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Is It A Cold Or Is It The Flu?

Winter is here and so are coughs, colds and flu. Common colds and flu are both caused by viruses and share many of the same symptoms however colds are usually milder and do not cause any serious complications. More than 200 viruses can cause a cold whereas the flu is caused by the Influenza virus. This is why there is no vaccine available for the common cold.

WHAT IS THE DIFFERENCE?

Generally colds affect you from the neck up where the flu attacks your entire body. A cold causes a runny or blocked nose and sneezing. There may be a sore throat with a slight headache because of nasal congestion. A cough can develop but this is mostly because of a post-nasal drip. Cold symptoms usually last for about a week. If the symptoms do not improve after a week it is less likely to be a cold and an allergy or sinusitis should be considered.

The flu on the other hand causes more distressing symptoms. These include fever, chills, body aches, cough, weakness and extreme tiredness in addition to all the symptoms of a cold. Most flu symotoms also improve after a week but it is common to still feel a little weak and tired for up to two weeks.

Pneumonia is a complication of the flu, especially in the young, elderly and those with pre-existing chronic diseases. If your child seems to be getting worse, has difficulty breathing, is extremely lethargic or irritable, is refusing to take in enough fluids and/or has a persistently high fever you need to seek medical assistance.

HOW TO REDUCE THE RISK OF CATCHING A COLD OR THE FLU

  1. Vaccinate: make sure everyone in your family gets the seasonal flu vaccine every year. It takes about two weeks for antibodies to develop and offer protection. It is recommended you receive the flu vaccine before the flu season starts but it’s never too late. In South Africa the flu season usually starts around the first week of June but in previous years it has started as early as April.

  2. Hand washing: Make sure you wash your hands frequently and teach your children about good hand washing. Wash with warm soapy water for at least 20 seconds. Cold and flu viruses enter the body through the mucous membranes of the nose, mouth and eyes. This means that every time you touch these parts of your body with hands that have the virus you have a high risk of infecting yourself.

  3. Cover up:  teach your children to sneeze or cough into a tissue or their elbow and NOT into their hands.

TREATING A COLD OR THE FLU

Antibiotics do not work against viruses. Therefore they will not work for a cold or the flu unless a bacterial complication has developed. Often I see that antibiotics are prescribed for viral infections to “treat” the parents rather than the children. This is dangerous and will only lead to the emergence of more antibiotic resistance, which is already a major global problem. Some parents will argue and say that their child started recovering after a few days on antibiotics but this is probably because the viral infection has run its course and is coming to an end instead.  

There are plenty of over the counter (OTC) medicines available for cold and flu symptoms targeting both adults and children. However, these are not recommended for use in children under two years of age. Some experts even suggest avoiding them up to six years. There is very little evidence to prove that these medications work at all and some of them can cause serious side effects in younger children such as hallucinations, irritability, restlessness and abnormal heart rhythms. More importantly codeine, which is an ingredient commonly found in cough, cold and flu medications should not be given to children younger than 18 years of age.

There are some antiviral medicines available for the flu. These are typically prescribed to children at high risk of complications, such as children with asthma. These drugs work best if taken within 48 hours of the onset of symptoms and help by reducing the length and severity of the infection.

Unfortunately, there is no cure for the common cold and flu. It will usually clear up on its own and all you need to do is treat it symptomatically:

Analgesics and antipyretics: you can give your child paracetamol or ibuprofen, NEVER aspirin. To find out more about medicines for pain and fever in children you can read my previous blog: https://www.oneaid.co.za/medications-for-pain-fever-in-children/

Fluids: make sure to give your child lots of fluids to prevent dehydration especially if they have a fever and/or are refusing to eat.

Rest, rest and more rest: allow your child to rest. The body needs rest to recover so keep your child home from school and forget about extra murals for a while.

Nose sprays: the most important nose spray you should use is a saline spray. These help thin the mucus and reduce nasal congestion. There are also other decongestant nose sprays that can be used in older children.

Warm steam and humidifiers: sitting in a steamy bathroom or using a humidifier, which adds moisture to the room, can help loosen mucus in the nose and relieve coughing.

TOP 5 COLD AND FLU MYTHS

  1. Milk and other dairy products make a cold worse
    There is no evidence that dairy products increase mucus production.

