying about raising a baby, "If you want to keep your baby safe, you need to be half hungry and cold" is really a truth that has been verified by generations of people. Don't chase after the baby to feed him. Eat a meal that is 70 to 80% full. Mix meat, eggs, vegetables and fruits with enough milk, which is better than taking any supplements. Don't wrap your baby in clothes that are thicker than those of your grandparents. Babies have a fast metabolism and sweat when they love to run and jump. When the clothes are wet with sweat, they will catch cold when the wind blows. If you touch the back of your baby's neck, it is just right. It is normal for your hands to be cold. Places exposed to the outside will not stay warm all the time.

Of course, there is no need to worry about your baby getting sick. Occasionally getting a common cold or rash in young children is actually the immune system fighting off monsters and upgrading. There are two extremes here. One is to run to the hospital as soon as you have a fever and go to the emergency room at two or three in the morning. It turns out that it was just a common cold but was cross-infected with the flu in the emergency room. The other is to carry it on. The baby has a fever for 3 days and is too exhausted to go to the hospital. In the end, it turns out to be pneumonia. Let me give you a practical standard: when your baby has a fever, as long as he can play, laugh, and eat, he should be observed at home first. If the temperature exceeds 38.5 degrees Celsius, take acetaminophen or ibuprofen, drink more water and rest. If the fever lasts for more than 24 hours, he is depressed, has severe vomiting, or has a rash, it is not too late to go to the hospital. Also, don’t give your baby antibiotics casually. Common colds are caused by viruses. Antibiotics cannot kill viruses. Only a blood test can confirm that it is a bacterial infection, and then take it under the guidance of a doctor.

I have been in this business for so many years, and my biggest feeling is that you don’t need to be too meticulous or too anxious when raising a baby. If you do these things well, it is much better than keeping an eye on whether the baby sneezes or coughs every day. The baby’s own immunity is much stronger than you think. Occasionally getting a minor illness is also the only way for him to grow up.