Babies born more than 8 weeks prematurely (at 32 weeks of pregnancy or earlier) face more than one threat to life in their early days. This is simply because not every part of their body has developed sufficiently to function properly outside the womb. One of these risks is that their poorly developed blood vessels will bleed into the brain. The brain requires an excellent blood supply, meaning that some parts have a large number of tiny blood vessels.

Small bleeds are commonplace in premature babies, occurring in 10-15 per cent of such babies – and doctors would expect the majority to resolve themselves. Up to 50 per cent of haemorrhages have no symptoms and most occur within 72 hours of birth.

The more premature the baby, the greater the risk of a significant haemorrhage into the brain (‘intraventricular’ IVH).

Water On The Brain

In addition, there is another potentially dangerous complication – hydrocephalus, or “water on the brain”. This possibly happens because large clots resulting from the bleeding interfere with the normal movement of cerebrospinal fluid, which begins to gather in inside the cranium. Over time, this can place the brain under great pressure, and cause damage.

The only treatment for hydrocephalus is an operation performed by a neurosurgeon to relieve the pressure.

Small haemorrhages may have no symptoms, as previously stated, whereas a larger bleed can cause the baby to collapse suddenly. The baby may have a seizure or fit, or become limp and floppy or develop a paralysis of one or more limbs. The loss of blood into the brain tissue may cause anaemia or jaundice.

An ultrasound scan is used to make a formal diagnosis, and many premature babies are given this check inside their first week.

The most effective strategy for IVH is to prevent premature delivery, and reduce the risk of the bleed happening in the first place. The longer the baby can be safely kept in the womb, the less likely IVH is to occur – particularly at its most severe grades. Advances in neonatal intensive care technologies and techniques have reduced the risk of IVH in recent years, and there is some medication, which, if given to the baby, may slightly reduce the chances of a bleed. However, once a premature baby has been born, and an IVH detected, doctors can do little to directly tackle the problem, and must hope that the bleeding resolves itself.

Long term effects

Children who survive IVH, particularly severe cases or those which go on develop hydrocephalus, may suffer neurodevelopmental disability, such as cerebral palsy, as a result. Those who suffer the mildest form of the condition have been found to suffer no significant neurodevelopment disabilities – but those with the most severe grades are far more likely to be affected.

Great Ormond Street Hospital in London has a help line offering advice and comfort to parents who have lost a child.

The Child Death Help Line – 080 0282 986.

SANDS – The Stillbirth and Neonatal Death Society

Email – helpline@uk-sands.org

Website – Sands

Author. Medical Advice By Vivienne Balonwu, Free Medical Advice Online.

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.

Influenza Suffer

Like a cold, influenza or flu means you have picked up a virus, which is passed on by coughing, sneezing or physical contact. In both cases you cannot treat or cure the infection itself, only its symptoms. Antibiotics will make no difference to flu unless you have a ‘secondary’ infection of the middle ear or chest.

A heavy cold can easily be mistaken for influenza, although flu is much less common and often spreads rapidly as an outbreak or, worse, an epidemic. The effects of flu, which infects the body’s breathing passages or respiratory tract, are more severe and can take longer to clear up than cold symptoms.

Flu is not normally dangerous, unless it strikes someone who is already ill or weak, or triggers off acute pneumonia – which is rare. If you are in a high-risk group you can arrange for an annual flu vaccination, which is around 70 per cent effective at preventing infection.

Catching one of the three main types of flu virus (A, B and C) will give you resistance to that particular virus in the future. Unfortunately, type B and (especially) type A produce new strains that your body’s natural defences cannot recognise or fight off – so you may get flu again and again.

How Do I Know If I Have Influenza?

Flu often comes on quite suddenly. The first symptoms are usually a fever, shivering, weakness, a headache, aching muscles and bones, tiredness and loss of appetite. A cough, sore throat and runny nose will normally follow.
After a couple of days your temperature will probably come down and the initial symptoms should be gone within a week. The cough, sore throat and runny nose will take longer, however, and you may feel tired and under the weather for a good two weeks.

What Can I Do Immediately To Make My Influenza better?

• Rest in bed and make sure your room is warm and well-ventilated.