  2. “Feed a cold, starve a fever”
    If your child have a fever they need more fluids. Fevers cause dehydration and this happens more rapidly in young children. Provide plenty of fluids when your child is sick and if he or she has an appetite, allow them to eat.

  3. The flu vaccine will give you the flu
    The flu vaccine is made from an inactivated virus so you cannot get the infection. People who do get sick after receiving the vaccine got the infection from another source and were going to get sick anyways. Also, some people develop flu-like symptoms after a vaccine. This is a normal immune response to a vaccine. These symptoms never last as long as the flu would.

  4. You can catch a cold or the flu by going outside in cold weather without a jacket, having wet hair in winter or walking barefoot
    Germs make you sick and not the cold. People make this natural association because the cold and flu season happens during winter. The reason for this is that in colder weather people tend to congregate closer together to keep warm and doors and windows stay closed. This allows viruses to spread more easily.

  5. Chicken soup will make you better
    There are no antiviral properties in chicken soup but it can definitely make one feel better. The warm liquid can soothe a sore throat and keep you hydrated and the steam can help break down nasal congestion and reduce stuffiness.

It’s quite common for children under two to have as many as 8-10 colds a year with prescholars getting around 7-8.  It takes years to develop an immunity to viruses and since there are more than 200 viruses that can cause a cold the high rate of infection in our little ones makes sense. Don’t despair, the cold and flu season does eventually end but for now it’s a great reason to give more healing cuddles and keep our little ones loved up and warm this winter.

RESOURCES

https://www.cdc.gov/flu/symptoms/coldflu.htm

https://www.fda.gov/consumers/consumer-updates/when-give-kids-medicine-coughs-and-colds

https://www.health.harvard.edu/diseases-and-conditions/10-flu-myths

http://www.nicd.ac.za/influenza-season-approaching/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2722603/

When Your Child Eats A Silica Gel Sachet

I’m sure many of you are familiar with those little sachets you find in almost anything these days.  The ones with the massive “DO NOT EAT” all over them. I have seen my fair share of hysterical parents bring their kids into the ER with a history of having swallowed the contents. But are these sachets really that dangerous?

These little sachets contain silica gel, which is silicon dioxide (Si02). The sachet does not actually contain a gel but rather small beads. Silica is a desiccant, which means it absorbs water. It has millions of small pores that hold moisture and can absorb up to 40% of its weight, which is why you find it in products that would otherwise spoil from excess moisture.

IS SILICA TOXIC?

Silica gel is chemically inert and considered to be non-toxic. Silica gel packets contain less than 5g of silica gel. If this tiny amount is ingested, it basically passes through the digestive tract without being absorbed or digested.

While this means that the contents of these sachets are harmless, it would be quite unpleasant if these are handled or swallowed. The mouth, gums and tongue would become parched, and if the contents were swallowed and not spat out, this would result in a few self-limiting side effects. Most notably, dry throat, eyes and mucous membranes in the nose, together with stomach discomfort and depending on the amount swallowed, nausea, vomiting and constipation. If the sachet was opened and the contents handled, it can also dry out and irritate the skin.

FIRST AID FIRST

If you think your child has played with silica gel, practice the principles of first aid. Anywhere the silica has come in contact, will be irritated. Wash whatever parts of the skin have been in contact with the silica and moisturise afterwards. If the eye has been touched, then rinse with running water for up to 15 minutes. If the contents were swallowed the best thing you can do is offer continuous sips of water to relieve the stomach distress. Do not give anything to induce vomiting! You don’t want the silica to be inhaled, because it can cause a very irritating cough and shortness of breath. The symptoms of silica ingestion are self-limiting, meaning that eventually, they will go away on their own.

IF SILICA IS NON-TOXIC WHAT IS THE BIG DEAL?

The biggest concern with these sachets is choking. These tiny beads are a choking hazard for small children. Unfortunately, additives, such as moisture indicators, are also sometimes added to the silica which can then make it toxic.

WHAT ARE MOISTURE INDICATORS?

Some silica gel sachets have moisture indicators. These indicator sachets are available in different colours depending on the type of indicator used. You may also find some sachets which contain a mixture of both indicator and non-indicator beads. The blue “indicator” silica gel is the more common one you may find. The blue comes from either cobalt dioxide, methyl violet or some other toxic substance that gets added to the silica. These substances change colour when wet and therefore are a good indicator of a saturated silica gel sachet. Cobalt dioxide, in particular, is a known carcinogen and also affects fertility. The FDA is busy banning this additive altogether, and thankfully, these indicator sachets are not commonly found in consumer products. If your child does, however, come into contact with one of these, you should seek immediate medical assistance.

