Asthma can’t be cured, but you and your child can reduce symptoms by following an asthma action plan. This is a written plan you develop with your child’s doctor to track symptoms and adjust treatment.

Asthma treatment in children improves day-to-day breathing, reduces asthma flare-ups and helps reduce other problems caused by asthma. With proper treatment, even severe asthma can be kept under control.

Asthma symptoms in children ages 5-11:

Common asthma signs and symptoms in children ages 5 to 11 include:

• Coughing, particularly at night.
• Difficulty breathing.
• Chest pain, tightness or discomfort.
• Avoiding or losing interest in sports or physical activities.

Some children have few day-to-day symptoms, but have severe asthma attacks now and then. Other children have mild symptoms or symptoms that get worse at certain times. You may notice that your child’s asthma symptoms get worse at night, with activity, when your child has a cold, or with triggers such as cigarette smoke or seasonal allergies.

Asthma emergencies

Severe asthma attacks can be life-threatening and require a trip to the emergency room. Signs and symptoms of an asthma emergency in children ages 5 to 11 include:

• Significant trouble breathing.
• Persistent coughing or wheezing.
• No improvement even after using a quick-relief inhaler, such as albuterol (ProAir HFA, Ventolin HFA, others).
• Being unable to speak without gasping.
• Peak flow meter readings in the red zone.

Asthma treatment

If your child’s asthma symptoms are severe, your family doctor or pediatricians may refer your child to see an asthma specialist.

The doctor will want your child to take just the right amount and type of medication needed to control his or her asthma. This will help prevent side effects.

Based on your record of how well your child’s current medications seem to control signs and symptoms, your child’s doctor may “step up” treatment to a higher dose or add another type of medication. If your child’s asthma is well controlled, the doctor may “step down” treatment by reducing your child’s medications. This is known as the stepwise approach to asthma treatment.

Long-term control medications

Known as maintenance medications, these are generally taken every day on a long-term basis to control persistent asthma. These medications may be used seasonally if your child’s asthma symptoms become worse during certain times of the year.

Types of long-term control medications include:

• Inhaled corticosteroids. These are the most common long-term control medications for asthma. These anti-inflammatory drugs include fluticasone (Flixotide), budesonide (Pulmicort), beclomethasone (Becotide), and mometasone (Asmanex).
• Leukotriene modifiers. These include montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo). They can be used alone or as an addition to treatment with inhaled corticosteroids.

In rare cases, montelukast and zileuton have been linked to psychological reactions such as agitation, aggression, hallucinations, depression and suicidal thinking. Seek medical advice right away if your child has any unusual psychological reaction.

• Combination inhalers. These medications contain an inhaled corticosteroid plus a long-acting beta agonist (LABA). They include the combinations fluticasone–salmeterol (Seretide), budesonide–formoterol (Symbicort), and mometasone-formoterol (Dulera). In some situations, long-acting beta agonists have been linked to severe asthma attacks.

control asthma triggers

Taking steps to help your child avoid triggers is an important part of controlling asthma. Asthma triggers vary from child to child. Work with your child’s doctor to identify triggers and steps you can take to help your child avoid them. Common asthma triggers include:

• Colds or other respiratory infections.
• Allergens such as dust mites or pollen.
• Pet dander.
  

  Little girl using inhaler and showing OK. 

   

• Cold weather.
• Mold and dampness.
• Cigarette smoke and other irritants in the air.
• Severe heartburn (gastroesophageal reflux disease, or GERD).

The key to asthma control: Stick to the plan

Following and updating your child’s asthma action plan is the key to keeping asthma under control. Carefully track your child’s asthma symptoms, and make medication changes as soon as they’re needed. If you act quickly, your child is less likely to have a severe attack, and he or she won’t need as much medication to control symptoms.

With careful asthma management, your child should be able to avoid flare-ups and minimize disruptions caused by asthma.

preparer by:

Dr. Taisser Zaki

paediatrician in Al Hafiz International Hospital

Yet, parents question the safety of vaccines.  Several factors contribute to parental concerns including:

• lack of information about the vaccines being given and about immunisation in general.
• conflicting ideas from other sources like antivaccine organisations.
• lack of appreciation of the severity of vaccine preventable illnesses.
• relative infrequency of vaccine preventable diseases.

What is immunisation?