• Soothe your throat and replace lost fluids by having plenty to drink. A hot drink made with honey and lemon or blackcurrant is preferable to tea or coffee.

• Do not smoke as this will make your symptoms worse.

• Try to eat a little, even if you do not feel up to it. If children are reluctant to eat, you could try extra drinks and semi-solid foods such as porridge or yoghurt.

• Treat your symptoms as you would those of a heavy cold – e.g., painkillers for a headache and fever, throat lozenges or gargling salt water for a sore throat, steam inhalations or cough medicines for a cough.

• Bring down a child’s temperature by sponging with lukewarm water.

• Remember to cover your mouth and nose when you sneeze, put your hand over your mouth when you cough and wash your hands regularly. This will help to avoid spreading infection.

• Do not rush back to work as soon as you feel better. Allow time for a full recovery.
What can I do generally to avoid catching flu?

• Steer clear of people who have the virus.

• Avoid places that are crowded or badly ventilated, particularly in winter when flu is more common.

• During the winter months, stay fit and healthy (and keep your body’s natural defences in shape) by eating and sleeping properly. Too much stress or a hectic lifestyle can lower your resistance to infection.

• Ask your doctor about having a flu vaccination if you are elderly and living in a nursing or residential home, over 80 years old, pregnant or have:

¤ a chronic respiratory disorder such as bronchitis, asthma, emphysema or cystic fibrosis
¤ a chronic heart condition
¤ diabetes
¤ kidney disease
¤ liver disease
¤ reduced resistance to infection, e.g., if you are having chemotherapy.

What Treatments Can I Buy Without A Prescription?

Your pharmacist will stock a variety of products for relieving the symptoms of flu, either separately or in combination. Some products, for example, contain a strong dose of painkiller together with ingredients for cough and a blocked or runny nose.
Ask your pharmacist which product is best for you and be careful not to mix products with the same ingredients in them. If your child has flu, get advice from your pharmacist on suitable medicines. Never give aspirin to a child under 12 years old.
For adults, paracetamol is useful for relieving a headache and bringing down a fever, while aching muscles and bones can be eased with soluble aspirin or ibuprofen every four to six hours (do not exceed the recommended doses).

When Do I Need To See A Doctor?

• If you are elderly or frail.
• If your temperature rises above 40°C.
• If your child’s temperature stays above 39°C for more than 24 hours.
• If your baby’s temperature is higher than 38.5°C.
• If you still have a fever after four days.
• If you are in a high-risk category (see above).
• If your symptoms get worse, you develop chest pain or are short of breath.
• If you are coughing up yellow or greenish phlegm.
• If you have severe earache.
• If you were recently in a country where there is a risk of malaria.
• If your baby or child is refusing to drink.
• If your child is sick and starts behaving strangely.

You Should Contact A Doctor Immediately If:

• Your child is weak.
• Your child is having problems breathing.
• Your child seems to find it painful breathing in.
• Your child has diarrhoea and is vomiting or refusing to drink.
• You, your child or baby show any signs of meningitis, e.g.

¤ a high temperature
¤ a persistent headache
¤ a stiff neck
¤ nausea or vomiting
¤ drowsiness or confusion
¤ dislike of bright light
¤ a red/blue skin rash

Babies

¤ a tight or bulging fontanelle (the soft spot on top of a baby’s head)
¤ listlessness
¤ a blank expression
¤ heavy or repeated vomiting
¤ refusal to feed
¤ high-pitched crying
¤ an arched back
¤ pale or blotchy skin with red or blue/black bruises

Note: Babies may display these symptoms without having a fever.

In Summary …

• Rest in bed and stay at home until you have fully recovered.
• Have plenty of fluids, particularly hot drinks to soothe your throat.
• Try to eat
• Treat your symptoms with home remedies or non-prescription medicines such as painkillers.
• Call a doctor if you develop worrying symptoms or are in an at-risk group.

By Peter Mansell, Edited by Dr Peter Stott. Published by Dr Vivienne Balonwu at Free Medical Advice Online.

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.

