- Most cases occur in children younger than ten
- Children under one year of age whose mothers have had chickenpox are not very likely to catch it, but if they haven’t had it or children whose inborn immunity has already waned, can get severe chickenpox
- Adults and older adolescents usually get sicker with chickenpox than younger children do
- Vague symptoms, such as a fever, headache, tummy ache, or loss of appetite for 2-4 days before the appearance of the pox rash
- The average child develops 250-500 small, fluid-filled blisters over red spots on the skin,starting on the face, trunk, or scalp and spread from there
- After 1-2 days blisters become cloudy and then scab
- The pox often appear in the mouth, in the vagina, and on the eyelid
- The rash is itchy
- The rash is worse in children who have other skin problems, such aseczema or a recent sunburn
- Chickenpox is contagious 24-48 hrs. before rash appearance till blisters are crusted & start to fall down. usually one week after breaking out
- It can be spread by direct contact, droplet transmission, and airborne transmission
- Keep the child comfortable while his body fights the illness
- Oatmeal baths in lukewarm water provides a crusty, comforting coating on the skin
- Oral antihistamine with topical lotions such as Calamine will help to ease the itching
- Trim the fingernails short to reduce secondary infections and scarring
- Chickenpox vaccine is available. It is about 100 percent effective against moderate or severe illness, and 85 or 90 percent effective against mild chickenpox
Fast Facts About Fevers
Most bacteria and viruses that cause infections in humans thrive best at 98.6 degrees F (37C). Raising the temperature a few degrees can give the body the winning edge. In addition, a fever activates the body’s immune system, accelerating the production of white blood cells, antibodies, and many other infection-fighting agents.
Brain damage from a fever will not occur unless the fever is over 107.6 degrees F (42C) for an extended period of time.
Untreated fevers caused by infection will seldom go over 105 degrees unless the child is overdressed or trapped in a hot place. The brain’s thermostat will stop the fever from climbing above 106 degrees F.
About 4% of children will sometimes have seizures with fever. These febrile seizures are caused by rapid increase in temperature, not by the height of the temperature. Once a child already has a high fever and a febrile seizure, a febrile seizure is unlikely to reoccur with the current illness. In any event, febrile seizures are over in moments with no lasting consequences. Treating fevers early in these children may prevent further febrile seizures.
While 98.6 degrees F is considered the normal core body temperature, this value varies between individuals and throughout the day. The daily variation is minimal in children less than six months of age, about 1 degree in children 6 months to 2 years old, and gradually increases to 2 degrees per day by age six. A person’s baseline temperature is usually highest in the evening. Body temperature, especially in children, is normally raised by physical activity, strong emotion, eating, heavy clothing, elevated room temperature, and elevated humidity. Rectal temperatures below 100.4 degrees F (38C) may be entirely normal (no fever). A rectal temperature of 100.4 or above should be considered a fever. Lower values might be a fever, depending on the child.
A fever does not necessarily need to be treated. If a child is playful and comfortable, drinking plenty of fluids, and able to sleep, fever treatment is not likely to be helpful.
Steps should be taken to lower a fever if the child is uncomfortable,vomiting, dehydrated, or having difficulty sleeping. The goal is to bring the temperature between about 100 and 102 degrees F — not to eliminate the fever.
When trying to reduce a fever, first remove excess clothing or blankets. The environment should be comfortably cool (one layer of light weight clothing, and one lightweight blanket to sleep).
Two medicines are useful for reducing fever in children: acetaminophen and ibuprofen. Acetaminophen is given every 4-6 hours, and works by turning down the brain’s thermostat. Don’t use under three months of age without first having the child examined by a physician. Ibuprofen is given every 6-8 hours, and helps fight the inflammation at the source of the fever. It is not approved for children under 6 months. Both medicines may be given for stubborn fevers, but be very careful about using the correct dose of each.
A lukewarm bath or sponge bath may help cool a febrile child (after medication is given — otherwise the temperature bounces right back up). Cold baths or alcohol rubs cool the skin, but often make the situation worse by causing shivering, which raises the core body temperature.
Fever is a signal that something is going on in your child. Usually this is a minor illness, but it can be a serious infection, such asmeningitis. Any child less than 90 days old with a fever should be examined by a physician right away, to rule out a serious infection (unless there was a DPT shot in the previous 24 hours). Children of any age who have a fever 104 degrees or more should also be seen, unless the fever comes down readily with treatment and the child is comfortable. Any child who has a fever and is very irritable, ill appearing, confused, has difficulty breathing, has a stiff neck, won’t move an arm or leg, or who has a seizure should also be seen right away.
Even without the above symptoms, children under 6 months of age with a fever should be examined by a physician within 24 hours (again unless they just had a DPT), since they may have some infection that needs to be treated. Older children with a fever (6 to 24 months old) who are acting well and have no other symptoms should be seen if the fever lasts >48 hours (or >72 hours if they do have minor cold or flu symptoms).