Always remember to discard these sachets immediately after opening your products. Given the uncertainty of the composition of some of these silica sachets, practice the principles of first aid and keep an eye out for any unusual signs and symptoms whenever your child comes into contact with silica. If there is any concern, head straight to your nearest emergency room and don’t forget to take the sachet with you so that the contents can be tested.

RESOURCES

https://www.productip.com/uploads/CClip_519_SilicaGel_20130827_v1.pdf

https://www.illinoispoisoncenter.org/my-child-ate-Silica-Gel

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3493316/

Should Your Child Be Using Fluoride Toothpaste?

Untreated tooth decay in children is one of the most common conditions worldwide, which is why many toothpaste manufacturers have a wide range of toothpaste aimed at children, available in a variety of sweet flavours with cartoon characters all over the packaging. I wanted to write this post to give parents a little more information about toothpaste because it’s not really about the cute packaging and the taste test (agreed this does help make brushing teeth a lot easier).

Many parents, unfortunately, do not know the proper guidelines when choosing and using toothpaste in children. Majority of mothers start brushing their children’s teeth late, use adult toothpaste and have no idea about the clinical significance of fluoride. Most moms also use a full length of toothpaste on their children’s brushes.

HOW MUCH FLUORIDE IS ENOUGH?

Your body takes in fluoride by swallowing it in food and water. Fluoride occurs naturally in varying amounts in water sources and to a lesser degree in certain foods and drinks. Some countries also fluoridate their public water supply. Another way to take in fluoride is by topical application (in fluoridated toothpastes and mouthwashes). The fluoride taken in from foods and drink also provides some topical benefits when it becomes mixed with saliva.

We all know that brushing your teeth is vital in preventing tooth decay. It helps remove plaque, and the fluoride in toothpaste makes tooth enamel stronger, and more resistant to cavities. But how do you know which toothpaste to buy for your little ones when the amount of fluoride between brands ranges from zero to as high as that of adult toothpaste?

Fluoride in toothpaste is expressed as parts per million of fluoride (ppmF). According to the UK Department of Health, children under three years of age need to use a toothpaste with 1,000 ppmF. Older kids and adults need to use 1,450 ppmF. Young children need less fluoride to reduce the risk of fluorosis.

WHAT IS FLUOROSIS?

Fluorosis is the change of appearance of permanent teeth where they develop white lines or streaks. This happens when the developing teeth under the gums in younger children are exposed to excess fluoride. Too much fluoride affects the mineralisation of the teeth, and children younger than six years are at highest risk. The severity of Fluorosis is dose-dependent.

Image Source: health2blog.com

Fluorosis is a cosmetic condition and not a disease. It does not increase or decrease the risk of cavities. While the majority of cases of Fluorosis are mild, it can still have a significant psychological effect on your child.

HOW MUCH TOOTHPASTE IS ENOUGH?

It can be challenging to get your child to spit out the toothpaste after brushing without swallowing, especially if the toothpaste tastes like candy. It is therefore essential to use a small amount of toothpaste until your child has learnt to spit after they brush since inevitably your child will end up swallowing about half of what’s on the brush.

To prevent too much fluoride from being swallowed, you have to be vigilant about the amount you put on the brush. It is recommended that children under three years of age use no more fluoride toothpaste than a smear or the size of a grain of rice. For children three to six you should use a pea-sized amount of fluoride toothpaste.

Teach your child from an early age to spit. They don’t need to rinse. It’s also a good idea to not let them eat or drink anything after they have brushed their teeth so that the fluoride can do its job overnight.

KEY POINTS

  • Start brushing your baby’s teeth as soon as you see them come through.
  • Brush your child’s teeth morning and night with an age-appropriate brush.
  • Use fluoride toothpaste with the right amount of fluoride recommended for your child’s age. It is no longer recommended that children start using fluoride toothpaste only after the age of two.
  • Use the correct amount of toothpaste for your child’s age.
  • Children under six years of age should never use a fluoride mouthwash.

