CHILDREN’S HEALTH.

When do you worry, and When don’t you?

children's doctor

Acute Childhood Illnesses

Thankfully, the vast majority of children’s illnesses are self-limiting viral infections. However, this cannot of course be taken for granted and serious illnesses need to be teased out at the earliest stage possible. Sometimes, it’s necessary to review a child with an acute illness the following day to check on progress.

Parents can often feel helpless in the face of what can seem like an assault of repeated viral infections over the winter months. Upper respiratory infections are common, unpleasant, and can cause considerable distress for the family and may have important implications for childcare. However,  there can be some comfort in the knowledge that the child is building a strong immune system, and no longstanding harm will occur.

There are decision-making aids with regards to whether to treat acute middle ear infections or tonsillitis with antibiotics and Dr Beatty will be happy to discuss these with you. The final decision about antibiotics is taken, of course, with the parent.

The most common outcome for a child with a fever and other respiratory tract symptoms will be a thorough examination, reassurance and advice on treating the symptoms. When you think about it, this is a great outcome and no parent wants their child having unnecessary antibiotics.

Urinary tract infection should be ruled out for children with acute fever and no indicator of a viral infection, and no indicator of an infection such as a middle ear infection.

I worry that I see the doctor too often

Pretty much every parent has worried that they go too often, or worry that they don’t go. Who says being a parent is easy!

Thankfully most of the kids that the GP Sees with an acute illness are not truly ‘sick’ in the medical sense. There’s no doubt that serious illnesses in children are rare. So why worry that you are seeing the doctor ‘Unnecessarily?’

The GP will not be judging you, and will be happy to let you know that your child is going to be fine.

Longer Term Children’s health issues

Other childhood illnesses that commonly cause problem and require treatment are constipation, and bedwetting.

Asthma and skin conditions like Eczema can usually be well controlled in general practice, and Dr Beatty has developed patient information leaflets to help support knowledge in managing these conditions.

Allergies are an increasingly common issue in general practice. The GP may request allergy testing for a variety of different allergies – from specific types of pollen to foods commonly implicated in food allergies. Your GP is also able to guide you through an elimination food challenge for a suspected food allergy.

Headaches are a common issue in childhood. Recurrent acute headache that makes the child feel unwell is usually migraine. Medication called “triptans” are for attacks of migraine & may be prescribed for kids. Preventative migraine medication may be considered for frequent migraines. There is limited evidence for which preventative medication is best for a child because drug manufacturers tend to fund expensive randomised trials in adults rather than kids. However, there are expert consensus guidelines that enable to GP to confidently prescribe certain preventative migraine medication for kids.

Kid’s Sleep Problems are a huge concern for many parents. A new (free) IOS kids sleep App was launched by Children’s Sleep Experts at Evelina, London, in 2015. This App has great credentials because it was developed by Children’s Sleep Expert Professor Byron of Guys & St Thomas’s hospital +  Evelina children’s hospital. It’s more than a sleep diary. The app comes up with ideas on how to manage sleep problems and is age-specific.

Obstructive Sleep apnoea (OSA) is a common kid’s health issue. Unlike in adult OSA, kid’s Sleep apnoea is most common in kids with a normal weight. The usual cause is large tonsils & adenoids. You might consider childhood sleep apnoea if your child has Snoring most nights, or Difficulty breathing when asleep, or you see your child stop breathing (no airflow) during the night or there is a tendency to mouth breathe during the daytime.

Childhood OSA may make your child grumpy for a while in the mornings, & has the potential to affect behaviour, concentration and learning – even causing hyperactivity. Sleep studies are difficult to come by in kids, and it may be best to go be referred to the Otorhinolaryngologist (ENT) specialist to check the space above the tonsils and around the adenoids.

Colic is defined as inconsolable crying for more than 3 hours per day, more than 3 days per week over at least 3 weeks. Not all crying is caused by colic and a thorough clinical assessment is required. Colic may be treated with some strains of probiotic.

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WRITTEN BY: Dr Richard Beatty
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