Horsham Information

Childrens Health - Treating childrens sickness and other ailments, can be tricky sometimes, especially, if the child is too young to explain, anything much more than, "I've got an ow".

Nappy rash
Most babies will suffer with nappy rash at some point, and it is not, in general, something for particular concern. The main thing is that it's sore for your baby and so quick treatment is the order of the day. There are several different types of nappy rash and therefore different causes too. Nappy rash can most often be caused by something as simple as infrequent nappy changes; this is because the mixture of urine and faeces produces ammonia, which has a high pH value, and that makes the skin more vulnerable to damage. Also, certain foods have a higher pH (e.g. tomato, orange, apples and apricots) and therefore can make the problem worse, this can be a particular noticeable with, for example, food intolerance (when the baby may have diarrhoea). On many occasions nappy rash can be a symptom of teething or even just a common cold. It possible that sever nappy rash may be caused by thrush, which should get medical attention.

Ideas to help reduce the occasions of nappy rash with suggestions of a cure:
It is possible that with more frequent nappy changing the problem of nappy rash will be no longer. Even when disposable nappies do not feel wet, they may still be holding a small amount of urine that is causing the irritation and also stopping the skin's natural protection to take place.

It's recommended that a baby's skin regularly and thoroughly cleaned by gently wiping its bottom with a clean, warm, wet cloth at every nappy change. Even if they are only wet there will still be urine on the skin which could make baby sore, particularly in the leg creases and under the genitals in boys. It reduce the chances of vaginal infection, girls should be wiped from front to back, (there is no need to clean inside the vagina as this is self-cleaning). Allow the skin to dry before putting on a fresh nappy.

A simple, but very effective, treatment is to allow your baby as much time as possible without his/her nappy on. The natural air flow on the skin will allow the baby's skin to do its amazing healing job on its own.

It's worth taking a look at the baby's diet to see if anything that baby is eating or drinking may be causing the problem. This can especially be the case when weaning your baby, and therefore introducing new foods. It's suggested to keep an eye on the balance of alkali and acid making foods and charting foods that give an adverse reaction. The chart below may help in choosing that right balance of foods:
Alkalizing foods (high PH)

Vegetables
Broccoli
Cabbage
Carrot
Cauliflower
Celery
Cucumber
Garlic
Green Beans
Kale
Lettuce
Mushrooms
Onions
Parsnips
Peas
Peppers
Pumpkin
Radishes
Spinach
Sprouts
Sweet Potatoes
Tomatoes
Watercress

Fruit
Apple
Apricot
Avocado
Banana
Berries
Blackberries
Cherries
Coconut
Currants
Dates
Figs
Grapes
Grapefruit*
Lemon*
Lime*
Melon
Nectarine*
Orange*
Peach
Pear
Pineapple
Plumbs
Raisins
Raspberries
Rhubarb
Strawberries
Tangerine*
Tomato
Tropical Fruits

*Although you may automatically think that citrus fruits would have an acidifying effect on the body, the citric acid that they contain actually has an alkalinizing effect in the body's system.

Protein
Almonds
Chestnuts
Tofu (fermented)
Whey Protein Powder

Seasoning and spices
Cinnamon
Curry
Ginger
Mustard
Chili Pepper
Sea Salt
Tamari
All Herbs

Other
Soured Dairy Products
Green Juices
Veggie Juices
Fresh Fruit Juice
Mineral Water
Alkaline Antioxidant Water

Minerals
Cesium (pH 14)
Potassium (pH 14)
Sodium (pH 14)
Calcium (pH 12)
Magnesium (pH 9)


Acidifying foods (low pH)

Vegetables
Corn
Lentils
Olives
Winter Squash

Fruits
Blueberries
Canned or Glazed Fruits
Cranberries
Currants
Plums**
Prunes**

Grains and grain products
Barley
Bran, wheat
Bran, oat
Corn
Hemp Seed Flour
Oats (rolled)
Oatmeal
Quinoa
Rice (all)
Rice Cakes
Rye
Spelt
Wheat
Wheat Germ
Noodles
Macaroni
Spaghetti
Bread
Crackers, soda
Flour, white
Flour, wheat

Beans and legumes
Black Beans
Chick Peas
Green Peas
Kidney Beans
Lentils
Pinto Beans
Red Beans
Soy Beans
Soy Milk
White Beans
Rice Milk
Almond Milk

