For the past one week, my three-year-old daughter has been running a mild to moderate fever at night. I searched on Google, and it seems the symptoms point to typhoid. Please advise.
— Shilpi Ravindra, Hyderabad
I strongly urge you and all parents to desist from turning to the Internet for medical diagnosis of children’s illnesses. There are way too many medical untruths and myths floating online. The most common fever in children these days is viral, lasting about five-seven days. Viral fevers mostly subside on their own with symptomatic treatment and without antibiotics. On the other hand, a typhoid fever spreads through the feco-oral route and persists for more than a week, and comes with specific symptoms such as abdomen pain, vomiting or other complications. I recommend you consult a doctor.
I have been exclusively breastfeeding my three-month-old daughter. But she vomits some milk after every feed. Is this a cause for worry?
— Masha Hiyanshi, Mumbai
Spit-outs are common in new-borns and could happen after every feed. This is mainly due to gastro-esophageal reflux (GER) caused by the under-developed lower esophageal sphincter in infants. There’s no cause for worry as long as the infant is feeding well and gaining weight. GER tends to subside by the age of six-nine months without any medical intervention. If there is large volume vomitus occurring after every feed and your daughter is losing weight or getting dehydrated, then your paediatrician will have to rule out pathological causes such as GERD, congenital pyloric stenosis, vascular rings, intestinal obstruction, tracheo- esophageal fistulas etc.
My three-year-old has just started school, and often falls sick. It is frustrating as she can’t go to school, and I need to take time off from work, and then after recovery, she is sick again in a few weeks. I ensure she eats nutritious, homemade food.
— Jisha Riddhi, Bengaluru
Most children tend to fall sick often during the first two years of school. This is due to sudden exposure to the outside world. Until they begin school, toddlers are more or less ensconced in a protected home environment. Please note this isn’t because of lack of immunity or poor nutrition. The primary reason is that your child’s immunity is shifting from innate to adaptive immunity. When a child is exposed to common viruses, bacteria and other microorganisms, her body produces antibodies that have memory cells.
So, the next time she is exposed to the same microorganisms, the body has antibodies to fight them without producing any or mild symptoms. Therefore your child needs to get exposed to all common microorganisms to develop immunity resembling adult immunity. And this mostly happens during the first few of years of school.
Meanwhile continue to provide a balanced diet, follow the immunisation chart and consult your paediatrician as soon as any illness begins.
(Dr. Amritha Rao Kordcal is consultant paediatrician at Shishu Clinic, Aaditya Hospital and Brindavan Hospital, Mysuru)
