Do you know what a healthy child is ?
The Healthy Child
Being healthy is more than being free from physical disease it includes
TO UNDERSTAND A SICK CHILD WE MUST FIRST KNOW THE HEALTHY CHILD.
Children all have a similar development rate e.g. the age that they first smile sit up, walk etc. These are called Milestones or development guides , and although variations do occur this is a guide line to normal infant development skills.
Remember children learn by example. Be happy, calm, clean and loving to the very best of your abilities.
A healthy, well balanced diet should be given.
Routine is important.
Hygiene procedures should always be strictly followed.
Keep baby away from harm.
Cuddles, love and play help the baby to develop his skills, feel secure, loved and help you both bond together
As you spend so much more time with your babies you can spot many abnormalities that the Doctor can miss during their examinations. While caring for, bathing, playing with your child observe closely and learn what is the normal look and behaviour to them,
Healthy skin is warm not too hot on touching. Healthy pink/brown (depending on ethnic background) any blueness or yellowing to be reported. In very dark skinned children pay attention to his nails and inside his mouth for colour observation.
Skin should have a nice layer of fatty tissue. It should be silky smooth, rash free, springy to touch with no offensive odours, dry areas or soreness. Check bottom and groins at each nappy change as nappy rash can cause an infant to become sore and miserable. It can be easily treated with the correct creams and cleaning procedures.
Nipples in new born babies (both boys and girls) can be swollen and discharge a milky fluid. This is because the baby has absorbed the milk producing hormone (chemical) from his mother’s bloodstream while in the womb; it is harmless and will soon pass.
Do not squeeze just wash/dry them as you would the rest of his body. Female babies can also have a small bleed from their vaginas due to the same absorption of hormone. This too is harmless and will soon pass just observe genital hygiene as normal. Umbilical site (belly button) should not be sticky, red, smelly or inflamed.
HAIR AND NAILS
Hair should be glossy, clean, free growing, bouncy and contain no sores or parasites . Hair roots should not be swollen or inflamed. Finger /toe nails should be pink and nails short and clean. Nails should be trimmed while infant is sleeping.
Any dirt under nails should be not scraped out; it can be removed by soaking during bath time. Ensure that there is no debris or soreness between fingers and toes or under nails. Joints should not be hot or swollen and the Infant should be able to wriggle fingers, toes and clutch toys etc without it causing pain and discomfort.
Well formed lobes, pink, with no discharges, soreness or debris in or behind. Even tiny infants will respond to noises. Never poke around in children’s ears with cotton buds. If a normal hearing toddler suddenly appears to ignoring you, rubs his ears frequently or rocks his head side to side report to paediatrician. This could be a sign of an ear infection .
Eyes should be alert, bright and shiny with no mucous or discharge. Whites of eyes should be sparkling with no yellow tinges. The very middle of eyes are called pupils (the black centre) and they will contract (shrink) when turned to bright sunlight. This is to protect them from allowing too much light in which can damage the delicate inside of the eyeball. In dim or dark lighting they will increase in size to allow more light in.
Have a look at each others eyes to see how they change in the light.They should be of even size.
To a trained eye different sizing of these pupils can show injuries or problems inside the head especially following an accident, so be aware of your infant’s eyes. Eyelashes are around eyes to collect dust and dirt from entering the eye. (This is why camels have such long sweeping lashes; it is to protect the eyes from desert sand) Lashes should be clean with no crusty pieces attached to them and have no swelling or infected hair roots.
As baby develops he will take a greater interest in you and his surroundings. Look and see – is he as aware as other babies of the same age? Does he respond to your voice? Is he happy and smiling? Does he just stare blankly in to space for long periods? Does he averts his eyes and will not look directly at you or people? If these things occur you should check with your Paediatrician as these can be the first signs of some deeper problem.
MOUTH AND GUMS
Pink, moist, clear with no white patches or blisters. Roof of the baby’s mouth should be whole and intact. Breath should be sweet smelling, moist and comparable to body temperature. Blue tinges to lips and gums should be reported. Look inside of your infant’s throat while he’s crying to learn how it normally looks. Any redness and swelling or abnormalities can then be easily detected if infection or damage occurs.
Babies are natural nose breathers. Passages in nostrils are lined with a sticky, wet, mucous producing layer and fine hair. This is to trap dust and microbes and prevent them from being inhaled. These passages are self cleaning. A sneeze is a natural reflex designed by nature to this job. If baby nose becomes too blocked sometimes steam from a warm bath is all that is needed to clear it. Drops can be prescribed to clear if very congested.
