Lesson Plan on Prevention and Management of Common Children's Diseases

Illness in childhood is an inevitable process for the establishment of the immune system. There is no need to pursue "zero illness". There are only four core goals for all prevention and management actions - to quickly identify signs of severe illness, avoid unnecessary medical intervention, shorten the course of the disease, reduce the child's discomfort, and reduce the risk of cross-infection. The following content is all organized around the 8-year practical experience of front-line pediatric health care physicians in kindergarten education. There is no empty theory. All methods have been verified by 4,000+ families in 17 public kindergartens.

Let me first ask a question that almost every parent has asked: Should I give my children "immunity-enhancing" health products such as lactoferrin, multivitamins, and probiotics? The current views in the pediatric community are actually divided into two groups: One group is that the guidelines of the Pediatric Branch of the Chinese Medical Association clearly state that as long as the child has a balanced daily diet and a cumulative outdoor exercise time of more than 10 hours per week, there is no need to supplement immune-related health products. If they are supplemented, they will most likely be metabolized in the urine, and it will be completely free of charge. ； On the other hand, some pediatric nutritionists suggest that immunocompromised children who are picky eaters and have been hospitalized more than twice within six months can take targeted supplements for 1-3 months after completing immune function tests. There is no need to eat them all year round. I met a grandmother in the garden who spent more than 3,000 a month to buy imported immune tablets for her grandson. As a result, the child still caught a cold every month. Later, she adjusted her schedule and ran and jumped outdoors for 2 hours a day. She only had a fever once in 3 months. She recovered very quickly. In fact, for the vast majority of healthy children, "eat well, sleep enough, and play more" is more effective than any health care products.

Last autumn, a child in the second class of middle school had a temperature of 37.2°C in the morning. The teacher asked his parents to take him home. The parents were very unhappy and said that the child was just a little hot and in good spirits, so there was no need to pick him up. As a result, the temperature reached 39.5°C at noon and he had convulsions. He was sent to the hospital and was diagnosed with herpetic angina. Many parents can't tell "when to observe at home and when to go to the hospital." There is no unified standard here. As long as it meets any of the three conditions, don't hesitate to go directly: First, the mental state is poor. The child who usually loves to run and jump suddenly becomes wilted and cannot get excited about feeding his favorite strawberries or cartoons. ； Second, there are comorbid symptoms, such as breathing twice as fast as usual, severe coughing for more than 3 days, vomiting and diarrhea as often as 6 hours without urination, unexplained rash, stiff neck and inability to lower the head. ； Third, children younger than 3 months old should go directly to the hospital if their fever exceeds 37.5℃, and do not give medicine by yourself. As for whether you should take antipyretics immediately when you have a fever, there is no one-size-fits-all requirement: if your child has a fever of 38.5°C but is still playing crazy with building blocks, you can first rub your body with warm water to cool down physically and observe. ； If the fever reaches 38°C and makes you unable to open your eyes, you can also give antipyretic medicine in advance. There is no need to stick to the temperature line. The child's comfort is the first priority. Oh, by the way, there is another common misunderstanding that needs to be mentioned: 90% of colds are viral infections, and antibiotics are of no use at all. You only need to take them when a blood routine confirms that it is a bacterial infection. Do not feed cephalosporins to your children as soon as they have a cold. On the contrary, it will destroy the intestinal flora, and the more you eat, the worse your health will be.

Many parents wrap their children in thick quilts to cover their sweat when they catch a cold. This is actually a taboo. Children's temperature regulation center has not yet developed well, so covering their children's sweat can easily lead to febrile convulsions. The most exaggerated case I have ever encountered was that there was no heating at home in the winter, and the parents wrapped the child with fever in three layers of quilts and two hot water bottles. When he was sent to the hospital, his body temperature reached 41°C, and he almost had a serious accident. Just remember one principle when caring for your child at home: put on more clothes when the child feels cold, and take off clothes when the child feels hot. Don’t wear too much when you have a fever, and don’t blow cold air directly against the air conditioner. There is also rehydration. Whether it is a cold, fever or diarrhea, oral rehydration salts should be given priority. It is more effective than drinking boiled water or freshly squeezed juice. It can quickly prevent electrolyte imbalance and dehydration. This is clearly recommended by the WHO and there is no controversy.

Many parents think that children are more likely to get sick in kindergarten because teachers do not disinfect them properly. In fact, this is not true. Children aged 3-6 are already in the immune building stage. If there are more than 20 children in a class, if one brings the virus, others will easily be infected if they touch the same toy and then rub their eyes. Our kindergarten had previously tried disinfecting three times a day in the morning, noon and evening, and irradiating all toys with ultraviolet light for an hour. As a result, a flu outbreak happened again. Later, we adjusted our strategy: ensuring outdoor activities for more than two hours a day. During the peak period of flu, children were given salt water to rinse their mouths once a day. During the morning check-up, children with sore throat or low fever were immediately advised to return. Last year, the influenza incidence rate dropped by 42%. Oh, and there is another point that many people overlook: after the child has a cold and fever, he must be observed at home for at least 24 hours before sending him to kindergarten. Otherwise, he will easily introduce the virus to other children. Last year, a parent sent his child to the kindergarten half a day after the fever was gone. As a result, 8 children were infected that day, and the parents group quarreled for several days.

Finally, I want to say something from my heart. I have worked in pediatric health care for so many years. I have seen too many parents panic when they see their children sick. They pile up antipyretics, cold medicines, and cough medicines for their children. In fact, in many cases, children with common colds and fevers will get better on their own in 5-7 days, and the course of the disease depends on whether you give them medicine or not. Our prevention and management is not to completely isolate the virus from the child's world, but to help the child successfully handle this process of immune upgrading. After all, a large number of studies have confirmed that if you get a few more common colds in childhood, the probability of allergies and autoimmune diseases will be lower when you grow up. There is no need to be too "clean" when raising children. A few minor problems are actually a good thing.