Doctor Komarovsky Evgeny Olegovich in his practice constantly encourages parents to treat children's illnesses more calmly and philosophically, not as tragedies, as temporary minor troubles.
Today we learn what to do to parents of a sickly child at home.
Who are: "Often ill children?"
Frequently ill children are a category of children exposed to a high incidence of acute respiratory diseases due to transient,violations in the body's defense systems.
Children who carry more than 4-6 episodes of ARI per year are included in the group of often ill children, which can occur in various clinical forms.
Often a sick child should be examined:
- ENT doctor,
- diagnostic algorithm includes: OAK, seeding from mucous membranes and nose, detection of infections by PCR, allergotests, immunogram examination, radiography of paranasal sinuses and thorax.
Frequently ill children need to sanitize foci of chronic infection, etiopathogenetic therapy of ARI, vaccination and non-specific prevention.
Often ill children( BWA) are children who carry acute respiratory infections more often than conditionally healthy children( more than 4-6 times a year).
The concept of "often ill children" is not a diagnosis and an independent nosological form: behind it may be various diseases of the respiratory system( rhinitis, nasopharyngitis, sinusitis, tonsillitis, laryngotracheitis, bronchitis, bronchopneumonia, etc.).In pediatrics, the term "often ill children" is used to refer to the group of dispensary follow-up and reflects mainly the multiplicity and severity of the infectious morbidity.
Sometimes, to emphasize the protracted nature of respiratory infections in this category of children, the concept of "often and long-term ill children"( BHDB) is used. In Western countries, the term "children with recurrent ARI" is applied to such patients. According to epidemiological data, often ill children account for 15-40% of the total number of children.
The ICD-10 classes for application to the category of "often ill children" vary widely - J00-J99 - Diseases of the respiratory system.
This class contains the following blocks:
- J00-J06 Acute respiratory infections of the upper respiratory tract
- J09-J18 Flu and pneumonia
- J20-J22 Other acute respiratory infections of the lower respiratory tract
- J30-J39 Other diseases of the upper respiratory tract
- J40-J47 Chronic lower respiratory illnesses
- J60-J70Lung diseases caused by external agents
- J80-J84 Other respiratory diseases affecting mainly the interstitial tissue
- J85-J86 Purulent and necrotic conditions of the lower respiratory tract
- J90-J94 Other pleura diseases
- J95-J99 DrRespiratory diseases
Frequently ill children: what to do?
Frequent situations - my mother can not say how many times a year the child was sick with ARI - these ORZs simply do not end. Some snots smoothly flow into others, a stuffy nose goes into a sick ear, a reddened throat turns pale, but a voice grows, a cough condenses, but the temperature rises again. ..
Who is to blame for this?
- Previously they said: "What to do, this one was born" and added: "Endure, grow out."
- Now they say: "Bad immunity" and, as a rule, they add: "We must treat".
Now try to figure out what to do - tolerate or treat?
Parents should know that innate immunity disorders - primary immunodeficiencies - are rare. They manifest not only frequent ARVI, but very severe ARVI with dangerous bacterial complications, which are difficult to treat. Congenital immunodeficiency is a deadly condition and it has nothing to do with a two-month runny nose.
Thus, frequent ORZ - in the vast majority of cases the consequence of secondary immunodeficiency - the child was born normal, but under the influence of certain external factors, its immunity either does not develop, or something is oppressed.
The main conclusion: if a normal child does not get out of life from illness, then he has a conflict with the environment. And there are two options for help: to try with medications to reconcile the child with the environment or to try to change the environment after all, so that she suits the child.
The formation and functioning of the immunity system is due, first of all, to external influences. Everything that is familiar to everyone, everything that we put into the concept of "lifestyle": food, drink, air, clothes, exercise, rest, treatment of diseases.
Parents of a child who is often ill with ARI should first of all understand that it is not the child who is to blame but the adults around him who can not understand the answers to the questions about good and bad. It is very difficult for ourselves to admit that this is something we are doing wrong - we do not feed so much, we do not dress like that, we do not so rest, we do not help so much with diseases.
The saddest thing is that no one can help such parents and such a child.
The child is often sick. Where should my mother go for advice?
Let's start with my grandmother. And what we hear: he at you badly eats, too to me mother, the child to feed not in a status;who is dressing like that - a completely naked neck;it opens at night, so you should sleep in warm socks and stuff. With songs and dances we will feed. Very warm scarf wrap tightly. We'll put our socks on. The frequency of ARD from all this will not decrease, but the grandmother is easier.