Head Lice

Head lice are tiny insects – no bigger than the head of a pin – that live on human hair, and feed by sucking blood from the scalp. Their egg cases are called ‘nits’ and these are always hatched or empty egg shells so their presence does not necessarily indicate active infestation. Once hatched, these shells are harmless. Head lice most commonly affect children, but adults in infected families can also get them. Lice cannot survive out of the hair, and cannot be transferred to animals or pets. They are spread only by relatively prolonged head to head contact, not by brief or fleeting contact, and they walk – not jump – from one person to another.

Any lice which are seen on someone’s clothes or back are incapable of transferring to another person and it is impossible to pick them up from towels, bedding or clothing. It is a fallacy that lice only live in dirty hair – they are found just as frequently in scrupulously clean households. They are seen most frequently in children between the ages of 4 and 11, with girls showing a slightly greater infection rate, possibly due to the length of their hair.

What Are The Signs And Symptoms Of Head Lice?

The main symptom is one of scalp itching, and this can be intense with considerable associated scratching. It can take several weeks for this itching to develop.This scratching can break the scalp skin, and so there may be an associated secondary skin infection which is often painful and may bleed.

Will I Have Any Tests Or Investigations For Head Lice?

Not as such, but it is always best to confirm the presence of active lice by using a special lice detector comb. This is the most effective way to spot them. The hair should be dampened and then combed carefully from the roots to the tips onto a clean sheet of paper. If lice are present they will be seen on the paper or the comb.

What Is The Treatment For Head Lice?

The treatment consists of insecticide lotions or shampoos applied regularly to kill both any live lice and eggs. The current practice in the UK is to use one insecticide for a course of treatment (two applications spaced one week apart) and if this treatment fails, to use another product whose active ingredient is in a different insecticide class. The current insecticides in use in the UK are malathion, the pyrethroids permethrin and phenothrin (all available over the counter from chemists without prescription) and carbaryl (prescription only).

In general, carbaryl is kept in reserve if all else fails. Another method of treating head lice is sometimes followed in the UK called ‘bug busting’. Here, the hair is wet combed intensely, using a special fine toothed comb and conditioner for at least 30 minutes every third day for a week. It remains unclear as to whether this method is any more or less effective than insecticide treatments and is time consuming for parents and children.

What Course Will Infestation With Head Lice Follow?

If treated effectively and correctly, head lice can be readily cleared. If they are left however, they will not disappear by themselves so treatment is the only option.

Can I Do Anything To Help Myself?

It can be impossible to prevent schoolchildren from catching head lice but prompt treatment and regular checking using a lice detector comb will mean their inconvenience is kept to a minimum.

Tell Your Doctor

1. Have you seen any lice or nits on your child or yourself?
2. Have you used a nit detector comb?
3. Do any of your child’s friends have head lice?
4. Has your child been scratching their head?
5. Have you used any treatments yourself?

Ask Your Doctor

1. Will ordinary shampoo remove lice?
2. Is there resistance to any of the treatments?
3. Are there any side effects?
4. Do I need to tell anyone about getting lice?
5. Does my whole family need treatment?

By Dr Roger Henderson, MB BS Lond., LMSSA Lond. Medical advice on head lice is published by Dr Vivienne Balonwu.

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.

A Boy Coughing

When you cough, it means your body is trying to clear its air passages of something that is blocking or irritating them. The culprit can be dust, smoke or a piece of lodged food.

Often, though, a cough is the result of a viral infection such as a cold, which inflames the upper part of our breathing apparatus. This encourages the production of sticky mucus, which drips down the back of the nose and throat.

If your cough is caused by a bacterial infection, you may need to go to a doctor for treatment with antibiotics. Otherwise, there are treatments available from the pharmacist for every type of minor cough.

How Do I Know If I Have A Cough?

Coughs divide into two main types: ‘productive’ or chesty coughs, which bring up mucus or phlegm into your mouth; and dry (‘unproductive’) coughs, which do not bring up any phlegm and are felt as a persistent tickling at the back of your throat.

Before you buy a cough remedy from your local pharmacist, it is important that you recognise which kind of cough you have. Using the wrong product could do you more harm than good. If you have a heavy cough or are finding it difficult to breathe, you should see a doctor.

Coughing can also be a nervous reaction to stress, particularly in children.

 
What Can I Do Immediately To Make My Cough Better?

