ASK THE DOCTOR

Whenever it’s time to give my toddler his medicine, he zips his lips closed, so it’s difficult to get the syringe into his mouth. It’s always a fight, and when I finally do manage to give him the medicine, he spits most of it out. Should I give him an extra dose when he does this?

DR PAUL SINCLAIR ANSWERS: Giving oral medication in some children is really a nightmare: they don’t like the taste or the texture, and having to take the medication every few hours just does not work for them. This is particularly noticeable with antibiotics, because they are what are known as suspensions, as opposed to true syrup, which makes them noticeably grainier in texture. Whether or not to give an extra dose of the medication depends on how long after having the medication your child spat or vomited it out. Simply put, if the medicine was spat out immediately or within an hour, you should repeat the dose because none of the medication was absorbed. Remember, the stomach empties about 50 percent of its contents every hour, so with a liquid antibiotic, enough will have passed through your child’s system and be absorbed within an hour of ingestion to have an effect, so he doesn’t need an extra dose then. Disguising the medicine with honey or jam, mixing it in a bit of yoghurt or using a medication-administering dummy can also be useful.

How do I tell if my child is too sick to go to crèche? I work full time and can’t take off work very often, but I don’t want to make things worse by sending him to crèche when he’s not feeling well.

DR PAUL SINCLAIR ANSWERS: The decision on whether to keep him at home or not involves both the health of your child and the other children at the crèche who will be exposed to your child’s illness. That being said, you can expect that in the first few years of your child’s life that he will have on average eight infections per year. These will include upper and lower respiratory infection, rashes and tummy bugs. To keep him away from crèche (and for you to take time off from work as a result) often is just not possible. Keep your child at home if he has a temperature that requires regular therapy (such as tepid sponge baths or medication) to be controlled. In terms of a snotty nose or a cough, it is safe to send your child to crèche when his condition is improving, he is sleeping well and is temperature free.

Be sure to feed your child a balanced diet and ensure good sleep to keep his immune system in check so that his body can fight off infections well. Remember that these infections are normal in young children, and will happen often.

If I develop a cold or the flu this winter, what is the best way to prevent my young baby from catching it?

DR PAUL SINCLAIR ANSWERS: Though most infections during the season are rather mild, there can be some nasty ones for babies, like respiratory syncytial virus or adeno. These can cause major chest issues, particularly in smaller infants. Because of this, I would say that prevention is always better than treatment. So, to best protect yourself and, in turn, your baby from getting sick this winter, be sure to get a flu vaccine (which is safe when breastfeeding), follow a healthy and balanced diet, and avoid crowded places (like malls). I would also suggest that you and your family take a good probiotic. These are all proven methods of avoiding acquiring viruses.

If, despite your best efforts, you do get sick, then I suggest you employ simple precautions to keep your baby from getting sick too. Try not to kiss her during this time, and remember to wash your hands very often. Breastfeeding is also really important and won’t make your little one sick, so don’t stop nursing your baby while you are sick.

ROLL UP YOUR SLEEVE

Dr Mirjana Lucic, a paediatrician at the Netcare Park Lane Hospital in Johannesburg, says she highly recommends all healthy children should receive the flu vaccine every year from the time they are six months old. “Pregnancy lowers your immunity, so pregnant women should definitely also be vaccinated. Acutely ill children should not be vaccinated, neither should those people with previously demonstrated severe allergic reactions to vaccines,” she says.

SYSTEM SUPPORT

“You start developing immunity from when you are born,” says Dr Wood-Thompson. “But up to the age of six months, you don’t yet have all the antibodies you need to fight disease, so you are more prone to getting sick.” A person needs to be exposed to (small amounts of) viruses and bacteria in order to build up their immunity. This is bound to happen naturally, simply by babies living in the world and touching the same surfaces and breathing the same air as other people, and yes, it does mean they can occasionally become ill.

“A good way to limit the risk is to vaccinate a very young baby’s parents, caregivers and older siblings against influenza,” says Dr Lucic. “Also try to avoid crowded, closed places.” Breastfeeding mothers do have a card up their sleeve: “Breastfeeding is the best thing you can do to protect your young baby from disease,” says Dr Wood-Thompson. “Breast milk contains antibodies from the mother, which the baby can use to fight disease and build up immunity. Breastfed babies get sick less.” Lastly, practise good hygiene. Wash your and your children’s hands regularly – certainly after every nappy change and before meals – and clean your household surfaces with an antibacterial cleaner.

HOW TO FEEL BETTER

Make sure your child gets plenty of rest, and continue breastfeeding if you have a young baby. For muscle aches and fever, give a pain reliever like children’s paracetamol or ibuprofen.

“Give regular, small volumes of fluid. Your child might not eat much, but needs to drink sufficient fluids,” says Dr Marie Wessels, a Cape Town paediatrician. It helps to keep your child hydrated and to keep the ever-present snot thin. “Treat fever with paracetamol and other feverfighting strategies.

“Also watch out for warning signs and know when to get to the doctor,” Dr Wessels says.

During dry colder months, nasal passages dry out and become the ideal breeding place for airborne germs. Taking care of your baby or tot’s nasal passages, ears and throat is therefore very important to avoid further complications. Saline spray is the easiest way to keep little nasal passages lubricated. It assists in flushing out bacteria easily and in doing so prevents further congestion and infection. Humidifiers can also assist in keeping secretions thin and ensure irritated airways stay moist and clear, helping baby to breathe easily.

PREVENT & PROTECT

Wash, wash, wash those hands to prevent cross-contamination and reinfection – after blowing your nose, going to the toilet, and before handling food. Correct hygiene practices are basic but absolutely essential in protecting yourself and your baby. Teach kids to sing “Happy Birthday” through twice while washing their hands with soap and water – it’s the ideal length to maximise hygiene. Keep hygiene wipes and hand sanitiser in your bag, and soap at every sink or basin.

Keep surfaces clean, and wipe down often – the flu virus can live on a surface for up to 48 hours.

All adults taking care of a baby should be vaccinated against influenza, especially caregivers of babies younger than 6 months.

Correct hygiene practices are basic but absolutely essential in protecting yourself and your baby.