Currently browsing nhs choices posts

1 in 10 Young People Self-Harm: Here’s How to Help

Self-harm is when somebody intentionally damages or injures their body. It’s usually a way of coping with or expressing overwhelming emotional distress.

Sometimes when people self-harm, they feel on some level that they intend to die. Over half of people who die by suicide have a history of self-harm.

However, the intention is more often to punish themselves, express their distress or relieve unbearable tension. Sometimes the reason is a mixture of both.

Self-harm can also be a cry for help.

Getting help

If you’re self-harming, you should see your GP (*physician) for help. They can refer you to healthcare professionals at a local community mental health service for further assessment. This assessment will result in your care team working out a treatment plan with you to help with your distress.

Treatment for people who self-harm usually involves seeing a therapist to discuss your thoughts and feelings, and how these affect your behaviour and wellbeing. They can also teach you coping strategies to help prevent further episodes of self-harm. If you’re badly depressed, it could also involve taking antidepressants or other medication.

Types of self-harm

There are many different ways people can intentionally harm themselves, such as:

  • cutting or burning their skin
  • punching or hitting themselves
  • poisoning themselves with tablets or toxic chemicals
  • misusing alcohol or drugs
  • deliberately starving themselves (anorexia nervosa) or binge eating (bulimia nervosa)
  • excessively exercising

People often try to keep self-harm a secret because of shame or fear of discovery. For example, if they’re cutting themselves, they may cover up their skin and avoid discussing the problem. It’s often up to close family and friends to notice when somebody is self-harming, and to approach the subject with care and understanding.

Signs of self-harm

If you think a friend or relative is self-harming, look out for any of the following signs:

  • unexplained cuts, bruises or cigarette burns, usually on their wrists, arms, thighs and chest
  • keeping themselves fully covered at all times, even in hot weather
  • signs of depression, such as low mood, tearfulness or a lack of motivation or interest in anything
  • self-loathing and expressing a wish to punish themselves
  • not wanting to go on and wishing to end it all
  • becoming very withdrawn and not speaking to others
  • changes in eating habits or being secretive about eating, and any unusual weight loss or weight gain
  • signs of low self-esteem, such as blaming themselves for any problems or thinking they’re not good enough for something
  • signs they have been pulling out their hair
  • signs of alcohol or drugs misuse

People who self-harm can seriously hurt themselves, so it’s important that they speak to a GP about the underlying issue and request treatment or therapy that could help them.

Why people self-harm

Self-harm is more common than many people realise, especially among younger people. It’s estimated around 10% of young people self-harm at some point, but people of all ages do. This figure is also likely to be an underestimate, as not everyone seeks help.

In most cases, people who self-harm do it to help them cope with overwhelming emotional issues, which may be caused by:

  • social problems – such as being bullied, having difficulties at work or school, having difficult relationships with friends or family, coming to terms with their sexuality if they think they might be gay or bisexual, or coping with cultural expectations, such as an arranged marriage
  • trauma – such as physical or sexual abuse, the death of a close family member or friend, or having a miscarriage
  • psychological causes – such as having repeated thoughts or voices telling them to self-harm, disassociating (losing touch with who they are and with their surroundings), or borderline personality disorder

These issues can lead to a build-up of intense feelings of anger, guilt, hopelessness and self-hatred. The person may not know who to turn to for help and self-harming may become a way to release these pent-up feelings.

Self-harm is linked to anxiety and depression. These mental health conditions can affect people of any age. Self-harm can also occur alongside antisocial behaviour, such as misbehaving at school or getting into trouble with the police.

Although some people who self-harm are at a high risk of suicide, many people who self-harm don’t want to end their lives. In fact, the self-harm may help them cope with emotional distress, so they don’t feel the need to kill themselves.

Useful organisations

There are organisations that offer support and advice for people who self-harm, as well as their friends and families. These include:

Find more mental health helplines.

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

** Resources outside the U.K.

  • Samaritans USA provides resources like hotlines and professional educational courses to prevent suicide.
  • NAMI is the National Alliance on Mental Illness, the largest grassroots mental health organization in the US.
  • The Self Injury Foundation is dedicated to providing funding for self-harm research and education as well as resources and information about self-harm.
  • Recover Your Life is a self-harm forum.
  • National Parents Hotline provides emotional support for parents dealing with a range of issues.

 

NHS Choices logo


From www.nhs.uk





Beyond Flu What Illness Should You Watch Your Child For

Children’s colds

It’s normal for a child to have 8 or more colds a year.

This is because there are hundreds of different cold viruses and young children have no immunity to any of them as they’ve never had them before.

