Babies

If you are seriously worried about your baby, don’t wait for an appointment with your GP. Contact your Plunket nurse or emergency department now.

Reflux

During the first few months many babies experience varying degrees of reflux, which occurs when the acidic stomach contents regurgitate back into the oesophagus, causing pain. Reflux is common in babies because the circular band of muscle that acts as a valve between the oesophagus and the stomach is immature.

Symptoms: Reflux often gets misdiagnosed as colic. Other symptoms include frequent spitting up or vomiting (though not all babies with reflux spit up), movements such as throwing the legs up or arching the back, frequent wet burps, or throaty gagging noises.

Treatment: Smaller, more frequent feedings (feed your baby half as much, twice as often) can help because less food in the stomach at one time decreases reflux. Frequent feedings will also stimulate the production of saliva, which neutralizes stomach acid and lubricates the oesophageal lining. Keep baby upright and quiet for at least a half hour after feeding to let gravity hold the food down. Breastfeed if you can since breast milk is digested faster than formula.

When to call the doctor: With mild reflux, these simple home remedies are usually enough. If the reflux is severe enough to interfere with weight gain and sleep, or is causing your baby a lot of pain, the doctor may prescribe medications that block the production of stomach acid. Reflux usually begins to subside around 7 months, when babies spend much of their day upright.


Colds

Most babies usually get several colds during their first year. Colds are caused by viral infections that cause the membranes of the nose and respiratory passages to swell and pour out mucus.

Symptoms: Narrowed, mucus-filled breathing passages can cause baby to cough, wheeze, breathe fast, and may interfere with normal sleeping and eating patterns. Your baby may also have a low-grade fever, runny nose, sneezing, and a decreased appetite.

Treatment: If your child is having trouble breathing, sit him on your lap in the bathroom with the shower on the hottest setting for ten minutes. The steam will help loosen the congestion. You can also try using a nasal aspirator with saline nasal spray to suction out the secretions. Doing this before bedtime can help your baby sleep. Offer your infant extra fluids. Don’t use cold medicines without checking with your doctor.

When to call the doctor: If your child is under three months, you should call your doctor at the first sign of illness. For infants older than three months, call the doctor if her lips or nails turn blue, if she’s having trouble breathing, or if she has a fever that warrants a call to the doctor. If your infant remains in good spirits and the nasal discharge is clear, give the cold a week on the above home treatment. If your baby’s nasal discharge becomes thick and yellow, visit the doctor: Antibiotics won’t work because they fight bacterial infections, and colds are caused by viruses.


Constipation

Often after babies start solid foods, they become constipated and have difficulty passing stools. It’s important to treat constipation because if the hard stool is painful, your baby may refuse to go. This may then stretch the intestines, weaken the muscle tone, and make it more difficult to pass the stool.

Symptoms: In a newborn, watch for stools that are firm and infrequent (less than once a day). It may be helpful to keep track of your baby’s bowel movements. If you see blood on your baby’s nappy, it may be due to a rectal fissure, a tiny tear in the rectal wall caused by a hard stool. These harmless yet painful tears heal quickly once the constipation is cured.

Treatment: If you’re feeding your baby formula, experiment with different brands until you find one that produces a softer stool. If your baby is more than 1 year old and you recently switched from formula to cow’s milk, try going back. Decrease constipating foods, such as bananas and rice cereal, in your baby’s diet and add high fluid and high fibre ones, such as puréed prunes and pears and barley cereal. You can also add a teaspoon of flax oil (not only a natural laxative but a source of healthy omega-3 fats) once a day in Baby’s cereal or bottle.

When to call the doctor: If your baby seems to be in pain and hasn’t had a bowel movement for more than four days, call your Doctor. In severe cases you may be prescribed a mild laxative or an enema.


Diarrhoea

Diarrhoea refers to having bowel movements that are too frequent and too watery. It is most often caused by a virus, but can also result from a bacterial infection, an allergy, or medication. The potential danger of diarrhoea is dehydration.

