Sick Baby

Know how to tell what’s wrong with your sick baby and how you can help her feel bet­ter

Your Baby & Toddler - - Health -

The younger the baby, the more im­por­tant it is to seek med­i­cal help im­me­di­ately.

It’s dif­fi­cult to know whether to take your child to the doc­tor, or even the emer­gency depart­ment, when she’s sick – es­pe­cially when symp­toms come on at night.

As a rule, the younger the baby, the more in­clined you should be to seek med­i­cal at­ten­tion. Ba­bies’ con­di­tions can de­te­ri­o­rate very quickly, so it’s al­ways best to be on the safe side.

As your child grows up, you will be more ex­pe­ri­enced in mon­i­tor­ing and treat­ing her ail­ments, and prob­a­bly more in­clined to keep an eye on her con­di­tion and see if things im­prove. What­ever the age of your child, trust your in­stincts and al­ways err on the side of cau­tion. Don’t de­lay be­cause you don’t want to worry your doc­tor with some­thing po­ten­tially silly. Your baby’s health takes pri­or­ity.

FEVER

Tem­per­a­tures vary through­out the day, and are in­flu­enced by ac­tiv­ity lev­els. How­ever, a high tem­per­a­ture is a sign of in­fec­tion.

A tem­per­a­ture is the body’s nor­mal re­sponse to an in­fec­tion and tem­per­a­tures un­der 38 ˚ C are nor­mal.

A nor­mal tem­per­a­ture be­low 38 ˚ C is not a con­cern and should not cause any panic.

How­ever, higher tem­per­a­tures that per­sist and tem­per­a­tures over 40 ˚ C do need med­i­cal at­ten­tion.

There are a few steps you can take to bring down your child’s tem­per­a­ture: • Re­move any ex­cess

cloth­ing. • Give her med­i­ca­tion such as parac­eta­mol, ibuprofen or pre­scribed sup­pos­i­to­ries. • A baby un­der three months who has a fever of any tem­per­a­ture must be seen by a doc­tor.

FITS AND CON­VUL­SIONS WHAT CAUSES FITS?

There are many causes of fit­ting in chil­dren. Some may be re­lated to: • A high tem­per­a­ture. This is the most com­mon cause and this kind of seizure is called a febrile con­vul­sion. • Head in­jury. • Epilepsy. • Poi­son­ing.

SYMP­TOMS

• Jerk­ing move­ments and

stiff mus­cles. • Your child may bite down

on her tongue. • Your child may stop breath­ing or lose con­scious­ness (it is nor­mal in a febrile con­vul­sion to briefly stop breath­ing. Breath­ing should re­turn spon­ta­neously when the fit is fin­ished). • Your child’s face may turn

bluish or grey. • Her eyes may roll up­wards. • She may drool or foam at the mouth and may lose con­trol of her blad­der or bowel (wee or poo un­con­trol­lably). • Your first pri­or­ity is to pre­vent your child from hur ting her­self. • If the child is a known epilep­tic and has fits, you do not need to call the emer­gency ser­vices as your

doc­tor would have told you what to do in the case of fit­ting. • If your child does not stop fit­ting, or if the child has stopped fit­ting and then starts fit­ting again, call the emer­gency ser­vices for as­sis­tance. • If this is your child’s first fit and you don’t know what the cause is, call the emer­gency ser­vices and fol­low the steps be­low.

FOL­LOW THESE STEPS

• Se­cure the air­way by putting the child on her left side. • Lay her down and place a cush­ion or some­thing soft un­der her, and loosen any tight cloth­ing she may be wear­ing. • Do not try to hold her down or try to force any­thing into her mouth. Do not give her any­thing to drink. • Any child who has a seizure should be seen by a doc­tor to de­ter­mine and/or treat the cause. • It is com­mon for a child to

be drowsy after a seizure.

FEBRILE CON­VUL­SIONS

Seizures usu­ally last for only three to four min­utes. Febrile con­vul­sions are fairly com­mon (two to five per­cent of chil­dren get febrile con- vul­sions), and usu­ally do not re­quire treat­ment. Chil­dren gen­er­ally grow out of febrile con­vul­sions by the age of five.

Chil­dren who have had a febrile con­vul­sion are at risk of hav­ing an­other one when­ever they get a high fever.

Any child who has a seizure should be eval­u­ated by a doc­tor to rule out other causes, such as epilepsy.

