Treating Baby or Young Child With a Cold

What can parents do when their babies and young children have a cold? It depends on the child’s age.

Although most colds in children don’t have serious complications, they can cause great worry to caregivers, and are among the top reasons for visiting a doctor. FDA doesn’t recommend over-the-counter (OTC) cold and cough medicines for children younger than 2. For infants and children younger than 2, those medicines may have serious and potentially life-threatening side effects.

So what’s a worried parent to do? Here are some tips from FDA on how to safely treat your child’s cold.

Relieving Cold Symptoms

There’s no cure for the common cold, a viral infection that cannot be treated with antibiotics, says FDA’s pediatrician Amy M. Taylor, M.D., M.H.S.

“A cold is self-limited, and patients will get better on their own in a week or two without any need for medications. For older children, some OTC medicines can help relieve the symptoms—but won’t change the natural course of the cold or make it go away faster,” says Taylor, a medical officer in FDA’s Division of Pediatric and Maternal Health.

Coughs are a normal symptom of a cold and aren’t all bad. “Coughs help the body clear the mucus out of the airway and protect the lungs; so you don’t want to suppress all coughs,” Taylor says.

Non-drug treatments for coughs include drinking plenty of fluids, especially warm drinks to soothe the throat.

When to Call a Doctor

Not every sniffle or cough merits a trip to the doctor’s office. When in doubt, parents should call their healthcare provider. “Call your pediatrician at the first sign of illness whenever a baby 3 months or younger is sick,” Taylor advises.

For all children, call a doctor if you see any of these symptoms:

• A fever in an infant 2 months or younger.
• A fever of 102 or higher at any age.
• Signs of labored breathing, including nostrils widening with each breath, wheezing, fast breathing, the ribs showing with each breath.
• Blue lips.
• Not eating or drinking, with signs of dehydration.
• Ear pain.
• Excessive crankiness or sleepiness.
• If the cough lasts for more than three weeks.
• If the child is getting worse.

Those symptoms can signal that your child has something more serious than a cold.

“You have to know your child,” Taylor says. “With small infants, fever is a major concern, and you need medical advice. If you are worried about your child’s symptoms, at any age, call your pediatrician for advice.”

What About Fevers?

Fever helps the body fight off an infection and does not always need to be treated. But if your child is uncomfortable because of fever or other symptoms of a cold, there are alternatives to cough and cold medicine to help them feel more comfortable. Taylor says they include the following actions:

• Using a clean cool-mist vaporizer or humidifier in a small area near the child’s bed may help moisten the air and decrease the drying of the nasal passages and throat.
• For infants with a stuffy nose, use saline or salt water drops/spray to moisten the nasal passages and loosen the mucus. Then clean the nose with a bulb syringe.
• Acetaminophen or ibuprofen can be used to reduce fever, aches and pains. Take care to use the correct dose. FDA recently published new manufacturing and labeling recommendations for acetaminophen-containing medications used to treat colds, fevers
• and headaches in children.

Giving the Right Dose

“We found that parents often can make errors with liquid medications. It’s often difficult for them to correctly measure liquid medications because they don’t understand what a milliliter is or may be confused about the difference between a teaspoon and a tablespoon,” Taylor says.

How can parents be sure to give the correct dose to their children? Follow the directions on the “Drug Facts”label. FDA encourages drug manufacturers to provide a dosing instrument, such as a syringe or a cup, marked with the correct measurements. Use them—and not household spoons—to measure medication.

”If you have questions or need advice, do ask the pharmacist,” Taylor adds. “She or he can tell you which dosing instrument to use, how much medication to give and how often.”

In the United States, adults have on average about three colds per year, and children have them even more often. Caregivers might be tempted to give children pain relievers, decongestants and other medications for a cold. But often it’s best to fight this common childhood illness with rest and care.

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• OTC Cough and Cold Products: Not For Infants and Children Under 2 Years of Age

Potential Vaccine against early Childhood Pneumonia and Bronchiolitis

An experimental vaccine to protect against respiratory syncytial virus (RSV), a leading cause of illness and hospitalization among very young children, elicited high levels of RSV-specific antibodies when tested in animals, according to a report in the journal Science.

Early-stage human clinical trials of the candidate vaccine are planned. The scientist built on their previous findings about the structure of a critical viral protein to design the vaccine. The team was led by Peter D. Kwong, Ph.D., and Barney S. Graham, M.D., Ph.D.

The respiratory syncytial virus (RSV) is responsible for a common chidhood illness. There is no vaccine available to prevent RSV infection.

In the United States, RSV infection is the most common cause of bronchiolitis (inflammation of small airways in the lungs) and pneumonia in children less than one year old and the most common cause for hospitalization in children under five. Worldwide, it is estimated that RSV is responsible for nearly 7 percent of deaths in babies aged 1 month to 1 year; only malaria kills more children in this age group. Others at risk for severe disease following RSV infection include adults over age 65 and those with compromised immune systems.

“Many common diseases of childhood are now vaccine-preventable, but a vaccine against RSV infection has eluded us for decades,” said NIAID Director Anthony S. Fauci, M.D. “This work marks a major step forward. Not only does the experimental vaccine developed by our scientists elicit strong RSV-neutralizing activity in animals, but, more broadly, this technique of using structural information to inform vaccine design is being applied to other viral diseases, including HIV/AIDS.”