Dairy
Butter
Cheese
Cheese, Processed
Ice Cream
Ice Milk

Nuts and butters
Cashews
Legumes
Peanuts
Peanut Butter
Pecans
Tahini
Walnuts

Animal protein
Bacon
Beef
Carp
Clams
Cod
Corned Beef
Fish
Haddock
Lamb
Lobster
Mussels
Organ Meats
Oyster
Pike
Pork
Rabbit
Salmon
Sardines
Sausage
Scallops
Shrimp
Scallops
Shellfish
Tuna
Turkey
Veal
Venison

Fats and oils
Avocado oil
Butter
Canola oil
Corn oil
Hemp Seed oil
Flax oil
Lard
Olive oil
Safflower oil
Sesame oil
Sunflower oil

Sweeteners
Carob
Sugar
Corn Syrup

Drugs and chemicals
Medicinal drugs
Aspirin

** These foods leave an alkaline ash but have an acidifying effect on the body.

Chicken Pox (Varicella zoster)
The chicken pox virus generally develops into a rash of spots which further develops into thin-walled blisters filled with clear fluid (this liquid later becomes cloudy). The blister wall breaks, leaving open sores, which then crust over to become dry, brown scabs. Most commonly a few blisters are first spotted on the trunk, the back, behind the ears and on the scalp, however, if the virus appears over night, your may not have any clues when the child goes to bed, but they may wake with blisters all over them.

Chickenpox blisters tend to come in batches, so after some of them begin to scab over, a new bout of spots may appear. New chickenpox may stop appearing as early as the third day, but usually by the seventh day. It normally takes 10 to14 days for all the blisters to dry up and crust over and then you are no longer contagious.
The illness often comes with common cold symptoms (runny nose, cough and general unwell feeling), as well as the itching of the blisters as they dry and scab-over. Most kids get chicken pox recover by just resting like you do with a cold or flu. It is possible to have a chicken pox vaccine; however this may not totally prevent getting chicken pox, but will probably make the illness less severe and therefore recovery will quicker.

Remember that chickenpox is very contagious, and most kids with chicken pox will pass it to a sibling. The sibling's symptoms will probably start to show about 2 weeks after the first child. To help in keeping the virus from spreading, try and make sure that your children wash their hands frequently, particularly before eating and after using the bathroom. People who haven't had chickenpox also can catch it from someone with shingles, but they cannot catch shingles itself.
Ways that you can help to relieve the discomfort, itching and fever of chickenpox:
* Use cool wet compresses on the affected areas, and/or give the child a bath in lukewarm water every 3 to 4 hours for the first few days. Oatmeal baths, available at the supermarket or pharmacy, can help to relieve itching. (Baths do not spread chickenpox.)
* Pat the body dry (don't rub).
* Put calamine lotion on the itchy areas (but not on the face, especially near the eyes).
* Chickenpox in the mouth may make drinking or eating difficult, so prepare food for your child that is cold, soft, and bland. Avoid food that is salty or acidic (like some fruit juices or crisps). Ask your pharmacist about pain relief for mouth blisters.
* Ask your pharmacist about pain-relieving creams to apply to blisters in the genital area.
* Trim your child's nails to minimise damage if scratching the blisters, and keep the nails as clean as possible to prevent the spread of infection.
* You may consider putting socks or mittens on your child's hand, especially at night to reduce scratching.
It's very important to ask the doctor or pharmacist for information on pain relief, as certain drugs should not be given in the case of chickenpox.
Most chickenpox infections don't require any special medical treatment. But sometimes, there are problems, so call the doctor if your child:
* has fever that lasts for more than 4 days or rises above 38.8° Celsius (102° Fahrenheit)
* has a severe cough or trouble breathing
* has an area of rash that leaks pus (thick, discolored fluid) or becomes red, warm, swollen, or particularly sore
* has a severe headache
* is lethargic (sluggish/drowsy) or has trouble waking up
* has trouble looking at bright lights
* has difficulty walking
* seems confused
* seems very ill or is vomiting
* has a stiff neck


Measles (Rubeola)
The measles (rubeols) virus is a highly contagious respiratory infection. It causes flu-like symptoms, including a cough, runny nose and fever, as well as a body skin rash. Since measles is caused by a virus, there is no specific medical treatment and the virus has to run its course. But a child who is sick should be sure to receive plenty of fluids and rest, and be kept from spreading the infection to others.
The first signs of the infection are usually similar to those of a flu type cold (hacking cough, runny nose, high fever, and red eyes. However, this is soon followed by a rash of small red spots with blue-white centers that appear inside the mouth, and then a full-body rash.

The typical measles rash has a red or reddish brown blotchy appearance, and normally first appears on the forehead, then spreading downward over the face, neck, and body, then down to the arms, hands, legs and feet.