It is the process of inducing immunity against a specific disease. Vaccination is one method of inducing immunity. It is one of the most beneficial and cost-effective disease prevention measures.

Are vaccines 100 % safe?

If the definition of safe is “harmless” it would imply that any negative consequence of a vaccine would make it unsafe. Using this definition, no vaccine is 100% safe. Almost all vaccines cause pain, redness or tenderness at the site of injection. Few things meet the definition of “harmless”. Even simple every day activities contain hidden dangers. The dangers of the disease is greater than the dangers of the vaccine used to protect against it.

Why should your child get vaccinated?

Vaccines can prevent infectious diseases that once killed or harmed many infants, children and adults. Without vaccines, your child is at risk of contracting serious illnesses like measles and whooping cough with much suffering, pain, disability and even death. It is always better to prevent a disease than to treat it after it occurs.

Why are some of these vaccines still needed if the diseases are not common?

Due to better nutrition, improved living conditions and most importantly vaccines, many diseases do not occur or spread at the same rate as they used to. But the bacteria and viruses that cause these diseases remain in the environment. Immunisations keep our children protected from these infections if they are reintroduced into our environment. For example, travellers from regions where some of these diseases are common, can bring them into your community.

What are the vaccinations every child should have?

All children should receive vaccinations against Tuberculosis, Hepatitis B, Diphtheria, Tetanus, Pertussis (whooping cough), Hemophilus influenza B, Poliomyelitis, Pneumococcal infection, Rotaviral diarrhoea, Measles, Mumps, Rubella and Chicken pox. In addition, there are other optional vaccines that are recommended based on the place of residence or travel.

How does a parent choose which vaccinations should be given to their child?

Every child should take the mandatory vaccines recommended by the national immunisation guidelines. UAE has a national vaccination schedule that is mandatory for all infants and children. Please discuss with your paediatrician regarding the mandatory and optional vaccines for further information.

What are the common ingredients in vaccines?

All vaccines contain antigens. Antigens make the vaccines work by stimulating the body to create an immune response to protect against infection.

Antigens in vaccines come in several forms:

• Weakened live viruses: They are too weak to cause disease, but still prompt an immune response, e.g. MMR and Chicken pox vaccines.
• Inactivated or killed viruses: They do not cause even a mild form of the disease, but create an immune response, e.g. Hepatitis A vaccine.
• Partial viruses: These are made up of specific parts of the virus that will stimulate a protective immune response, e.g. Hepatitis B vaccine.
• Partial bacteria: They are made up of specific parts of the bacteria that produce a specific immune response to protect against the infection, e.g. DTP vaccine.

In addition, vaccines also contain other ingredients to be keep it stable, preserve it in a sterile form and to enhance the immune response. Each of these ingredients have been studied and are safe for humans in the amounts used in vaccines. This amount is much less than what children encounter in their environment, food and water.

Is it OK to delay vaccines till my baby is older?

Firstly, of all age groups, young babies are hospitalised and die more often from the diseases that we are trying to prevent with vaccines, so it is important to vaccinate them according to the recommended schedule. Secondly, the schedule is designed to work best with a child’s immune system at certain ages and at specific time intervals between doses. There is no research to show that spreading out the vaccines would be safer. Any length of time without immunisations is a time with risk for infection from that particular vaccine preventable disease. If many parents decide to delay vaccinations or follow alternate or incomplete schedules, diseases will spread quickly in a community.

Is it safe to administer multiple vaccines simultaneously?

There are no contraindications to the simultaneous administration of multiple vaccines routinely recommended for infants and children. Immune response to one vaccine does not generally interfere with the immune response to other vaccines.

Many parents worry that receiving too many vaccines especially early in life can overwhelm a baby’s immune system. From the moment of a baby’s birth, the immune system begins coping with microorganisms like bacteria, viruses and fungi. Our immune system is remarkably powerful to handle this load and the antigens presented through the vaccines are miniscule compared to the infections and allergens presented by the natural world. A single bacterium contains a large number of antigens than are found in all the recommended early childhood vaccines combined.

What are the advantages of combination vaccines?

Combination vaccines contain ingredients that protect against multiple infections in one dose, e.g. MMR vaccine, that protects against three illnesses namely measles, mumps and rubella. It helps to reduce the number of injections during the clinic visit, without compromising efficacy or safety of the vaccine.