Let's turn to friends, acquaintances, colleagues for help. The main advice( wise and safe) is patience. But, be sure to hear a story about how "a woman had a child all the time sick, but she did not spare money and bought him a special and very biologically active vitamin complex with additives crushed horns of the high-mountain Tibetan goat, after which everything as a hand removed - ARD stopped, adenoids resolved, and the famous professor said that he was shocked and bought the complex for his grandson. "By the way, the last package of these vitamins is still in Klavdia Petrovna, but we must hurry - the hunting season for goats is over, new income will be only in a year.
Hurried. Bought. They began to save the child. Ah, how it became easy! We, parents, are easy - after all, we do not regret anything for the child, we, the parents, are right. Are ARD continuing? Well, it's such a child.
How to improve immunity, will it help?
Maybe we'll turn to serious doctors?
- Doctor, we have 10 ARDs per year. We have already eaten 3 kg of vitamins, 2 kg of medicines for cough and 1 kg of antibiotics for this year. Help! From our frivolous pediatrician Anna Nikolaevna no use - it requires a child to temper, but how can one temper it with such a "unimmunity"!We certainly have some terrible disease started. ..
- Well, let's examine.Ши д C C C C Cши Cши C C C C Cшиши C C Cшиши C Cши Cши C C C Cши Cши C Cши C C Cши C C Cшиши C C C +
Surveyed. They found herpes, cytomegalovirus, lamblia, and in the intestine staphylococcus. A blood test with the clever name "immunogram" showed numerous deviations.
Now everything is clear! It's not our fault! We, the parents, are good, attentive, caring. Hooray!!!We are normal! Poor Lenochka, how many of it all at once all of a sudden - and staphylococcus, and viruses, horror! Well, nothing! We have already been told about special medicines, which all this stuff will necessarily wipe out. ..
And what's nice, you can show these analyzes to my grandmother, she, I suppose, and she did not hear the words "cytomegalovirus"!But at least criticize will cease. ..
And necessarily we will show analyzes to Anna Nikolaevna. Let him realize his delusions, it's good that we did not listen to her and did not become tempered with such a terrible immunogram.
The saddest thing is that Anna Nikolayevna does not want to admit mistakes! He claims that staphylococcus is a normal inhabitant of the intestine in most people. He says that it is impossible to live in the city and not have antibodies to lamblia, herpes and cytomegalovirus. Perseveres! Insists that all this is nonsense, and refuses to treat! Again and again trying to convince us that the blame for everything is not staphylococcus herpes, and we are parents! !!
The author is aware that you can be very upset and even close this book. But Anna Nikolaevna is absolutely right with the greatest possible degree of probability - really you are to blame, parents! Not by malice, not by harmfulness. By ignorance, by misunderstanding, by laziness, by gullibility, but you are guilty.
If a child often suffers from acute respiratory disease, no pills can solve this problem. Eliminate conflict with the environment. Change your way of life. Do not look for the guilty - it's a dead end. Your and your child's chances of escaping from the vicious circle of eternal snot are quite real.
Once again I repeat: there are no magic tablets "from bad immunity".But there is an effective algorithm for real practical actions. We will not talk about everything in detail - answers to questions about how it should be, and already a lot of pages are devoted, both in this and in other books of the author.
Nevertheless, the most important points we will now list and emphasize.Ши C Cшиши Cши Cши C C Cши C C C C Cши Cши д + C C C C C C C C C C C C C C C C C C д C C C C C C C C C C Cши C C Cши C Cши Cши C C C C C C Cшиши C C C C C C C CI focus attention - this is not explanations, but ready answers: there have already been explanations so much that if they did not help, it means that there is nothing to be done, although Lenochka is very sorry. ..
What if the child is very often sick with colds?
Detailed algorithm of action for parents, recommended by Dr. EO Komarovsky, what needs to be changed - the situation, habits and much more.
Air .Clean, cool, damp. Avoid everything that smells - varnishes, paints, deodorants, detergents.
Housing .At the slightest opportunity to organize a child a personal nursery. In the children's room there are no dust accumulators, everything is subject to wet cleaning( ordinary water without disinfectants).The regulator is on the radiator. Humidifier. Vacuum cleaner with water filter. Toys in the box. Books behind the glass. Folding everything scattered + washing the floor + wiping the dust - standard action before bedtime. On the wall in the room is a thermometer and a hygrometer. At night they should show a temperature of 18 degrees and a humidity of 50-70%.Ши д C C Cшиши д C C C C Cшиши д C C C C Cши C Cши C C Cшишиши Cши Cши д C C C Cшишиши Cши Cши д Cши C Cши C C C C C C Cши д C + C C C C C C Cши C C C C C C C C
Sleep .In a cool, damp room.Шиши Cши C C Cши Cши д Cши C C C C C Cши Cши Cши д C C C C C Cши C C C C C C C C C Cши C Cши C C C Cши C C д C C C C C C д C C C C C C д C C C C Cши C Cши C C CWhite bed linen washed with baby powder and thoroughly rinsed.