* Stop your throat from drying out by having plenty to drink. A dry atmosphere or abrupt changes in temperature may also make your cough worse.

* Stay away from smoky rooms and do not smoke yourself.

* You can soothe your cough by sucking a boiled sweet or throat lozenge, or making yourself a hot drink of lemon and honey.

* Prop up your head at night with extra pillows or by raising the mattress at one end.

* Breathing in steam from a bowl of hot water may help. You can also buy inhalation treatments that contain natural oils such as eucalyptus.

* Try to bring up mucus if you have a productive cough.

* Ask your pharmacist to recommend a suitable cough medicine.

What can I do generally to stop my cough from getting worse?

* Give up smoking. Your pharmacist or doctor will advise you about products that can help you quit.

* Make sure you cover your mouth with your hand when coughing, to avoid passing on infection.

What Treatments Can I Buy Without A Prescription?

There is a huge range of products available to treat cough symptoms, including special mixtures for children. Most cough remedies are syrups or other liquids containing either expectorants, which make it easier to cough up phlegm, or suppressants, which act on the part of the brain that makes us cough.

You should take an expectorant for a chesty (‘productive’) cough and a suppressant for a dry cough. Do not take a suppressant if you have a chesty cough, as this may prevent you from bringing up phlegm.

Ask you pharmacist which medicine is right for you. Cough suppressants can make you feel drowsy, so be careful about driving or operating machinery. They should also be avoided if you have asthma or chronic bronchitis.

When Do I Need To See A Doctor?

* If you are coughing up blood with your mucus.

* If you are consistently bringing up thick, green, yellow, grey or foul-smelling phlegm.

* If your cough carries on for more than two weeks or starts to get worse.

* If you have a cough and high temperature for more than five days (three days for a child).

* If coughing makes you wheezy or short of breath.

* If you are getting a sharp pain in your chest when you cough or breathe in.

* If a child with a cough is dribbling and cannot swallow.

You should contact a doctor immediately if:

* You are panting or generally having difficulty breathing.

* If your breathing is rapid or painful.

* If your child’s lips have a bluish tinge.

In summary …

* Stay away from dry or smoky environments.

* Soothe your throat with a hot honey and lemon drink.

* Work out which kind of cough you have and ask your pharmacist for the right treatment.

* Go to the doctor if your symptoms are severe or you are having problems breathing.
By Peter Mansell.

Free medical advice online presented by Vivienne Balonwu.

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.

Conjunctivitis – or ‘pink eye’ as it is sometimes called – is the term used for redness and irritation of the surface of the eye and eyelids. One or both eyes may be affected.

The eyes and eyelids are very sensitive to a number of irritants:

either infections (such as bacteria and viruses) or non-infectious substances (such as pollen or chemicals).

Conjunctivitis very common in childhood and it is usually classified and treated according to whether it is due to an infection or not.

What Causes Conjunctivitis?

Conjunctivitis is caused either by infections (infectious conjunctivitis) or non-infectious substances (non-infectious conjunctivitis).

Infectious Conjunctivitis has two main causes – bacteria and viruses.

Bacterial conjunctivitis is caused by bacterial infections – usually either streptococci, staphylococci or pneumococci. These are contagious infections, and are spread by touch.

Viral conjunctivitis is usually seen along with typical symptoms of a cold, and the symptoms may differ very slightly from a bacterial infection (see below). Viral conjunctivitis is not as contagious as the bacterial form.

Non-infectious Conjunctivitis has three main causes.

The first is allergic conjunctivitis, produced by substances that cause an allergy (such as pollen and animal fur). The second is chemical conjunctivitis, this is when an irritating substance comes into contact with the eye (such as household sprays or smoke). Eye make-up, for example mascara, can cause symptoms.

The third form of non-infectious conjunctivitis is rare, and is due to an underlying illness. For example, inflammatory bowel disease and rheumatoid arthritis may sometimes cause this rare form of conjunctivitis.

Sometimes red eyes can be caused by another condition. Occasionally the whites of a person’s eyes can suddenly become bright red, but this is not due to a conjunctivitis. This is due to some of the tiny blood vessels under the whites of the eyes breaking when under pressure. This pressure can be caused by laughing, vomiting or even bending the head forwards. It is called a subconjunctival haemorrhage. While this
condition looks impressive (and worrying), it needs no treatment and will settle by itself.

