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Decreased activity The baby is less active, and moves arms and legs less. He may just tend to lie around, or want to be cuddled by a parent rather than be involved in activities that are normally of interest.

Breathing difficulty This is an important sign of a potentially serious illness, and may take several forms. The baby may be breathing very quickly, or grunting with each breath. He may be coughing non-stop, and with each breath you may notice the muscles between the ribs being sucked in, or else he may be blue around the mouth. Sometimes it is difficult for parents to assess the baby’s breathing, and you should not hesitate to seek immediate medical advice if you are unsure. Poor circulation The baby may look paler than usual, and this can last for up to several hours. In addition, you may notice that his hands and feet may be cold or even blue.

Poor feeding The baby drinks much less than usual. Breastfed babies suck less strongly and for shorter periods of time. Bottle-fed babies take less than half the normal amount of milk that they normally drink in 24 hours. The baby may not be very interested in feeding in general.

Poor urine output The baby has fewer than four wet nappies in 24 hours.

The more of these signs the baby or young child has, the more chance there is that he has a potentially serious illness. You should see the doctor if any one of these signs is present in your child. If the child shows more than one of these signs, you should seek urgent medical attention.

A doctor should also see the baby as a matter of urgency if any of the following

occur:

• the baby vomits green fluid;

• the baby has a convulsion (fit);

• the baby has a very high temperature (fever). (Note that a high fever is potentially much more serious in a baby of less than 6 months than it is in an older child. Fever in a baby always needs medical attention as it is more likely to indicate a significant and potentially serious infection.);

• the baby stops breathing for more than 15 seconds (apnoeic episode);

• the baby has a lump in the groin area (hernia).

Remember that in babies and young children illness can progress more quickly. If in doubt, seek medical advice.

Sometimes parents may put off seeking advice for a variety of reasons. They may not want to worry the doctor with what may turn out to be a trivial illness, especially at night or if they think that he or she is very busy. They may be anxious that their fears are groundless and that they will appear foolish if the baby turns out to have a minor illness. In addition to diagnosing and treating illness, one of the most important things that a doctor should do is to reassure parents that their child is in fact well. This can alleviate a lot of unnecessary anxiety.

If you are concerned, for whatever reason, you should seek medical advice. Usually this will mean taking the child to your general practitioner. Most doctors repeated difficulty getting a rapid appointment for your baby to be seen by a doctor, or if you are made to feel guilty for ‘wasting the doctor’s time’, then it may be time to find a different doctor.

If you are worried about your baby or young child for any reason, do not hesitate to seek medical advice.

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This test is used to detect the presence of abnormalities of the middle ear, such as whether fluid is present, or whether there is ‘glue ear’. A sophisticated probe attached to an earplug is placed in the child’s ear. This may be slightly uncomfortable but does not hurt. It will help if you sit your child on your knee during the procedure, and continually reassure him. The probe varies the pressure in the ear and results in a graphic printout which represents the functioning of the middle ear. The doctor uses this to determine whether there are abnormalities which need to be treated. Tympanometry is often performed in conjunction with a hearing test.

ULTRASOUND SCANNING

Ultrasound is a technique which uses high frequency sound waves to produce an image on a television screen of internal organs. The sound waves are bounced off individual organs, and converted into pictures. Different organs have characteristic appearances on ultrasounds, so structural abnormalities can be discovered in this way. Many organs can be visualised well using the ultrasound technique but not all can.

The procedure is quite painless. The person to be examined is asked to lie on a bed and an instrument which looks like a microphone is covered in jelly and then rubbed over the abdomen. The procedure does not involve the use of radiation.

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Hydatid cysts are common in countries with large sheep populations and so are found not only in Australia but also in the Middle East, in parts of Europe and in North America.

They were first recognised in Australia in 1850 and in the years between the world wars, Sir Harold Dew, professor of surgery at Sydney University, wrote the definitive textbook on this disease.

What is a tragedy is that, although we have the knowledge to eradicate this problem, it is still as common as it was in the first half of this century.

Echinococcus granulosis is a tapeworm of dogs. It is only 4 to 6 mm in length and consists of a head, or scolex, with three or four segments (proglottides).

Each segment has a complete set of both male and female reproductive organs. When the lowest segment is mature, it drops off and the eggs it contains are liberated and pass out with the faeces. A segment may contain up to 1000 eggs and is usually shed every 14 days.

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It was first described in children in 1978.

It usually has an acute onset with fever, vomiting, diarrhoea, headache, muscular aches, a spreading rash followed by collapse or shock.

Some women use tampons because they have a vaginal discharge rather than only when menstruating. It may be worthwhile considering seeing a doctor to determine the cause of the discharge and what can be done to cure it rather than using tampons for protection and putting up with the discharge.

Any serious illness, such as this, with what appears to be a high mortality can frighten women but, so far, the incidence is low and there may be a greater danger of dying in a road accident than from toxic shock syndrome.

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In an attack of tonsillitis, the throat may become so swollen, that the patient will have difficulty swallowing. In extreme cases, breathing can be obstructed and, if distress of this kind is evident, you should seek professional advice immediately. Fever, headache, vomiting and a cough commonly accompany the swelling of the tonsils.

