Principles of prevention and treatment of common childhood diseases

The prevention side is based on "reducing the risk of exposure and strengthening autoimmunity", while the treatment side is based on "relieving discomfort, avoiding complications, avoiding excessive intervention, and not affecting long-term growth and development" as the bottom line. There is no absolute universal solution, and all measures must be adjusted based on the child's individual situation.

It's funny. Last month, a parent brought his baby to the clinic. He said that in order to prevent colds, he gave his baby half a bag of isatis root to drink every day. After drinking it for half a month, the baby had diarrhea for three days. In fact, this is also the easiest pitfall for many parents on the prevention side: they always want to rely on "external blessings" to buff their children, but instead ignore the most basic protection logic. Children's immune system is like a new system that has just come online. It is being patched and upgraded every time it is exposed to pathogens. If you put it in a completely sterile greenhouse, it will easily collapse as soon as you go out. Just pay attention to hand and mouth hygiene in daily life. Washing with ordinary soap and running water for 20 seconds is more effective than any disinfectant wipes. Don't spray disinfectant at home every day. On the contrary, it will easily destroy the baby's respiratory mucosal barrier and more easily induce allergic rhinitis, asthma and other problems.

When it comes to prevention, there are actually many controversial points. For example, at what age should vitamin D be supplemented? The current mainstream guidelines recommend supplementing the calcium until the age of 2 years old, but many pediatricians have suggested that if the sunshine hours in northern winter are short and children have less outdoor activities, it is no problem to supplement the calcium until adolescence. Do exclusively breastfed babies need additional calcium supplements? Some schools of thought believe that pure breast milk can provide enough calcium within 6 months, and only D supplementation is enough. Others believe that if the mother is deficient in calcium during pregnancy, she can properly supplement calcium lactate after the baby is one month old. There is no absolute right or wrong in this. Just adjust it based on your own feeding situation and the child's growth curve. Can probiotics prevent diarrhea? The current evidence of evidence-based medicine is indeed not sufficient, but if the baby is born prematurely and has weak intestinal function, eating appropriately for 1-2 weeks during the change of seasons can regulate the intestinal flora. There are indeed many clinical cases showing that it can reduce the incidence of diarrhea in autumn.

No matter how careful you are in taking precautions, your child will inevitably have headaches and fever. The most taboo thing at this time is "seeking a doctor in case of emergency". Last week, I met a mother who rushed in with her 3-year-old baby in her arms. She said that her baby had a fever of 38.2 degrees Celsius and asked for an immediate infusion to reduce the fever, for fear that she would go crazy with the fever. In fact, for fevers caused by common viral colds, as long as the baby is in good spirits, can eat and play, there is no need to use antibiotics at all. If the temperature is above 38.5 degrees, take antipyretics on time. If the baby is under 3 months old, do not treat the fever by yourself and send it directly to the hospital. If the baby is over 3 months old, acetaminophen can be used, and if the baby is over 6 months old, ibuprofen can be used. The dosage must be calculated based on body weight, and do not feed blindly based on the age on the instructions. Of course, if you trust the idea of ​​​​TCM more, boil some scallion water and do chiropractic massage for the baby when the nose is just clear. As long as the baby does not resist, it can also have a relief effect. There is no need to argue whether Chinese and Western medicine are right or wrong.

There is another topic that has been discussed for many years: Should a child cover his sweat when he has a fever? The older generation always said that the fever will go away if you cover your body with sweat, but now many popular science says that you should never cover it. In fact, both theories are applicable in scenarios: If the child's hands and feet are cold and shivering due to fever, it means that the body temperature is still rising. At this time, you can cover it with a thin blanket to keep warm. When the child's hands and feet are hot and start to sweat, you must quickly loosen the clothes to dissipate heat. Otherwise, the heat cannot be dissipated and it will easily induce febrile convulsions, which is what we often call "fever." I have been working as a clinician for so many years, and I have seen too many parents clinging to the old concept of "covering sweat" at this time, wrapping their babies in three or four layers of thick quilts. When the babies come in, their faces are purple, which is really worrying.

My own child got influenza A last winter and his fever reached 39 degrees. I didn’t give him an infusion. I just took antipyretics on time and fed him more freshly squeezed orange water. When the fever subsided, I let him come down and crawl a few steps. He was completely cured in three days. Of course, the premise for me to dare to do this is that I can judge that he has no signs of pneumonia. If your child has a fever that has not subsided for more than 3 days, is depressed, complains of headache and chest pain, or is breathing much faster than usual, then don’t hesitate, rush to the hospital, don’t carry it. There are also many parents who always think that "infusion will make the child better quickly". In fact, common cold infusions are all antibiotics, which are completely useless against viruses. Instead, they will destroy the intestinal flora of the baby and make the child recover more slowly.

In fact, after all is said and done, there is never a standard answer to the matter of raising a baby and seeing a doctor. You don’t have to read through popular science guides on the Internet, and you don’t have to just copy what your relatives and neighbors say, “This is how my baby was cured before.” Pay more attention to your baby’s condition, which is more important than anything else. After all, what we want to treat is "sick children", not "children's diseases", right?