They gradually build up immunity and get fewer colds. Most colds get better in 5 to 7 days.

Here are some suggestions on how to ease the symptoms in your child:

  • Make sure your child drinks plenty of fluids.
  • Saline nose drops can help loosen dried snot and relieve a stuffy nose. Ask your pharmacist, GP (*physician) or health visitor about them.
  • If your child has a fever, pain or discomfort, children’s paracetamol (*acetaminophen) or ibuprofen can help. Children with asthma may not be able to take ibuprofen, so check with your pharmacist, GP or health visitor first. Always follow the instructions on the packet.
  • Encourage the whole family to wash their hands regularly to stop the cold spreading.

Cough and cold remedies for children

Children under 6 shouldn’t have over-the-counter cough and cold remedies, including decongestants (medicines to clear a blocked nose), unless advised by a GP or pharmacist.

Children’s sore throats

Sore throats are often caused by viral illnesses such as colds or flu.

Your child’s throat may be dry and sore for a day or two before a cold starts. You can give them paracetamol or ibuprofen to reduce the pain.

Most sore throats clear up on their own after a few days. If your child has a sore throat for more than 4 days, a high temperature and is generally unwell or unable to swallow fluids or saliva, see your GP.

Children’s coughs

  • Children often cough when they have a cold because of mucus trickling down the back of the throat.
  • If your child is feeding, drinking, eating and breathing normally and there’s no wheezing, a cough isn’t usually anything to worry about.
  • If your child has a bad cough that won’t go away, see your GP. If your child also has a high temperature and is breathless, they may have a chest infection.
  • If this is caused by bacteria rather than a virus, your GP will prescribe antibiotics to clear up the infection. Antibiotics won’t soothe or stop the cough straight away.
  • If a cough continues for a long time, especially if it’s worse at night or is brought on by your child running about, it could be a sign of asthma.
  • Some children with asthma also have a wheeze or breathlessness. If your child has any of these symptoms, take them to the GP.
  • If your child seems to be having trouble breathing, contact your GP, even if it’s the middle of the night.
  • Although it’s upsetting to hear your child cough, coughing helps clear away phlegm from the chest or mucus from the back of the throat.
  • If your child is over the age of 1, try a warm drink of lemon and honey.

Find out more about coughs.

Croup

A child with croup has a distinctive barking cough and will make a harsh sound, known as stridor, when they breathe in. They may also have a runny nose, sore throat and high temperature.

Croup can usually be diagnosed by a GP and treated at home. But if your child’s symptoms are severe and they’re finding it difficult to breathe, take them to the nearest hospital’s accident and emergency (A&E) department (*ER).

Read more about the symptoms of croup.

Children’s ear infections

Ear infections are common in babies and small children. They often follow a cold and sometimes cause a high temperature. A baby or toddler may pull or rub at an ear.

Other possible symptoms include fever, irritability, crying, difficulty feeding, restlessness at night and a cough.

If your child has earache, with or without fever, you can give them paracetamol or ibuprofen at the recommended dose. Try one first and, if it doesn’t work, you can try giving the other one.

Don’t put any oil, eardrops or cotton buds into your child’s ear unless your GP (*physician) advises you to do so.

Most ear infections are caused by viruses, which can’t be treated with antibiotics. They’ll just get better by themselves, usually within about 3 days.

After an ear infection, your child may have a problem hearing for 2 to 6 weeks. If the problem lasts for any longer than this, ask your GP for advice.

Find out more about ear infection (otitis media).

Glue ear in children

Repeated middle ear infections (otitis media) may lead to glue ear (otitis media with effusion), where sticky fluid builds up and can affect your child’s hearing. This may lead to unclear speech or behavioural problems.

If you smoke, your child is more likely to develop glue ear and will get better more slowly. Your GP can give you advice on treating glue ear.

See glue ear for further information.

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

NHS Choices logo


From www.nhs.uk





Pneumococcal Infections: What You Need to Know

Pneumococcal infections are caused by the Streptococcus pneumoniae bacteria, and range from mild to severe.

There are more than 90 different strains of Streptococcus pneumoniae (S. pneumoniae) bacteria (known as serotypes), some of which cause more serious infection than others.

