Principles of prevention and treatment of common childhood diseases

Prevention is better than cure, use medication with caution, and intervene as needed. There is no need to pursue a "quick recovery", nor can it be forced into a serious condition. All decisions must be based on the actual condition of the child. Don't be tied up by various Internet celebrity popular science and the experience of the elderly.

I encountered a typical negative example in the emergency room last Wednesday night: a 3-year-old boy had a fever of 38.7°C. His parents were so panicked that they fed him acetaminophen and ibuprofen suspension within half an hour, and also washed a The Chinese patent medicine cold granules, which is said to "quickly reduce fever", arrived. When the child's face was pale, he was sweating, and he didn't even have the strength to cry. My parents still held half a box of cephalosporins and asked me if I wanted to add an anti-inflammatory medicine to get better. In fact, I have seen this misunderstanding of "superimposing medications, seeking speed and stability" in my 12 years of outpatient service.

When it comes to medication, I have to mention that children are not smaller versions of adults. Their liver and kidney metabolism are much weaker than adults. Many medications that adults can use are not safe for children. For example, the U.S. FDA clearly stipulates that children under 4 years old cannot use over-the-counter cough medicines, and babies under 1 year old must not eat honey. The 2023 version of the Chinese Children's Fever Guidelines also clearly does not recommend the use of metamizole and aspirin to reduce fevers in children. These are hard standards. Don't use "I was fine if I ate this as a child" to argue. The probability of the problem being applied to your own children is 100%.

Of course, there are many issues for which there is currently no unified conclusion, so you don’t have to choose a side. For example, physical cooling. Mainstream Western medicine guidelines only recommend that if a child is intolerant to antipyretics or has not cooled down after taking antipyretics for 2 hours, use a warm towel at 32-34°C to wipe large blood vessels such as the armpits and groin. Irritating operations such as alcohol bathing and ice pack application on the forehead are clearly prohibited. ； However, some schools of traditional Chinese medicine in pediatrics believe that if a child has a fever and cold hands and feet caused by a cold, rubbing the tips of the hands and feet with warm ginger water can actually help induce sweating and cool down. At this time, it just depends on the child's acceptance. If the child is crying out of breath after applying a warm towel, there is no need to force it. It is better to give him a few more sips of warm water to feel comfortable. There are also probiotics that people ask about most. The current consensus of Western medicine is that only when you have acute diarrhea or when intestinal flora is disordered after taking antibiotics, you need to supplement the probiotics of the corresponding strain. Taking it for 1-2 weeks is enough. It is not recommended to take it all year round. ； However, there are also small sample studies showing that long-term consumption of specific strains of probiotics for children with allergies can reduce the probability of eczema and allergic rhinitis. If parents want to try it, there is no problem, but just don’t treat it as a miracle cure-all.

Oh, by the way, don’t always focus on treatment, prevention is more effective than anything else. Many parents chase me and ask if there are any health care products to enhance immunity. I laugh every time. My own child had fever twice in the first month of kindergarten. Later, I prepared a thin vest for her. She took off her thick coat when she entered the classroom. When she got sweaty from running and jumping, she wiped her sweat and changed into a vest. When spring begins, don’t dress as thickly as the elderly, just wear a thinner layer than adults. This is much more effective than eating a bottle of protein powder worth hundreds of yuan. There are also vaccines. Don’t just listen to people who say “you will still catch a cold after getting the flu vaccine”. Last year, I counted the flu patients in our outpatient clinic. The probability of severe illness in children who were vaccinated was 62% lower than those who were not vaccinated. This is hard data. Of course, there are also special circumstances. For example, if a child is experiencing an allergy attack or has just suffered a serious infection, the vaccination can be postponed without having to stick to a hard time in the vaccination book.

Many parents always think that when their children get sick, they have to suppress it immediately. In fact, if you think about it, every time a common viral cold occurs, the child's immune system is fighting monsters and leveling up. If you use a bunch of unnecessary medicine to suppress the symptoms, it will interrupt the training process of immune cells, making it easier to catch the same type of virus next time. Of course, I’m not asking everyone to bear the burden. For example, children with a history of febrile convulsions must take antipyretics when their fever reaches 38°C. Don’t wait for the standard line of 38.5°C. ； If your child has a fever of 38°C and is unable to open his eyes, vomits frequently, or has an unexplained rash on his body, don’t hesitate and go to the hospital quickly.

There is no standard answer to raising a baby, so you don’t have to follow a perfect template. When you are really in doubt, asking a reliable pediatrician for a few questions is much more useful than spending an entire night browsing popular science on Moments.