Fluoride toothpaste is generally safe and recommended for babies and young children provided you use it correctly. The most important thing you need to worry about is the amount of fluoride in the toothpaste. The next time you go out shopping for toothpaste take a look at the ppmF. You will be quite surprised since many of the “children’s” toothpastes have exactly the same amount of fluoride as adult toothpaste. Therefore it really only boils down to cost and taste and whether or not your little is a fan of Barbie.

How To Clean A Wound: The Controversy Of Antiseptics

What do you do when your little one scrapes their leg? Do you rush off to your medicine cupboard to grab your bottle of Dettol of Savlon? This may actually not be necessary. Whilst it’s important you clean a wound as soon as possible in order to reduce the risk of infection, what you clean it with has been an area of debate in the medical world for years. Research has shown that running tap water over a wounds is just as effictive in cleaning a wound. Antiseptics may actually damage the skin and slow down the healing process.

WHAT IS THE DIFFERENCE BETWEEN AN ANTISEPTIC AND A DISINFECTANT?

A Biocide is the general term for a chemical agent that inactivates microorganisms and depending on their activity they can either inhibit the growth of, or kill microorganisms completely.

Both antiseptics and disinfectants inactivate microorganisms. These terms are often used interchangeably but there is a very big difference. Antiseptics are biocides that are used on living tissues and disinfectants are biocides used on inanimate objects or surfaces. So for example in your kitchen, you would use an antiseptic to wash your hands and a disinfectant to wash the countertops.

HOW SHOULD I CLEAN A WOUND?

Before you clean a wound you have to stop any bleeding. This is done by applying direct pressure. Of course the wound may still continue to bleed a little for a while and/or when you clean the wound it may start to bleed again. As long as the wound is not bleeding excessively you can proceed to clean it.

For most simple wounds I would simply recommend rinsing them under cool running water. In the ER and in theatre we always clean wounds with lots and lots of water. If you are out and about and don’t have running water, you can always use bottled water. If this weren’t available then I would rinse the wound with a diluted antiseptic such as cetrimide or povidine-iodine (if of course there are no known allergies). If you are going to use an antiseptic, use it only once to initially clean and never chronically. When you clean the wound again after a day or so use water. Don’t ever use rubbing alcohol or peroxide to clean an open wound.

You can gently rub off any foreign material using a piece of gauze soaked in water. Use tweezers to remove any debris that may still remain. Remember to disinfect the tweezers before use.

Once the wound is clean you can then apply a moist dressing. You can use petroleum jelly or what I love to use is a lanolin ointment such as a nipple cream. To find out more about moist healing you can read my previous blog: https://www.oneaid.co.za/picking-scabs-popping-blisters/

WHAT ABOUT ANTIBIOTIC CREAMS?

These include creams such as Supiroban, Fucidin and Neosporin. I do not recommend using an antibiotic cream for a simple wound. Most wounds heal very well on their own.

The problem with using these creams is the possibility of developing bacterial resistence. If the wound were to get infected later on and you have been applying an antibiotic cream since day one, this cream would not be very effective against the infection.

Technically you can develop resistence towards antiseptics but this is very unlikely since antiseptics have a broader spectrum of microorganisms they inactivate than antibiotic creams. If the wound was very contaminated and has a high chance of infection then I would rather apply a very thin layer of an antiseptic cream.

Newer research has found that the body’s surface actually supports wound healing on its own. We all have bacteria that live on our skins that cause us no harm. These bacteria help protect us from pathogens in the environment. Using creams and solutions that have antimicrobial activity will upset the balance of organisms on our skins and interfere with this defense system.

WHAT ARE THE SIGNS OF AN INFECTED WOUND?

After you have cleaned the wound and applied a dressing it’s important to monitor the wound for any signs of infection over the next few days:

  • Swelling;
  • Redness;
  • Increasing pain;
  • Bad smell from the wound;
  • Warm skin around wound;
  • Wound is leaking pus; and/or
  • Body temperature > 38 degrees Celsius.

If you notice any of these above changes, go straight to the emergency room.

If you are anything like my mother you probably have very old big bottles of antiseptics lying around. One of my microbiology Professors at University once told us that microorganisms can grow on the surface of these antiseptic liquids after a while. Also the antiseptic components of these solutions deteriorate after some time so always check the expiry dates. Rather buy smaller bottles and don’t keep them too long after they have been opened.