Gastro-Enteritis feeding program
for infants and children
1. Continue Breast Feeding
2. Artificial formula fed infants should shift to Lactose Free Formula
3. Oral Rehydration Therapy: for every loose motion compensate him slowly with a rate of 5 ml/5 min
4. Increase Fluid intake like: Water, light tea, seven up or sprite without soda, Rice water
5. If child is vomiting stop food and give only clear liquids in small frequent quantities for 2 – 4 hours till vomiting stops otherwise you should take him to the doctor if vomiting persists
6. If no vomiting give light Food like :
- Boiled potatoes, carrot, rice, pasta, noodles
- Apple, Banana, Guava
- Marie Biscuits with light tea
- Plain toast or crackers
- Vegetable soup of stock made of potatoes, carrot & noodles
- Yoghurt or laban
- Starch pudding with lemon
- Any diarrhea special formula from the pharmacy
7. Avoid artificial milk and all milk products
8. Avoid fatty and fried food
9. Avoid fiber containing food like cereals, orange, figs, melon, grapes, and green leafy vegetables
10. Avoid juices
11. Avoid use of artificial sugar
Immunizations – general overview
It’s a process used to initiate or augment resistance to infectious diseases. The ultimate goal is to prevent, & in some cases eradicate, potentially serious-life-threatening diseases.
Alternative name is vaccination.
The immune system of the body protects it against diseases.
Immunization is a means of triggering acquired immunity that provides long – lasting protection against specific antigens, which can cause certain diseases. This works because the immune system can learn to recognize dangerous invaders if they are presented to it in a weakened form.
In immunization, small doses of the antigen (such as dead or weakened live viruses) are given to activate the immune system. When the immune system comes in contact with the antigens, it learns how to attack them and remembers what they look like. This allows the body to react quickly and efficiently when faced with the actual disease-causing organism. Immunization is one of the best means to protect against many contagious diseases.
Four different types of vaccines are currently available:
- Attenuated (weakened) live virus is used in the measles, mumps, and rubella (MMR)vaccine, the varicella (chicken pox) vaccine and oral Polio vaccine.
- Killed (inactivated) viruses or bacteria used in some vaccines. For example, the influenza vaccine uses killed virus.
- Toxoid vaccines contain a toxin produced by the bacterium or virus. For example, the diphtheria and tetanus vaccines.
- Biosynthetic vaccines contain synthetic “man-made” substances, which appear to be antigens to the immune system. For example, the Hib (Haemophilus influenzae type B) conjugate vaccine.
- BCG — Birth
- Hepatitis B #1 — Birth
- Hepatitis B #2 — 2 months
- Hepatitis B #3 — 4 months
- Hepatitis B # 4 – 6 months
- Diphtheria, Tetanus, acellular Pertussis (DTaP) #1 – 2 months
- DTaP #2 — 4 months
- DTaP #3 — 6 months
- DTaP #4 — 15 to 18 months
- DTaP #5 — 4 to 6 years
- dtpa # 6 – 10 years
- H. Influenzae type b (Hib) #1 — 2 months
- Hib #2 — 4 months
- Hib #3 — 6 months
- Hib #4 — 15 to 18 months
- Polio #1 — 2 months
- Polio #2 — 4 months
- Polio #3 — 6 months
- Polio #4 – 18 months
- Polio # 5 – 4 — 6 years
- Polio # 6 – 10 years
- Measles, Mumps, and Rubella (MMR) #1 — 12 months
- MMR #2 — 4 to 6 years
- Varicella-Zoster Virus Vaccine (chickenpox) # 1 — 12 months
- Varicella Zoster Virus Vaccine (Chicken Pox) #2 – 4 years
- Pneumococcal conjugate vaccine #1 — 2 months
- Pneumococcal conjugate vaccine #2 — 4 months
- Pneumoccocal conjugate vaccine #3 — 6 months
- Pneumococcal conjugate vaccine #4 — 12-15 months
- Hepatitis A #1 — 2 years or older (in selected areas/situations)
- Hepatitis A #2 — 6-12 months after Hepatitis A #1 (in selected
- Influenza — Annually for children older than 6 months with certain risk factors. May also be given to all others wishing immunity. Children under 8 years old receiving influenza immunization for the first time require 2 doses, 4 weeks apart.
- Meningococcal vaccine– 2 years or older in high-risk groups.
Important steps to discipline your child
- Get to know your child intimately by spending adequate time with him & knowing how his behaviour is
- Read, study & research discipline techniques
- Think about your style of discipline & be a model of the discipline you want your child to have
- Use language to help solve problems by establishing fair simple rules & state them clearly.when the child acquire language,help him to use words rather than actions to express his feelings
- Ignore the bad behaviour & give attention to the good one
- Rewarding the good behaviour is the best technique to encourage its establishment
- Natural consequences help children learn to take responsibility for their actions & help parents realize that the long term gain will be worth the short term discomfort
- Don’t tell “NO” all the time as too many no’s lose their meaning but positive statements teach children what’s appropriate
- Don’t dictate but negotiate with your child
- Pick your battles as there are times when you should decide if what your child is carrying on about is worth the fuss or not