Experience on the prevention and management of common childhood diseases

The core of the prevention and management of common childhood diseases is not "zero illness" at all, nor is there a universally applicable protection formula. The most effective plan is "daily layered care + graded response to incidences". It can neither blindly drag the disease into severe disease, nor overuse medication to destroy the child's own immune rhythm. All decisions must be anchored in the child's individual physique and current state adjustment.

I have been working as a child care worker in the community for 6 years, and with my own 4-year-old baby at home, I have come across thousands of related cases. The most common misunderstanding is that parents always want to find a "once and for all disease prevention trick." Last week, I met a mother whose baby had two fevers in the first week of starting kindergarten. She panicked and fed the oseltamivir, cephalosporin, and acetaminophen that she had stored at home. As a result, the baby developed a drug rash on the third day and came to see a doctor. After asking, she found out that the first fever was just a common rhinovirus infection, and there was no need to take antibiotics and anti-influenza drugs. It was purely due to excessive anxiety.

Speaking of this, I have to mention the fever handling controversy that is currently making a lot of noise on the Internet. The guidelines of evidence-based medicine clearly state that children over 3 months old, as long as their mental state is good, can be physically cooled down for observation even if the fever reaches 38.5°C. Only when they are in poor spirits or crying and restless do they need to use acetaminophen or ibuprofen. ； However, many doctors of traditional Chinese medicine and pediatrics suggest that if a child has a low-grade fever caused by obvious cold, with cold hands and feet and a runny nose, there is no need to rush to give anti-fever medicine. Just boil some scallion, white, ginger and brown sugar water to drink, soak for 10 minutes to make the feet sweat, and the temperature will soon drop. ； There are also many elderly people who always say that they should cover their sweat. Although covering their sweat may increase the risk of dehydration for children whose body temperature is rising, the elders’ saying, “Don’t face the air conditioner when you have a fever, and don’t eat ice cream,” actually makes sense. My own baby caught a cold and had a fever of 38.2°C last time. He was in good spirits. I boiled some onion and ginger water and applied an antipyretic patch. It was gone in the afternoon. If it had been before when I was just at work, I might have given him antipyretics. Only after raising my own baby did I realize that individual differences are really more important than the standard line in the guidelines.

By the way, many parents ask me whether they should vaccinate their children with second-category vaccines at their own expense, such as 13-valent pneumonia, hand, foot and mouth, and influenza vaccines. I have no hesitation about this. No matter what my opinion is, as long as it meets the vaccination indications, I recommend vaccination. After all, if a disease can be prevented in advance, why wait until it can be treated?

In addition to the response after the onset of the disease, there are actually more pitfalls in daily prevention. Many parents are now willing to buy various immunity-boosting supplements for their children. Lactoferrin, probiotics, and vitamin C gummies are piled up like a mountain. There is also a lot of controversy here. Many studies in the field of nutrition have shown that as long as children eat a balanced daily diet, including meat, eggs, milk, fruits and vegetables, there is no need to supplement these supplements. Most of the supplements will be excreted through metabolism, which is a waste of money. ； However, many clinicians in our department will recommend parents to take probiotics or lactoferrin for three months to regulate the intestinal mucosal barrier when they encounter children with allergies, more than two episodes of pneumonia within six months, and repeated diarrhea. My own child had urticaria repeatedly before, and the allergen was tested to be dust mite allergy. I took Lactobacillus rhamnosus for 2 consecutive months, and the frequency of attacks was indeed reduced from twice a week to once every two months. However, my colleague’s child with the same allergy took the same product for three months and it had no effect at all. Who are you talking to to explain this? To put it bluntly, each child’s intestinal flora environment is different and cannot be generalized.

There is also the issue of cross-infection in kindergartens that parents are now generally worried about. When many people first send their children to kindergarten, they want to wear a three-layer mask for their children. When they come home from school, they spray disinfectant all over their bodies, but they still can't stop their children from getting sick once a week. There are two completely opposite views here: One group of parents feels that "it would be better to miss two months of school than to let their children get sick." As long as a child in the class catches a cold, they will immediately ask for leave for their children. ； Pediatricians on the other side believe that appropriate exposure of children over 3 years old to pathogens in the environment actually helps their own immune systems build memory, which in turn can reduce the probability of allergies and repeated respiratory infections when they grow up. My own child had three fevers in the first month of primary school. I didn’t take a single leave. Except for the requirement to wear a mask during the flu outbreak week, I also let him play on slides and build blocks with other children. After the second month, he rarely got sick. Of course, if the child has basic diseases such as asthma, congenital heart disease, or immune deficiency, he must be extra careful and cannot forcefully carry him to school.

I always carry a small bottle of no-rinse disinfectant gel in my bag when I go out, but I will not stop my children from touching the slides in the community or picking up small leaves on the ground. I have seen a Nordic study before, saying that children who are often exposed to microorganisms in the natural environment since childhood have a 30% lower probability of allergies than children who stay in a sterile environment every day. Don't tell me, it actually makes sense. Also, when my baby coughs, I never give him cough medicine. Domestic and foreign guidelines clearly state that over-the-counter cough medicine is not recommended for children under 6 years old. If the cough affects their sleep, give your baby over one year old some warm honey water or steam a salted orange. Most of them can relieve the cough. If it is really serious, go to the hospital to listen to the lungs to rule out pneumonia and bronchitis.

After working as a child care provider for so many years, I finally realized that preventing and managing common childhood diseases does not require you to memorize many guides or stock up on medicines. The most important thing is to understand your own child’s constitution: For example, if my child rubs his nose and tosses and turns in his sleep, it is a sign of a cold. I need to drink more warm water and soak his feet, and most of them can be suppressed.； If he has poor appetite and bad mouth for two consecutive days, it means he has accumulated food. If he eats less meat and drinks some hawthorn water, he will not develop a fever and cough. These are experiences that cannot be written in textbooks. There is no perfect plan for raising a baby. It is just a matter of slowly exploring and finding the rhythm that is most suitable for your own baby.