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Video: How Big a Concern is Fever and Vomiting in Children?

In this short video, Dr Rupal Shah explains how to tell if your child’s fever and vomiting are a sign of a serious illness requiring medical attention or the result of a common virus with no cause for alarm.

Editor’s Note: Video Highlights

  • Fever and vomiting are common symptoms in childhood and there are many possible causes
  • fever-and-vomiting-in-kidsThe most important thing to consider is how well your child appears to be….
    • For example, if they’re quite drowsy and floppy or if they’re not eating, then there’s a higher chance that they could be seriously ill with a nasty infection and you should see your doctor
    • If your child appears fairly well and is still eating and drinking, is still playing and interested in their environment, then it’s less likely they are suffering from a serious illness
  • Also, if your child isn’t managing to tolerate any fluids you should take them to the doctor, since children get dehydrated quite easily
  • Fever and vomiting can be caused by fairly common viral illness, like a rotavirus infection – or tummy bug – and generally the child is relatively well and cheerful despite throwing up at times
  • However, there are more serious causes of fever and vomiting – ranging from a bladder infection all the way to meningitis
  • If you’re worried that your child is less responsive, more floppy, not themselves – then it’s always worth seeking urgent medical help





Parents Share Their Tips for Helping Kids with Homework

Homework is an important part of your child’s education and as a parent you can take steps to help them to get the most from it.

Managing homework can be a source of tension. Three parents share the tips that helped them.

Turn Off the TV During Homework

helping with homework“The best thing I’ve ever done is ban all screen time on the TV and computer from Monday to Thursday,” says Patricia, 39, mum to two boys aged 8 and 12.

“Before I did this, my younger son would always be creeping off to watch cartoons. Now that’s not an option, it’s much easier to get homework done. Interestingly, his headmistress thinks that’s the best policy, too. She often sees a big improvement in overall mood and performance in children who have this partial ban.”

Don’t Help Your Children with Homework

“They’re not being marked on what you can do,” says Linda, 39, mum to twin eight-year-old girls. “I know people who virtually do their children’s homework for them, but what’s the point in that? It’s not a competition.”

Dr Susan Hallam of the Institute of Education also advises that you offer moral support, but only give help when your child asks for it.

Do Homework While Your Child’s Alert

“The golden rule with a seven-year-old is to get it done as soon as you get in from school, before tea (*dinner),” says Michael, who has a seven-year-old daughter. “The attention span deteriorates pretty quickly after tea for anything other than Barbie websites.”

Patricia agrees. “Some kids need a little downtime immediately after getting home from school, but if you leave it too late, they’ll be too tired to concentrate.”

Homework Tip: Use a Timer

“If you have one of those children who endlessly dawdle over homework, sharpening all their pencils, getting up and down or reading all their previous homework, it can sometimes help to set a timer,” says Patricia.

“If the school recommends 20 minutes a night, then set the timer for 20 minutes and say that’s the limit. This can sometimes backfire and result in hysteria though, so play it by ear.”

Let Children Know You’re on Their Side

“I find that if they’re complaining bitterly, it can help to sympathise with them,” says Patricia. “I do genuinely feel for them over homework and it does help them to know I’m on their side. But at the same time I feel I need to insist on it being done, so it’s a balancing act.”

Editor’s Note: *clarification provided for our US readers.





How to Recognize and Treat Headaches in Kids and Teens

Prof Anne MacGregor gives tips for parents on how to recognise and treat headaches in children.

headaches in kidsMost children and teenagers get at least one headache a year. They’re often different from the headaches that adults get, so parents and healthcare professionals can fail to notice the problem.

Headaches, including migraines, tend to be much shorter in children, according to Prof MacGregor of the Centre for Neuroscience and Trauma at Barts and the London School of Medicine and Dentistry.

In children, headaches start suddenly, with the child quickly becoming pale and listless, and often feeling sick and vomiting.

Children also generally recover very quickly. “The headache can be over half an hour later, with the child feeling well and playing outside as if nothing’s happened,” Prof MacGregor says.

Children’s headaches can also affect their stomach, so tummy ache is a common complaint, she says.

Skipping Lunch Causes Headaches in Children

“In my experience, children very rarely fake headaches,” says Prof MacGregor. “Children with headaches often get them if, for example, they skip their packed lunch or they haven’t had anything to drink all day.

“The best way for parents to prevent their children getting these headaches is to make sure they have regular meals and drinks, and that they get enough sleep,” says Prof MacGregor. “Give children a good breakfast so that, even if they miss lunch, they’ve been set up for the day. It’s also helpful to put children to bed at a fixed time each evening.”

Read more about healthy eating, including five healthy breakfasts.

Find out how many hours sleep a night your child needs.

Read advice on how much children need to drink.

