Illnesses are important factors holding back a
child's growth. Some ailments are very common and some account for a
greater portion of the under 5 mortality rate. For raising of a healthy
child the mothers must know basic facts and know how to give First Aid
before the physician comes into the pricture in case of some of these
ailments and problems. Some of these body ailments are dealt with
hereunder:
Diarrhoea
"Acute diarrhoea is one of your body's best defence mechanisms.
It's your body's way of getting some thing nasty out of your system!"
Lyun McFarland
University of Washington
Medicinal Chemistry
Purge is consnidered beneficial and helps speedy recovery. At the
same time diarrhoea can kill a child by draining too much liquid from
his body, if you are not vigilant.
Intestines of the infant are sensitive for one or two years and
can be upset by milder germs even. A new food or too much of fruit juice
can cause such an upset. But this kind of upset is usually mild. There
could be a couple of extra loose stools greenish in colour and different
in appetite. In such cases the symptoms are gone in a couple of days
without any special treatment.
Chronic diarrhoea may begin spontaneously or with a stomach flu.
These are soft, runny and smelly bowel movements, four or five in
number. These may have mucus or undigested food also therein. These are
the signs of the irritation of the intestines resulting in the refusal
of food by the baby and repeated watery, green and smelly stools,
sometimes even with pus and blood therein. The baby has a temperature of
100 degree F (38 degree C) or more, is listless and has dark ringed
eyes. If the fontanels on the head are depressed, this is a sure sign of
dehydration. Possible dehydration must be treated immediately.
It is essential to give him plenty of liquids. Avoid milk
products other than yoghurt. Avoid carbonated drinks, jelly, too sugary
drinks, apple and other juices. The best drink for such a situation is
the mother's milk, 'daal' water, water from 'khichri', butter milk or
lemon water and water with both salt and sugar.
An effective drink for diarrhoea can also be made by using eight
level tea-spoons of sugar and one of salt dissolvd in one litre of clean
water. This is the simplest to make. Do not alter the proportions.
A special drink can be made by using a packet of ORS-oral
rehydration salts available from pharmacies and Health Centres. Dissolve
the contents in the amount of water indicated on the packet. If you use
too little water, the drink could make the diarrhoea worse. If you use
too much water the drink will be less effective. Give this to the child
to drink from a cup or a spoon. Do not add O R S to other liquids such
as milk, soup or soft drinks. Other alternatives are weak tea and green
coconut water. If nothing else is available, give water from the
cleanest possible source. Though plain water is difficult to retain but
it is better than giving no liquid whatsoever.
Give these liquids every time a watery stool is passed or a vomit
is made. Dose-between a quarter and a half of a large cup for older
children. If the child vomits, wait for ten minutes and then begin
again, giving the drink slowly in small sips at a time.
Continues these extra liquids until the diarrhoea has stopped.
This will usually take between three and five days. Continue to nurse
the baby if you are breastfeeding. If you are bottle feeding the child
add equal quantity of water to the usual bottle content. This extra
dilution should be stopped as soon as diarrhoea stops.
Discontinuting of soild foods during diarrhoea is wrong. The
child's appetite is low so he will have to be tempted to his favourite
foods. These should be well meshed, softened pulses or vegetables,
mashed potatoes, strained cooked carrots or ripened bananas or other
fruits like mangoes. Food should be freshly prepared and given five or
six times a day in smaller quantities.
In many countries yogurt is used as a treatment for diarrhoea.
The friendly bacteria in yogurt called acidophilus tends to help
normalise bowel functions. Yogurt has an antibiotic effect, especially
against E. coli, the main cause of traveller's diarrhoea. Bran also
helps normalise the bowel function. Bran helps relieve both constipation
and diarrhoea. Bran thickens the loose stool of diarrhoea and softens
the hard dry stools in constipation. Bran may help in diarrhoea though
not recommended as a part of the normal diet for infants.
Most medicines for diarrhoea are either unseless or harmful. Do
not give any medicines unless prescribed by a trained health worker.
After recovery from diarrhoea, the child would need extra food
for the nourishment lost. Feed and food may be increased for about a
weak.
Diarrhoea can be prevented by keeping food and water clean and by
washing hands before touching food. Use latrines or bury the faeces.
Bury or burn all refuse to stop flies spreading disease. Cover food and
drinking water as a protection from germs. If cooking was done more than
11/2 hours before consumption, heat the cooked food to 75 degree C
before eating.