Symptoms: Breastfed newborns may have up to 12 small bowel movements a day, but by three months, they may go a day without any. If your infant’s bowel movements become much more frequent and watery all of a sudden, he probably has diarrhoea.

Treatment: Treatment of diarrhoea is basically resting your baby’s intestines until they naturally return to normal. Keep track of your baby’s stools to report to your doctor. It is important to make sure that you baby is getting adequate fluids to prevent dehydration. Give your baby frequent fluids.

When to call the doctor: If your baby has a high fever, bloody diarrhoea, increasing abdominal pain, vomiting, or you suspect he’s dehydrated or losing weight, medical attention is needed. Signs of dehydration are lethargy, dry eyes, dry mouth, and fewer wet nappies. Your doctor may suggest changing your baby’s diet and replacing lost fluids with an electrolyte solution.


Ear infections

When fluid accumulates in the middle ear, it can act like a culture for germs to grow in. The infected fluid presses on the eardrum, producing intense pain.

Symptoms: If your infant has an ear infection, she’ll probably be cranky, wake up during the night because of pain, be unwilling to lie flat, and cry during feeding.

Treatment: To treat middle-of-the-night earaches give your baby the appropriate dose of infant pain reliever. Keep her upright, which will allow the fluid to drain away from the eardrum and cause less pressure.

When to call the doctor: If you suspect an ear infection, have your doctor or nurse examine your baby’s ears. If the eardrum looks very infected, she may prescribe an antibiotic. It’s important to seek medical help, since repeated untreated ear infections may lead to hearing loss and consequent speech delay.

Prevention: Breastfeed your infant if you can since breastfed infants have fewer ear infections. Control allergens (such as cigarette smoke, dust, and animal dander) since they can cause fluid build-up behind the eardrum. If your child has a cold, suction her nose, to prevent germs from entering the ear. If your baby is bottle-feeding, feed her in an upright position to lessen the chance of milk or formula entering the middle ear from the throat.


Fever

Fever is a symptom of an underlying illness, not an illness in itself. It’s a clue that something is going on that needs attention.

Symptoms: If your baby feels hot or looks flushed, take his temperature to confirm a fever.

Treatment: If your child is over a year old, seems happy, and doesn’t have related symptoms such as a cold, there’s usually no need to call the doctor immediately. To lower the fever, you can give your child paracetamol; a tepid sponge bath may help as well.

When to call the doctor: This will depend on your baby’s age. A temperature of around 37ºC is normal. A digital thermometer is the best type to use to get an accurate temperature reading.

Fever ranges and symptoms

38–38.9°C – mild fever
With a mild fever your child might have flushed cheeks, be less active and feel warm when you touch them.

39–39.9°C – high fever
With a high fever your child may have flushed cheeks, be less active, be fussy, might not want to eat or drink, and feel hot when you touch them.

40°C or higher – very high fever
With a very high fever your child will have flushed cheeks and feel very hot to touch.  They will be fussy, refusing food and drink, and will be very listless (lacking in energy).


Tummy Bug

This illness, better known as a stomach bug, causes vomiting, diarrhoea, and abdominal pain. A variety of viruses, including norovirus—which often sweeps through child-care centres, can cause gastroenteritis. Most stomach viruses clear up within a few days to a week and require nothing more than rest and TLC. It is important to monitor hydration. If you suspect that you baby is dehydrated or they seem very unwell contact your doctor or nurse.


Hand-Foot-Mouth Disease

Symptoms: painful sores in the mouth and throat

Hand-foot and mouth disease is highly contagious viral illness, passing from kid to kid through touch, coughs, sneezes, and faecal matter. The sores are often accompanied by red blisters on the hands and soles of the feet that last seven to ten days. If your child also feels achy, give him children’s ibuprofen or paracetamol. Ease his sore throat with ice pops and cold fluids. You should also watch for dehydration, since some kids’ sores are so uncomfortable that they resist drinking at all.