Power supply .Never and under no circumstances do not force the child to eat. It is ideal to feed not when there is agreement, but when food is begging. Prevent feeding in the intervals between feedings. Do not abuse overseas products. Do not get involved in a variety of food. Natural sweets( honey, raisins, dried apricots, etc.) are preferable to artificial( based on sucrose).Make sure that there are no leftovers in your mouth, especially sweet.
Drinking .At will, but the child should always be able to quench his thirst. I pay attention: do not get pleasure from a sweet carbonated drink, namely quench your thirst! Optimum drink: non-carbonated, unboiled mineral water, compotes, fruit drinks, fruit teas. The temperature of the drinks is room. If earlier all warmed - gradually reduce the intensity of heating.
Clothing .A sufficient minimum. Remember that sweating causes diseases more often than hypothermia. The child should not have any more garments than his parents. The decrease in quantity is gradual.
Toys .The most careful way to monitor the quality, especially if the child takes them in the mouth. Any hint that this toy smells or gets dirty - from the purchase to refuse. Any soft toys - accumulators of dust, allergens and microorganisms. Prefer toys washable. Washable toys wash.
Walking .Daily, active. Through the parent "I'm tired - I can not - I do not want to."Very desirable before a night sleep.
Hardening of .There are many methods of tempering the body, including those developed for children.
Sport .Ideal for outdoor activities. Any sports that involve active communication with other children in a confined space are not desirable. Swimming in public pools is impractical for a sick child.
Additional lessons .Good at the place of permanent residence, when the state of health does not allow you to leave the house. First you need to stop being often sick and only then start visiting the choir, foreign language courses, fine art studios and more.
Summer Holiday .The child should rest from contact with many people, from urban air, from chlorinated water and household chemicals. In the vast majority of cases, rest "on the seas" does not have anything to do with the healing of a sickly child, since most of the harmful factors remain, plus public catering is added and, as a rule, worse than in the home, housing conditions.
The ideal rest of a sick child often looks like this( every word is important): summer in the village;an inflatable pool with well water, next to a pile of sand;form of clothing - cowards, barefoot;restriction on the use of soap;feed only when he screams: "Mom, I'll eat you!".A dirty naked child who rushes from the water into the sand, begs for food, breathes fresh air and does not contact with a lot of people for 3-4 weeks restores immunity, damaged by urban life.
Prevention of acute respiratory infections and treatment of acute respiratory infections and viral infections
It is extremely unlikely that a frequently ill child is constantly supercooled or ate kilograms of ice cream. Thus, frequent illnesses are not colds, it is ARVI.If Petya is finally healthy on Friday, and on Sunday again has a stuffy nose, it means that in the interval between Friday and Sunday Petya found a new virus. And in this uniquely guilty his relatives, in particular, grandfather, who took advantage of an unexpected recovery, in order to urgently reduce his grandson to the circus.
The main task of parents is to avoid unnecessary contacts with people, to wash their hands, to support local immunity, to vaccinate all family members from influenza.
If a child is often sick with ARVI, then he often becomes infected.
A child can not be to blame for this. This is a model of his family's behavior. So, we need to change the model, and not treat the child.
Treat ARVI - this does not mean giving medicine. It means to create such conditions that the body of the child coped with the virus as quickly and with minimal losses of health. To treat ARVI means to provide optimum parameters of temperature and humidity of air, warmly to dress, not to feed, yet will not ask, actively to water. Saline drops in the nose and paracetamol at high body temperature - quite a list of medicines. Any active treatment prevents the formation of immunity. If the child is often ill, so any medicinal product should be used only when it can not be dispensed with unequivocally. This is especially true of antibiotic therapy, which in most cases is carried out without any real reason - from fear, from fear of responsibility, from doubt in the diagnosis.
What to do after recovery
It is very important to remember: improvement in the state and normalization of temperature does not at all indicate that immunity has recovered. But in fact very often the child goes to the children's collective literally the next day after the improvement of the condition. And even earlier, before the children's collective, he goes to the polyclinic, where he is seen by a doctor who says that the child is healthy.
In the queue to the doctor and the next day at school or in kindergarten the child will necessarily meet with a new virus. A child with immunity that has not yet recovered after the disease! A new disease will begin in a weakened organism. It will be heavier than the previous, with a greater probability of complications, will require the use of drugs.