In case of young babies the greatest danger from diarrhoea is
dehydration. Some signs of dehydration are sunken eyes, extreme thirst,
no tears when the child cries, depressed fontanels on the head, not
eating normally and vomitting frequently, passing several watery stools
in one or two hours and sometimes passing mucus or even blood in stools.
In such cases seek qualified medical help.
Infantile Colic
In colic a baby cries inconsolably for several hours on end,
often putting his legs up to his chest as though in response to
intermittent periods of abdominal pain for which no organic reasons can
be established. These are period of estreme fussiness associated with
clenching of first and flexing of legs, belching, passing of gas and
stomach rumbling. No one knows for certain what causes colic. There is
no pathological explanation. It cannot be measured by blood tests or
medical machines. It amounts to a pattern of unsettled behaviour.
Inspite of all this colic is a very real condition which leaves the
parents at their wits end. Ceaseless inconsolable crying transforms the
confident, optimistic happy parents into demoralised defeatists. In
colic the crying is generally of a high pitched screams. It is not known
why it happens but it usually starts after the first three weeks of the
baby's life. These spells last for about 12 weeks and then colic
disappears as mysteriously as it begins. All babies always get better in
the end.
In the matter of treatment of colic it is important for the
parents to recognise that the condition is fairly common, does not do
the baby any permanent harm and will go away in 3 months time. If the
parents can, therefore, accept the condition in a fairly calm and
resigned way the battle is half won.
In this behalf the good news is that babies with colic are
generally healthy children. They eat and sleep well, gain weight
normally and show no ill effects from the colic.
For treatment no drugs are needed. The baby may be soothed by any
rhythmic activity such as rocking, swaying, being taken in the car for
ride, in a swing, a rocking cradle or a rocking chair or putting him in a
sling. Vibration, thus, some times, soothes a colicky baby.
Ann Price of National Academy of Denver Colorado suggests "Extend
your forearm with your palm up. Then place the baby on your own arm
chest down, with his head in your hand and his legs on either side of
your elbow. Support the baby with your other hand and walk around the
house with the baby in this position. It definitely helps".
Wrapping the baby snugly in a blanket has a calming effect. It is
used extensively in some countries. Warm bath and heating pad applied
to the abdomen could also help.
Some people slice an onion and dip it in hot water. Give the baby
a tea spoonful of the onion water a few times a day. Burp the baby
frequently while feeding.
Maternal diet should, during the colic days, be free of cow's
milk. In colic it reportedly went when intake of cow's milk was given up
both by the mother and the child. This is worth a trial. Some contend
that the caffeine and spiced foods in the mother's diet could be the
culprits.
Colicky babies are usually more comfortable on their stomachs.
They get relief so laid across the parent's knees or on a hot water
bottle and massaged at the back.
The fact that the trouble is commonest in the evenings suggests
that fatigue plays a part in bringing about this condition. The remedy
may, in that case lie in having the child rested for the crucial period.
One guess is that this condition is due to a periodic tension in
the baby's immature nervous system and, therefore, nothing will calm a
colicky baby.
Each child has on "Achilles heal" i.e. an organ which responds to
stress and creates symptoms. If that organ is the stomach and if the
symptom is the colic pain, then all that has to be done is to reduce the
stress factor in the child to get rid of colic pain.
Respiratory Problems
A child generally gets sick with colds ten times more than with
all other illnesses combined. Most colds are started by a virus which
lowers the resistence and some regular bacteria get their chance to
multiply and spread, causing pneumonia, ear infections, and sinusites.
The best thing to avoid a cold is to avoid close phycial contact with
any one who has one. Colds are not serious till a complication sets in.
There is no cure for the common cold. Only symptoms can be
treated. In the absence of complications. Home remedies suffice.
Symptoms generally are stuffy running nose, cough, fever &
listlessness. The nasal discharge is first clear and then thick and
yellow. Cold cannot be treated with antibiotics. Ordinary nose drops may
cause "rebound" congestion. Saline nose drops, prepared at home by
dissolving half tea spoon of table salt in about a quarter litre of
water, help in loosening up tick mucus. So it could be below out more
easily. Nasal obstruction could also be lossened by the child sleeping
on his side opposite to the stuffed nasal passage. Use of vasallne or an
oil with a little finger on the inside of the nostril upto 1 cm depth,
could help stop a running nose. Use of vitamin 'C' supplement meant for
children can also provide some relief. Extra moisture in the room
prevents stuffiness of the nose. Keep the child indoors. Humidify the
nose secretions by giving the child lot of liquids. Dilute the baby's
milk with water.