The symptoms of a pneumococcal infection can vary, depending on the type of infection you have. Common symptoms include:

  • a high temperature (fever) of 38C (100.4F)
  • aches and pains
  • headache

Types of pneumococcal infection

Pneumococcal infections usually fall into one of two categories:

  • non-invasive pneumococcal infections – these occur outside the major organs or the blood and tend to be less serious
  • invasive pneumococcal infections – these occur inside a major organ or the blood and tend to be more serious

Non-invasive pneumococcal infections

Non-invasive pneumococcal infections include:

  • bronchitis – infection of the bronchi (the tubes that run from the windpipe down into the lungs)
  • otitis media – ear infection
  • sinusitis – infection of the sinuses

Invasive pneumococcal infections

Invasive pneumococcal infections include:

  • bacteraemia – a relatively mild infection of the blood
  • septicaemia (blood poisoning) – a more serious blood infection
  • osteomyelitis – infection of the bone
  • septic arthritis – infection of a joint
  • pneumonia – infection of the lungs
  • meningitis – infection of the meninges (the protective membranes surrounding the brain and spinal cord)

Who is at risk?

People with a weakened immune system are most at risk of catching a pneumococcal infection. This may be because:

  • they have a serious health condition, such as HIV or diabetes, that weakens their immune system
  • they are having treatment or taking medication that weakens their immune system, such as chemotherapy

Other at-risk groups include:

  • babies and young children under two years of age
  • adults over 65 years of age
  • people who smoke or misuse alcohol

Read more about the causes of pneumococcal infections.

Cases of invasive pneumococcal infection usually peak in the winter, during December and January.

Treating pneumococcal infections

Non-invasive pneumococcal infections are usually mild and go away without the need for treatment. Rest, fluids and over-the-counter painkillers such as paracetamol are usually advised.

More invasive types of pneumococcal infections can be treated with antibiotics, either at home or in hospital.

Read more about how pneumococcal infections are treated.

Pneumococcal vaccines

There are two different types of pneumococcal vaccine used. These are:

  • pneumococcal conjugate vaccine (PCV) – which is given to all children as part of the childhood vaccination programme; it’s given in three separate doses at eight and 16 weeks and at one year of age
  • pneumococcal polysaccharide vaccine (PPV) – which is given to people aged 65 years or over, and others who are at high risk

The PCV protects against 13 types of S. pneumoniae bacteria, and the PPV protects against 23 types. It is thought that the PPV is around 50-70% effective at preventing more serious types of invasive pneumococcal infection.

Read about pneumococcal vaccination and when pneumococcal vaccination is used.

Outlook

The outlook for pneumonia in people who are otherwise healthy is good, but the infection can lead to serious complications in people who are very young, very old or have another serious health condition.

However, due to the introduction of the PCV in 2002, the number of people dying from complications that arise from pneumonia has fallen to around 7%.

The outlook for other types of invasive pneumococcal infections such as bacteraemia is generally good, although there is about a 1 in 20 chance that bacteraemia will trigger meningitis as a secondary infection.

Multidrug-resistant Streptococcus pneumoniae (MDRSP)

During the 1990s, the increasing levels of S. pneumoniae that had developed a resistance to three or more types of antibiotics was a major concern. These types of bacteria are known as multidrug-resistant Streptococcus pneumoniae (MDRSP).

MDRSP is a real concern because it is challenging to treat and carries a higher risk of causing complications.

Since the introduction of pneumococcal vaccines, fewer cases of infection have led to antibiotics being used less and the chance of bacteria developing resistance to antibiotics becoming smaller.

The ability for bacteria to become resistant to antibiotics is the reason why GPs (*physicians) are becoming increasingly reluctant to prescribe antibiotics for mild infections.

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

NHS Choices logo


From www.nhs.uk





Teaching Your Special Needs Child How to Eat On Their Own

Children with special needs can take longer to learn how to eat independently. Read these top tips for mealtimes.

Eating a meal can be particularly challenging for children who have disabilities. A lack of fine motor skills (like finding it hard to hold a fork), sensory restrictions (like being paralysed or unable to see) and co-ordination difficulties are some of the many reasons that may delay the learning process. This can be frustrating for you and your child.

Author Deborah French has four children, two of whom have special needs. Her eldest daughter, Amariah, has Down’s syndrome and her son, Henry, has autism spectrum disorder. “Socialising with others generally includes eating together,” she says. “So learning how to eat neatly is crucial to helping our children to integrate.”

Deborah, who also runs cookery classes for children with special needs, came to realise that nagging her children about their table manners wasn’t working. Instead, she developed practical solutions to help them learn, with rapid results.

Deborah’s top tips for happy mealtimes

1. Be patient

“When stress or frustration controls your reactions while trying to teach your child, they will reflect your mood and act accordingly. They will fear your reaction to their mistakes, and as a result will not be able to give their best efforts. Give instructions calmly, with positive reinforcement.”

2. Invest in a funky child-sized apron

“As your child gets older, even though it may still be necessary for them to wear a bib to protect their clothing, this can also be demoralising and embarrassing in front of other family members or peers. An apron is more discreet and will help eliminate any negative feelings your child may harbour before mealtime has even begun.”