But this illness will end. And you will go to the polyclinic, and then to the kindergarten. .. And then you will talk about the often sick child who "was such a man"!
Became better - it means you have to start living normally. Normal life is not a campaign in a circus, not a school, and certainly not a children's polyclinic. Normal life is jumping-jumping in the fresh air, "nagulovanie" appetite, healthy sleep, restoration of mucous membranes.
With an active lifestyle and the maximum possible restriction of contacts with people, a full recovery usually takes no more than a week. Now you can go to the circus!
We should not forget that contacts with people are risky, primarily in the premises. Games with children in the open air, as a rule, are safe( if not spitting and not kissing).Hence quite acceptable algorithm of visiting the kindergarten immediately after recovery - go there when the children go for a walk. We went for a walk, all for lunch in the room, and we went home. It is clear that this is not always possible to realize( mother works, the teacher does not agree, the kindergarten is far from home), but this option, at least, one can bear in mind.
And, in conclusion, we note the obvious: the algorithm of "action after recovery" applies to all children, and not only to the often ill. This is actually one of the most important rules that helps a normal child not become often sick.
Well, as soon as we started talking about "all the children", we note that after going to the children's group after the illness, we should think not only about ourselves, but about other children. In the end, SARS can flow in mild form, when the body temperature remains normal. The snot ran, you stayed at home for a couple of days, and then went to the kindergarten, while remaining infectious!
Antibodies to the virus are produced no earlier than the fifth day of the disease. Therefore, it is possible to resume visiting the children's collective not earlier than the sixth day from the beginning of the acute respiratory virus infection, regardless of its severity, but in any case, at least three days after the normalization of body temperature.
Visiting children's groups: "nonsadikovy" child
The situation in which a child becomes sick often only after the begins to visit the kindergarten is absolutely typical. Up to three years practically did not fall ill, walked, hardened, never and did not treat anything. In three years he went to a kindergarten - and for five winter sickness. .. Do you already understand who is to blame? Definitely not a child.
When the phrase "till three years was not sick" is pronounced, this phrase is affirmed - we have an absolutely normal, healthy child. The environment has changed - illnesses have begun.
What should I do? First, to recognize the fact that it is impossible to start actively communicating with children and not get sick. But you, in fact, were ready for this, but did not think that the diseases would be permanent. Constant diseases means that either you are in a hurry to return to the children after the illness, or something is fundamentally wrong in the kindergarten itself( take ill children, do not air, walk a little, etc.).
Do we have the opportunity to influence the kindergarten? As a rule, we do not have. Can we change the kindergarten? Sometimes we can. But this is not easy and expensive.
Can we not take the child to a kindergarten if the bosses at work demand us, and the doctor does not intend to extend the sick leave sheet?
We can not. We can not change the kindergarten. We can not take them to the kindergarten. We set aside. We are ill. Recover. We set aside. We are ill. Suddenly we understand that everything we earn at work is spent on childhood illnesses!
And then someone from the surrounding says the phrase: your child is "nesadikovsky".And everything suddenly becomes clear. We throw our work. We stop going to the kindergarten. And really after 1-2 months we cease to be often a sick child.
We stopped going to kindergarten because we could not find a normal kindergarten.
We stopped going to kindergarten because we did not have the opportunity to rebuild the child after the illness.
Please note: "we could not. ..", "we had no opportunity. ..".
Conclusion: there are no Nesadikov children. There are nesadikov's parents.
We did not find a normal kindergarten because it simply does not exist.
We did not have the opportunity to rebuild the child after the illness, because this possibility does not include the instructions of our pediatrician and the code of labor laws.
Conclusion: there are no nesadikov's parents. There is a nesadikov society.
But in fact everything is not so dramatic. Since even very frequent acute respiratory diseases with proper treatment do not affect the health of the child at all.
Ill. Humidified, aired, watered, dripped a nose. Has recovered. I went to kindergarten for two days. I got sick. Humidified, aired, watered, dripped a nose. Has recovered. We did not do anything dangerous, bad or harmful.
But if every sneeze is a reason for appointing a dozen tablet syrups, for bullying under the name of "distracting procedures", for injections of antibiotics, for a thorough examination, for consultation of a dozen specialists, each of whom considers it necessary to add a couple more drugs,- such acute respiratory infections are unequivocal and obvious, and such acute respiratory infections do not pass without a trace and do not grow painlessly. And for such a child, a kindergarten is dangerous. And parents are dangerous. And the doctors. ..
If the child is sick with ARI often, even very often, but does not recover with medication, but in a natural way - so let him be sick, let him go to the kindergarten, even if he does what he wants.
It's not harmful - so sick and so recover!
Author Komarovsky EO O.
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