Where There Is No Doctor:Review of Children's Health Problems Discussed in Other Chapters

Many of the sicknesses discussed in other chapters of this book are found in children. Here some of the more frequent problems are reviewed in brief. For more information on each problem, see the pages indicated.

For special care and problems of newborn babies, see Template:See Page to Template:See Page, and Template:See Page.

Remember: In children, sicknesses often become serious very quickly. An illness that takes days or weeks to severely harm or kill an adult may kill a small child in hours. So, it is important to notice early signs of sickness and attend to them right away.

Malnourished Children

Template:From page Many children are malnourished because they do not get enough to eat. Or if they eat mainly foods with a lot of water and fiber in them, like cassava, taro root, or maize gruel, their bellies may get full before they get enough energy food for their bodies' needs. Also, some children may lack certain things in their food, like Vitamin A (see p. 226) or iodine (see p. 130). For a fuller discussion of the foods children need, read Chapter 11, especially pages 120 to 122.

Malnutrition may cause many different problems in children, including:

In mild cases:	In more serious cases:
slower growth swollen belly thin body loss of appetite loss of energy paleness (anemia) desire to eat dirt (anemia) sores in corners of mouth frequent colds and other infections night blindness	little or no weight gain swelling of feet (sometimes face also) dark spots, `bruises', or open peeling sores thinness or loss of hair lack of desire to laugh or play sores inside mouth failure to develop normal intelligence `dry eyes' (xerophthalmia) blindness (p. 226)

Severe forms of general malnutrition are `dry malnutrition' or marasmus, and `wet malnutrition' or kwashiorkor. Their causes and prevention are discussed on p. 112 and 113.

Signs of malnutrition are often first seen after an acute illness like diarrhea or measles. A child who is sick, or who is getting well after a sickness, has an even greater need for enough good food than a child who is well.

Diarrhea and Dysentery

For more complete information see Diarrhea.

The greatest danger to children with diarrhea is dehydration, or losing too much liquid from the body. The danger is even greater if the child is also vomiting. Give Rehydration Drink. If the child is breast feeding, continue giving breast milk, but give Rehydration Drink also.

The second big danger to children with diarrhea is malnutrition. Give the child nutritious food as soon as he will eat.

Fever

For more complete information, see Fever.

In small children, high fever (over 39°) can easily cause fits or damage the brain. To lower fever, take the clothes off the child. If she is crying and seems unhappy, give her acetaminophen (paracetamol) or ibuprofen in the right dosage (Template:See Page), and give her lots of liquids. If she is very hot and shaky, wet her with cool (not cold) water and fan her.

Seizures (Fits, Convulsions)

For more complete information, see Convulsions.

Common causes of fits or convulsions in children are high fever, dehydration, epilepsy, and meningitis. If fever is high, lower it rapidly (Template:See Page). Check for signs of dehydration (Template:See Page) and meningitis (Template:See Page). Fits that come suddenly without fever or other signs are probably epilepsy (Template:See Page), especially if the child seems well between them. Fits or spasms in which first the jaw and then the whole body become stiff may be tetanus.

Meningitis

Template:From page For more complete information, see Meningitis.

This dangerous disease may come as a complication of measles, mumps, or another serious illness. Children of mothers who have tuberculosis may get tubercular meningitis. A very sick child who lies with his head tilted way back, whose neck is too stiff to bend forward, and whose body makes strange movements (fits) may have meningitis.

Anemia

Common signs in children:

• Has symptom:: pale, especially inside eyelids, gums, and fingernails
• Has symptom:: weak, tires easily
• Has symptom:: likes to eat dirt

Common causes:

• Has cause:: diet poor in iron (p. 124)
• Has cause:: chronic gut infections (p. 145)
• Has cause:: hookworm (p. 142)
• Has cause::malaria (p. 186)

Prevention and Treatment:

• Has treatment:: Eat iron-rich foods like meat and eggs. Beans, lentils, groundnuts (peanuts), and dark green vegetables also have some iron.
• Has treatment:: Treat the cause of anemia--and do not go barefoot if hookworm is common.
• If you suspect hookworm, a health worker may be able to look at the child's stools under a microscope. If hookworm eggs are found, treat for hookworm (p. 374 to 376).
• If necessary, Has treatment::give iron salts by mouth (ferrous sulfate, p. 393).

Worms and Other Parasites of the gut

For more complete information, see Worms.

If one child in the family has worms, all the family should be treated. To prevent worm infections, children should:

• Observe the Guidelines of Cleanliness.
• Use latrines.
• Never go barefoot.
• Never eat raw or partly raw meat or fish.
• Drink only boiled or pure water.

Skin Problems

For more complete information, see Chapter 15.

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Those most common in children include:

• scabies (Template:See Page)
• infected sores and impetigo (Template:See Page and Template:See Page)
• ringworm and other fungus infections (Template:See Page)

To prevent skin problems, observe the Guidelines of Cleanliness.

• Bathe and delouse children often.
• Control bedbugs, lice, and scabies.
• Do not let children with scabies, lice, ringworm, or infected sores play or sleep together with other children. Treat them early.

Conjunctivitis and Pinkeye

Template:From page For more complete information, see Pink Eye.

Wipe the eyelids clean with a clean wet cloth several times a day. Put an antibiotic eye ointment (Template:See Page) inside the eyelids 4 times a day. Do not let a child with pink eye play or sleep with others. If he does not get well in a few days, see a health worker.

Colds and the `Flu'

see Has chapter topic:: Flu (See p. 163)

The common cold, with runny nose, mild fever, cough, often sore throat, and sometimes diarrhea is a frequent but not a serious problem in children.

Treat with lots of liquids. Give acetaminophen or perhaps aspirin (see p. 379). Let children who want to stay in bed do so. Good food and lots of fruit help children avoid colds and get well quickly.

Penicillin, tetracycline, and other antibiotics do no good for the common cold or `flu'. Injections are not needed for colds.

If a child with a cold becomes very ill, with high fever and shallow, rapid breathing, he may be getting pneumonia (see p. 171), and antibiotics should be given. Also watch for an ear infection (next page) or `strep throat' (p. 310).