Sinusitis occurs when drainage of mucus from the sinuses into the
nose is impaired during a bout of cold or flu. Symptoms of sinusitis,
besides those for cold, include a feeling of fullness and discomfort
around the top of the nose. Humidifying the room would help
considerably.
Bronchitis or laryngitis usually show up as coughs, wheezes and
breathing difficulties and, may be, fever also. Coughing, unless
persistent and severe, is not necessarily a bad sign. It is nature's way
of getting rid of mucus and foreign matter in the respiratory tract.
Cough medication generally does not help. In these cases also keeping
the child properly hyderated with warm soothing beverages like tea with
honey helps. For bronchitis, humidification of the surroundings will
help. In case of laryngitis with hoarseness and coughing, a doctor must
be consulted.
Pneumonia is an inflammation of the lungs caused by a virus. The
affected lung may get out of action. Pneumonia may be caused by cold or
by conditions like asthma, whooping cough and measles etc. Fever, chills
and pale damp skin are some of the symptoms. These may be supplemented
by difficulty in breathing and even indrawing of the chest. In all cases
of pneumonia medical advice should be taken without delay, more so, if
the child is breathing more rapidly or if the lower part of the child's
chest goes in as the child breathes in.
Pneumonia kills about 6,00,000 (Six lakh) children each year in
India. Breastmilk protects against many infections. Breastfed babies
have half the number of pneumonia bouts as compared to the bottlefed-
more so, if the breast milk alone has been given to the child during the
first four months. Well fed babies are less likely to catch this
disease. Vitamin A helps greatly Oranges, carrots, dark green leafy
vegetables and yellow fruits should be taken in abundance. Vitamin A
supplements also help. Primary immunization also affords some protection
against pneumonia.
During cough and cold amongst young children, they must be fed
both to fight the infection and protect the rate of growth. With a
blocked nose, it may be difficult for the child to suck the breasts. It
may become necessary to squeeze out the breast milk and feed the child
from a cup or spoon. Other foods should be fed in small amounts more
frequently. After termination of the illness give the child an extra
feed till he comes back to the pre-illness weight.
A child with cough or cold should be kept warm and covered if he
is running temperature also, give some temperature lowering medicines
meant for children which through experience you find suit him best.
Smoking surroundings increase the risk of pneumonia. Keep the
child away from tobacco smoke. Other children who are sneezing and
spitting also increase that risk.
Air in the child's room should be kept fresh by opening a door or
a window but ensure that he is kept away from draughts. Clean the nose
frequently. A moist atmosphere will help easing the breathing. Inhaling
water vapours from a bottle of hot water will be extremely helpful.
Fever
When the child is unwell his body temperature and breathing rate
go up and his appetite goes down. Normal temperature for a child is 37
degree C (98.6 degree F) When on rectal reading the temperature goes
above 39 degree C or below 35 degree C medical help may be sought if the
temperature so persists. Child's temperature varies considerably at
different times of the day. It is lower in the morning than during the
day and is higher in the evening. A rapid pulse also indicates that the
child is unwell. The average pulse rate for a very young baby is 100-150
beats per minute. This slows to 100-120 for a one year old and 80-90
for a five year old Both the temperature and pulse rate increase with
exertion also.
A raised temperature is usually the result of a bacterial or
viral infection. When the bacteria overcome the defence system of the
child and invade the bloodstream, then a general fever develops. Small
children upto the age of 5 years become feverish very easily. A minor
digestive upset may be enough to raise the temperature for a few hours.
Only if the fever persists that it becomes a cause of concern. High
fever may be brought down by sponging the child's body with tepid water.
Always encourage a child with a fever to drink as much fluid as
possible to maintain a proper hydration level. Removal of warm clothing
and bed clothes to expose as much of his body surface also helps. Ensure
that he is not exposed to a draught. Lowering room temperature is
useful. Parents are advised to give nothing except extra liquids and
observe. No aspirin or a similar tablet may be given because it may mask
how high the fever is going to go. Generally, in most children
temperatures upto 39 degree C (102 degree F) are not dangerous but if
there are some complicating factors, medical advice may be sought early.
Please do not forget that the fever is one of the methods the body uses
to help overcome the infection.