Sport is a Headache Trigger for Children

Sport can trigger children’s headaches, probably because of dehydration and the effect on blood sugar. “Drinking lots of water and sucking glucose tablets (available from pharmacies and supermarkets) before and during sport can help. So can a mid-morning and mid-afternoon snack, as well as meals,” says Prof MacGregor.

Headaches and Childhood Emotional Problems

Sometimes, headaches can be the result of emotional problems. “They can come on during times of stress, like being bullied at school or because of anxiety over parents splitting up,” says Prof MacGregor. “Parents often think their child is fine, that they’re adjusting to the divorce and that they like their parent’s new partner. Sometimes, however, the child is not fine and their unhappiness is expressing itself as headaches.”

Find out if your child is depressed.

Keep a Headache Diary

It can be helpful to keep a diary of your child’s headaches. If your child is old enough, they can keep their own diary. This is a good way of working out specific headache triggers.

Keep a record of when the headaches happen. Also record any event that’s different from the normal routine or that might be relevant. This could be a missed meal, sports activity or a late night, or an emotionally upsetting incident, such as a stressful exam or an argument with friends or parents.

After a few months, look through the diaries together with your child to see if there’s a pattern of triggers that could be causing the headaches.

Download a headache diary from The Migraine Trust

Once you’ve identified possible causes, get your child to avoid them one at a time over the next few months to see if this prevents the headaches.

Headache Self Help Tips for Kids

Often, simple steps will be enough to help your child through a headache or migraine attack:

  • Lie them down in a quiet, dark room.
  • Put a cool, moist cloth across their forehead or eyes.
  • Get them to breathe easily and deeply.
  • Encourage them to sleep, as this speeds recovery.
  • Encourage them to eat or drink something (but not drinks containing caffeine).

If you think your child needs painkillers, start the medicine as soon as possible after the headache has begun. Paracetamol (*acetaminophen/Tylenol) and ibuprofen are both safe and work well for children with headaches. The syrups are easier for children to take than tablets. Alternatively, try Migraleve, a pharmacy remedy that treats migraine and is suitable for children aged over 12 (*may not be available in all countries – not available in the USA).

When to See a Doctor for Your Child’s Headaches

As with adults, most headaches in children aren’t a serious health problem. They can be treated at home with pharmacy remedies and avoided by making sure children get enough food, drink and sleep.

But don’t delay consulting a doctor or pharmacist if you’re worried about your child’s headaches, says Prof MacGregor. “I’d advise parents to seek help if their child hasn’t been helped by painkillers or if the headaches are interfering with schoolwork. It’s important for these children to get the all-clear from a doctor.”

Here is information from The Brain Tumour Charity’s HeadSmart campaign on how to recognise the symptoms of brain tumours in children.

Read more about how to treat common conditions using your local pharmacy.

Editor’s Note: *clarification provided for our US readers.

 

 





Study: Snoring When Pregnant Linked to Low Birth Weight Babies

Snoring while pregnant is linked to smaller babies,” reports The Daily Telegraph. There is also evidence that snoring can lead to an increased risk of a baby having to be delivered by caesarean section.

This news is based on the results of a US cohort study that questioned a group of women during their last trimester of pregnancy (weeks 29 and over).

The researchers asked whether the women “habitually” snored (snoring three to four nights per week or nearly every night), and then followed up their birth outcomes. It found that self-reported “habitual” snoring, in particular snoring before and during pregnancy, was associated with increased likelihood of having a baby small for gestational age. There was also an increased likelihood of caesarean delivery.

The researchers adjusted for a number of factors that could be responsible for any association seen (confounders), such as mother’s age. However, this study cannot show that snoring directly caused the poorer delivery outcomes, as there could be other confounding health or lifestyle factors that were not adjusted for.

snoring when pregnantThe researchers speculate that snoring leads to increased levels of inflammation which could affect the placenta leading to low birthweight. But this hypothesis needs further investigation.

Overall, pregnant women who snore should not be overly concerned by this research that snoring is going to have a harmful effect on their baby. What is important though, is for pregnant women to be able to get adequate rest.

Though, as the researchers suggest, it may be useful for health professionals to ask about snoring symptoms, and if appropriate, recommend treatments.

Why do people snore?

Snoring is caused by the vibration of the soft tissue in the head and neck as a person breathes in.

The vibration can be amplified by a number of risk factors, leading to louder snoring. The factors include:

  • Obesity
  • Smoking
  • Drinking alcohol before going to sleep

Read more about the causes of snoring.

Where did the story come from?

The study was carried out by researchers from the University of Michigan, US. It was funded by the Gene and Tubie Gilmore Fund for Sleep Research, the University of Michigan Institute for Clinical and Health Research and the US National Heart, Lung and Blood Institute.

The study was published in the peer-reviewed journal Sleep.

The results of the study were accurately reported in the media.

What kind of research was this?