My child has missed a few doses of vaccines. What should be done to complete the series?

A lapse in the immunisation schedule does not require restitution of the entire series. The subsequent dose should be given as if the usual interval has elapsed. Talk to your doctor if you have questions.

What is herd immunity?

Herd immunity is the concept that when most people in a community are protected, everyone in the community is better protected. A highly vaccinated community means that fewer people are available to spread the disease. So, the number of protected should be higher for a community to enjoy the effects of herd immunity.

What to expect after vaccinations?

After a vaccination, your baby may cry for a little while, that usually stops soon afterwards with a feed or a cuddle. Some children may have a reaction at the site of injection like redness, swelling or soreness. Apply a clean, cool wet wash cloth over the area. For pain or fever give paracetamol or ibuprofen as advised by your paediatrician.

Call you doctor if the redness or swelling increases after 24 hours, if fever is high or persistent, if your child is crying for more than three hours, if your child is noticeably less active or less responsive.

What about vaccines and autism?

There is no link between vaccines and autism. No one knows for certain what causes autism, though recent studies suggest a genetic component. Researchers have looked into the possibility that vaccines might cause autism. Dozens of studies have been conducted by different groups of scientists from around the world and they have failed to suggest vaccines as a cause of autism. The suggestion that too many vaccines given too early in life at the same time have also been dispelled. Parents often first notice the behaviours of autism when their child is 18 to 24 months old, the age by which most vaccines are given. Because of this, parents often incorrectly associate autism with vaccinations.

Prepare by:

Dr. Taisser Zaki

Paediatrician in Al Hafiz International Hospital 

Many doctors see worried parents bring in their feverish children for treatment. When it comes to fever, prompt medical treatment can be very important. However, in most cases, fevers are not dangerous and can even be viewed as helpful as they fight infections naturally.

Causes of Fever

Fever is a healthy sign the body is working properly to fight and overcome an infection. Through a chemical reaction, your body elevates your core temperature in an effort to stop bad viruses and bacteria from replicating. Since viruses and bacteria can normally only reproduce when conditions are just right, this is a very effective way to shut them down.

Viruses are the most common sources of fever in kids. Young children may have seven to 10 viral illnesses with fever each year — especially if they’re in daycare or preschool, where viruses spread easily among children. The second most common sources of infection are bacteria. Both types of infections can cause fevers.

In very young children — especially infants under 3 months old — fevers can be concerning. This is because their immune systems are still developing, and a fever can put them at risk for a severe infection.

For preschoolers and school-age children, pediatricians worry much less about fevers unless the fever lasts for four days or more. Look for symptoms such as significant listlessness/irritability, a bad sore throat, worsening coughing or pain with urination.

The Right Way to Take a Temperature

Knowing how to take a temperature correctly is one of the most important parenting skills. In babies and children less than 1 year old, it is important to feel comfortable taking a rectal temperature.

To take a rectal temperature, lubricate the digital thermometer with petroleum jelly. Then insert the silver tip of the thermometer into your baby’s rectum about one-quarter of an inch to one-half of an inch. Hold it gently for one minute, then remove and read the temperature.

For children older than 1 year of age, the best and most accurate methods of taking a temperature are with an oral digital thermometer or a tympanic (ear) thermometer. Ear thermometers work well for toddlers and are usually accurate, but can be off if your child has lots of ear wax.

When to See a doctor?

In infants less than 2 months old, a fever is any temperature over 38 c degrees. It’s also a concern if your newborn’s temperature is less than 35,5 degrees. For an abnormal temperature in your newborn, call your doctor or go to the urgent care clinic or emergency room — your newborn needs to be seen right away.

In babies and children older than 3 months, a fever is a temperature greater than 38,5 c, call your doctor if your child’s temperature reaches 39 c degrees or higher.

Most fevers go away in a couple of days. Call your doctor if the fever lasts four days or more. Call the doctor right away if your feverish child has vomiting or diarrhea, earache, severe abdominal pain, headache, stiff neck, sore throat, trouble breathing, pain when urinating, swollen joints, other localized pain and a purplish/dark rash that does not fade when you press on it. Also call the doctor if your child is listless or refuses to drink or eat.

When to Use Fever Relievers?