RESOURCES

https://emj.bmj.com/content/19/6/556.1

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88911/

https://www.sciencedirect.com/science/article/pii/S1743919117305368

https://www.woundsresearch.com/article/1585

https://www.woundsresearch.com/article/1586

https://www.woundsresearch.com/article/sams-dodd

https://mospace.umsystem.edu/xmlui/bitstream/handle/10355/3613/DoTopicalAntibioticsImproveWound.pdf?sequence=1&isAllowed=y

https://www.researchgate.net/publication/45149036_Benefit_and_harm_of_iodine_in_wound_care_A_systematic_review

Tips For Choosing The Right High Chair

Before going out and buying a high chair it’s important to know the safety requirements. A US study found that more than 9 400 children, aging three years and younger, were treated each year for high chair related injuries in emergency rooms from 2003 to 2010. That’s one child every hour!

Nearly all of these injuries were as a result of a fall where the child either climbed in or out of the chair or stood in it. Majority of the injuries seen were head injuries (37%) then bumps and bruises (33%) followed by lacerations (19%). Most of us use our high chairs in the dining room or kitchen where the flooring is usually hard, so you can imagine the impact this has on a small brain.

This has prompted the US to update their safety standards (unfortunately there are no available statistics for South Africa). From mid-2019 all high chairs in the US will have to have a passive crotch restraint and a three-point restraint system, which means there has to be a fixed post that sits between a child’s legs and restraints that are fixed to the high chair in three different places. They found that children were able to slip out the bottom of a high chair and hope a fixed post will prevent this.

High chairs are not recommended for children younger than 6 months of age. A child is only ready for a chair once they have good head and neck control and are able to sit up on their own. If one is used too early a child could experience positional asphyxia. You may however, be able to start a little sooner with a reclining high chair (see my previous blog, ‘How safe is your car seat?’). https://www.oneaid.co.za/how-safe-is-your-car-seat/

CHOOSING THE RIGHT HIGH CHAIR

Framework: choose a high chair that is sturdy. Put some weight on it and see if it squeaks, deforms or moves or collapses.

Gaps: make sure there are no gaps your child can slip out of. Also check for gaps that little fingers can get caught in.

Harness: choose a high chair with either a three-point or five-point harness that includes a crotch strap or a post. The restraint should go over the shoulders, around the waist and if a five-point harness then between the legs.  

Wide base: a high chair becomes top heavy when your child is in. Choosing a chair with a wide base will make it more stable so that it does not tip easily.

Wheels: if you choose a high chair with wheels, make sure they can be locked when the chair is in use.

Folding locks: if the high chair folds check that the locks work well enough so that the chair cannot fall or collapse when in use.

Joints: choose a high chair with metal joints. These are stronger than plastic, which can crack after time.

Safety standards: make sure the high chair meets current safety standards and has been approved by an international safety authority.

BOOSTER SEATS AND HOOK-ON SEATS

Please be careful when you use these chairs. If not used correctly these seats can be dangerous.

Hook-on seat: These chairs are mounted directly onto a table and should only be used once your baby has good head and neck control and can sit upright. The mounts must be slip resistant and because this seat carries the entire weight of your baby the table has to be strong so that it does not tip over.

Booster seat: These seats are attached to normals chair by straps to raise a child’s height. They are usually used when a child has outgrown the high chair but is not quite tall enough to sit at the table unaided. They should also have straps to keep your child in the seat.

KEEPING YOUR CHILD SAFE IN A HIGH CHAIR

  • Never leave your child unsupervised when they are in a high chair.
  • Always use the safety straps when your child sits in the chair, even if only for a few minutes. The tray is not a restraint.
  • If the chair folds, make sure it is locked each time you set the chair up.
  • If the chair has wheels, make sure they are locked each time you set the chair up.
  • Never allow your child to stand in the high chair.
  • Do not place the high chair near a counter or table. Your child may be able to push against the surface and cause the chair to tip over.
  • Don’t allow older children to climb or play on the high chair while another child is seated in it because it could tip over.
  • Position the high chair at its lowest possible height if this is adjustable.
  • Make sure potential hazards such as hot food, drink and sharp cutlery are out of reach.