This was a cohort study. It aimed to examine the impact of maternal snoring during pregnancy on key delivery outcomes.

These outcomes included mode of delivery (vaginal or via caesarean section) and birth centile. Birth centiles are a method of comparing birthweight to the rest of the population. For example, if birth centile was below the 10th centile, this means that for every 100 infants less than 10 have lower birthweights. In this study, centiles were customised to take into account factors including maternal height, weight, and ethnicity and the infant’s gender and gestational age at birth.

A cohort study is the ideal study design to investigate this question. However, while the researchers adjusted for a number of factors that could be responsible for any association seen (confounders), this study cannot show that snoring caused poorer delivery outcomes. There could be other confounders that were not adjusted for.

What did the research involve?

The researchers recruited 1,673 pregnant women in their third trimester of pregnancy (this study included those of 28 weeks’ gestation or more) who attended antenatal clinics within the University of Michigan.

The women were asked whether they habitually snored or whether they had stopped breathing or gasped for air at night. Habitual snoring was defined as snoring either “three to four times per week” or “almost every day”. If women reported habitual snoring, they were asked when they started snoring. If women snored both before and during pregnancy, their snoring was classified as chronic. If snoring only started during pregnancy, the snoring was classified as pregnancy-onset snoring.

Delivery outcomes were obtained from medical records. The primary study outcomes were birth centile, mode of delivery (vaginal or caesarean section), cord blood gases (which helps determine whether the baby has been deprived of oxygen) and newborn transfer (whether the baby had to go into intensive care).

The researchers looked at whether snoring was associated with poorer delivery outcomes. The researchers tried to control their analyses for important potential confounders, such as mother’s age, body mass index (BMI)pre-eclampsia, number of previous pregnancies and maternal smoking.

What were the basic results?

Of the 1,673 women, 35% reported habitual snoring (26% who had started snoring in pregnancy, and 9% who were “chronic” snorers).

Chronic snoring was associated with:

  • Having a small for gestational age baby (birthweight less than the 10th birth centile) (odds ratio [OR] 1.65, 95% confidence interval [CI] 1.02 to 2.66).
  • Having a caesarean section (planned, not emergency) (OR 2.25, 95% CO 1.22 to 4.18)

Pregnancy onset snoring was associated with:

  • Having an emergency caesarean delivery (OR 1.68, 95% CO 1.22 to 2.30)

How did the researchers interpret the results?

The researchers concluded that: “Maternal snoring during pregnancy is a risk factor for adverse delivery outcomes including caesarean delivery and small-for-gestational age. Screening pregnant women for symptoms of SDB [sleep disorders breathing] may provide an early opportunity to identify women at risk of poor delivery outcomes.”

Conclusion

This large cohort study has found that self-reported snoring during the last trimester of pregnancy – and in particular chronic snoring – is associated with having a small for gestational age baby as well as a caesarean delivery.

A cohort study is the ideal study design to investigate this question, and the researchers have attempted to adjust for a number of important potential confounding factors that could be responsible for any association seen, such as maternal age, BMI and smoking status.

However, this study cannot show that snoring directly caused the poorer delivery outcomes, as there could be other health or lifestyle factors not adjusted for that are involved in the relationship.

In addition, in this study snoring was self-reported. It is possible that other women snored who were not aware of it (though the vast majority of women had bed partners, and only 2% of partners complained about snoring when women reported not snoring).

This study cannot tell us whether, if there is a direct link between snoring and poor delivery outcomes, by what biological mechanism this may be.

The researchers speculate that snoring leads to increase levels of inflammation which could affect the placenta leading to low birthweight. But this hypothesis needs further investigation.

Overall, pregnant women who snore should not be overly concerned by this research that this is going to have a harmful effect on their baby.

The research does raise the possibility that it may be helpful for health professionals to ask whether an expectant mother is a snoring, and if so, offer advice or treatment.

Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter.

Summary

“Snoring while pregnant is linked to smaller babies,” reports The Daily Telegraph. There is also evidence that snoring can lead to an increased risk of a baby having to be delivered by caesarean section.

Links to Headlines

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Is Your Child a Bullying Victim? Read this Mother’s Story

When Maria’s daughter moved to secondary school (*middle school), she was bullied by a group of girls who had been her best friends at primary school (*elementary school).

Halfway through the school year, Maria** became aware that her daughter Sam** wasn’t being invited to her friends’ houses anymore.

mother's-bullying-story“She doesn’t always tell me what’s going on at school, but I noticed that she was biting her fingernails a lot and sleeping badly. She seemed quite upset.

“I talked to her about her friends and why they weren’t meeting up. Eventually, she told me that they didn’t get on anymore. I found out that her old friends were excluding her.

“For example, when she bumped into them in the street, one of the girls said directly to her, ‘This is the one we’re not talking to anymore’.

