Taking Care of the Sick Child: Precautions and Some Household Remedies
If a child is ill it is easily detectable. Normally a child is very gay and lively. No healthy child has ever been found to be lying listlessly or sitting around inertly.
If the face of a child lacks animation or liveliness, or if the child is lethargic, lacking interest in food and other playful activities it should be obvious to the mother that there is something wrong with the health of the child, some morbid condition or sickness which is responsible for this drastic change. At times the child becomes frightened or gets stubborn. Some children keep trying. There are some apparent symptoms which show that the child is sick.
The first duty of the mother is to check the temperature of the child not by touching its body with her hand and estimating its body temperature but with a thermometer.
Taking of the Temperature
- This the doctor does for you normally. But in case the doctor is not available you can also do it easily. Normally temperature fluctuates between 98°-100°F. The Same now is taken in centigrade which records the normal temperature to be 37°C.
- When you are taking the temperature keep the child’s bottom-up and face down. Use a thermometer with a thick short bulb. Lubricate the bulb of the thermometer with a little bit of vaseline and push half an inch into the rectum. Hold the child over the buttock with the thermometer firmly held.
- Before you start taking the temperature see that the mercury column is pushed down below the normal mark. You must keep the mercury bulb for about half a minute in the rectum to take the correct temperature.
- In case the child feels discomfort in your registering its temperature this way, you may put the thermometer in the armpit.
- The temperature in the armpit or axilla may appear to a degree less than the mouth temperature. You can get some idea of the body temperature from axilla. The mouth temperature is one degree less than the rectal temperature.
- Unless your child is about five or six years’ of age, it may not be able to keep the temperature properly in his mouth. Parents can be easily trained to take the rectal temperature which is the highest temperature of the body at a given time.
- Always wash the thermometer in cold soapy water. NEVER USE WARM OR HOT WATER, as it can even break the thermometer. Dry the thermometer to keep it in a clean place. If the child is really sick take the temperature thrice a day.
- The evening temperature would be normally higher.
- At times some children develop convulsion because of high temperature. This may occur at the beginning of temperature or at the height of the temperature. If there is a convulsion it could appear frightening. Immediately consult the doctor.
- However, convulsions don’t indicate any serious disorder. Some children develop convulsions while others may puke or feel shooting headache in high temperature. This tendency will pass out with age. Normally boys have such minor complications until the age of ten and the girls till they reach the puberty stage. So there is nothing frightening about it.
Some Preliminary House Hold Precautions
The moment the mother feels her child having the temperature, she should immediately take the following measures by way of preliminary precautions:
- The cradle or bed of the child should be moved to a clean, airy and well-lighted place. Clean and germ-free bed covers, chadars, blankets, etc., should be used.
- If mosquitoes are likely to bother the child, a mosquito net should be hung over the bed.
- The child must be given only pure, boiled water. Make sure that the milk to be given to the child is also uncontaminated.
- All glasses, bowls, cups, saucers, etc., to be used by the child must be kept thoroughly clean.
- The used and soiled clothes of the child should be exchanged for clean ones. The mother or other persons who are the nurse the child should also keep themselves clean, and wear clean clothes. Hands must be washed with soap before, and after, touching the child.
- The urine and stools of the child must be disposed of properly, and antiseptics like phenyl should be used wherever necessary.
- If typhoid or other infectious disease is suspected, antiseptics should be mixed with the child’s urine and stools before they are disposed of, and spread of infection should be guarded against in other ways.
Control of temperature
- A rise in temperature is associated with most illnesses. It is therefore necessary to check the temperature of the child frequently.
- A thermometer should be placed in the mouth or the armpit of the child, and kept there for three to five minutes before the temperature is read. The temperature of a healthy person is normally 98.4° Fahrenheit (39.9° Centigrade). Fluctuations of about 1°F are not considered abnormal.
- But temperatures of 100 °F or above indicate fever. A clean wet towel should be applied to the child in such a case. If in spite of this the temperature rises above 101 °F, an ice bag should be applied to the head and forehead of the child.
- If the temperature rises to 104°F, the body of the child must be sponged with cold water, preferably ice water. After that three handkerchiefs should be wrung out in cold water, and placed on the chest and thighs of the child. When these handkerchiefs get warmed up, they should be wrung out in cold water again, and the whole process repeated. After about 15 to 20 minutes of such applications, the temperature should be taken again. Some drop in temperature will have occurred. A gradual reduction in temperature is desirable. If an attempt is made to reduce the temperature too quickly, there is the danger of the child losing too much heat, and having tremors.
- Half a tablet of aspirin or paracetamol should be given to the feverish child. This may bring down the temperature. If the child cannot swallow the tablet, crush the tablet to powder, and dissolve it in water. The child will then be able to swallow the solution. Solutions of paracetamol are also marketed under the names ‘metacin’, ‘ultragin’, etc.
- All these are emergency measures only. For further directions, a doctor should be consulted.