Fever-reducing medicines are not needed for low-grade fevers 37.5 – 38 C, unless your child seems uncomfortable or is not drinking well. Once a child’s fever rises above 38 C degrees, they generally feel miserable and fever-reducing medicine can help them feel better. Children may also be more likely to drink fluids properly after taking fever-reducing medicines.

Make sure you’re giving your child the correct dose of medicine. Too little medicine won’t be effective, but too much could be dangerous. Follow the instructions on the label carefully and only use the cup or syringe that came with that medicine. (Never use a household teaspoon. They vary in size, so your dose may be wrong.)

Child-Safe Fever Medicines

Two types of fever medicine are safe for children: paracetamol, (Tylenol) and ibuprofen, Tylenol is the only fever-reducing medicine approved by the Food and Drug Administration for babies younger than 6 months old.

Ibuprofen has a few advantages over paracetamol for children older than 6 months of age:

• It lasts between six and eight hours.
• It can reduce swelling from teething and ear infections with its anti-inflammatory properties.
• It may be a better choice for children who have asthma or recurrent wheezing.

It’s a good idea to print out the correct dosing for these medicines. Or bookmark the pages from the American Academy of Pediatrics for easy reference:

Although fevers can be frightening, they’re a sign of a healthy immune system. If your child has a low fever and no other worrisome symptoms, provide plenty of fluids, rest and love. The fever should go away in a few days.

Prepare by:

Dr. Taisser Zaki

Pediatrician in Al Hafiz International Hospital

Treatment is dependent on the type of conjunctivitis affecting your child. Conjunctivitis can be an infectious or allergic condition. Infectious conjunctivitis is highly contagious.

Signs and symptoms of conjunctivitis

If your child has conjunctivitis, they may have:

• a red or pink eye (or both eyes).
• redness behind the eyelid.
• swelling of the eyelids, making them appear puffy.
• excessive tears.
• a yellow-green discharge from the eye which dries when your child sleeps, causing crusting around the eyelids.
• a dislike of bright lights (photophobia).
• a gritty feeling (like there is sand in the eye).
• itchiness of the eyes and eye rubbing.

Symptoms usually develop within 24 to 72 hours of becoming infected and can last from two days to three weeks.

What causes conjunctivitis?

Infectious conjunctivitis

Conjunctivitis can be caused by an infection (either a virus or bacteria), which is highly contagious. Your child could develop infectious conjunctivitis if they come into contact with:

the discharge from the eyes, nose, or throat of an infected person through touch, coughing or sneezing.

contaminated fingers or objects.

contaminated water or contaminated towels when swimming.

A person with infectious conjunctivitis will remain infectious as long as there is a discharge from their eye.

If your child has infectious conjunctivitis, do not allow them to share eye drops, tissues, make-up, towels or pillowcases with other people. Children with infectious conjunctivitis should be kept home from child care, kindergarten or school until the discharge from the eyes has cleared. Be sure to regularly wash hands thoroughly to prevent the infection spreading to others.

Allergic conjunctivitis

Conjunctivitis can also be caused by an allergic reaction. Allergic conjunctivitis is not contagious. It is more likely in children with a history of other allergies. Your child will often show other signs of hay fever if their conjunctivitis is the result of an allergy. Signs can include an itchy or runny nose and sneezing, and the eyes are itchy and watery. Children with allergic conjunctivitis almost always rub their eyes a lot.

Care at home

If the symptoms are mild, gentle cleaning of the eyes with cotton balls soaked in warm water may help your child feel better.

Clean in one direction only, outwards from the inside (nose side) of the eye. This prevents the other eye from becoming infected if only one eye is affected.

Discard the cotton ball each time to prevent recontamination.

Do not try to clean inside the eyelids as this may cause damage to the conjunctiva. Lubricating eye drops such as ‘artificial tears’ may give some relief.

Sore, inflamed, and itchy eyes due to allergic conjunctivitis may be helped by antihistamines. Speak to your doctor or pharmacist about antihistamine use for your child.

You may have heard breastmilk can be used on a baby’s eyes if they are gunky or sticky. Breastmilk does not treat conjunctivitis and there is no benefit to using it on your baby’s eyes, but it is not harmful. The formula should never be used.

When to see a doctor

See a GP if your child’s conjunctivitis isn’t getting better after two days, or if your child has any of the following:

• severe pain
• problems with their vision/eyesight.
• increased swelling, redness, and tenderness in the eyelids and around the eyes

is generally unwell and has a fever.

