Experience on prevention and control of common childhood diseases

There is never a universal formula that works. The core is to walk the middle line between "over-protection" and "complete protection" and give priority to the prevention and control of three types of high-incidence problems such as respiratory tract, digestive tract, and infectious diseases. This is much more effective than stocking up a cabinet of children's medicines or following the trend of buying a bunch of Internet celebrity protective supplies.

Don’t believe it. The mother of a 3-year-old boy who was treated last month said she had to wipe the floor with chlorine-containing disinfectant three times a day and disinfect her children’s toys once a day. She wore two layers of N95 when going out and was not allowed to touch the slides or fitness equipment in the community for fear of contaminating bacteria. As a result, the child caught a cold in the first week of kindergarten. After that, he had an average of two fevers a month. He developed pneumonia when he coughed. Instead, he was crawling around on the floor with another child in the same neighborhood all day long. The parents only stared at the child who washed his hands before meals and after using the toilet. He had a cold once in half a year.

In fact, there have been two voices in the academic community regarding children's daily cleaning. One school advocates the hygiene hypothesis of "appropriate exposure", which believes that moderate exposure of children to non-pathogenic microorganisms in the environment during childhood can help improve the development of the immune system and reduce the probability of allergies and autoimmune diseases.； The other group insists on "sterile protection" and believes that cutting off all contact paths for pathogens can reduce the risk of getting sick. The more cases I come into contact with, I will find that the two are not contradictory at all - cleaning needs to be done, but in scoring scenarios, daily home care does not require disinfection of the entire house. As long as the bottom line of "wash your hands carefully with the seven-step method before touching food, after using the toilet, and after going home" is observed, door handles and toys that children often touch are enough to be disinfected 1-2 times a week. Over-disinfection will destroy the normal flora environment of the child's respiratory tract and intestines, and become a "glass man" who is prone to illness.

When it comes to the most troublesome situations for parents, it must be in collective places such as kindergartens and elementary schools. In spring and autumn, influenza, hand, foot and mouth, chickenpox, and norovirus take turns to come, and only half of the class will be wiped out. Previously, our community conducted a semester-long comparative observation of two public large classes in the area. One class strictly implemented the morning inspection process, checking the temperature, touching the throat, and looking at the soles of the hands and feet every morning. If any symptoms of fever, rash, or vomiting were found, the parents were immediately notified to take them home for observation. The other class only performed routine temperature measurements. As a result, after one semester, the class with strict morning inspection had a 62% lower incidence of infectious diseases than the other class.

Parents have completely polarized attitudes about whether to send their sick children to school: some think their children just have a low-grade fever and are in good spirits, so they will forcefully send them to kindergarten.； Some people will immediately ask for leave for their children to hide at home as soon as they hear that a child in the class has a cold. In fact, from a public health perspective, as long as a child has typical prodromal symptoms of infectious diseases such as fever, vomiting, diarrhea, and unexplained rash, no matter how good the mental state is, it is not recommended to go to group places. This is to avoid cross-infection to other children, and to allow your child to get adequate rest and avoid aggravation of the condition. But if only a few children in the class catch a common cold, there is no need to be overly nervous and ask for leave. Disrupting the child's normal social and work rhythm will actually affect the child's immunity.

Of course, all prevention and control principles cannot be applied to a template, and the care points for babies with different physiques are completely different. I used to follow up on a 5-year-old child with allergic asthma. Previously, the parents always thought that the child was prone to getting sick because of the cold. They had to wear three layers of clothing inside and outside in three layers in winter. The child would break out in sweat when running around and catch a cold when the wind blew. A cold would trigger asthma, and he would have to be hospitalized two or three times a year. Later, we suggested that he not dress the baby too much, just wear a thin coat more than adults, wash his nose with saline once a day, go to crowded and closed places as little as possible during the spring and autumn pollen season, and avoid keeping flowering plants and furry pets at home. After that, the baby didn't have an attack for more than half a year, and the number of colds was reduced a lot. Building a child's immunity is actually like practicing martial arts. You lock him in a greenhouse every day and never let him fight with others. He will definitely not be able to handle a little storm when he goes out. Occasionally, he gets a common cold and fever. In fact, his immunity is "training and upgrading" with pathogens. There is really no need to panic when your baby's body temperature rises.

Speaking of panic, the most common thing many parents do when they panic is to give them random medicines. I stock up on a bunch of "Children's Cold Liquid" and "Antiviral Oral Liquid" at home. Whenever I see my baby sneezing, I feed them in advance, which is called "prevention." In fact, both domestic and international children's diagnosis and treatment guidelines clearly state that the common cold is a self-limiting disease. There is no specific medicine, and no oral medicine can prevent the common cold in advance. As long as the body If the temperature exceeds 38.5°C (or the child's mental state is less than 38.5°C, it can also be used). Take acetaminophen (preferred for those under 6 months old) or ibuprofen (available for those over 6 months old) according to the dose. Drink more water and rest. Generally, it will heal on its own in 3-7 days. However, random feeding of medicine will increase the metabolic burden of the child's liver and kidneys, which is not worth the gain.

After working in this industry for so many years, I have seen too many parents go to extremes to prevent their children from getting sick. They either wish they could put their children in a sterile cover, or they are completely free and think that getting sick is "detoxification" and don't care about anything. In fact, there is really no need to pursue "zero illness". As long as you stick to the general principles of prevention and control, observe your baby's physical characteristics and adjust flexibly, it is not a bad thing to have a minor illness occasionally.