Nappy Rash
In infants the epidermis layer is thin and susceptible to
irritation and infection. Sweating is scanty. Skin is more prone to
blistering from trauma or infection. Diaper rash is caused by the baby's
skin being in prolonged contact with the warm acidic urine. Recent
research has shown that it is the urine itself, not the ammonia produced
therefrom that causes rash. Itching is, perhaps the most common and
least tolerated of symptoms. Skin rashes may be mainfestation of so many
different conditions.
For treatment, take the baby's nappy off and lay him chest down,
with the face turned to one side, on a towel underlaid with a waterproof
sheet. Rinse the bottom with water to remove excess urine and bacteria
and then dry well. Do not wash the affected area with soap while there
is rash. Use plain water instead of diaper wipes from the market. Then
expose the whole diaper area to the air for several hours.
Discontinue use of water proof and plastic pants. Avoid woolen
clothing. Avoid disposable diapers so long as the rash problem subsists.
Avoid cleaning with baby wipes that contain alcohol. May use a skin
protective lotion. When preparing the baby for bed, take extra care.
Wash and dry the bottom before applying a coat of protective cream.
Change wet and soiled diapers as soon as possible. Traditional
cloth diaper is the most comfortable for your baby. Do not forget that
in case of one baby there are as many as 7000 changes before you are
finished. Give cloth nappies a vinegar rinse sometimes - 25 ml. vinegar
to one litre of water during the final rinse. Breast fed babies have
less nappy rash!
Sore Throat
An uncomfortable and painful throat is usually due to bacterial
infection or a virus. The child may say that he has difficulty in
swallowing or has pain in the throat if he is asked about it
specifically. Swollen glands in the neck may indicate a bacterial
infection. If the tonsils appear enlarged with yellow and white patches
and the breath smells foul with swollen glands, it may be a case of
tonsillitis. This happens rarely in children under one year but common
amongst children who are exposed to a new range of bacteria on starting
school. For treatment liquify his diet. The doctor, after taking a
throat swab and examination of neck glands, may prescribe an antibiotic.
In such cases you may find that on one side of the forearm in
alignment of thumb, there are knots. Slightly rub those knots for a
couple of minutes each time for 2 or 3 days. As those knots disappear,
the soreness of the throat also disappears.
Heat a few drops of oil and at night apply that oil on his throat
all around but gently and then tie a cloth around the neck to save it
from exposure. Repeat for 2 or 3 nights and the difference will become
obvious.
Take a few drops of squeezed ginger in half a teaspoon of honey
and let the child lick that. This should not be given to infants below
six months of age.
Warm liquids will be more acceptable to the children and these
will do good. Be on the watchout for possible complications. Avoid dry
winter air. Humidification helps.
Ear Infection
Ear infections are common amongst children below 5 years because
at that age tubes that connect the middle ear to the throat are short
and straight and, therefore, all throat infections can travel to the
middle ear more quickly and easily. In such cases the drainage is
frequently blocked. Frequent lying down also diminishes drainage from
the middle ear. This infection requires early treatment, otherwise,
could cause permanent hearing loss. Fever, ear ache, loss of appetite
and discharge from the ear are some of the symptoms.
The ears are self cleaning and the ear wax produced by his glands
protects the ear from dust, foreign bodies and infection. This
infection is not contagious. Keep the child cool and comfortable. Give
him lots of drinks. Nasal decongestant is recommended. Warm glycerine
may be used as ear drops. Application of heat from the hot water bottle
may provide relief. Garlic oil and olive oil drops are also likely to
help. You may wash only the outer ear and the entrance to the canal, not
inside. Use a cotton swab or a wash cloth for this purpose. Sipping
water and swallowing foods also helps. Researchers in Finland have
established that breast feeding invokes response and reduces pain.
Lying down aggravates ear pain. Keep the child's head propped up.
When the child is busy playing during the day, the tubes which connect
the throat to the middle ear are draining in the throat and no pain is
experienced. Use of antibiotics in such cases must be left to the
decision of the doctor.
Malaria
Eradication of malaria a concerted action at the Government
level, by the local community and the families. Places where water
collects or stagnates should either be filled or drained or spread over
with an oil surface. Regular clean up of the neighberhood is also
important.
Young children should be protected from mosquito bites by putting
screens on windows and doors, by use of mosquito nets and by using
fumigants.