BREATH­ING PROB­LEMS

There are var­i­ous con­di­tions that can cause breath­ing prob­lems in ba­bies and young chil­dren. A doc­tor should al­ways see a baby or child who has dif­fi­culty breath­ing. In se­vere cases, call an am­bu­lance or visit the emer­gency depart­ment of a hos­pi­tal. You should seek med­i­cal at­ten­tion im­me­di­ately if a cough is ac­com­pa­nied by laboured or ab­nor­mal breath­ing.

ASTHMA

This is a chronic in­flam­ma­tory lung disease that causes the air­ways to nar­row. Symp­toms in­clude cough­ing, wheez­ing, short­ness of breath, chest tight­ness, in­creased heart rate and per­spi­ra­tion. It can be life threat­en­ing, so if an at­tack is se­vere, seek med­i­cal at­ten­tion im­me­di­ately or call for an am­bu­lance.

BRON­CHI­OLI­TIS

A vi­ral in­fec­tion of the small air­ways in the lungs that af­fects ba­bies un­der one year. Cre­at­ing a steamy at­mos­phere, us­ing a hu­mid­i­fier or a pan of boil­ing wa­ter, will ease the breath­ing. Take your child to the doc­tor.

BRON­CHI­TIS

In­flam­ma­tion of the lin­ing of the bronchial tubes. Most cases are mild, but in se­vere cases, the child may have dif­fi­culty breath­ing, in which case you should take him to your doc­tor or the hos­pi­tal, or call an am­bu­lance.

CROUP

Croup is caused by a vi­ral in­fec­tion and in­volves the in­flam­ma­tion and nar­row­ing of the up­per air­way to the lungs. This re­sults in a char­ac­ter­is­tic bark­ing cough. It nor­mally af­fects chil­dren be­tween three months and five years of age. Steam helps to ease the con­stricted air­ways. Use a cool mist hu­mid­i­fier if you have one and get the child to breathe in the moist air through his mouth.

Al­ter­na­tively, mist up the bath­room with hot shower steam and have the child sit in it for about 10 min­utes.

If your child has dif­fi­culty tak­ing a breath, if there is

stri­dor (a high-pitched noise when he is breath­ing in), or if she is pale or bluish around the mouth, seek med­i­cal help.

PNEU­MO­NIA

This in­flam­ma­tion of the lungs may be par­tic­u­larly se­vere in young chil­dren. It gen­er­ally re­sponds well to an­tibi­otics if treated ex­pe­di­tiously. If your child is not well, see your doc­tor im­me­di­ately.

COLDS AND FLU

Flu or a com­mon cold gen­er­ally lasts about a week. Un­less there are com­pli­ca­tions, treat the child at home: • Give plenty of flu­ids, as both ill­nesses are de­hy­drat­ing. • Make sure the child gets

lots of rest. • Give your child pae­di­atric parac­eta­mol or ibuprofen if nec­es­sary to help with aches and pains. An­tibi­otics will not help sim­ple colds and flu. They are pre­scribed if your child de­vel­ops a bac­te­rial in­fec­tion like an ear in­fec­tion or pneu­mo­nia (see above).

STUFFY NOSE

A blocked nose is an an­noy­ing side ef­fect of a cold. Ba­bies’ small noses get blocked very eas­ily. They bat­tle to breathe and suck, which can be dis­tress­ing for them and you. Try these tips: • Use a bulb sy­ringe to suck

out fluid from the nose. • Use a hu­mid­i­fier in her room to keep the mu­cus soft and moist. • Ask your phar­ma­cist for eu­ca­lyp­tus- based drops to add to the hu­mid­i­fier, or put a few drops on her pil­low. • To help break up clogged mu­cus, use a drop of saline so­lu­tion or ex­pressed breast­milk in her nose. • Tickle her nose with the cor­ner of a tis­sue to en­cour­age her to sneeze.

DE­HY­DRA­TION

Chil­dren some­times lose large amounts of wa­ter and salts (elec­trolytes) through fever, di­ar­rhoea or vom­it­ing. This can cause de­hy­dra­tion and, in some in­stances, re­sult in death.

The younger and smaller the child, the greater the dan­ger, so be very vig­i­lant if your baby has di­ar­rhoea or vom­it­ing. Don’t wait un­til you see the warn­ing signs!

To pre­vent de­hy­dra­tion, give your child small sips of liq­uid reg­u­larly. Tiny chips of ice to suck are some­times more ac­cept­able. If you sus­pect your child is in dan­ger of de­hy­dra­tion, give her re­hy­dra­tion so­lu­tion rather than wa­ter, and take her to the doc­tor or emer­gency depart­ment. Spe­cially pre­pared elec­trolyte so­lu­tions are bal­anced with salt and min­er­als. If a child has bad di­ar­rhoea or vom­it­ing, it may be dif­fi­cult for you to re­hy­drate her ad­e­quately at home, in which case she may be hos­pi­talised and given flu­ids through a drip.