Measles is highly contagious and spreads when someone comes in direct contact with infected droplets, i.e. when someone with measles sneezes or coughs they spread the virus in droplets through the air. A person with measles is contagious from 1 to 2 days before the first symptoms starts until approximately 4 days after the rash appears.
The most important thing you can do to protect kids from measles is to have them vaccinated, and so it's recommended to have a chat to your doctor to find out more.

As measles is a virus there is no special medical treatment. The symptoms normally last for about 2 weeks, so during this time make sure that you child is fully hydrated and has plenty of extra rest. It's very important to ask the doctor or pharmacist for information on pain relief or fever, as certain drugs should not be given in the case of measles.
Monitor you child closely in this time and for the next few weeks as sometimes complications can occur like otitis media, croup, diarrhoea, pneumonia, and encephalitis (a serious brain infection).

Call the doctor immediately if you suspect that your child has measles. Also, it's important to get medical care following measles exposure, especially if your child:
* is an infant
* is taking medicines that suppress the immune system
* has tuberculosis, cancer, or a disease that affects the immune system

Mumps
Mumps is an illness that's caused by a viral infection that generally spreads through saliva and can infect many parts of the body, in particular the parotid salivary glands. These glands, which generate saliva for the mouth, are situated toward the back of each cheek, in the part between the ear and the jaw. When you have mumps, these glands usually swell up and become tender and sore. Generally the most common age for mumps to occur is between 5 and 14 years old, and rarely happens in children younger than 1 year old.

Mumps generally starts with a fever of up to 39.4° Celsius (103° Fahrenheit), and often accompanied by a headache and loss of appetite. The most obvious symptom of mumps is the pain and swelling of the parotid glands, giving the infected person a 'hamster like' look. Over a period of 1 to 3 days the swelling of the glands usually become increasingly worse and painful, and becomes worse when the child swallows, talks, chews, or drinks acidic juices (like orange juice). Mumps would normally affect one side of the face first, spreading to the other side with a few days.

In extraordinary cases, mumps could attack other groups of salivary glands instead of the parotids. If this occurs, swelling may possibly be noticed under the tongue, under the jaw, and/or all the way down to the front of the chest.

Mumps can lead to inflammation and swelling of the brain and other organs, although this is not common. Rare complications of mumps include encephalitis, which is the inflammation of the brain, and meningitis, which is the inflammation of the lining of the brain and spinal cord. Symptoms of any complications would normal appear during the first week after the parotid glands begin to swell and could include: high fever, stiff neck, headache, nausea and vomiting, drowsiness, convulsions, and other signs of brain involvement.

The development of orchitis (an inflammation of the testicles) is another rare complication in the infection of mumps in adolescent and adult males. In these cases generally one testicle becomes swollen and painful about 7 to 10 days after the parotids glands swell. This can be accompanied by a high fever, shaking chills, headache, nausea, vomiting, and sharp abdominal pain. After 3 to 7 days, the testicular pain and swelling will normally subside, this is generally the same time as the fever stops. In some cases, both testicles are involved. Even with involvement of both testicles, sterility is still a rare complication of orchitis.

In other rare cases mumps could also affect the pancreas or, in females, the ovaries, causing pain and tenderness in parts of the abdomen.

The mumps virus is contagious and can be passed to others through sneezing, coughing, or even laughing, as it spreads in tiny drops of fluid from the mouth and nose of the infected person. The virus can also spread to other people through direct contact, such as using drinking glasses that have been used by the infected person.

The virus is contagious from 2 days before symptoms begin to 6 days after they end. The virus can also spread from people who are infected but have no symptoms.

The most successful way of preventing the mumps virus is by vaccination, which is normally given in the form of the MMR vaccine. Please speak to your doctor about more information on this vaccine.


Whooping cough (pertussis)
The bacterium called Bordetella pertussis is the cause of the infection of the respiratory system called whooping cough or pertussis. The symptoms of whooping cough include a sever cough, and at the end of a coughing spell, the child may make a characteristic whooping sound when breathing in or may even vomit, although not all children have this reaction to the cough. Between spells, the child usually feels well. Having said this, sometimes infants don't cough or whoop as older kids do. Young infants may look as if they're gasping for air with a reddened face and may actually stop breathing for a few seconds during particularly bad spells.

Whooping cough mainly affects infants younger than 6 months old, before they're sufficiently protected by immunizations and kids between 11 and 18 years old whose immunity has weakened.