Allergies

An allergy can occur when the body’s immune system reacts to the presence of an allergen (foreign protein or other substance).  This allergen may be something the child has eaten or it might be from an insect bite or some substance that has been in contact with the skin.  Some allergy problems, such as hay fever, asthma and eczema, often run in families.

Very rarely, an allergic reaction needs immediate medical attention due to anaphylaxis causing breathing and circulation collapse.  If your child’s lips swell, or they have difficulty breathing or they faint or collapse, call 111 for an ambulance and get your child to a doctor as soon as possible.


Asthma

Asthma is due to inflammation of the bronchial tubes, the airways leading to the lungs.  This inflammation leads to swelling of the lining and increased mucus which obstruct normal airflow in and out of the tubes.  Difficulty moving air in and out of the lungs is frightening and this itself can make breathing even worse.  In most children, asthma starts with a runny nose and then wheezing with coughing bouts.  Other triggers can include smoke, cold air, specific allergens, or even exercise.  Symptoms are often worse at night.  Sometimes the child needs hospital treatment.  Antibiotics are not needed, but other effective treatment is available both for asthma attacks and for prevention long term.

If you are concerned that your child has asthma, talk to your doctor.  If he is having difficulty breathing, seek help from a doctor immediately.  There are very effective ways to control most asthma, usually with relieving inhalers, sometimes with regular preventer inhalers, and with breathing exercises.


Eczema

Eczema is an inflammation (rash) of the skin, which if often red, dry and itchy.

The causes of eczema are not known but there appears to be increased reactivity of the immune system, and children affected by eczema often have other allergic conditions.  Some ‘triggers’ which make symptoms worse in some children including dietary factors (such as cow’s milk, peanuts, fish, eggs), stress and contact with chemicals such as certain perfumes, lanolin and some detergents.  Woollen clothing can irritate eczema, while continuing with breastfeeding can delay the onset of eczema.

Treatments:

  • Try to work out what triggers make your child’s eczema worse.
  • If wool makes it worse, try putting cotton singlets or cotton tops under woollen jerseys.
  • Soaps tend to dry out the skin, you can use alternative ointments which  your doctor can prescribe
  • Moisturising the skin is very important to maintain skin health
  • Avoid overheating which can often make eczema worse.
  • If your child scratches the eczema, try to keep his finger nails short and use gloves at night.
  • Discuss creams to improve the eczema with your doctor.  Moisturisers are the usual form of treatment.  They can be applied several times a day and the greasy ones trap water in the skin.  Sometimes steroid creams are used for red inflamed areas.  Weepy crusted areas may be due to infection and may need oral antibiotics.

Chickenpox

Chickenpox is a common virus that causes an itchy skin rash and blisters. Chickenpox is also called varicella. It’s very infectious and spreads easily. Most children will catch it between the ages of 2 and 10 years. If one child in your household gets chickenpox, it’s very likely that others will too.

Symptoms:

  • Itchy skin
  • Rash/spots/blisters
  • Fever
  • Headache
  • Skin infections and scarring.

Chickenpox is uncomfortable, but usually mild and children will recover quickly. Most children will need around a week off school or early childhood education to recover and to avoid spreading disease. Your pharmacist, doctor or nurse can give advice about treating the itchy rash.

Chickenpox can lead to skin infections, and rarely, more serious complications like eye damage, inflammation (swelling) of the brain, pneumonia, kidney problems and sometimes death.

Chickenpox during pregnancy can harm the baby and cause stillbirth.

The virus that causes chickenpox stays in your body even after you recover and can cause shingles many decades later.

Chickenpox Vaccination

One dose of the vaccine will protect around four out of five people from any kind of chickenpox and almost everyone from severe chickenpox.

Some people who have been vaccinated will still get chickenpox, but they will have a milder illness.

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