Experiences on the prevention and management of common childhood diseases

There is no "universal protection formula" suitable for all children. Prevention is better than cure is the core principle, but you don't need to be overly anxious. You can do layered protection based on your child's physical condition, and treat illness based on evidence and don't blindly believe in folk remedies. This is the most cost-effective solution.

Last winter, the door of the pediatric clinic was almost broken open by parents. Half of them were children with repeated colds, their little noses were red and their heads were hanging down in their parents' arms. The one who impressed me deeply was my best friend. Her baby just entered kindergarten. She came to check in almost every week during those two months. She followed the parenting bloggers and took a full set of protection: she must wear an N95 when going out, disinfect her whole body before returning home, take half a cup of Vitamin CC effervescent tablets every day, and was not even allowed to touch the slide in the community downstairs. As a result, the baby still got infected as soon as the temperature cooled down. In the end, she cried when she saw the mask and was unwilling to even leave the door. In fact, this is also a misunderstanding of many parents: they always think of putting their children in a sterile cover, but ignore the adaptability of different protection ideas.

At present, regarding the prevention of common childhood diseases, the two mainstream directions actually have their own reasons: evidence-based medicine emphasizes pathogen avoidance, giving priority to vaccination, good hand hygiene, and reducing exposure to confined spaces during high epidemic periods. This method is very effective for children with allergies and weak innate immunity. My second child had allergic rhinitis when he was a child, and he would die whenever he encountered pollen in the spring. He continued to sneeze and shed tears. At first, I heard people told him to close the window completely and not go out. As a result, the baby kept it at home for half a month, and caught a cold when exposed to the wind when he went out. Later, I adjusted the plan: wear an ordinary medical mask when going out, wash his nose and change his coat as soon as he comes home, take him for a half-hour run in an open park twice a week, and take vitamin D regularly. The number of rhinitis attacks has dropped by two-thirds in the past two years. The traditional Chinese medicine system focuses more on internal regulation. It is believed that the root cause of many recurring colds and fevers is a weak spleen and stomach and accumulation of internal heat due to food. This method is more effective for children who can usually eat and run, but have thick tongue coating, dry stools, and are prone to tonsil inflammation if they eat too much. , many parents around me have followed the advice of regular Chinese medicine practitioners to adjust their diets, giving their children less cold and sweet snacks, and eating only 70% full meals. The frequency of their children's illnesses has indeed dropped a lot. There is no need to argue about who is right and who is wrong. What is suitable for their children is the best.

Oh, by the way, there are still many parents who ask whether they should give their children health care products to improve immunity. My suggestion is: there is currently no evidence-based evidence to prove that high-priced products such as ordinary "immunity syrup" and "lactoferrin" can reduce the probability of illness. However, if the child is really picky about food and a blood test reveals that he is deficient in vitamin D, iron or zinc, it is useful to supplement as needed. Just don't kill him or pay an IQ tax.

Don't panic if your baby gets sick. I've seen too many parents rush to stuff antipyretics and feed antibiotics as soon as their baby's forehead feels hot. On the contrary, it's easy for them to do bad things with good intentions. There has always been a lot of controversy about the use of medication. The elderly always say "take medication as soon as possible to suppress the disease", and the evidence-based principle requires "if you can do it without medication, then don't use medication". In fact, the middle point is easy to grasp: I usually judge whether my child needs intervention and whether he should go to the hospital based on three points: whether his mental state is good and whether he can eat. If the baby cannot reach more than half of the usual volume and the amount of urine is significantly reduced, as long as these three standards are met, even if the fever reaches 38.5℃, physical cooling can be done first. If the baby has a fever of 38℃, he will be unable to open his eyes and even refuses to touch his favorite strawberry. Even if the temperature is not high, he should seek medical treatment immediately. I once treated a 5-year-old boy. The parents refused to take medicine for 4 days, saying that "antibiotics have side effects." The boy was eventually found to have bacterial pneumonia, and instead he was hospitalized for a week. Some parents gave the baby cephalosporins as soon as they saw a runny nose, and many ended up with diarrhea due to dysbiosis. There is no absolutely correct way to deal with it. Flexible judgment is much more important than sticking to standards.

Some parents have asked me before if they want to take their children to do "resistance massage". If you find a pediatric masseur from a regular hospital and the baby is not opposed to it, you can do it. It is absolutely fine as an auxiliary conditioning, but don't go to the small shops on the street that claim "one push will keep you from catching a cold for half a year." I just picked up a 3-year-old baby last month who was pushed and suffered subcutaneous bleeding in the back. It was so painful that I refused to touch it. It was too painful.

The longer I work in this business, the more I realize that raising children is really not a math problem, and there is no standard answer. You stare at the standard card indicators of parenting bloggers every day, comparing the height and weight today and the frequency of illness tomorrow. Instead, you might as well spend more time observing your own baby: whether eating too many mangoes will cause a rash, whether running and sweating without changing clothes in time will lead to a cold, whether eating meat for three days in a row will make the tongue coating thicker. These small details that only you know are more effective than 100 popular science articles. To be honest, children who grow up healthy and healthy are not born out of strict precautions. A little trouble is normal, and it is better to deal with it calmly than anything else.