Experience on the prevention and management of common childhood diseases

Prevention always takes precedence over cure. There is no unified standard plan that applies to all children. The most effective principle is "graded response, individualized adjustment, neither blind over-medical treatment, nor forcing the disease to become severe."

To be honest, when I first entered the industry, I memorized a lot of standardized nursing guidelines. I wanted to print out a "universal table for common childhood diseases" for all parents. It was not until I raised my own children and saw thousands of cases in the outpatient clinic that I knew there was no universal formula. A while ago, I encountered two extreme parents in the emergency room: a baby had just had a fever of 37.8°C. She rushed in with her baby in her arms and asked for cephalosporins, saying she was afraid of pneumonia. ； Another baby had been suffering from fever for 3 days and was sent to the hospital after having one stroke. The question was, "Online said that carrying a fever can improve immunity."

In fact, there are a lot of debates about common childhood diseases on the Internet. One group says, "If you have symptoms, go to the hospital immediately and don't delay things by messing around." The other group says, "It's medicine that contains three parts of poison. If you can't help it, don't take it. It's better to rely on your immunity to deal with it." Both sides actually make sense, and the core thing is that it depends on the situation. Take prevention as an example. I used to be superstitious about "taking 100 mg of vitamin C every day to prevent colds" and "wiping all furniture and toys with chlorine-containing disinfectant every day". I even didn't let my children touch the public slides in the community. What's the result? When my child was two years old, I detoxified him for a month, so I took him downstairs to play on the slide for half an hour. When he came back, he was still infected with herpetic angina and had a fever for three days.

Later, I read a lot of information and talked with the TCM pediatrician in the hospital, and I discovered that the views of different systems are actually interoperable: the evidence-based view of Western medicine is that there is no need to over-sterilize the home environment. Normal environmental flora can help children build an immune barrier. As long as they eat a balanced diet, ensure more than 2 hours of outdoor activities every day, and get vaccinated on time, more than 80% of the risks of common diseases can be avoided.； The traditional Chinese medicine pediatricians often say, "To keep children safe, they must be hungry and cold." The essence is to remind children not to overfeed or dress them too thickly. On the contrary, they are prone to food accumulation, internal heat, and colds when they blow the wind. Don't tell me, I later adjusted the way I took care of my baby. I replaced the disinfectant with ordinary baby detergent. I also allowed him to touch public toys and wash his hands before eating. I stopped feeding him until he was eighty percent full every time he ate. In the winter, he only had to wear one more coat than me. In the past year, the number of colds and fevers he had has been reduced by half.

As for the management after illness, I have gone through more pitfalls. The child had diarrhea for the first time when he was just one year old. I heard the old man said that he had to eat several times on an empty stomach. However, within 12 hours, the child had oliguria and dry lips. He went to the hospital to check that he was mildly dehydrated. After being scolded by the doctor, I learned that whether it is viral or bacterial diarrhea, the first priority is to replenish oral rehydration salt III. As long as the child is willing to eat, he can eat light porridge and steamed apples, and there is no need to fast. Later I found out that the "steamed apples to stop diarrhea" mentioned by the old man were really not a folk trick. The ripe pectin in the steamed apples does have the effect of astringing the intestines, and it does not conflict with the nursing principles of Western medicine.

There is also the much-discussed question of "will a fever make you stupid?" My own experience is that ordinary infectious fevers below 41°C will not cause damage to a child's brain, unless the fever is caused by a central nervous system infection, which may have sequelae. But we can’t stick to the standard of “take antipyretics at 38.5°C”. I have seen babies with a history of febrile seizures who had seizures when the fever reached 38°C. In this case, the medication threshold should be relaxed, and even antipyretics should be taken in advance to prevent it. This is what I call “individualized adjustment”. The experience of others can only be used as a reference. The state of your own child is the most accurate. If the fever reaches 39°C and you can still run, jump, and eat and drink, you can observe physical cooling at home. ； If your fever reaches 38°C and you become unable to open your eyes, vomit frequently, or have shortness of breath, don’t hesitate to go to the hospital immediately.

When I do science popularization for parents now, I never give them any "ten rules that must be followed." The longer I do this, the more I realize that children's bodies are stronger and more delicate than we thought, so we don't need to be wary of everything, and we can't be careless. If you ask me if I have any most practical advice, it’s actually just one: spend more time with your baby, and you will naturally know what is normal and what is wrong with him. This is more useful than memorizing 100 guides.