Some mothers believe that a sick child should not be bathed, nor should water be used to clean its body even by sponging. This belief is erroneous. Cleanliness is an important factor in the maintenance and restoration of the health of the body. When the fever has subsided, or when the child is feeling relatively better, the opportunity should be taken to bathe the baby, or to sponge its body with comfortably warm water. Afterward, the baby should be wrapped up in clean clothing and dried gently. Most probably this soothes the child into deep, peaceful sleep. Never bathe the child with hot water when it has the fever, nor in the summer. If the child is very ill, it would be advisable to dispense with the bath and keep its body clean by sponging at suitable intervals.
- There is a prevalent belief that no food should be given to a child who is suffering from fever. This belief, too, is without foundation. In fact, a child suffering from fever needs more sustenance.
- It would be best to give the sick child such food as it relishes, and in such amounts, as it finds acceptable. As an when it becomes necessary, more food can be given. If too much food is given at a time, the child may get indigestion. On the other hand, if no food is given to the child when it is sick, the energy requirements of its body will be supplied by the consumption of muscular tissue, the natural consequence is that the child weakens, and loses weight.
- However, if the child refuses food, or expresses disinclination for it, forcing food upon the child is not advisable. Such insistence may cause the child to feel harassed.
Keep a Record
Keep a record of the child’s illness whenever the child is sick. Write down temperature every time, number of feeds, number of bowel movements, number of vomits or any other important event regarding the sickness before you consult your doctor.
Babies often have hiccups during illness. Don’t get anxious about it. Give the baby sips of warm water or ‘burp’ him well. Turn him over, put him on the back or pick him up. If it is still persisting with hiccups, give your child a few drops of ‘Largactyl’ syrup or an antispasmodic like ‘neoctimum’ syrup and also consult your doctor if it is a frequent trouble.
Some Household Remedies
These are the remedies that have been found quite effective from very early times. All ‘Nanis’ or ‘Dadis’ stood by them and managed to cure their darlings of the following troubles.
(i) The remedy for Diarrhoea:
Symptoms: Frequent watery stools, pain in the abdomen, recurring thirst, eyes sinking into their sockets, with the eyeballs standing out prominently, etc.
Treatment: Give the child ‘Electoral’ powder at short intervals. Give it plenty of previously boiled and cooled water. If ‘electoral’ powder is not at hand, use a solution made up by dissolving 2 teaspoonfuls of common salt, 6 teaspoonfuls of sugar and half a teaspoon of soda bicarb (baking soda) in 21/2 cups of previously boiled water. If the baby is being fed on breast milk, let it suckle as much as it wants to. If the child does not urinate in four hours, or if the skin and eyes become dry, the child should be hospitalized forthwith.
Caution: If the measures described above do not result in noticeable improvement, or if any of the following symptoms appear, the child should be immediately taken to a doctor.
(1) The child has not urinated for 4 to 6 hours.
(2) The child is panting, or its breathing is labored.
(3) The child keeps vomiting.
(4) When the skin of the child is pinched and released, it remains pinched for 30 seconds without reverting to the original contours, the eyes have sunk into their sockets, and the face of the child lacks luster.
(ii) Boils: Many infants have very sensitive skin and develop boils especially in summers or hot and humid rainy seasons.
Symptoms: Boils or pustules develop on the face arms, legs, etc., exuding pus.
Treatment: Dip cotton or apiece of clean cloth in warm water and place it gently on the boil. Do not exert any pressure. Clean the boil by wiping them lightly with cotton dipped in Dettol solution. This may sometimes dislodge the encrustation (clot) formed on the boil. Apply furacin ointment or powder over the boil. Never use the same wad of cotton to wipe a boil more than once. The used cotton should be discarded and destroyed.
Caution: If the boils are accompanied by fever, a doctor should be consulted.
(iii) Anemia: Owing to lack of iron in the body and due to faulty diet, most infants in India become anemic.
Symptoms: The lips, tongue, and nails of the child appear pale and yellowish, the child is easily fatigued and loses weight.
Treatment: The child should be given tablets containing iron, one tablet a day for a hundred days. The mother, too, should be given a tablet a day for a hundred days. Moreover, plenty of green leafy vegetables should be included in the daily diet of the mother and child. (Tablets containing 65 mg of iron are supplied free by health centers, government hospitals and family planning centers).
Caution: If no improvements result from the above treatment, a doctor should be contacted for advice and treatment. Frequent checks should be carried out to ascertain whether the child has worms.
(iv) Conjunctivitis: Though believed to be of recent origin, it is an old eye trouble chiefly caused by a germ especially during the rainy season or at the beginning of the post-rains season. Earlier it was called ‘Aankhen Aana’. Owing to the polluted atmospheric condition this trouble surface with more intensity. Sometimes eyes become as sore as to cause even fever.
Symptoms: The eyes are inflamed, and water copiously. The cornea is reddened, and viscous yellowish rheum is formed in the eyes.
Treatment: Clean the eyes two or three times a day with cotton dipped in a warm solution of boric acid powder in boiled water.
Caution: If the eyes do not clear up in two or three days under this treatment, consult a doctor.
(v) Sty: Called a ‘ghueri’ in colloquial parlance in northern India, it is a small plausible formed at the corner of the eye or eyes.