Noses can discharge or bleed. The common cold accounts for most watery discharges.
Nose bleeds can be caused by trauma, picking, inserting a foreign object or a blood disorder. Chronic persistent discharge can be caused by an inflammation or an allergy. All children will snore occasionally but if it is loud and excessive it could be the sign of a medical problem.
Children’s appetite we know varies as much as an adult. Some are picky eaters and can become thin and difficult to keep well nourished while others will eat everything in sight and tend to become chubby. So therefore diets should be tailored to an individual child’s needs as much as conditions will allow.
Food should always be prepared to the highest safety and hygiene standards .It should be nourishing and varied. Food consistency adjusted according to age requirement. Temperature should be as warm or cool as type of food decrees. Nobody likes a cold ‘‘hot’’ dinner or warm ice cream do they?
Just be aware of how much your infant eats and drinks.
Is his swallowing reflex good?
Is he taking an adequate amount for his age and size?
Does he have pain, vomit or retch during or after feeding?
Does he become breathless at any point?
Is he not sucking well?
Is he fighting the spoon away from his mouth?
Look inside his mouth to see if there is an obvious problem such as teething problems or sore mouth etc. Check that food/milk is of the right temperature and taste.
NEVER force feed a child, if you are having problems then discuss with a senior member of staff and a feeding regime/pattern that is suitable can be arranged and the child checked to find if there is any underlying problem causing them not to eat.
Remember that eating together is an enjoyable social pastime as well as a physical requirement so do your best to make every mealtime a relaxed, happy, pleasant event.
A lot of people think that babies shouldn’t cry. They think that if babies do cry there must always be a reason, but all babies cry and some cry a lot for no apparent reason. Crying is the main means of communication. Usually this is in response to hunger, thirst or pain but some babies even after feeding and changing will still cry without obvious reason and are difficult to pacify. Boredom and feeling insecure even in very young infants can be the cause. You can try rocking and swaying gently. Softly singing and talking. Finding things to look at or listen too such as the radio or a rattle or a mobile above the cot. Stroking rhythmically or massaging gently and firmly will sometimes do the trick. Make sure that infant is not too hot or cold has nothing on or near his body causing discomfort. Sometimes just a kiss and cuddle is all that’s needed.
Knowing your infant’s particular times of crying and pitch is a good indicator of something amiss. Many infants suffer from colic (type of stomach cramps) at certain times of day.
Ask yourself, is baby feeling ill? Is this crying more high pitched then his normal cry? Have I done my best to make them comfortable and is there anything I can do to do to ease his pain?
Is there any other change in your infant such as loss of appetite, diarrhoea, vomiting, feeling hotter etc?
Any variation from his normal pattern should be reported
NEVER become angry with a crying infant.
NEVER shake a child. Shaking causes a baby or infants head to move violently and can cause bleeding and damage to his brain. If you feel frustrated and angry and think you are losing control just place your infant safely in his cot and go and calm yourself down.
Be patient with your baby and yourself. DON’T BE ASHAMED IN ASKING FOR HELP! Nobody can cope alone with a constantly crying child.
Babies and toddlers breathe at a much faster rate than older children or adults, as much as 35 breaths a minute in newborn babies. It is always a natural non distress causing procedure. it is quiet and effortless. Breaths are moist and not foul smelling. Skin remains warm and pink. Occasional coughing to clear throat or airways is a natural reflex.
Report to doctor if any signs of wheezing, gurgling noises from chest occur, frequent coughing especially if harsh or noisy. Look at any mucous that is coughed up. Is there lots of it? Is it discoloured? Green, blood stained? Listen and watch!
Note if infant comes into contact with anything that alters his breathing pattern. Does he become breathless after eating or drinking certain food items? Or after contact with dust or certain toys?
Does his skin colour change unnaturally after playing and running, does he become pale, faint or blue and has his breathing pattern altered? All these observations if they occur and are reported are a good indicator to the Doctor of what is wrong with your infant and a quick diagnosis can be made and treatment given promptly.
FONTANELLES (SOFT SPOT)
These are gaps in the bony plates of the skull that can slide over each other during childbirth so prevent the skull from becoming crushed while passing down the tight birth canal. There are two sites in a newborn. One is at the back of the head (this closes at 6-8 weeks) and the one more visible on the top of the head (this closes at 9-18 months).
They slowly fuse together as the healthy child develops and are totally fused together by adulthood, in a normal infant they are slightly hollowed and gently pulsating in time with the infant’s heart rate.
These are a good indication of health. During dehydration they become deep and sunken. In some illnesses they can become swollen and bulging. Although more delicate they are still covered with a tough membrane and are quite able to withstand normal activities of hair washing and brushing.