The initial symptoms of whooping cough are comparable to those of a common cold:
runny nose
sneezing
mild cough
low-grade fever

Whooping cough is highly contagious, as the bacteria spreads from person to person through tiny drops of fluid from an infected person's nose or mouth. This bacterium becomes airborne when the person sneezes, coughs, or even laughs. Alternatively the infection can be caught by inhaling the drops or getting the drops on the hand and then touching the mouth or nose.
Infected people are at their most contagious during the earliest stages of the illness and up to approximately 2 weeks after the cough begins, although antibiotics can shorten this period of contagiousness to 5 days following the start of antibiotic treatment, it is best to air on the side of caution, and keep the child away from other people for the full 2 weeks.  The most successful way of preventing whooping cough (pertussis) is by vaccination. Please speak to your doctor about more information on this vaccine.  The incubation period (the time between infection and the onset of symptoms) for whooping cough (pertussis) is generally 7 to 10 days, but can be as long as 21 days.

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Colic
If your normally healthy baby cries on average more than 3 hours per day, for more than 3 days per week and for at least 3 weeks, it's generally put down to a condition called colic. Colic is a common and quite normal condition that will eventually go away on its own. It's an upsetting condition for mother and baby as the continued crying can easily get you down.

All newborns cry, need attention and show a degree of fussiness about when, how long and how they like to be cuddled, but when a child who is otherwise healthy cries like this, you can but wonder why.

It's likely that up to 40% of all infants have some degree of colic. It usually starts between the 3rd and 6th week after birth and ends by the time the baby is 3 months old. If the baby is still crying excessively after that, other health issues could be to blame.

Here are some key facts about colic:
* Babies with colic have a normal sucking reflex and a good appetite, and are otherwise healthy and growing well. If your baby isn't feeding well and/or doesn't have a strong sucking reflex you should consult your doctor.
* Babies with colic like to be handled and cuddled. If your baby seems uncomfortable or distressed when cuddled and/or is difficult to console you should consult your doctor.
* Babies with colic may bring up bits of milk from time to time, but if your baby is actually vomiting and/or losing weight, you should consult your doctor.
* Babies with colic usually have normal stools, and so if your baby has diarrhoea or blood in the stool you should consult your doctor.

Medical professionals don't have the exact answer about what causes colic, but will give you suggestions and helpful tips that could help to relive the severity of the condition or even solve the problem altogether. Milk intolerance is normally one of the causes that's suggested, and it's worth looking into if the baby is bottle fed. In the case of breast fed babies, it may be recommended that the mother changes her diet but cutting different things out one by one (e.g. caffeine or dairy products) and then re-introducing them to see if there is any affect on the babies colic.

In general babies with colic will also have wind, but it's not clear if the wind causes colic or if babies develop wind as a result of swallowing too much air whilst crying.

Other speculations imply that colic occurs when food moves too quickly through a baby's digestive system or is not completely digested. Additional theories are that colic is due to a baby's personality, that some babies just take a little bit longer to get adjusted to the world, or that some have undiagnosed gastro issues. It's also been found that infants of mothers who smoke are more likely to have colic.  There is no single treatment that has been proven to make colic go away, but there are ways to make life easier for both you and your colicky baby.

If your baby has stopped feeding and is not hungry, don't try to continue feeding, instead, try to console your little one. It's a natural concern for parents that they don't want to spoil it with too much affection, but you'll not be doing any harm by cuddling your baby and giving them the attention that they need to develop at this time. You can also try some of the following:
* Walk around holding your baby in various positions.
* Hold your baby whilst rocking in a rocking chair, again trying various positions.
* Try burping your baby more often during feedings, trying the over the shoulder and the sitting up positions.
* Place your baby across your lap on his/her belly and rub your baby's back.
* Put your baby in a vibrating or swinging seat.
* Take your baby for a ride in their car seat in the car. Car motion has an amazing calming effect.
* Some babies respond positively to sound and music, so play some different types of music until you find one that works, or put the TV on in the same room.
* Sometimes the sound of a washing machine, tumble dryer or vacuum cleaner can provide the baby with the soothing sounds that will calm them down.
* Some babies aren't ready for the freedom and brightness of the outside world and bundling them up in a light cotton sheet or towel and putting them in a darker room (re-creating some of the conditions of the womb) may work wonders.

Your baby will eventually grow out of this condition, but in the mean time, caring for a constantly crying baby can be extremely frustrating. It should be remembered that your moods and feelings project to the baby, and so you too need to take steps to relax and take care of yourself. Remember that colic is nobody's fault, so try not to blame yourself. It's not a failure to take a friend up on a little time off. Consider letting them take you baby on a short walk or similar, giving you an opportunity for a relaxing bath or even a massage or facial, (your baby will benefit from it too). It's OK to put the baby down in the crib to take a break before making another attempt comfort him/her. If, at any time, you feel like you might hurt yourself or the baby, you should put the baby down in the crib and call someone for help immediately.

