Experience on the prevention and control of common childhood diseases

There has never been a unified template for the prevention and control of common childhood diseases that is “one-size-fits-all”. The core logic is “prevention is better than cure, and adaptation is priority.” There is no absolutely correct parenting standard, only prevention and control plans suitable for your own children.

To be honest, I have seen too many parents come to me with three or five popular science articles with completely opposite views. Sometimes they say that a certain blogger said, "Children should wear less clothes and freeze to avoid getting sick." At other times, they say that the elderly at home said, "You need to cover yourself up in a sweat to avoid catching a cold." Each has its own reasons, and no one can convince the other. Take the most controversial "immunity supplement" as an example. The view of evidence-based Western medicine is very clear: except for children diagnosed with immune deficiency, children with normal development should supplement with products such as lactoferrin and spleen aminopeptide. Most of them have a placebo effect, and there is not enough large sample data to prove that it can reduce the number of illnesses. ； However, clinical studies in TCM pediatrics have indeed shown that children with weak spleen and stomach who often suffer from food accumulation and cough can reduce the frequency of respiratory tract infections by about 30% if they use ingredients with the same source of medicine and food such as fried malt, yam, and dried tangerine peel for 1-2 months. Both statements are supported by data. There is no need to argue about right or wrong. If your child eats well and has normal bowel movements, there is no need to spend unnecessary money on health care products. ； If you have diarrhea as soon as you eat something cold or cough if you blow a little bit of wind, there is nothing wrong with seeking treatment from a regular Chinese medicine doctor.

Last month, I met a mother who was even more anxious. Her baby had two fevers in the first month of day care. She wiped all the toys in the house with disinfectant three times a day. She was not allowed to touch the public handrails or hold hands with other children when she went out. As a result, she still got herpetic angina half a month later. She came crying and asked me if I had done something wrong. In fact, this is also a collision between two parenting concepts: one advocates "sterile parenting" and believes that the cleaner the baby, the less likely it is to contract diseases. ； The other school advocates "moderate exposure" and believes that children need to be exposed to the flora in their daily environment in order to build a complete immunity. I would say there is nothing wrong with either of these. There is absolutely no need to wipe with disinfectant every day at home. On the contrary, it may destroy the normal flora of the child's skin. ； But if it is the season when hand, foot, and mouth and norovirus are high, and you come back from high-touch places such as daycares and shopping malls, it is not unnecessary to wash your hands well with the seven-step handwashing method and disinfect toys regularly, and you don’t have to go to extremes.

Speaking of this, I have to mention the issue of Category II vaccines that has been quarreling among parents for several years. I have met extreme parents who say, "The free ones are the vaccinations required by the state, and the fees are all IQ taxes." There are also parents who want to get all the second-class vaccines they can get an appointment for. They even want to arrange for their children to get the shingles vaccine that has just been launched and is suitable for older children. From the perspective of our public health, the second-category vaccines are essentially supplements to the first-category vaccines. EV71 hand, foot and mouth vaccine, 13-valent pneumococcal vaccine, and influenza vaccine are all recommended by the WHO for children under 5 years old. Clinical data show that they can reduce the risk of severe infection by more than 80%. It is enough for those with financial conditions to give priority to these three categories. ； If you really have a limited budget, getting all the vaccines in a category as required can cover most high-risk diseases. There is no need to feel guilty that "if you don't get all the vaccines, you are irresponsible."

I met a hard-core evidence-based father before. His baby had a fever of 39.5 degrees and was exhausted. He refused to take antipyretics, saying, "Fever is to improve immunity, and taking medicine has side effects." As a result, the baby went into febrile convulsions and was sent to the emergency room to stabilize himself. There was also a grandmother who was even more exaggerated. She fed her baby ibuprofen as soon as the fever reached 37.5 degrees Celsius, and even actively asked for cystitis. As a result, the baby's bacterial flora was disordered and she had diarrhea for a week. In fact, whether you are a "hard-core person" or a "medication person", the core criterion is never the body temperature number, but the child's mental state: if the fever reaches 39 degrees and you can still run around and play, you can physically cool down and then observe. ； If your fever reaches 38 degrees Celsius and you cannot open your eyes or eat, you should take antipyretics. If you have a bacterial infection, you should check your blood routine and decide whether to use antibiotics. There is no need to stick to the standards of a certain school.

When my own child was 3 years old and just entered kindergarten, he also had 6 colds in one semester. At that time, I heard from a friend that spleen aminopeptide was useful, so I bought two boxes for more than 1,000 yuan. However, after eating half of the box, my child was disgusted with the taste and refused to touch it, and I did not force him. Later, I took him to run downstairs for 40 minutes every day after school, and gave him less sweet cream cakes and iced drinks. After half a semester, the number of illnesses was reduced by half. To be honest, many times the health care products you spend a lot of money on are not as effective as running with your baby for half an hour every day.

The longer I work in this field, the more I realize that child disease prevention is not a test at all, and there is no single right answer. You don’t have to check everything off the parenting blogger’s checklist, and you don’t have to lie down when your relatives say, “I didn’t pay attention to your brother when I took care of him, so he didn’t grow up like this.” Touch the back of the baby's neck more often. If it's warm, it means it's just right. Don't worry about how many other people's babies are wearing. ； Pay more attention to the baby's condition. If the tongue coating is thick and the breath is heavy for two days in a row, feed less meat. It will be more effective than any food accumulation medicine. If you are really unsure, just go to a pediatrician or health care doctor in a regular hospital. Don't frighten yourself by blindly searching Baidu. That's enough.