Symptoms: There is the pain in the eyelid, followed by a swelling of the eyelid. This develops into a boil on the edge of the eyelid, which is even more painful.
Treatment: Wash the eyes frequently with cotton dipped in a warm solution of boric acid in boiled in boiled water.
Caution: If there is no relief in about five days, or if he sty develops further, a doctor should be consulted.
Care must be taken to ensure that the infection does not spread to the other eye. Fingers, handkerchiefs, etc., that have been in contact with the infected eye should not be allowed to touch the other eye without cleaning them first.
(vi) Scabies: The common symptoms are: itching in the affected part. Initially, small furuncles develop on the affected skin area. This itching becomes particularly troublesome at night. Usually, two or three persons in a family are affected simultaneously.
Treatment: Avoid scratching the infected parts. See that the child too does not scratch itself. Soap containing sulphur, such as cytosol soap, should be used to clean thoroughly the body of the child and those of others in the family who are affected. The clothes of the child should be changed frequently and washed in boiling water. The bedsheets also must be washed often and exposed to sunlight. Application of one percent solution of gamma benzene hexachloride is highly effective, and it does not cause burning of the skin. Alternatively, 25% benzyl benzoate ointment should be applied all over the body except around the mouth for three consecutive days, and no baths should be taken for this period: contact of the medicine with the skin must be maintained for 72 hours without interruption. (This ointment will cause a burning sensation). If necessary, cortex ointment can be applied once a day to supplement the above treatment. If others in the family are affected, all should be treated simultaneously.
Caution: If this treatment does not result in a cure in reasonable time, a doctor should be consulted.
(vii) A whooping Cough: The details about this trouble have already been given in the earlier pages.
Symptoms: There is prolonged coughing, with consequent difficulty in breathing, so that the child pants after the attack of the fit of coughing. Phlegm is expectorated. The child experiences uneasiness and weakness.
Treatment: The child should be given the vaccine for whooping cough without delay. Gargling with warm salt water helps. Tea, coffee, milk, etc., should be drunk when fairly warm.
Caution: If despite the above treatment there is no amelioration in the condition, and the child does not start taking an interest in playing and other activities, a doctor should be consulted.
(viii) Vitamin Deficiency Diseases: The following disease and disorder mostly occur due to vitamin deficiency although there could be other causes also. We will, however, confine our field to the symptoms due to vitamin deficiency only.
- Vitamin A deficiency causes difficulty in child’s seeing clearly in faint light as in the morning or at night. A child with vitamin A deficiency also can’t tolerate intense light. The eyes are painful and may develop white pleasant patches on the cornea over the iris.
- A deficiency of vitamin B results in the formation of sores in the mouth and on the tongue. Cracks develop on the lips. Wider racks or fissures develop on the soles and heels of the feet.
- A deficiency of vitamin C results in the development of sores and cracks on the hands and feet. The cracks may even bleed. There is bleeding from the gums. The bones become soft. The child suffers frequently from colds.
- A deficiency of vitamin D causes the enlargement of the abdomen and wasting of muscles of the arms and legs. The bones of the child become soft, sometimes to such an extent that even standing may cause them to bend under the load. The child becomes knock-kneed so that the knees strike one another when walking. The child finds it difficult to sit down or stand up. The disease known as ‘Rickets’ is due to the deficiency of vitamin D.
Treatment: The following treatments for the various Vitamins’ deficiency are not confined to only administering the vitamin in the right does and at right time-also in the right way to make the body absorb them properly.
- To compensate for the deficiency of the vitamin. The child should be given vitamin A drops every six months. These drops are supplied free by health centers. Plenty of green leafy vegetables like tandaljo, methi (fenugreek) leaves, palak (spinach), chil (Bathua) leaves, dodi, radishes, carrots, tuver (red grams), peas, etc., should be given to the child. Alternatively, juices of these vegetables can be given. Fruits like phalsa, strawberries, papayas, mangoes, rayan (khirni, mimusops) etc., also contain plenty of vitamin A.
- In cases of deficiency of vitamin B, tablets of vitamin B complex should be given, Fruits, leafy vegetables, milk, ground-nuts, etc., should be included in the daily diet. The skins of vegetables should not be discarded but consumed in the suitable form. Only unpolished manually dehusked rice should be taken.
- In order to counter the deficiency of vitamin C, it is necessary to cat plenty of sour fruits such as tomatoes, amlas (myrobalan fruits, Indian gooseberries), pears, citrus fruits like lemons and oranges. Vitamin C tablets are also available.
- No expense has to be incurred for remedying the deficiency of vitamin D. Adequate amounts of his vitamin are produced right in the body of the child itself if it is exposed to the mild sunlight of morning and evenings for about half an hour every day. If there has been an excessive loss of vitamin D through diarrhea, the child should be given nutritious food containing milk and milk products. Drops or medicines containing vitamins A and D are distributed free by health centers. These drops contain the vitamins in such high concentrations that giving the child one dose every month ensures the maintenance of adequate levels of the vitamins in the body to satisfy the requirements of the child.
It must be understood that all these treatments are a sort of ‘first-aid’ treatments. As hinted already, in case these treatments are not found effective the doctor must be consulted.