3. Encourage your child to help lay the table

“Irrespective of the nature of your child’s disability, take the time to involve them in preparing the table for dinner. Even watching you collect cutlery, cups and napkins helps your child to feel they have participated. During this process, talk your child through what you are doing and why. For example: ‘We use a fork to pick up pieces of food on our plate instead of our fingers. That way, the fork gets dirty and not our fingers’.”

4. Use heavy cutlery and solid crockery

“As parents, we instinctively opt for plastic or disposable utensils to avoid breakage and to make cleaning up easier. But for a child who has either low or high muscle tone or difficulty with their fine motor skills, a plastic fork simply feels like air. These children need to be able to feel the cutlery they are holding. The same is true for plastic plates and cups, which are unstable and easily knocked over. Solid cutlery and crockery will make it easier to teach your child how to eat.”

Read about other eating equipment that can help.

5. Take the time to eat with your child

“If you eat your evening meal later than your child, compromise by ensuring that during your child’s mealtime, you too are seated at the table. Even if you enjoy your coffee or a smaller version of what your child is eating, they will be encouraged by your presence. You can then talk about your food and how you eat with your cutlery. Take note of how quickly your child imitates your actions.”

6. Keep a standalone mirror and wet cloth handy

“The most effective way of teaching self-awareness to a child is to let them view themselves. Even as adults, how often after enjoying a meal with friends have we been unaware that a chunk of food, usually green in colour, has become wedged between our front teeth?

“Apply this theory when helping your child to understand food residue on their face after eating. Before they leave the table, place the mirror in front of them and encourage them to look at their reflection and clean themselves using the wet cloth.”

7. Encourage your child to clear their place

“Again, irrespective of your child’s disability, teach them how to participate in the cleaning up process after eating according to their ability. This may involve them handing their plate to you or taking it to the side to be washed; alternatively wiping their place clean as best they can. Any level of participation helps to develop their self-awareness and obligations at mealtimes.

“It’s important to remember that everyone likes to feel valued and needed. When you give your child responsibilities, they feel important to you and the family. This in turn boosts their self-confidence and speeds up the learning process.”

Read our interview with Deborah about parenting children with special needs.

Specialist eating and drinking equipment

To help your child learn good eating skills, you may find that specialist eating or drinking equipment will make a real difference. The Caroline Walker Trust, a food charity, recommends a number of helpful aids to eating that parents of children with learning disabilities may find useful for their child.

These include:

  • Different shaped cups, with one or two handles, of different weights, materials, transparencies and designs. The cups should be designed not to shatter or break if they are bitten.
  • A transparent cup can be helpful when helping someone to drink, because you can see how much liquid they’re taking.
  • Cutlery of differing shapes, sizes, depths and materials. Again, the cutlery shouldn’t shatter if it is bitten. Solid plastic cutlery or plastic-coated metal might be better for people who have a bite reflex when cutlery is placed in their mouth. Shorter-handled cutlery is easier to manage, and hand grips or irregularly shaped handles may help someone in using a utensil.
  • Plates and bowls that do not slip, have higher sides to prevent spillage, or are angled to make access to food easier.
  • Insulated crockery that keeps food hot if mealtimes are lengthy.
  • Non-slip mats that support crockery.
  • Straws, which can help those with a weaker suck and can have different widths.
  • Feeding systems that deliver food to the diner’s mouth through, for example, a rotating plate and a mechanical or electronically controlled spoon. Some systems are powered, others are hand- or foot-operated.

For more information and details of suppliers, visit the Living Made Easy website.

NHS Choices logo


From www.nhs.uk





How To Prevent and Treat Teen Smelly Feet

Smelly feet aren’t fun for anyone, but there is an effective, simple and cheap treatment that you can use at home which will banish foot odour within a week.

Medically known as bromodosis, stinky feet are a common year-round problem.

The main cause is sweaty feet combined with wearing the same shoes every day.

Why feet sweat

Anyone can get sweaty feet, regardless of the temperature or time of year. But teenagers and pregnant women are especially prone because hormonal changes make them sweat more.

You’re also more likely to have foot perspiration if you’re on your feet all day, if you’re under a lot of stress or if you have a medical condition called hyperhidrosis, which makes you sweat more than usual. Fungal infections, such as athlete’s foot, can also lead to bad foot odour.

According to podiatrist, Lorraine Jones, feet become smelly if sweat soaks into shoes and they don’t dry before you wear them again.