Normally the acute symptoms last just a couple of days. Gargle a mixture of sage, thyme or myrrh, drink plenty of fluids and take garlic capsules to fight the infection. A tonic containing golden seal will help to reduce the inflammation of the membranes in the throat and a tincture of golden seal can be sprayed directly on the glands. Avoid mucous rich foods such as dairy foods and, if eating is difficult, take fruit and vegetable juices until the worst symptoms have eased.

Recurrent tonsillitis can indicate poor nutrition or reduced immunity. Boost your intake of Vitamins B and C and zinc.

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The first step is to decide whether a child is actually ill more often than most other children. Some reports show that the average, normal child between one and 12 years of age may have as many as eight illnesses per year. Other figures show that a first child will seldom be ill during the first year; then the child will have increasingly frequent sicknesses as he or she begins to play with other children and attend school. An infant with older brothers or sisters will be sick the first year as often as the other children are. To decide if your child is ill too frequently, compare the number and seriousness of the illnesses with those of the child’s brothers, sisters, and friends.

Home care

How much your child is exposed to illnesses depends somewhat on you and your circumstances. Over-protectiveness and isolation from other children can lead to emotional problems that could be harder to treat than physical problems. On the other hand, overexposure to other children who may be ill can lead to almost constant minor illnesses, especially in very young children. Keep older children who are ill – yours and the neighbor’s-away from infants. Isolate any ill child from your other children as much as is practical.

Precautions

• Frequent illnesses that could interfere with normal growth must be investigated. If the child stops gaining height or weight or begins to lose weight, see your doctor.

• Repeated pneumonia in the same part of a lung must be evaluated by your doctor.

• Frequent lower respiratory infections with a prolonged cough can be a sign of cystic fibrosis or asthma.

Medical treatment

Your doctor will help you decide whether your child is ill more often than others of the same age and under similar circumstances. If so, your doctor will seek the cause through a variety of tests. These tests may include a sweat test, measurement of immune globulins, blood count, sedimentation rate, chest X ray, sinus X rays, nose and throat cultures, and allergy tests. You and your child may be referred to an ear, nose, and throat specialist, to an allergist, or to a medical center for thorough investigation of all immune mechanisms.

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“All of these emotional problems have been found to increase the risk of heart disease and other health problems. And it’s not one or the other. In fact, they usually cluster. If you’re hostile, you’re more likely to have higher levels of depression and you’re more likely to be socially isolated,” says Redford B. Williams, M.D., professor of psychiatry and director of the Behavioral Medicine Research Center at Duke University Medical Center in Durham, North Carolina, and author of Life skills.

In fact, if you’re a brooding loner, you may be asked to appear in a foreign film someday, but you may not live long enough to see it on the big screen. One five-year study found that people who were socially isolated were three times more likely to die from heart disease than those who had more social lifestyles.

What’s more, research has shown that those who already have had heart attacks and were depressed were also more likely to die within six months of their attack, says Dr. Williams. And a Danish study found that those who suffered from despair, low self-esteem, difficulty concentrating, and low motivation were 70 percent more likely to die from heart disease.

“These people weren’t clinically depressed, but did have persistent symptoms of depression,” says John Ñ Barefoot, Ph.D., psychologist and associate research professor at Duke University Medical Center in Durham, North Carolina.

What’s happening in these situations that increases your risk for heart problems? Anger, frustration, depression, and other emotional upsets are thought to activate your body’s fight-or-flight response-an automatic reaction that sets off a chain of internal physiological changes like a home security system gone berserk. Chemicals such as adrenaline and Cortisol, for example, rush to mobilize fat from your body’s stores in case you need a high energy source in your bloodstream to fuel your muscles-and your escape, says Dr. Williams. Not surprising, this raises your cholesterol and blood pressure and even makes your blood more likely to clot.

If that’s not bad enough, those who are socially isolated, depressed, and hostile seem to have worse health habits, making them more likely to drink and smoke, he says.

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A two month study at the University of Texas Medical Branch in Galveston, tested the effect of supplements on the memories of 34 iron-and zinc- deficient women whose ages ranged from 18 to 40. Eleven other women who had normal levels of both iron and zinc served as a control group. Each subject had a normal memory range and took a vitamin supplement. Some of the subjects who were deficient in iron and zinc took 30 extra milligrams of iron and/or zinc. At the end of eight weeks, the iron and zinc deficient women who had taken one of the supplements had improved their memory test scores by as much as 20 percent. Women who had taken both iron and zinc showed only a slight improvement in memory, while those who took just a common multivitamin experienced no improvement at all. The researchers explain the disparity by pointing out that iron and zinc can interfere with each other’s absorption when they are taken as supplements. There is no such interference when the two are part of a balanced diet.

The best source of both nutrients is red meat, and not eating enough red meat is a typical cause of iron and zinc deficiencies. Iron and zinc can also be found in chicken, fish and beans, but in lesser amounts than in red meat.

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