Guidelines for the Prevention and Control of Common Diseases in Children

Pay attention to the key points in daily protection, pay attention to science in disease prevention, and lay the foundation for long-term immunity. Don't believe those "secrets to keeping your baby from getting sick for a year" on the Internet. I have been in pediatric clinics for almost 10 years and have seen tens of thousands of babies. There is really no child who is immune to all kinds of diseases. As long as you step on a few key points, you don't have to follow the whole family.

I just saw a mother of a middle school kid last week. Her son has had colds four times since September when she started school. It was only two weeks after the last mycoplasma infection, and she got the flu again. Grandma wants to cook "weird green onion, ginger and garlic water" to get rid of the cold, and dad wants to give him cephalosporin directly to say it will heal faster. The two of them argue so much that they almost have to go to the community for review. I encounter this kind of scene almost every week. Many family conflicts actually stem from cognitive biases about common childhood diseases.

Nowadays, there is a lot of quarrel in the parenting circle about daily protection. One group is the "sterile group". They mop the floor with disinfectant three times a day and spray alcohol on anything their children touch. They want to put two layers of N95 on their children when they go out. They are not even allowed to touch the fitness equipment in the community.； The other group is the "free range" group, which says that only by "dirty raising" can we develop good immunity. Even during the flu season, they take their children to crowded indoor naughty castles without even wearing masks. In fact, both groups have gone to extremes. To be honest, there is no need to over-disinfect in daily life. Ordinary dust and a small amount of environmental bacteria can actually stimulate the development of children's immune systems. However, in the high disease season of autumn and winter, it is better to go to closed shopping malls, cinemas, and indoor playgrounds as little as possible. The first thing you do when you get home is to wash your hands with ordinary soap for 20 seconds. It is more effective than any disinfectant product.

Many parents are most worried about their baby having a fever, and there has been ongoing controversy over the standards for reducing fever: some guidelines say that fever-reducing drugs should be used when temperatures are above 38.5°C, while others say that as long as you are in good spirits, there is no need to stick to the temperature line. My advice to parents is always to look at the condition first: if the child has a fever of 39°C and is still running around playing Lego, chewing apples and chasing cartoons, you can give him more warm water first and put on an antipyretic patch to make him feel more comfortable. There is no need to rush to give medicine. ； If the baby becomes droopy as soon as the temperature reaches 38°C, pushes aside his favorite strawberries, and complains of headache and body aches, then give the drug directly without sticking to the 38.5°C line. Oh, by the way, babies under 3 months old should be sent directly to the hospital if their fever exceeds 38°C. Do not give them random medicines at home. This is a red line that cannot be touched.

Oh, by the way, in addition to respiratory problems, what parents ask about most is digestive tract problems, such as diarrhea, vomiting, and food accumulation. Eight out of ten children have encountered it. There is an old saying that has been passed down for decades and some people still believe it: If a baby has diarrhea, he will be hungry for two days, and it will be better on an empty stomach. Last month I met a grandmother whose baby was infected with rotavirus and had diarrhea. She starved her baby for two whole days and didn't even dare to give her more water. In the end, the baby was so dehydrated that she became mentally depressed, so she arranged for an infusion when she arrived. Current clinical guidelines do not recommend fasting for diarrhea. As long as the baby does not vomit, he can eat normally, as long as it is light. Millet porridge, steamed apples, and soft boiled noodles can be eaten. Instead, he needs to drink more water to avoid dehydration. Drink oral rehydration salts as much as possible. It is much more efficient than drinking boiled water to replenish electrolytes.

When it comes to rotavirus, we have to mention the vaccine. Many parents are confused about whether to take the second-class vaccine. Some people say that the second-class vaccine is an IQ tax, and free ones are necessary. Some people say that all available vaccines should be used. It is always good to have an extra layer of protection. My personal suggestion is that if your child usually has weak immunity and gets sick when the seasons change, or if there are other children at home, try to arrange for second-class vaccines such as influenza, rotavirus, pneumococcus, and hand, foot and mouth. Especially for children under 5 years old, the risk of serious illness after infection is high. Vaccination is the most cost-effective way of protection. ； If your child is usually in good health and seldom goes to crowded closed places, he can make his own choice based on family circumstances and do whatever he wants without having to listen to what others say.

Another common disease that is particularly annoying is eczema, especially for children with allergies. It recurs in autumn and winter, with red rashes on the face and body, making it difficult to sleep due to itchiness. Many parents asked me if I had any food taboos. Should I not touch milk or eggs? In fact, as long as the eczema is not obviously aggravated after eating certain foods, there is no need to blindly restrict food. I have seen too many parents restrict their children to eat only white rice. In the end, the child cannot keep up with nutrition, has poor immunity, and the eczema becomes more serious. There is also controversy about eczema care. Some people say that you should touch less water, while others say that you should apply more moisturizer. In fact, it depends on the situation: if there is drainage and exudation in the acute stage, touch the water as little as possible, do not use shower gel, and use ointment as directed by the doctor. ； Once the isotonic fluid has worn off and entered the remission period, apply a thick layer of moisturizing cream all over your body every day, at least twice a day. A medical moisturizing cream that costs tens of dollars is enough. You don't need to buy so-called "special-effect eczema creams" that cost hundreds of dollars. Many products from unknown sources secretly add powerful hormones, which is not safe.

To be honest, many children's illnesses are inseparable from parents' anxiety. I have seen many parents who keep an eye on their children's body temperature and stool every day. They get extremely nervous when something is slightly wrong. They dress their children in two or three more clothes than others. They give their children "preventive medicine" at the slightest sign of trouble. In fact, the more nervous you are, the more your children's emotions will be affected, and their immunity will be prone to problems. There is really no need to be too meticulous in raising a baby. Let the baby run and jump more often, stay outdoors for at least 2 hours every day, eat a variety of food, including meat, eggs, vegetables and milk, and sleep for 10 hours, which is more effective than eating any number of health care products that are said to "enhance immunity."

In fact, there are really not so many fancy secrets to prevent and control common childhood diseases, and there is no need to pursue perfection. A minor illness occasionally is not a bad thing. It is because the child's immunity is fighting monsters and upgrading. As long as you don't believe in those unfounded folk remedies, don't give medicines to children indiscriminately, and grasp a few core key points, adults will be less anxious and children will suffer less, which is better than anything else.