You should contact your doctor if:
If the baby has a temperature of 38° Celsius (100.4° Fahrenheit)
If your baby is crying for more than 2 hours at a time, and is inconsolable
If your baby isn't feeding well
If your baby has diarrhoea
If your baby has persistent vomiting
If you're unsure whether your baby's crying is colic or a symptom of another illness.
If your baby is less awake or alert than usual you should call the doctor straight away for advice.


Croup
Croup is a common respiratory condition in young children which generally occurs in the autumn and winter time. Croup is caused by a swelling and narrowing in the voice box, windpipe, and the breathing tubes that lead to the lungs. This condition is distinctive by the harsh 'barking seal' type cough, hoarse voice and possible difficulty in breathe.

The onset of croup is normally first noticed a few days after the start of a cold and is usually caused by the same 'common cold' viruses. Croup is a contagious condition and the germs spread from one person to another through coughing, sneezing and general close contact. Regular hand-washing and limiting contact with others can help prevent spreading croup to others.

With age, children's lungs and windpipes mature, and they are less likely to get croup.

The symptoms of croup are often better in the daytime then at night, and sometimes children have croup attacks that wake them up in the middle of the night. Although a little scary, croup is rarely serious, and children usually improve within 2 to 5 days with rest and care at home.

As a precaution, and to check if enough oxygen is reaching the blood, your doctor may place a small clip called a pulse oximeter on your child's finger, toe, or earlobe. This is because when croup makes breathing harder, oxygen finds it more difficult to get into the blood and this can cause related complications.

Even though your child's coughing and troubled breathing can be frightening, home treatment usually eases the symptoms.

During a croup attack any crying and/or panic can make the swelling in the windpipe worse and therefore even harder to breathe, so try to stay composed to project an air of calm and tranquility on the situation. This will, in turn, calm the breathing pattern of the affected child.

Using a humidifier directly onto the child's face during a croup attack can help, because breathing in moist air can relieve the symptoms. Alternatively, fill your bathroom with steam from hot water, and sit in the bathroom with your child for 10 minutes. Even the cool night air seems to help, so you could dress him/her up warm and go outside for 10 minutes.

After an attack it's a good idea to put a humidifier next to the child to keep a moist air flow near by. If the attacks reoccur during the night, you may consider sleeping close to your child to be on hand immediately. Do not smoke, especially in the house.

If the symptoms of the croup attack do not improve after 30 minutes, call or see your doctor. If the attack is in the middle of the night and you are very worried, consider taking your child to casualty. Or call the 'doctor on call'. If your child has severe difficulties in breathing you should call for an ambulance immediately.

It is important to keep your child well hydrated with water, flavored ice treats (ice pops), or crushed ice drinks several times each hour.

If your child has severe croup or is not responding to normal home treatment, return to your doctor for further advice. It's not advised to give normal over the counter cough medicines for croup, so check with your pharmacist or doctor before administering any medicines, especially for under 2's.


Jaundice in newborns (Hyperbilirubinemia)
Bilirubin is a bodily substance that is made when the body breaks down old red blood cells, and, when there is too much bilirubin in the baby's body, they get a condition called jaundice. During pregnancy, a mother's body gets rid of bilirubin from the baby through her placenta. After birth, the baby's body must get rid of the bilirubin on its own through urine and stool.

The symptoms of jaundice are generally easily visible as the condition makes the baby's skin and the white part of the eyes look yellow. The yellowing normally first shows in the baby's face and chest,
and the baby may have an unusually high-pitched cry, and /or they also may be sluggish and cranky.

Jaundice is not usually a problem and, even in perfectly healthy babies, a degree of jaundice almost always appears by 2 to 4 days of age. It usually gets better or goes away on its own within a week or two without causing problems. In breast-fed babies, mild jaundice sometimes lasts until 10 to 14 days after birth. In some breast-fed babies, jaundice disappears and then returns. It's possible that jaundice could last throughout breast-feeding, but this isn't usually a problem as long as the baby gets enough milk by being fed at regular times.

In very rare cases, too much bilirubin in the blood can cause damage to the brain, leading to hearing loss, mental retardation, or behaviour problems.

Your doctor will probably ask you to keep checking your baby at home to make sure the jaundice is clearing up. Your baby will need a follow-up examination within the first 5 days after birth. It's important to call your doctor for immediate advice if the yellow color gets brighter after your baby is 3 days old. Sometimes babies with jaundice are put under a type of fluorescent light, because when the skin absorbs the light it helps the baby's body to process the bilirubin so that the body can more easily expel it in the stool and urine. The treatment is usually done in a hospital, however sometimes this can take place at home.

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