What Are The Signs And Symptoms Of Conjunctivitis?

In bacterial conjunctivitis there is usually eye soreness or pain, with swelling and redness of the affected eye. There is a discharge from the corner of the eye, usually coloured greenish-yellow. The discharge is seen most commonly on waking. This discharge can ‘stick’ the eyes shut, sometimes to the concern of a child, but is easily cleared with a warm cloth.

Viral conjunctivitis causes the same sort of eye irritation but the discharge is more watery or clear rather than coloured.

With the non-infectious types of conjunctivitis, an allergic reaction causes considerable itching of the eye, often with much rubbing. This rubbing of eye only makes the symptoms worse. There may be a runny nose, sneezing and a sore throat associated with it too as part of the allergic reaction. Similar symptoms occur when the conjunctivitis is due to a chemical irritation or underlying disease too. However, if the conjunctivitis persists for a long time, it suggests that the cause may be an underlying disease.

Will I have Any Tests Or Investigations?

Doctors usually diagnose which type of conjunctivitis is present from the history and examination alone and rarely perform tests. In babies or children who have a persisting conjunctivitis or eye discharge, eye swabs may be taken to identify the organism that has infected the eye.

What Treatment Might I Need?

This depends on the underlying cause. 

In bacterial conjunctivitis, antibiotic eye drops or ointments are usually prescribed – usually chloramphenicol. Regular eye bathing with warm water, using a different cloth for each eye, is also recommended.

Note: It is important to use the eye treatment prescribed only for the person it was prescribed for. There are two important reasons. First, the medication will go out of date. Second, old bottles and tubes that have been used by one infected person may have been contaminated and this infection could be passed to the next person who uses that bottle or tube.

The easiest way to apply drops to a child is to lie the child down flat, ask them to shut their eyes and put the drops into the inner corner of the eye, next to the nose. The drops will form a tiny pool there. Ask the child to open their eyes, and the drops will then flow easily into the eye without worrying the child.

If your doctor thinks that the bacteria causing the conjunctivitis are part of a more general infection such as tonsillitis or an ear infection, the doctor will usually prescribe oral antibiotics rather than eye drops or ointments in order to treat the general infection.

In viral conjunctivitis there is no need for any anti-bacterial treatment, so no drops or ointments will be prescribed. All that will be needed is for the person with conjunctivitis to maintain simple eye hygiene, such as washing and drying each eye with a different cloth. Any flu-like symptoms, such as a runny nose, should be treated in the normal way.

With allergic conjunctivitis, the allergic symptoms are treated by placing cool cloths on the eyes regularly, and by using non-sedating anti-histamine eye drops or tablets. These eye drops or tablets can be obtained either over the counter from your local pharmacist or from your doctor.

Conjunctivitis caused by chemical irritation should always be first treated by very thoroughly washing the eyes for 5 to 10 minutes with large quantities of water. The person should then visit their doctor for a medical opinion.

What course will the illness follow?

Most cases of bacterial conjunctivitis will start to settle within 24 hours of beginning treatment, and the usual length of treatment is 3 to 5 days. Viral infections settle along with the underlying viral symptoms, typically between 2 and 6 days after their onset.

Can I do anything to help myself?

If you have a red eye that is discharging fluid, you should try to resist rubbing your eyes and you should seek medical advice. It is important not to rub the eye because bacterial infections are highly infectious and you may easily transfer the infection to your other eye.

Make sure you use your own personal towel and flannel so that others are not infected, and bathe the eye regularly. Remember to wash your hands thoroughly each time after using the treatment. If you suffer from allergic conjunctivitis during certain seasons (for example, during the summer), it is often worth using antihistamine treatment throughout the allergic season to prevent attacks.

Tell Your Doctor

1. How long have you had your symptoms?

2. Do you get symptoms like this regularly?

3. Do your eyes itch rather than hurt?

4. Does anyone else in your family or who you work with have a similar
problem?

5. Did one eye have symptoms before the other?

Ask your Doctor

1. Am I allowed to wear my contact lenses?

2. If my baby has a conjunctivitis, have they caught it from me?

3. What is the right way to bathe my eyes?

4. How long should I leave it before returning to see you if my symptoms
do not clear?

5. How long will my eye drops last before needing to be thrown away?

By Dr Roger Henderson, MB BS, LMSSA.