“They were also really nasty in the playground. They left her standing on her own. She was still trying to be friends with them but they just ignored her. She was very upset.

Bullying Incident

“Then I witnessed an incident one Saturday afternoon.

“Two of her old friends phoned her. They asked her if she’d started her periods. She said it was none of their business, but they kept her on the phone. She wasn’t strong enough to end the conversation.

“They were laughing and shouting, ‘We want to know, we want to know’. I was standing next to her, and felt disgusted. I felt really sorry for Sam. Afterwards, I thought of calling one of the girls’ mums, but I decided not to because I thought it might make things worse.

“I was very upset because I used to spend a lot of time with these girls, but now they didn’t think my daughter was good enough for them.

“I was worried about Sam because I thought it must be horrible to believe you’ve got really good friends and then they suddenly turn against you.

How Sam got Help with Bullying

“I told Sam that she should talk to Nicole, a learning mentor at her school. I knew that Sam liked Nicole, whose role was to sort out this kind of issue.

“Soon after, Nicole contacted me. Both she and Sam’s form teacher had noticed that Sam was being bullied.

“I found out that she wasn’t only being bullied by this group. Sam is half-Polish, and another girl was calling her a ‘Polish sket’ in class.

“The school intervened quickly. They cracked down on the racist comments and the use of the insult ‘sket’. After that, the problem with that particular girl was completely resolved.

“Nicole, the learning mentor, also set up a friendship group to understand the dynamic in this circle of girls who’d all moved up from primary school together. She asked the bullies and a few other pupils to talk together about friendship, boyfriends, fashion, puberty and growing up. A lot was revealed.

“It seems that Sam’s primary school (*elementary school) friends got to know other girls at secondary school (*middle school) and became more interested in fashion, make-up and boyfriends. Because Sam was more childlike, they didn’t want her in their group anymore. She wasn’t cool enough.

“Sam was different. I think that’s often what bullying is based on. She has her own style and doesn’t follow everyone else.

“Nicole had several chats with Sam, and helped to strengthen Sam’s self-esteem. When she was picked on, Sam used to get quite upset and would try to defend herself, but now she’s able to ignore it.

“When I spoke to Sam about the meetings with Nicole, I could see that things were improving. At home, I explained to her that friendships change, and primary school (*elementary school) friends don’t necessarily stay friends for life. I didn’t want to suggest that Sam was the victim because that can make you feel weaker.

“Sam has finally found a new set of friends and is really happy with them. She’s become more confident, and she no longer tries to be friends with girls who don’t want to be friends with her.”

**The names in this article have been changed.

Bullying: Information and Support for Parents

To find out more about how you can help your child if they’ve been bullied, read Bullying: advice for parents.

 Editor’s Note: *clarification provided for our US readers.

Video: Kids and Cancer – What You Need to Know About ALL

Dr Victoria Grandage, Consultant Hematologist at the Children and Young People’s Cancer Service at University College London, describes the signs and symptoms of Acute Lymphoblastic Leukemia, also known as A.L.L. She and the mother of a young former patient, Josh, talk about the treatment and experience of ALL; a cancer that, thankfully, has a high cure rate in children. Click on the picture below to go to the NHS YouTube channel to watch the video.

Editor’s Note: Video Highlights

  • Acute lymphoblastic leukaemia or ALL is a form of cancer of the blood
  • For reasons we do not yet fully understand, immature cells in the bone marrow – lymphocytes or lymphoblasts – rapidly build up and crowd out the normal bone marrow cells
  • Some of the symptoms of ALL include:
    • Anemia: tiredness, shortness of breath, lethargy
    • Infections, high fevers, maybe mouth ulcers
    • Bleeding, bruising and rashes
    • Enlargement of some lymph nodes around the neck or in the groin
    • Enlargement of the liver and spleen
    • Bone pain (a prominent symptom)

“When Josh was about two and a half, he went back to crawling rather than walking. He’d say his legs were too sore to walk and he’d crawl around for the first half hour or so (after getting up) and then start walking after that.”                                    Josh’s Mom, Angela

  • child with cancerInitial treatment, before a diagnosis has been confirmed, is supportive to address the above symptoms and can include fluids for hydration, antibiotics, and possibly a blood transfusion
  • Treatment of the leukemia itself involves chemotherapy, a broad term for many different drugs that may be given in tablet form, as injections, or directly into the blood stream as IV infusions
    • Some ALL chemotherapy drugs are also given via a lumbar puncture
  • Side effects of the chemotherapy include nausea, tiredness, and hair loss
  • Treatment begins with acute therapy – for Josh this lasted 9 months – and is followed by maintenance treatment for a couple of years
    • Josh’s total treatment lasted three years
  • The majority of children with ALL go into remission – and 75%-80% of those are cured
  • Further intensified treatment, including a stem cell transplant, may be required for children who do not go into remission

 





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