When choosing a high chair opt for an age-appropriate one with plenty of safety features. It’s also important to check often for recalls once you have purchased your chair. High chairs are commonly recalled because of their safety issues. Recent recalls include the Skip Hop Tuo convertible high chair and the Graco Table2Table 6-in-1. You can check http://www.recalls.gov to see if your high chair has been recalled.

RESOURCES

https://journals.sagepub.com/doi/abs/10.1177/0009922813510599

http:// https://www.nationwidechildrens.org/newsroom/news-releases/2013/12/new-study-finds-24-children-a-day-are-treated-in-us-emergency-departments-for-high-chair-related

How Safe Is Your Car Seat?

We all know how long it can take for a child to fall asleep. So when you reach your destination and your little one has finally fallen asleep you couldn’t feel more relieved. You wouldn’t dream of disturbing them by removing him or her from the car seat. Instead you do what is the most convenient, and move your child from your car into a pram chassis or straight into your home without ever moving them from the car seat.

Whilst car seats have saved many lives, they do have some hidden dangers. A study in 2015 found that out of all the sitting and carrying devices for young children, car seats were responsible for the most number of deaths. Hypoxia and suffocation from either poor positioning in the car seat or strangulation by the straps and buckles was the cause of death in all these cases.

HYPOXIA

This is when there is a loss of oxygen in the blood which reduces the amount of oxygen reaching the tissues. When there is an extreme loss of oxygen a child will suffocate.

The developing brain is very sensitive to a decrease in oxygen. Loss of oxygen can cause brain injury and result in a range of developmental problems as well as seizures.

POSITIONING

The position of your car seat is important. The Recline Angle of a rear-facing car seat is critical and an angle between 30-45o from the vertical is recommended. A recline angle more than 45o offers very little protection in the event of a crash.

A newborn or young infant’s head is heavy and the neck muscles are weak. If the recline angle becomes less and the car seat more upright, the head will flop down and obstruct the airway. A newborn should therefore be positioned in the lowest possible position, which still offers crash protection. As babies grow their neck muscles get stronger and the angle of the car seat can become more upright since their head and neck control improves.

 

The recline angle of a rear-facing car

 

A number of studies have looked at the level of oxygen in an infant’s blood whilst in their car seat. A level of oxygen less than 90% is considered dangerous. It was shown that children’s oxygen levels dropped as far down to 83.7% when in incorrectly positioned car seats. The authors also found that the longer the child remained in the car seat the lower the oxygen level would drop.

Another study found that a child in a correctly placed rear-facing car seat is still at risk of suffocation. The vibration produced by a car could cause newborns and young children’s head and shoulders to fall forward, despite correct use of the straps and buckles. This risk was also similar for both term and preterm infants.

Some specialists recommended that young babies spend no more than 30 minutes to an hour in a car seat at a time. If a long journey is unavoidable it may be wise for someone to sit in the back with your child to keep an eye out.

STRAPS AND BUCKLES

Always make sure your child is properly securely in a car seat. If the straps are too loose a child can easily slip or even wriggle down far enough to become strangled by the straps. If the child falls lower down in the seat the child may also suffocate from an obstructed airway if the head falls onto the chest.

NEVER

  • Never place your baby in a car seat on a soft surface such as a bed or couch. This type of surface could cause the recline angle to change resulting in your child’s head falling forward and obstructing the airway.
  • Never loosen or unbuckle any straps if you do decide to keep your baby in a car seat outside of the car. A child can wriggle and slip down far enough to be strangled by the straps and even fall out of the car seat altogether.
  • Never leave an infant or young child unsupervised in a car seat if they are asleep or even if they are awake.
  • Never place your baby in a car seat on an elevated surface such as a table. A baby can wriggle enough to cause the seat to move and fall off the surface.
  • Never place your baby in a car seat on the floor without looking at the recline angle. Some car seats may become more upright when placed on the floor.

Always make sure your car seat is installed correctly. Most car seats come with a built-in indicator that allows you to see if the seat is installed at the proper angle.

Read the manual carefully and if in doubt contact the local manufacturer or distributor. You can also contact Julie at Precious Cargo (www.preciouscargo.co.za) to book a professional car seat installation.

