Prevention and management of common childhood diseases

The prevention and management of common childhood diseases are not as complex as those posted on the Internet. The core logic is simply 7 points for daily protection, 2 points for graded response, and 1 point for individualized adjustment and adaptation. This is the most practical principle that I have summarized after 8 years of experience in pediatric clinical practice and combined with the follow-up data of thousands of families. There is no pretentiousness. If you follow it, you can help your child avoid more than 80% of unnecessary pain and the trouble of running to the hospital.

I met an old neighbor a while ago. Her baby had just started kindergarten and had three consecutive fevers in the first month. Her tonsils were swollen like two round peaches. She was holding her baby in the emergency corridor and wiping her tears. She asked whether she had not given the baby enough vitamins and whether she should take gamma globulin. In fact, it's not the case at all. She has arranged all kinds of expensive nutritional supplements for her baby, but she has not developed the habit of washing hands before entering the house and wiping the table before eating. When her baby comes home from school, she grabs the biscuits and stuffs them into her mouth. She has eaten all the germs she brought back from kindergarten. It would be strange if she doesn't get sick.

When it comes to hand washing, there are actually two opinions in the industry. Colleagues in the Department of Infectious Diseases recommend washing hands with running water and soap for 15 seconds every time, especially after coming into contact with public toys or going to the hospital. No-rinse disinfectant gel is completely useless against non-enveloped viruses such as norovirus and hand, foot and mouth. Rubbing it just for a while is useless.； However, some doctor friends who care for children think that when you are playing in the suburbs with your children and cannot find a faucet, it is okay to use 75% alcohol-free gel that meets the national standard for emergency use. It is better than eating with dusty hands. My own experience with taking my children out is that I try to wash them with running water at home and in kindergartens. You can prepare disposables when going out. However, after playing in the sand or touching public handrails in scenic spots, you should try to find a nearby convenience store or public toilet to flush your hands. Don’t bother with those two minutes.

Oh, by the way, there are still many parents asking whether they should give their children probiotics and lactoferrin to improve immunity. This controversy is bigger than washing hands. According to the evidence-based evidence of Western medicine, no health care product has been proven to clearly improve children's immunity. On the contrary, many imported supplements contain excessive additives and sweeteners. Eating too much will increase the metabolic burden on the liver and kidneys. ； However, colleagues in the Department of Traditional Chinese Medicine will recommend that children with weak spleen and stomach who often suffer from food and diarrhea should eat steamed yam and stir-fried Poria cocos, which are the same medicinal and food ingredients, to slowly regulate the spleen and stomach. Many children I followed up after eating this for three or four months have indeed reduced the frequency of illness. My general advice to parents is not to buy so-called "immunity miracle medicine" that costs hundreds of dollars per jar. First, give your child a balanced meal three meals a day, and give them less high-sugar puffed snacks and ice drinks. They are more effective than any supplement.

Don’t panic if you are really sick. Don’t rush to the emergency room as soon as you see the thermometer soar to 38 degrees. Last month, I met a father in the outpatient clinic. His baby had a fever of 39.2 degrees. When he entered the clinic, he held up Ultraman and showed me how to fight the little monsters. He was so energetic that he insisted on me prescribing an infusion because he was afraid the fever would make him crazy. In fact, if a baby over 3 months old has a fever, as long as he is in a normal mental state and can eat and play, he can be observed at home first. If the body temperature exceeds 38.5 degrees, he should take ibuprofen or acetaminophen according to the dosage, and just replenish water. There are also different treatment ideas here: Western medicine generally does not recommend physical cooling, especially rubbing the body with alcohol, which can easily lead to alcohol poisoning absorbed by the baby's skin. ； However, many parents have reported that wiping their children’s neck and armpits with a warm towel when they first have a fever can indeed make them feel more comfortable. As long as the baby doesn’t resist, there is no need to completely prohibit it. The key is to look at the baby’s condition, rather than staring at the number on the thermometer. But remember a red line that everyone recognizes: as long as a baby under 3 months old has a fever exceeding 37.5 degrees, regardless of whether he is in good spirits or not, he must be sent to the doctor immediately. Don’t carry it at home. There is no room for negotiation.

The most easily overlooked thing is actually the 1-point individualized adjustment. I often tell parents that raising a child is not about taking standardized test questions, and other people’s experiences may not apply to your child. For example, my cousin's child has allergies. When he went for a run in the park in the spring, he got rhinitis and sneezed non-stop. Other parents said that more contact with nature can improve immunity, so she took the child to a botanical garden with a lot of pollen for an afternoon. As a result, the child coughed for half a month before he recovered, but it hurt his body. Babies with allergies, premature babies, and babies with weak spleen and stomach must have stricter protection standards than ordinary babies. If your baby gets diarrhea after eating popsicles that other people can eat, don’t give them to them. If others can stay up until 10 o’clock, your baby will catch a cold if he stays up late. , then go to bed on time at 9 o'clock every day, just like growing flowers. If you water a cactus every day, the roots will rot, and if you don't water the pothos for half a month, it will wither. Finding the right rhythm for your own children is much better than following the strategies of Internet celebrities.

In fact, after working in pediatrics for so many years, my biggest feeling is that the prevention and management of common childhood diseases has never meant raising babies in sterile glass covers, nor does it require parents to become half-doctors. Pay more attention to trivial details at ordinary times. If you are really sick, don't mess up. Pay more attention to your baby's condition and be less anxious. Your baby will be happy and jumping, which is better than anything else.