If you see signs of de­hy­dra­tion, con­tact your doc­tor im­me­di­ately, or take your child to the emer­gency depart­ment.

SIGNS AND SYMP­TOMS

• Dry mouth. • Few or no tears when cry

ing. • Pro­duc­ing fewer than six wet nap­pies a day (for an in­fant). • No uri­na­tion for six to eight

hours (in older chil­dren). • Fon­tanelle looks flat­ter than nor­mal, or some­what sunken.

IN SE­VERE CASES, YOU MAY ALSO SEE THE FOL­LOW­ING

• Skin that ap­pears dry, wrin

kled or doughy. • In­ac­tiv­ity or weak­ness

(lethargy). • Sunken eyes or fon­tanelle. • Ex­ces­sive sleepi­ness or

dis­ori­en­ta­tion. • Mus­cle cramps. • Deep, rapid breath­ing, or

fast or weak­ened pulse.

GAS­TROIN­TESTI­NAL IN­FEC­TIONS

These in­fec­tions are usu­ally short-lived, but there is a dan­ger of de­hy­dra­tion. Call your doc­tor if your child has: • Fever, vom­it­ing and diar

rhoea to­gether. • More com­ing out of ei­ther end than is go­ing in through the mouth. • Signs of de­hy­dra­tion. If your child has fever and vom­it­ing with­out di­ar­rhoea, keep the child hy­drated and see if the child starts to im­prove.

A CHILD NEEDS TO BE SEEN BY A DOC­TOR OR GO TO AN EMER­GENCY DEPART­MENT IF

• She vomits up blood. • Vomits some­thing that looks like dried cof­fee grounds (this is blood mixed with stom­ach acid). • Starts pro­jec­tile vom­it­ing.

MENIN­GI­TIS AND EN­CEPHALI­TIS

En­cephali­tis is the in­flam­ma­tion of the brain. Menin­gi­tis is a gen­eral name for in­flam­ma­tion of the meninges (sheaths that cover the brain and spinal cord) and the cere­brospinal fluid (the fluid that cir­cu­lates in the spa­ces in and around the brain and spinal cord). Menin­gi­tis can be caused by bac­te­ria, virus- es, fungi and other or­gan­isms. The sever­ity and the symp­toms will de­pend on the cause. How­ever, a child can de­te­ri­o­rate quickly and menin­gi­tis can be fa­tal, so get­ting med­i­cal at­ten­tion im­me­di­ately is essential. Take your child to the doc­tor or emer­gency depart­ment im­me­di­ately if you sus­pect menin­gi­tis or en­cephali­tis.

SIGNS AND SYMP­TOMS OF EN­CEPHALI­TIS AND MENIN­GI­TIS

• First signs are fever, lethargy, vom­it­ing and ir­ri­tabil­ity. Older chil­dren may com­plain of a headache. • A stiff neck or body. • Bulging fontanelle­s. • Jaun­dice. • Seizures oc­cur in about a third of pa­tients with bac­te­rial menin­gi­tis and are some­times the only symp­toms. • As the disease de­vel­ops, symp­toms may in­clude in­creased ir­ri­tabil­ity with a high- pitched cry (es­pe­cially in in­fants) and dif­fi­culty breath­ing. • New­borns with menin­gi­tis some­times don’t dis­play the clas­si­cal signs de­scribed above and may sim­ply be ex­tremely ir­ri­ta­ble or lethar­gic. • An in­fant who isn’t feel­ing well is usu­ally com­forted when her mother picks her up. Ba­bies with menin­gi­tis some­times dis­play “para­dox­i­cal ir­ri­tabil­ity” and pick­ing up and rock­ing a child may make her more dis­tressed. This can be a sign of ir­ri­tated meninges. • Meningo­coc­cal menin­gi­tis ( bac­te­rial) may be ac­com­pa­nied by a rapidly spread­ing pur­plish rash that does not fade when pressed.

Many com­bi­na­tion cold and cough med­i­ca­tions con­tain fever- low­er­ing drugs. Check their la­bels care­fully and don’t give your child a sep­a­rate fever re­ducer if she is al­ready tak­ing one of these com­bi­na­tion prod­ucts. Do not use com­bi­na­tion medicines for chil­dren un­der six years.

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