Fever is a symptom and not a disease, but ...

As I have mentioned in my earlier post, fever is not a disease by itself. Treating it with paracetamol merely causes the fever to subside, without actually affecting the underlying cause of the fever. It is important to know the following additional facts about fever:

1. High fever can produce fits in infants and toddlers; although these fits look very dangerous to parents and care-takers, they are merely a reflection of the immaturity of a small child's brain and nervous system pathways; no long-term medicine is needed except in the rarest of circumstances.
2. In children (and adults) of all ages, fever increases the thirst and fluid requirements of the patient; thus, febrile children or adults must be given extra liquids - usually 10% more than the usual for every degree Centigrade the fever is above 38 degrees.
3. A patient who is running a fever should never be force-fed food; nor should food be withheld from one who desires it. In short, let the patient decide what, how much and in what form he needs. Starving a child with fever is a criminal act, since it further weakens his/her body and prevents it from fighting the underlying cause of the fever (usually an infection with bacteria).
4. Very high fever (more than 105 degrees Fahrenheit) is termed malignant hyperpyrexia ... and in the extreme case, it can be potentially fatal, i.e. kill the patient due to complete derangement of all systems in the body.

While most causes of fever in children are easy to manage and not life-threatening, fever accompanied by any of the following additional symptoms should be considered as "not just fever" and such children should be referred to a Paediatrician immediately:           

• High grade fever
• Uncontrolled or repeated or very large-sized vomiting or loose stools
• Irritable, excessively jumpy or crying child
• Older child who remains in bed all the time and refuses to drink liquids or appears inactive, dull or lethargic
• Has had fever-associated fits in the past, or during the present illness
• There are significant symptoms pointing to a serious infection such as arching of the back (meningitis), dark coloured, blackish urine (malaria), stomach bloating (typhoid) or moist, hacking cough with sputum and chest pain (pneumonia)

Learn to understand fever and try not to panic.  Check out the link to my earlier detailed post on fever to learn how to manage fever at home. When in doubt, go to your child's doctor immediately.

My Child Care book is now available off the net

Dear Readers,

I have updated and revised my original child care book that I first wrote a decade ago, and have now made a soft copy available on the internet for sale at a very low price. Do check out the link below: 



Click here or see the full link below, copy and paste it into the address bar of your browser and click "go".

http://pothi.com/pothi/book/ebook-dr-taher-y-kagalwala-child-care-birth-eighteen

I trust that you will like it and will buy it. Proceeds will be shared between the marketing site and me, and I will use the money to help children from poor communities in Mumbai and around Mumbai to realise their true potential. Thank you very much. 

If you do buy it, please write a comment about this in this blog and I will be sure to add you to my prayers. Also, after browsing through it and using it for a few months, do write to me a testimonial, telling me how you found the book and send it to my email address drtaher@gmail.com

Thank you.

A crying baby

When a baby cries, parents get extremely worried and immediately consider calling the pediatrician or taking the baby to the doctor. This is a very natural thing to do as parents think there must be something wrong for a baby to cry so much. In my experience, while about 10 in 100 children are certainly sick and need medical attention, almost 90% of the babies who cry excessively have no major problem and can be soothed and comforted with just a few simple measures.


While an entire discussion on causes of crying is outside the scope of this blog, the commonest causes of crying include:

• hunger or thirst
• stomach colic
• uncomfortable clothing/swaddling/too cold or too warm a temperature
• passed urine or stool and feeling uncomfortable
• has a stuffy nose and cannot breathe easily
• has pain somewhere, most commonly the ears, the throat or some place else
• is feeling bored or tired and wants you to soothe him, carry him, cuddle him or just talk to him

Having said that, let me add that sometimes, it is not possible to discover the cause - not even the doctor succeeds in finding out the reason in each and every case. In such cases, the doctor may order some tests such as trying out a feed, changing his clothing, offering him water, putting salt-water nose drops, turning him on the stomach and gently stroking his back, and so on.

If your baby cries without any apparent reason, try doing those things before you run to the doctor. However, do not waste time if the baby has additional symptoms like fever, refusal of feeds, loose motions, vomiting, a bad cough or running nose, or almost anything else that you, as a parent, do not understand.

Among all the causes that I have listed, stomach colic is by far the most common cause of excessive crying in infants less than four months old. When the pain comes, the baby draws his legs upto this stomach, clenches his fists, and starts crying loudly. The stomach feels tight. He may vomit some milk or curd from a previous feed, and will stop suckling when the pain occurs. The problem tends to subside on its own within two or three minutes. It recurs almost every night; the good news is that although it looks bad, there is no long-term problem with it and babies almost always outgrow this condition in three to four months.

One word of advice. Most mothers think that if their baby is crying, it means that they don't have sufficient milk and therefore the baby remains hungry. This is almost always NOT TRUE. However, the ensuing panic may actually cause so much tension in the mother's mind that she may stop secreting the right quantity of milk as a result.

Introduction

Hello. Most people who know who I am aren't fazed much by my unconventional and practical approach to children and their myriad problems. As they say, "I am like that only". I am, of course, a qualified Pediatrician with over twenty years of practice behind me. I graduated from the Seth G.S.Medical College and the K.E.M. Hospital, Mumbai. (To read more about these institutions, click here and here.)

Today, I am an active consulting online expert on http://www.healthcaremagic.com/ (see my profile here). Besides these activities that I sustain with regular inputs on the net, I am an avid internet surfer, a voracious reader and a busy practitioner. I have also written a book on Parenting, but the  book is out of print at present.

In this blog, I am going to write about common topics of child-care that trouble parents from all over the world. I will try and use simple language and keep the advice easy to replicate. Wherever possible, I will try and provide evidence to support my line of treatment/advice. I urge readers to send me requests for topics so that I can make this blog really worthwhile.

Thank you all for reading this.