Bacteria on the skin break down sweat as it comes from the pores. A cheesy odour is released as the sweat decomposes.

“Your feet sweat into your shoes all day so they get damp and bacteria start to grow. The bacteria continue to breed once you’ve taken your shoes off, especially if you put them in a dark cupboard. Then, when you put your shoes back on the next day, even if you’ve just had a shower, putting your feet into still damp shoes creates the perfect conditions for the bacteria to thrive – warm, dark and moist.”

How to treat smelly feet

The good news is that there’s a simple, quick, sure-fire solution to smelly feet.

  • Wash your feet with an anti-bacterial soap called Hibiscrub. There are lots of over-the-counter foot hygiene products at your local chemist, but Hibiscrub is the best one.
  • Leave on the Hibiscrub for a couple of minutes, then wash it off.

According to Lorraine, “if you do this twice a day, you’ll definitely banish smelly feet within a week.”

She adds that you shouldn’t use Hibiscrub on your feet if you have broken skin, such as eczema.

Preventing smelly feet

Keeping feet fresh and sweet smelling is all down to good personal hygiene and changing your shoes regularly. To keep feet fresh:

  • Never wear the same pair of shoes two days in a row. Instead, wear different shoes on successive days so they have at least 24 hours to dry out.
  • Make sure teenage boys have two pairs of trainers so that they don’t have to wear the same pair for two or more consecutive days.
  • Wash and dry your feet every day and change your socks (ideally wool or cotton, not nylon) at least once a day.
  • Keep your toenails short and clean and remove any hard skin with a foot file. Hard skin can become soggy when damp, which provides an ideal home for bacteria

If you’re particularly susceptible to sweaty feet, it’s a good idea to:

  • dab between your toes with cotton wool dipped in surgical spirit after a shower or bath – surgical spirit helps dry out the skin between the toes really well – in addition to drying them with a towel
  • use a spray deodorant or antiperspirant on your feet – a normal underarm deodorant or antiperspirant works just as well as a specialist foot product and will cost you less
  • put medicated insoles, which have a deodorising effect, in your shoes
  • try feet-fresh socks – some sports socks have ventilation panels to keep feet dry, and antibacterial socks are impregnated with chemicals to discourage the odour-producing bacteria that feed on sweat
  • wear leather or canvas shoes, as they let your feet breathe, unlike plastic ones
  • wear open-toed sandals in summer and go barefoot at home in the evenings

When to see a doctor

Smelly feet are a harmless problem that generally clears up. Sometimes, however, it can be a sign of a medical condition.

See your GP (*doctor) if simple measures to reduce your foot odour don’t help, or if you’re worried that your level of sweating is abnormally high.

Your doctor can offer you a strong prescription antiperspirant or refer you for a treatment called iontophoresis, which delivers a mild electric current through water to your feet to combat excessive sweating.

Here are more tips on how to look after your feet.

 

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

NHS Choices logo


From www.nhs.uk





Video: Childhood Squint – How to Identify and Treat It

John Sloper, a paediatric consultant at Moorfields Eye Hospital explains the causes of squints, a misalignment of the eye. He describes how to identify the symptoms and the treatment options..

Editor’s Note: Video Highlights

What Is Childhood Squint:

  • Occurs when the two eyes point in different directions and as a result see different things and the brain can’t combine the images – vision in one eye deteriorates (amblyopia)
  • Amblyopia is very common and affects one child in 20
  • Squints can occur in children at any age although it commonly occur in babies between 4-6 months old or children ages 2-3 and it’s important up to about age 7 because that’s the age at which it can affect the development of vision

Symptoms

  • Parents will notice the two eyes are not pointing in the same direction
  • Lazy eye is more difficult to diagnose because it can also occur because the focus in the two eyes is different

Treatment

  • First question is whether vision is affected in both eyes
    • Glasses are first line of treatment
    • Patching good eye to develop vision in poor eye
    • Improvements typically seen in 80% of children
  • Goal of treatment
    • Good vision in both eyes
    • Get the eyes to work together (achieved with a minority of children)
    • Make the eyes look straight (helps the children socially)
  • Surgery is an uncomfortable 2nd option, but children bounce back quickly
    • Good vision results are usually permanent
    • If eyes work together results are usually long lasting
    • If not, the affected eye may drift over 20-30 years and can be corrected with further surgery as an adult
    • Surgical complications are extremely rare
    • Squint surgery is typically a single day procedure with no overnight hospital stay required
  • Results
    • Squints are common and a lot can be done to improve them, however it is important to treat children with squints early – as the earlier they’re seen, typically the better the outcome of the treatment.

NHS Choices logo


From www.nhs.uk





Next Page »