Pregnant women face the danger of malaria doubly. It may cause
miscarriage & premature births. The children of malarial mothers may
be small, weak and vulnerable to infections. The pregnant mothers could
be effectively protected by taking anti-malaria tablets regularly.
These tablets are available free from Government health centres.
Children should also take similar medication but not daily because that
may prevent the child from building up a natural resistence to Malaria.
A child with malaria should be kept cool. Do not put too many
clothes or blankets on the child. A child recovering form malaria needs
plenty of liquids and food.
Use of black Tulsi (the holy basil) is highly recommended as a
curative as also for preventive purpose. Imperial Malaria Conference of
1907 came to the conslusion that "use of black Tulsi reduces
considerably the havoc caused by malaria". A couple of washed Tulsi
leaves or a few seeds of the plant could do the trick.
Chinckenpox
Chickenpox is a common viral disease which is highly infectious,
but rarely serious. It usually appars in winter and spring and rarely
affects infants below six months. One attack virtually ensures permanent
protection against future infections. Possible symptoms are red, itchy
spots that become fluid-filled blisters and then scabs. It could be
accompanied by headache and mild fever.
Chickenpox is passed by close contact with a patient in the first
week of the rash. The incubation period of 14 to 21 days is followed by
a short period when the child feels generally unwell with a mild fever
and headache. Crops of spots appear during the next 5 days. As a rule,
it is self limiting and resolves completely with no adverse effects. The
blister like elevations on the skin usually persist for about a week.
Keep the child at home and discourage scratching. May use an
antiseptic cream. Never give aspirin. Aspirin can cause another serious
illness. Do not rub the scrabs off. The only complication is boils which
come from infecting the pox by scratching. Wash the child's hands with
soap several times a day. A small tub may be prepared with one cup full
of the baking soda or corn starch.
A vaccine to protect children against chickenpox has been
developed by U.S.A. but has not yet been made available for general use.
Childhood Leukaemia
According to February 1993 issue of "Here's Health" De Shmuel Ben
Sasson of Hubert Humphrey Centre for Experimental Medicine and Cancer
Research in Jerusalem first suspected there might be a direct link
between childhood Leukaemia and fluorescent lighting. In examined cases
this disease was fully developed at the age of four. It was seen that
the white children were more susceptible than the black children. It
indicated that the pigmentation in black skin served as a protection
screen against flouresent light which emit blue light (400 nm
wavelength).This light penetrates the skin and is suspected to produce
free radicals which in turn, damage the child's DNA. This causes the
leukaemia to develop. It could be prevented by cheap plastic filters
being fitted to flouresent lights in maternity wards and in those rooms
in the house where infants pass their time. These doctors found
supporting evidence from the Netherlands that those born in hospitals
were more likely to get leukaemia than those born at home. A unique
nationwide investigation into this cancer in children started in U.K.
The National Radiological Protection Board of U.K. is also looking into
this question. It could take a few more years to decide whether or not
to do further research on this subject.
Asthma
Asthma is an allergy in which when an irritating substance
reaches the bronchial tubes in the lung (the sensitive organ) the tubes
swell, thick mucus is secreted and the passageways for air are so
narrowed that breathing becomes diffucult, laboured and wheezing. A
child who has asthma suffers consurrents attacks of breathlessness when
the tries to exhale. Even a mild attack can be frightening in a child.
Typical symptom pattern of asthma in a child would be cold with attacks
of coughing and wheezing with many restless nights on that account.
Causes could be passive smoke, cold air & family history of
allergies etc. Even in developed countries 2 % of persons under 18
suffer from asthma. Figures of asthmatic children under 5 are not
available for India or even some developed countries. Following
precautions be taken in case of children.
If there is a family history of allergies you should reduce the
child's exposure to potential allergins e.g. if either parent had a milk
allergy in childhood, do not use milk in bottles till he is six months
old. Breastfeeding is the safest. After 6 months experiment and decide.
Solid foods should not be started till 5 months. Each new food
should then be started separately a week apart and study the sensitivity
to each. Common allergins e.g. dust, grasses, pollens, animal hair,
feather pillows should be eliminated from the baby's bed.
Asthmatic wheezing should be treated vigorously and the child
told about it. Keep the child occupied so that his anxiety about the
disease does not make things worse. Over 30% of children affected by
asthma grow out of that condition by adulthood. Get it diagnosed and
treated vigorously. Reverse this condition at an early stage.