Should be clear with a good pale, golden colour containing no debris, be fresh smelling
(except for ammonia development in unchanged nappy), cause no discomfort, have a nice even flow while being passed and there should be PLENTY of it..!
See Doctor if urine decreases in amount passed, becomes dark, smoky or pink in colour or if infant shows signs of swelling of feet, legs and face.
Depending on Childs age and diet stools should be soft, formed easily passed with no pain or discomfort .Observe frequency, colour and texture.(Remembering that food/drink ingested can discolour or alter texture stools e.g. Beetroot/food dyes makes stool/urine discoloured. Some foods such as beans and vegetables can pass through gut undigested.)
See doctor for any abnormal stools e. g. Diarrhoea, worms, foul smelling, green frothy stools containing blood, mucous, redcurrant jelly like mucous, black tarry or any that are pale or greasy. Immediate help is required if child is in pain, distressed and showing signs of dehydration or becomes pale, weak and lethargic. Remember the history of the previous days. What has he eaten? Has the child had an accident? Nose bleeds or injuries to the mouth that have caused bleeding will make the faeces black, smelly and sticky.
Vomiting is usually without distress but if your baby is vomiting often or violently and/or there are other signs of illness/pain contact the Doctor straight away. Babies can lose a dangerous amount of fluid if he is sick often, especially if he has diarrhea as well.If vomiting continues and/or there are any other signs of illness/pain again report this. Observe vomit material that it contains no blood, is not black or green or contains any thing abnormal e.g. tablets, small items that may have been swallowed. Keep vomit specimen in clean, well wrapped container to show to Doctor if in any doubt.
GENITALS (PRIVATE PARTS)
In boys any swelling, hardness or tenderness of testicles or swelling in groin area. Especially if accompanied by vomiting or a high temperature. Observe that they have no problems passing urine.
If he has been newly circumcised, look for signs of bleeding or infection. See doctor if discharge becomes yellow, has an offensive odour or if excessive swelling or discoloration occurs.
In little girls do not be afraid to clean thoroughly in all her creases .You will not damage her as long as you are gentle and clean her as you are taught. When cleaning, wipe bottom from front to back to prevent stools from being smeared into her vagina. Leaving this area unwashed can cause infections and discomfort. Vaginal discharge can occur in very small babies. Just report to any thing that appears out of normal to the Paediatrician and save any soiled nappies or pants for her to see.
Watching your baby quietly while they are at rest and play is a good observation technique. Observe how they move and do little tasks. Watch how they walk, play, talk and move. See how they react to other adults and children. Observe their new social and development skills. Compare them to other children of their own age. This is a good guide to normal behavioural patterns, not an exact guide as all children are individuals but variations are not too vast.
Know his body and gently feel his bones and muscles during massage and bathing. Remember if a limb or body part looks odd then compare it to the opposite limb or part. Feel if any joints or parts are hot and swollen. Note any lumps or swellings that may occur in his neck, under his arms, in his groin or abdomen. Any odd jerking movements he may have or unexplained bruising. Pain on touching or movement. Report to doctor if anything out of the ordinary.
We know that an accident can happen to any child even while being carefully watched. Children move so quickly and take only seconds to get into mischief. This is understandable what is not understandable or acceptable is when an accident has occurred and it is NOT reported a doctor .This means that the infant can be left in pain while his injury could become worse.
SUMMARY OF A HEALTHY CHILD
The perfect, healthy child eats well, plays hard, is sweet, loving and is never ill or naughty- but that is a storybook child- not a normal child….!
A healthy child’s body and mind develops at the rate that is usual and expected of his age group. He should be free from disease, strong as he can be and happy and contented as we would like ourselves to be. To achieve these things he needs your help. Good nourishing food, fresh air and exercise, a happy, clean, safe environment to live in, expert medical care, mental stimulation and lots of playtime, patience and love.
Respect your child as an individual human being. Your child is unique with his own little ways (good or bad), living habits, and health problems (if there are any) this is what makes him who he is and what he will become. Have fun together. Praise and enjoy his/her little achievements, don’t criticize or compare him/her unfavourable to other children. Help them to become confident, happy children. With your love, patience and guidance despite having such an unfortunate start to his/her life they can grow to become responsible, well adjusted adults. What an achievement for you!
So always be observant. Look, listen and learn how his/her little mind and body function. Know his/her routine with all its faults and problems. It is when they differ from their own normal, little style of living, eating or usual routine, play or behaves differently that you know something is wrong. Know them well.