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.

Diabetes

Diabetes is a condition which affects the body’s ability to take glucose (sugar) from the bloodstream and use it inside cells. Glucose is essential to the body as an energy source. It is a component of carbohydrate foods (sugars and starches). Glucose is helped into the body’s cells by the hormone insulin, which is produced by the pancreas. In diabetes, the level of glucose in the blood rises because the body isn’t producing enough insulin or the body’s cells don’t respond to it as well as they should.

There Are Two Types Of Diabetes.

accounts for about 15 per cent of people with diabetes and usually occurs in younger age groups. With this type, the body stops producing insulin so that diet and insulin injections are required for treatment.

makes up 85 per cent of people with diabetes. Although people with this type still produce insulin, their body’s cells do not respond to it as well and they cannot keep their blood sugar in the normal range (between 4 and 8 mmol/L). This type occurs later in life and requires diet and possibly tablets or insulin for treatment.

What Causes Diabetes?

Type I diabetes is caused by the body producing antibodies that attack and destroy the insulin-producing cells in the pancreas. It is usually ‘triggered’ in susceptible people by a viral infection. There are several problems in the body that lead to Type II diabetes but the exact cause remains unknown. It is brought out in susceptible people particularly by being overweight and physically inactive. Diabetes can also develop in people who have other diseases of the pancreas, it can develop following treatment with some medications (such as high doses of cortisone that may be required to treat asthma or arthritis), and it occasionally develops in association with other rarer inherited conditions. The tendency to develop diabetes can be inherited. Stress and shock do not cause the pancreas to stop working (and hence do not cause diabetes), but stress usually causes the blood sugar level to rise in people with diabetes. This sometimes brings previously undiagnosed diabetes to light.

What Are The Risk Factors?

Having a close relative with Type I diabetes raises the risk of diabetes. In Type II diabetes, the risks include:

What Are The Symptoms?

Tiredness, thirst, passing water frequently, blurred vision, increased skin or bladder infections and occasionally leg cramps are common symptoms. Any combination of these can occur. Sometimes few or no symptoms occur. However, it is important for people with any of these risk factors to be tested for diabetes.

What Treatment Is Available?

If you have diabetes and it is not treated properly, a number of problems can result. High blood sugar levels increase your risk of infections and poor healing of cuts and wounds. In the long term, there can be other complications including problems with large blood vessels (causing increased risk of heart attack, stroke and foot problems), small blood vessels (in your eyes or kidneys) or with the nerves in your feet (causing numbness or sometimes burning pain). It is important to avoid complications from diabetes by following appropriate treatment that keeps blood sugar levels as close as possible to the normal range.All people with diabetes need to have a healthy lifestyle with regular meals and some exercise. If you have Type I diabetes you will require daily insulin injections which can be given by needle and syringe, or by an insulin pen device. If you have Type II diabetes you may be able to manage the condition with diet alone, particularly if you lose weight and exercise regularly. Some people with Type II require tablets or perhaps insulin injections in addition to dietary measures.

What Is A ‘Hypo’?

If you take insulin or some types of tablets to control diabetes, you may occasionally suffer a ‘hypo’. A hypo, or hypoglycaemic reaction (also called an insulin reaction), occurs when the blood sugar falls below danger level (below 4 mmol/L). It is usually accompanied by any combination of the following symptoms: sweating, blurred vision, hunger, light headedness, and/or you may have a change in mood, becoming either quieter, perhaps appearing drunk or even becoming aggressive. If untreated, you may lose consciousness. A hypo can occur if you delay or miss a meal, exercise more than usual, or take excess tablets or insulin by mistake. If this happens you should eat something sweet immediately, for example glucose tablets, two barley sugars, seven jelly beans, ordinary lemonade or cola (not diet or low calorie drinks) to build your sugar level up. You should then have some starchy food, for example biscuits or a piece of fruit to keep your sugar level up. This treatment is taken in addition to your normal diet. You will need to discuss with your GP whether you need to alter your medication. This will depend on the cause of the hypo.