• a persistent white spot in the cornea (the clear ‘window’ at the front of the eye).

The GP will determine what type of conjunctivitis your child has, and may recommend treatment with antibiotic drops for bacterial conjunctivitis. Treatment should be applied to both eyes, even if only one eye appears to be infected. Continue using the drops for two days after the discharge stops.

Key points to remember

Conjunctivitis can be an infectious or allergic condition. If infectious, it is often highly contagious.

A child with infectious conjunctivitis is contagious until discharge from the eyes has disappeared.

Children with infectious conjunctivitis should be kept home from childcare, kindergarten, or school.

When your child has a bad cough, it’s natural to want to do something, anything, to soothe the sore throat, stop the painful cough, and generally make your kid feel better again.

There are plenty of over-the-counter cough suppressants out there, but is medicine the best treatment?

“Probably not,” says pediatrician Dr. Pamela Phillips. “Cough is the body’s way of keeping bacteria out of the lungs, so it’s not a good idea to suppress a cough.”

In fact, the American Academy of Pediatrics recommends against giving children younger than 4 over-the-counter cold and cough medications. Instead, the advice is to let the illness run its course and wait it out.

Getting through a cough without medication.

Most school-age kids get 5 or 6 colds a year and each one can last 2-3 weeks. So, it may feel like your child is constantly battling a cold or cough, especially from October through March.

“We don’t generally recommend over-the-counter cough medications for children because side effects such as sedation, irritability, and behavioral changes tend to outweigh any potential benefits,”

What should I use instead of medication?

In the absence of medication, most pediatricians suggest supportive care to help kids weather coughs and other cold symptoms.

Because cough and sore throat result from postnasal drip, clearing out your child’s sinuses is the first step. Top remedies include:

Steamy showers: One way to loosen up phlegm is to stand in a steamy shower for 10 minutes. If your child has a barking, croup-like cough, have them step into cold air after the steam. “For whatever reason, that 1-2 punch of steam followed by cold air tends to quiet down the cough.

Saline nasal drops or sprays: Saline helps flush the nasal cavity of the icky stuff that causes cough. It also helps moisturize the nasal passages, which can ease sore throats.

Nasal aspirators: For children who can’t blow their own noses, nasal aspirators can help you clear out their nasal passages so they can breathe a little easier. The process eliminates excess mucus from stuffy nasal passages and helps eliminate cough irritants in the process. 

Humidifiers: Cool-mist humidifiers disperse moisture into the air, which can help loosen mucus and relieve swollen throats. Choose cool mist instead of hot water or steam to prevent a child from getting burned.

Prop your child’s head up: When kids lie flat, mucus can build up in the sinuses, where it can clog nasal passages and interfere with restful slumber. You can help relieve the pressure by propping up your child’s head with a pillow to decrease blood flow to the nose.

When to see a pediatrician?

The majority of kids’ coughs go away without treatment. But there are cases where you have to be more vigilant.

“Viruses can wear down the body’s ability to keep bacteria out of the lungs where it doesn’t belong,”

“So if a cough or cold gets worse instead of better, particularly with a fever that comes on later in the course of the illness, the child should be seen by a doctor to make sure they’re not developing a bacterial infection.”

Other signs that warrant a visit to the pediatrician:

Persistent cough: Children who have a cough that lasts for more than 3 weeks should see a pediatrician.

Difficulty breathing: If your child has labored breathing, or if they’re using their belly to breathe, call a doctor right away.

A seal-like barking cough: This signature sound can indicate a specific virus called croup, which can be especially dangerous for young children.

Stridor breathing: Stridor is noisy breathing that is high-pitched or creaky. If a child has stridor at rest, they may need steroid treatment to weather the illness.

Wheezing: Wheezing is especially common in young babies and it often sounds like a whistle on the exhale.

Severe malaise: A child who is not interacting with you, or who is lethargic and has no appetite, should see a physician.

The best medicine.

When it comes to cold and cough, prevention is the best medicine. Encourage your child to get plenty of rest, eat a mix of fruits and vegetables to boost the immune system, and practice good hand-washing hygiene.

A solid hand-washing routine should take 20-30 seconds, about the time it takes to sing “Happy Birthday.” No soap or water? Use hand sanitizer until your kid can get to a sink.