FEVER IN CHILDREN

Fever is one of the most common reasons for calling a Paediatrician.

The most accurate ways of taking your child’s temperature are orally or rectally with a digital thermometer. Fever is defined as 100.4 oF (rectal) and 99.4 oC (axillary).

Fever is one of the signs that the body is fighting an infection e.g. viral or bacterial.

This is an Infection of the Upper or Lower Respiratory Tract which is caused by any of a number of viruses.  

The symptoms are so well known to you all, that there is no need to mention them here.  

Treatment involves treating the symptoms only i.e., decongesting the nasal passages, drying up excess secretions, bringing down any associated elevated temperature etc. There is NO need for Antibiotics unless Secondary Bacterial Infection has taken place.  

The yellowness of the nasal secretions/sputum does Not necessarily indicate Secondary Bacterial Infection.       

What every parent needs to know about GASTROENTERITIS  

Causes:
This is a condition usually caused by irritation of the stomach and bowel by Infection (for example with viruses, bacteria or other types of germs). Other causes include eating spoiled food, dairy products (for those who are allergic to or intolerant of dairy products), medication (especially antibiotics) and laxatives.  


Symptoms:

One or more of the following symptoms may be seen: 

  • Diarrhoea (frequent passage of watery stools)
  • Abdominal Pain (with or without bloating)
  • Fever (usually low grade)
  • Nausea with or without vomiting

Definition
Asthma is a chronic (longstanding) inflammatory disorder of the airways (breathing passages). This inflammation causes recurrent or persistent episodes of wheezing, breathlessness, coughing and chest tightness.  

What triggers an asthma attack?
The inflammation causes an increase in airway responsiveness (hyper-responsive) to various stimuli (triggers). Children with asthma therefore have extra-sensitive airways. An asthma attack is usually brought on by something that irritates the sensitive airways. These triggers can be different for each individual. 

Haemoglobin (Hb) is the substance in the blood which is responsible for transporting oxygen around the body.  Each person has 2 “sets of Hb”.  There is Normal Hb [Hb A] and there is Abnormal Hb [Hb S, Hb C …etc].

Most persons have 2 sets of normal Hb, and are therefore designated Hb AA. Some persons have 1 set of Normal Hb, and one set of Abnormal Hb e.g. Hb AS, Hb AC…etc.  More rarely some persons have 2 sets of Abnormal Hb e.g. Hb SS, Hb CC, Hb SC ...etc. The incidence [frequency with which it is found] of Hb S in Jamaica is approximately 1 to every 10 persons therefore, 1:10 persons in Jamaica is Hb AS [ i.e. they have the trait for HB S …The Sickle Cell Trait] Mathematics dictates that if the frequency of the Hb S Trait is 1:10, then the chance of the 2 Abnormal S-Hb’s coming together is 1:10 x 1:10 x 1:4 = 1:400 therefore, approximately 1:400 persons in Jamaica is Hb SS [i.e. they have full blown Sickle Cell Anaemia ].

Eczema is a form of inflammation of the upper layers of the skin. The term is broadly applied to a range of persistent or recurring skin rashes characterized by redness, skin swelling, itching and dryness, with possible crusting, flaking, blistering, cracking, oozing or bleeding. Areas of temporary skin discoloration sometimes characterize healed lesions, though scarring is rare. Affected areas include the face, chest and other skin crease areas.  

Eczema is not contagious and currently cannot be cured. However, for most patients the condition may be managed well with treatment and avoidance of triggers.

Enuresis (includes Bedwetting)

This term refers to the involuntary passage of urine in a child developmentally old enough to have achieved bladder control.
98% of children are dry by age 4 years, during the day, 70% are dry at night by that age.  The prevalence of Enuresis is 7% at age 5 years for Males and 2% for Females.  At 18 yrs of age, the prevalence is 1% for Males and rare for Females.  

Enuresis can be divided into Nocturnal Enuresis (bedwetting at night), Diurnal Enuresis (voiding urine while awake) and Nocturnal/Diurnal Enuresis which involves passage of urine while awake and asleep.  Each of these types may be further subdivided into Primary Enuresis (bladder control was never achieved) and Secondary Enuresis (occurring after a period of dryness of 6 – 12 months).  

Congenital heart disease means that your baby is born with a heart problem. This problem affects 1 in every 100 to 150 newborns. Some things that happen during pregnancy can lead to congenital heart problems, but most often the reason is not known.

The heart starts out as a simple tube and very early in pregnancy, it is fashioned into a complex pump. The process involves the growth of tissue that divides the heart into compartments, specialization of some cells to take on the pumping action, and others to conduct electrical impulses. Various other complex changes also take place. It is indeed a miracle that so many of us are born with normal hearts.

We are not sure what is the cause of most effects but the causative factors that result in defects must be present between the second to ninth week of pregnancy. One thought is that the genetic material concerned with the normal development of the heart is carried on a number of different genes. In the presence of certain environmental conditions these genes malfunction, leading to errors in the formation of the heart.

WHAT IS DOWN’S SYNDROME?
Down’s syndrome is the most common disorder of the human chromosome. It results from the presence of an extra chromosome, in some or all body cells. People with Down syndrome may share some physical and mental features. However, the symptoms can vary from mild to severe. Children with Down’s syndrome grow and learn more slowly and may have a variety of health challenges. It is present in 1 out of every 800 live births.

The condition was first described by an English doctor, Dr. John Langdon Down, for whom the syndrome is named. Down’s syndrome is also called Trisomy 21.

I am confronted with the problem on a daily basis ----- I see it acted out by kids in my office ---- I hear the parents cry [sometimes literally] ---- and, if the truth be told, very few [parents, that is] deal with it appropriately------------temper tantrums.
The little kid doesn’t get to have his own way, so the performance begins--------  

Act I  -------  He cries loudly, sometimes breath-holding, while stomping his feet or jogging on this spot.  

Act II ------- He proceeds to throw himself to the ground in a sitting position while continuing to wail as if he’s been mortally wounded while beating the ground [or any object/person in his vicinity] with his feet.  

Act III ------ He then throws himself backwards into a supine position [usually taking care to prevent personal injury] and wails even louder.  The feet continue as mentioned above, but now the trunk and the upper limbs get into the act as he thrashes around on the ground.

To spank or not to spank, that is the question?

The Bible (The word of the Lord God Almighty) advises us "to train up a child in the way he should go, so that when he is old, he will not depart from it" (Proverbs 22:6). As Parents, therefore, we must teach our children.  We cannot leave the job to the school, the church, or the media. It is our God-given responsibility as parents. 

The Bible also emphasises that "He who spares the Rod, hates his son, But he who corrects him shows him that he loves him” (Proverbs 13: 24; see also Proverbs 19:18,  22:15).

The Bible is NOT encouraging us to physically or verbally abuse our children. 
DO NOT PHYSICALLY, PSYCHOLOGICALLY, OR VERBALLY ABUSE OUR CHILDREN.  Therefore we need to know when to Spank, when not to Spank, where to Spank and how to Spank.