By Dr Peter Stott

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.

Immunisation has saved hundreds of thousands of children from death and handicap. Since the introduction of routine childhood immunization, many diseases including poliomyelitis, tetanus and diphtheria have been virtually eliminated.

What Is Immunization?

Immunization is a safe way of giving children a ‘mini dose’ of an infection. The child’s immune system builds resistance to the infection from this tiny dose. Later, when the child or adult comes into contact with the real disease in the community, they are protected from harm. Eight serious childhood diseases and serious infections can be prevented by immunization. Immunization is given by injection, or in the case of polio vaccine, taken as drops by mouth.

What Immunization Should My Child Be Given?

Immunization begins when your child is two months old (see panel at the bottom of this article). The first vaccines given are triple antigen (to protect against diphtheria, whooping cough and tetanus), Hib vaccine (to protect against meningitis) and poliomyelitis vaccine. At the age of one year, another vaccine called MMR is given to protect against measles, mumps and rubella (German measles). It is important that children receive all the doses shown in the box overleaf.

Where Can You Go?

Most children are given immunizations by their GP or by nurses at a health authority immunization clinic.

Computerised registers are kept in most areas.

Keeping Track Of Your Child’s Immunizations

This is best done in the child’s personal health record book which is provided by the Department of Health. Otherwise, ask your GP about it. You will need to have this record when your child starts pre-school or school.

When Is My Child’s Immunization Due?

If your child is being immunized by a GP, ask that GP when the next immunization is due. Every time your child receives an immunisation, a record is kept on the register. An optional recall reminder system can inform you when your child’s next immunization is due. Information on the register is confidential.

Are there any side-effects?

Minor side-effects such as redness or soreness at the site of the injection are common. These may last a day or two. Fever sometimes occurs and may be relieved by giving your child an appropriate dose of paracetamol mixture for his/her age. Serious side-effects are exceedingly rare and are most unlikely to cause any permanent harm to your child. However, contact your doctor immediately if your child:

How Long Do Vaccines Take To Work?

Most vaccines take some weeks to work and your child will only be fully protected after completing the full course for each vaccine.

The protective effect from vaccines is not lifelong. Some vaccines like tetanus last for only 10 years; after that a booster injection needs to be given. If you want more information, ask your GP.

Even when all doses of vaccine have been given, not everyone is fully protected after completing the course for each vaccination. Whooping cough vaccine fully protects 80-90 per cent of children who have been immunized. Measles and rubella vaccines protect more than 95 per cent of children.

Should Immunisation Be Postponed If My Child Has An Infection Or Allergy?

Babies can be immunized safely if they have minor coughs or colds without a fever, or if they are taking antibiotics but are well. Children with asthma, eczema, hay fever and allergies may be safely immunized but remember to tell your GP. If your child has had a severe allergic reaction to egg, talk to your GP again before the measles vaccine is given at the age of one year.

Homoeopathic ‘immunization’ offers no protection against infectious diseases.

By Dr Peter Stott.

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.

If you suffer from an allergy, you are definitely not alone. In fact, the number of people suffering from allergies such as hayfever, asthma, eczema and food allergies is increasing.

Your immune system protects you against infections by producing antibodies to kill harmful organisms. When you have an allergy, your immune system overreacts to substances that are not harmful to other people. True allergies are reactions to substances called allergens.

Common allergens are pollen, mould, house dust mites, animal hairs, feathers, nickel, rubber and certain foods. Reducing your exposure to allergens can be an effective way of preventing an allergic reaction; however, this is not always possible. There are many treatments available to help reduce the symptoms of allergies, although at the moment there are no cures.

What Are The Most Common Allergens?

The house dust mite, which feeds on flakes of human skin, is one of the most common allergens, and causes symptoms all year round. Every household has house dust mites, no matter how clean and hygienic it is, but house dust mites are only a problem if you are allergic to them. Pollen, mould and animal hairs are other common allergens. You can even become allergic to a substance you have used or eaten for years.

All of these allergens are mostly breathed in. They cause sneezing, running or blocked noses, watery eyes and wheezing in up to 40 per cent of the population. Food allergies are most commonly caused by eggs, cow’s milk, nuts, fish and shellfish (such as prawns).

