Contents of the Handbook on Prevention of Common Diseases in Children

This common disease prevention handbook for parents of children aged 0-12 years old has the core logic of "preventing the disease before it becomes a disease, and preventing the disease from developing". It covers prevention programs for four major categories of high-risk problems: respiratory diseases, digestive tract diseases, common infectious diseases, and growth and development-related diseases. All contents are jointly written by 12 medical staff with more than 3 years of front-line pediatric clinical experience. It takes into account the conclusions of evidence-based medicine and the practical experience of traditional child care. It does not make absolute promises or spread unverified folk remedies.

People who often go to community pediatric free clinics must have experienced that there are a lot of parents who come to ask questions with fragmented parenting knowledge points - "Should my baby take health care products to enhance immunity when she catches a cold every month when she first enters kindergarten?" "Does my baby have to be hungry for two days with diarrhea?" "Can allergic rhinitis be cured?" These frequently asked questions have corresponding answers in the handbook, which are also specially marked which are confirmed conclusions and which are experiences with clinical feedback but no clear evidence-based basis, for parents to make their own reference choices.

Taking the respiratory problems that parents are most concerned about as an example, colds, flu, pneumonia, and allergic rhinitis account for more than 60% of pediatric outpatient visits. The clear conclusion of evidence-based medicine is: children under 6 years old are not recommended to use compound cold medicines. The common cold is a self-limiting disease. The focus of care is to ensure rest, drink plenty of warm water, and spray the nose with normal saline when the nose is blocked. There is no need to take additional anti-inflammatory drugs or antiviral drugs. ； Timely vaccination during the flu season and ensuring 1-2 hours of outdoor activities every day are the most effective ways to reduce the probability of respiratory infections. Different schools have different opinions on the issue of dressing in different seasons: Evidence-based medicine believes that as long as the back of the neck is warm and the hands and feet are slightly cool, the child is in a suitable state. There is no hard requirement of "covering up in spring and freezing in autumn". ； However, many practitioners of traditional Chinese medicine and pediatrics will recommend not to take off thick coats too early for children in early spring, especially to keep the neck and back warm. It has been clinically observed that many children who shed clothes too early during the season change have recurring colds and rhinitis. There is currently no large sample data to support this. The manual also states that parents can flexibly adjust according to their children's physical condition. Not long ago, I treated a 4-year-old boy who had to report for bronchitis every month. Later, we suggested that his mother should stop chasing after meals, eat less sweet foods such as chocolate and cakes at night, and run downstairs for 20 minutes every day to bask in the sun. In 3 months, he only caught a cold once and did not develop bronchitis. We also included a lot of these practical experience manuals.

Rather than getting nervous when coughing, many parents are more troubled by their children's vomiting, diarrhea, constipation and food accumulation. First of all, several minefields are marked in red in the manual: Diarrhea does not require fasting. Instead, it is necessary to ensure the intake of water and electrolytes. Oral rehydration salt III is the first choice. Do not give antidiarrheal medicine to your child casually, especially for diarrhea caused by norovirus. Blindly stopping diarrhea will prolong the detoxification time, and in severe cases, it may cause toxin retention. ； Children under 2 years old should not use Kaiselu for constipation, and they must not give adult laxatives, so-called "detox fruits" or "colon cleansing products." There was a mother who gave her 2-year-old baby a detox jelly she bought, and she went to the emergency room with diarrhea for two days and went to the emergency room for dehydration. We have also attached this kind of pitfalls to the reminder in the corresponding section. As for the auxiliary conditioning methods commonly used by many parents, such as coke rice soup and steamed apples, the manual also makes it clear: as long as the child is willing to eat it and does not feel any discomfort after eating it, it can be used. It is a mild auxiliary method and does not need to be completely denied, nor should it be regarded as a miracle medicine that can cure diseases.

Then there are the parents who panic every time an illness breaks out in kindergarten. The handbook specifically lists out a prevention list for childcare settings. The current clear conclusion is that vaccines are the most effective way to prevent infectious diseases such as hand, foot and mouth, chickenpox, measles, and mumps. As long as there are no vaccination contraindications, it is recommended to vaccinate on time. There is no need to overdo it in daily protection. There is no need to wipe the baby's hands and mouth with disinfectant wipes at any time. Washing hands with ordinary soap and running water for 20 seconds is enough. Over-sterilization will destroy the baby's skin barrier and intestinal flora. Regarding the controversy over "clean raising" or "extensive raising", the manual also gives neutral advice: you must wash your hands after touching pets, using the toilet, and before eating. Don't be overly anxious when playing on the grass or touching public toys. Just wash them in time. There is no need to prevent the baby from touching anything outside for the sake of "preventing germs", which is not conducive to the normal establishment of the immune system.

Common non-infectious diseases that many parents tend to ignore also take up a lot of space in the manual. For example, myopia is not just about looking at mobile phones less. The core of prevention is to ensure more than 2 hours of outdoor natural light exposure every day. Many children read picture books and take online classes at home every day and rarely go out, so they still put on glasses early. ； It is not enough to treat caries after replacing the teeth. When the first tooth comes out, you need to brush it with fluoride toothpaste. After the age of 3, you can do pit and fissure sealing and apply fluoride every six months. Otherwise, the decay of the deciduous teeth will also affect the development of the permanent teeth. There are also many elders who always think that babies who are fat are "well-raised". The manual specifically mentions: If the weight of a child under 7 years old exceeds 20% of the standard for the same age group, timely intervention is required. Otherwise, it will easily induce problems such as precocious puberty and hyperlipidemia. Don't wait until something goes wrong and then regret it. I myself have encountered many grandmothers chasing after their babies to feed them. They feed the babies until they vomit, fearing that they are not full. In fact, the babies themselves know that they are hungry and full, and forcing them to eat will hurt the spleen and stomach. This point is consistent with both Western medicine and traditional Chinese medicine.

In fact, when we were making this manual, all the doctors and nurses we wrote discussed it and never wrote any headline-grabbing content about "do these 5 things and your baby will never get sick again." After all, getting sick as a child grows is a necessary step for the immune system to upgrade. Our prevention is nothing more than to help children suffer less and reduce the risk of developing serious diseases. If you are really unsure, don't stick to the manual and see a pediatrician in a regular hospital, which is better than anything else.