Guide to prevention and treatment of common childhood diseases

80%-90% of children have common problems such as fever, colds, diarrhea, and rashes. There is no need to rush to the emergency room as soon as possible. They can be cured by standard home care and symptomatic medication. Wrong covering sweat, taking antibiotics indiscriminately, and force-feeding medicines are more harmful to the baby than the disease itself.

I have been in the pediatric clinic for almost 7 years. Last week, I met a mother who came to the emergency department in the middle of the night with her 3-year-old baby. The baby had a fever of 38.8 degrees Celsius and was still in good spirits. She waited in line for 3 hours. By the time we got to the clinic, the fever had mostly subsided and the baby was running around with toys. In the end, the doctor only prescribed a box of ibuprofen and sent him home for observation. The mother was still worried and asked if she wanted a chest X-ray and a routine blood test. It made me laugh and cry.

Regarding fever, there are indeed two mainstream ways of dealing with it: Evidence-based medicine recommends that babies over 3 months old take acetaminophen according to dosage if their body temperature exceeds 38.5°C and are not in good spirits. Ibuprofen can be used for babies over 6 months old. The purpose is to relieve the discomfort of the baby, not to force the body temperature to normal.； Most schools of traditional Chinese medicine believe that if the baby can run, jump, eat and sleep below 39°C, there is no need to rush to reduce the fever. This is a normal response of the immune system to fight the virus. Forcibly reducing the fever will disrupt the immune rhythm. There is no absolute right or wrong between these two ideas. The core judgment criterion is always the child's mental state, not the number on the thermometer. Don’t believe in the old trick of covering up sweat to reduce fever. Last winter, I saw a grandmother who wrapped her feverish baby in three layers of quilts. When she came in, the baby was already convulsing. She just covered it too tightly and the heat couldn’t escape. So be careful. Also, when having febrile convulsions, don't pinch the child or put chopsticks or spoons in the mouth. Turn the baby sideways and lie flat to prevent vomitus from choking into the trachea. Most of the time, the baby will recover on its own in 1-2 minutes. If the seizure lasts for more than 5 minutes, just give 120 degrees.

What makes parents more depressed than having a fever is most likely acute diarrhea involving vomiting and diarrhea. Many parents rush to give antidiarrheal medicine when they see the baby's water. In fact, whether diarrhea is caused by rotavirus or norovirus, the body is expelling viruses in essence. If you use antidiarrheal medicine right after diarrhea, the accumulation of toxins in the intestines can easily cause abdominal distension and toxic encephalopathy, which is not worth the gain. At present, there is no unified "standard answer" for diarrhea care: some doctors advocate that as long as you are not dehydrated, you can just drink oral rehydration salt III without taking any medicine. ； Some people recommend adding some probiotics to regulate intestinal flora. ； Some Chinese medicine doctors will prescribe belly button patching and massage. As long as the baby can drink water, the urine output is not significantly reduced, and the energy is not bad, all of these methods can be used. There is no need to worry about which is the "most scientific". Previously, my neighbor's baby had diarrhea and had diarrhea for 4 days. She read the popular science on the Internet and said that probiotics are useless, so she refused to give it to the baby. As a result, the baby's intestinal flora was disordered and the baby had diarrhea on and off for almost 20 days. After a week of supplementation with probiotics, it was cured. It really doesn't need to be too extreme. By the way, there is no need to completely avoid food during diarrhea. You can give your child steamed apples or boiled noodles if he wants, as long as they are not too oily or sweet. The so-called "diarrhea cannot eat eggs or drink milk." Unless the child is allergic to these things, it is really unnecessary. Diarrhea is already nutritionally deficient, so adding food restrictions will make things worse.

Let’s talk about the skin problems that parents ask most about, such as eczema and urticaria. When many parents see their babies with rashes, they think it's due to "heavy moisture" or "low immunity", and they give their babies dehumidifying soups and health care products to improve their immunity. In fact, most infants and young children's eczema is caused by an underdeveloped skin barrier and has nothing to do with immunity. Nowadays, there are two schools of thought in dealing with eczema: Western medicine generally recommends thick application of moisturizing cream + weak hormone ointments. Many parents talk about the discoloration of hormones. In fact, weak hormones such as desonide and hydrocortisone butyrate are safe if used continuously for no more than 2 weeks. They are better than those you buy randomly and claim to be " The "purely natural and hormone-free" eczema cream from WeChat is much more reliable. Last year, a mother brought her baby for a checkup and said that the eczema was not getting better. I asked her to take the eczema cream she bought for testing. It contains powerful hormones. After using it for almost half a year, the baby's skin shrank. It was really a scam. Some parents are willing to find regular Chinese medicine doctors to drink medicine for conditioning. As long as the syndrome differentiation is accurate, the effect will be good. Both methods are optional, and there is no need to step on each other.

As for prevention, it really doesn’t have to be that complicated. I have seen too many parents stock up on lactoferrin, vitamins, and immune-boosting nutritional solutions for their children, spending tens of thousands a year, only for the child to still catch a cold once a month. It is not as useful as taking the child to run downstairs for an hour every day, washing hands carefully before meals and after using the toilet, and not dressing the child in two layers more than adults. My grandma was always afraid that my baby would get cold, so she would wear fleece pants in the spring. He would sweat all over his body when he ran, and would catch a cold when the wind blew. Later, I forced him to wear the same amount as me, and he didn't have much fever for most of half a year. Vaccines are definitely the most cost-effective means of prevention. Don’t believe that “if you take the flu vaccine, you will still get the flu, so it’s useless.” My colleague’s child received the flu vaccine last year. Half of the children in the class had a fever above 39 degrees Celsius. Her child had a low-grade fever for a day and was very active. Even if he gets infected, it will be much less severe. Vaccines for whorls, hand, foot, and mouth, and chickenpox should be taken as much as possible.

After all, there is really no need to be too anxious about raising a baby. It is normal for a baby to have headaches and fever. Immunity is developed through dealing with germs again and again. It is like target practice for a new recruit. Every time he gets sick, it is a real battle. You have to help him fight every time, and he will never be able to develop his skills. Of course, don’t take it hard. If your baby has been feverish for more than 3 days, is so exhausted that he doesn’t even want to touch his favorite toys, is vomiting and can’t even drink water, has a rash and is accompanied by difficulty breathing, go to the hospital when it’s time to go. All we have to do is not torment the baby or delay the condition. That’s enough.