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.
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