RESOURCES

Arya, R., Williams, G. and Kilonback, A. et al. (2017) Is the infant car seat challenge useful? A pilot study in a simulated moving vehicle. Arch Dis Child Fetal Neonatal Ed, [online] 102, pp. 136-141. Available from: https://fn.bmj.com/content/fetalneonatal/102/2/F136.full.pdf [Accessed 13 September 2018].

Batra, E.K., Midgett, J.D. and Rachel Y. Moon (2015) Hazards Associated with Sitting and Carrying Devices for Children Two Years and Younger. The Journal of Pediatrics, [online] 167, pp. 183-187. Available from: http://dx.doi.org/10.1016/j.jpeds.2015.03.044 [Accessed 13 September 2018].

CPSBestPractice (2018). Rear-facing restraint recline angle. [image] Available at: https://sites.google.com/a/umich.edu/cpsbestpraci/resources/rear-facing-child-restraints [Accessed 14 Sep. 2018].

NHS (2016) Warning over babies sleeping in car seats. [online] Available from: https://www.nhs.uk/news/pregnancy-and-child/warning-over-babies-sleeping-in-car-seats/ [Accessed 13 September 2018].

Rholdon, R. (2017) Understanding the Risks Sitting and Carrying Devices Pose to Safe Infant Sleep. Nursing for Women’s Health, [online] 21 (3), pp. 225-230. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28599744 [Accessed 13 September 2018].

Does Your Child Need a Tetanus Shot or Not?

I’ve had parents often come into the emergency room after their child has taken a tumble asking for a Tetanus vaccine, which is why I felt the need to write a post explaining what Tetanus is and why we need to vaccinate our kids.

WHAT IS TETANUS?

Tetanus is a disease commonly known as lockjaw. It is caused by the bacteria, Clostridium tetani and can be fatal. The toxin from the bacteria affects the nervous system and causes severe painful muscle spasms, which can interfere with the ability to breathe. Currently there is no cure for Tetanus and treatment is mainly symptomatic until the effects of the toxin wear off. Complete recovery can take up to several months.

WHERE IS THE BACTERIA FOUND?

Clostridial spores can be found everywhere. They are found in soil, dust and animal faeces (including humans). Once the spores enter a wound they grow into mature bacteria, which produce the powerful toxin. Clostridium tetani is found worldwide.

WHAT ARE THE SIGNS AND SYMPTOMS OF TETANUS?

Signs and symptoms of tetanus can appear anytime from a few days to a few weeks from infection:

  • Spasms and stiffness of jaw muscles (hence the name lockjaw);
  • Spasms and stiffness of the neck muscles;
  • Difficulty swallowing;
  • Spasms and stiffness of other body muscles, commonly the abdominal muscles;
  • Other constitutional symptoms such as fever, sweating and palpitations.

TETANUS VACCINATION

I won’t go into too much detail regarding the various combination vaccines as there are many and every country has its own recommendations. A copy of the latest South African immunisation schedule can be downloaded from my resources page. The WHO recommends an initial 6-dose schedule to achieve tetanus immunity.

1. Primary vaccination

Three primary doses of the vaccine are recommended in childhood starting from 6 weeks.

2. Booster vaccination

Three booster doses are recommended prior to adolescence. Booster vaccines are then recommended every 10 years thereafter.

TETANUS-PRONE WOUND

  • This is any wound that has been contaminated with material that could contain tetanus spores;
  • This is any wound that is deep;
  • This is any wound that is dirty;
  • This is any wound that contains a foreign body.

Note: any wound can be tetanus-prone – cuts, scrapes, burns, animal (including human) and insect bites.

WHEN TO SEE A DOCTOR

It is recommended you see a doctor if:

  • Your child has a tetanus-prone wound and has not had a booster vaccine in the last 5 years;
  • Your child has a minor, clean wound and has not had a booster vaccine in the last 10 years;
  • Your child has a wound and you cannot remember when their last booster vaccine was.

RESOURCES

CDC (2018) Tetanus. [online]. Available from: https://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html#contraindications [Accessed 30 August 2018].

WHO (2018) Tetanus vaccines: WHO position paper, February 2017 – Recommendations. Vaccine. [online] 36 (25). Available from: http://dx.doi.org/10.1016/j.vaccine.2017.02.034 [Accessed 30 August 2018].

WHO (2018) Tetanus. [online]. http://www.who.int/ith/vaccines/tetanus/en/ [Accessed 30 August 2018].

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