Food allergies may cause eczema to develop in babies, but older children and young adults often develop a rash (hives). Hives affect one in five people during their lifetime.

Why Are Allergies Increasing?

There have been a number of possible reasons put forward for the rise in allergies. It could be due to an increase in house dust mites because of the way we build and furnish homes. Most homes now have wall-to-wall carpets, and ventilation is reduced to keep warmth in winter and coolness in summer. This results in an even temperature and high humidity – ideal conditions for house dust mites.

Air pollution may be playing a role in increasing asthma, and processed foods containing artificial colour and preservatives could be responsible for an increase in food allergies. Changes in children’s diets mean they are being exposed to a much wider variety of foods earlier on in life than in the past, possibly stimulating their immune system.

How Do You Find Out What Causes Your Allergies?

Keep a record of when and where your symptoms appear. For example:
• Do you sneeze or wheeze when you clean the house or empty the vacuum cleaner bag?
• Do your symptoms occur when you are in a room with a cat (even if you don’t handle the cat)?
• Do your symptoms occur throughout the year, or only in certain seasons, such as spring and early summer?
• Do your symptoms occur at particular times in the day, for example in the morning and evening?

Noticing your own pattern of symptoms is the most useful way of identifying the cause of your allergies. Allergy testing is not routinely done as the results can be confusing, but in certain cases blood tests and skin pricks can be helpful. A positive reaction identifies an allergen but does not necessarily mean that it is responsible for your symptoms at that time.

Using blood test and skin pricks to test for food allergies is difficult and cutting certain foods from your diet and then reintroducing them is the best way to identify the allergen causing the problem. This needs to be done carefully and under the supervision of a dietitian, particularly for children, who may otherwise lose out on essential nutrients.

Allergies Treatment

First you have to work with your GP to identify the allergens responsible for your symptoms and then try to avoid them. You can do this by doing the following:
• Remove carpets and soft furnishings to reduce house dust mites
• Keep your house well ventilated and free from damp
• Buy special mattresses and pillow coverings that are resistant to house dust mites
• Don’t buy pets (such as cats, mice or guinea pigs) if family members are allergic to animal hairs
• Place soft toys and teddy bears in the freezer every 6 months to kill the house dust mites
• Mow your lawn regularly to prevent the grass from flowering
• Avoid visiting rural areas during high pollen seasons
• Don’t allow people to smoke cigarettes in the house.
• Breastfeeding your baby for as long as possible (preferably 4 to 6 months) can help your child build up an immunity to allergens. Try to avoid exposing your baby to pets and dust during this time.
• Avoid sheepskin underlays as they encourage house dust mites.

It is also important to improve your general health. These measures include having a good diet, getting plenty of exercise, getting enough sleep and not smoking.

Antihistamines

If you have an allergy, you may need to take antihistamines. Rashes are also often well controlled by the newer non-drowsy antihistamines. Antihistamines prevent symptoms (like itching, sneezing, watery eyes, runny noses and rashes) that are caused by the body releasing a substance called histamine during an allergic reaction. The newer antihistamines have very few side-effects. Your doctor will help you find one that does not make you drowsy.

If your symptoms cannot be controlled by avoiding allergens or taking antihistamines, your GP may prescribe a steroid nasal spray. These sprays are anti-inflammatory drugs that will help the symptoms of allergies. Because they are applied to the lining of the nose and lungs, the newer steroid drug is hardly absorbed into the blood stream, so the risk of side-effects is reduced. Many different home remedies have been used for treating allergies, but there is no evidence that they are effective.

What is anaphylaxis?

Anaphylaxis or anaphylactic shock is a sudden, severe reaction to a substance, but it is very rare. The reaction rarely occurs in response to allergens in the air (like pollen) but may be in response to a food, bee sting or a drug. The severe reaction causes swelling of the face and throat, difficulty in breathing and a drop in blood pressure.

You should call for an ambulance unless your GP’s surgery or casualty department is very close. After your first attack you will probably be given an adrenaline injection to carry with you in case it occurs again.

Edited by Dr Carol Blow, MB BS, MRCP, MRCGP, DRCOG.

Free medical advice online published by Vivienne Balonwu.

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.