Viruses are made of proteins.For a vaccine to work there need to be a protein that is the same shape as the virus but will not cause illness. When The immune system comes in contact with the vaccine it learns to attack this protein. That way your immune system will attack the virus when it comes in concact with them.

“Here is a case in which information gained from structural biology has provided the insight needed to solve an immunological puzzle and apply the findings to address a real-world public health problem,” said Dr. Graham. He and the VRC scientists are continuing to refine the engineered F glycoproteins and hope to launch early-stage human clinical trials of a candidate RSV vaccine as soon as clinical grade material can be manufactured, a process that takes about 18 to 24 months.

“Previously, structure-based vaccine design held promise at a conceptual level,” said Dr. Kwong. “This advance delivers on that promise and sets the stage for similar applications of structure-guided design to effective vaccines against other pathogens.”

Dr. Fauci added, “This latest advance underscores the advantages of the VRC’s organizational design, where experts in RSV virology, vaccinology and clinical studies, such as Dr. Graham, are in daily contact with Dr. Kwong and others who are experts in structural biology. Such close collaboration across disciplines allows for rapid testing of new approaches to a given problem.”

Source NIH

India Works to End Childhood Malnutrition

Close to 1.3 million children die every year in India because of malnutrition, according to the World Health Organization (WHO). Ninety nine per cent of all under-five deaths occur in developing countries, with the most common causes of death being pneumonia, diarrhoea and malaria. These are illnesses to which children are particularly vulnerable, especially when they are malnourished, a condition that weakens their immune systems. Malnutrition contributes to more than a third of all child deaths.

Worldwide, over 100 million children are underweight. While it is a serious problem in sub-Saharan Africa, even higher rates of stunting are found in South Asia, particularly in India. Along with Nepal and Bangladesh, India has the world’s highest rate of malnutrition.

One way to fix the problem is to teach mothers about the right nutrition for their children or to incentivize them through conditional cash transfers. Distributing information is an important part of a solution, although it does not always lead to behavioural changes. Mothers are advised that when their child has diarrhoea they should increase their child’s fluid intake and continue to feed them normally. According to the National Family Health Survey (NFHS) -3, nine out of 10 mothers do not follow this recommendation. In fact, four out of 10 mothers actually reduce their child’s fluid intake.

Medical solutions to the problem of malnutrition include deworming and nutritional supplements. De-worming campaigns are quite effective and have been conducted in many day care centres and health encampments. The treatment has been especially popular in Kenya and other parts of Africa, and now in India, the practice has become compulsory in all schools. Popularly used nutritional supplements include vitamin A, zinc, iron, and various minerals. In addition, iodised salt has been a popular weapon of the government of India as it continues to try and promote its consumption over normal salt.

There is also a behavioural approach that attempts to alter the behaviour of mothers and workers who interact with the child. This includes giving children the right type and amount of nutrition. They  try to change behaviour towards calorific food and encourage the consumption of a variety of foods.

About 50,000 people live In the slums that surround the city limits of Chandigarh. Less than 5% of the houses have working water filters. At the same time, however, 70% of the households own mobile phones. The people living in these slums are typically migrants from rural areas where wages are extremely low. The mothers in this treatment group are women who send their children to daycare centres in the slums.

India is home to the world’s largest child care programme. There are currently over one million of these day care centres run by the government across India. Each day care centre serves around 30 children on an average. The children go to the centre every morning at 9am and are fed their midday meals by daycare workers. The workers are given training on child health and nutrition when they are hired by the government.

Another aspect of the daycare workers’ responsibilities is to visit and communicate with the mothers whose children attend the centre, giving them advice on how to keep their children healthy. The daycare centres offer two potential channels by which to help children living in the slums. The first is by the distribution of the midday meal and the second is by providing information and counsel to the mothers. However, a World Bank report finds leakages in the provision of meals and almost no effective communication between workers and mothers. A total of 145 daycare centres were sampled for this study.

The experiment tackles the question of whether it is the lack of information on nutrition given to mothers, or the lack of child care worker motivation that makes child malnutrition persist. The total children weighed twice (before and after an intervention. There were 4,101 children with around 1,000 in each one of three treatment groups (subject to an intervention) and a control group (not subject to any intervention). In the first treatment group, mothers receive recipe books written in Hindi. As around half of these mothers cannot read, the information is also distributed to other family members, including fathers, older sons and daughters. Government workers may also assist by reading and sharing information from the recipe book. The recipe book is designed with the help of a local nutritionist and contains 10 recipes, which provide an array of vitamins and minerals as well as sufficient calories.

In the second treatment group The child care workers were provide incentives to perform better. They are paid bonuses of Rs.100 for each child whose weight they successfully increase so that he or she is no longer classified as malnourished after three months. For each child under their care, the workers are given a goal card with the weight at which the child will no longer be considered malnourished. If a child at a normal weight becomes malnourished, however, I subtract Rs.100 from the total. This motivates the worker to make the necessary household visits.

To test how the two types of treatments interact, the informational and incentives treatments are combined in the third group. Complementarity may exist if incentivized workers are able to be more effective with nutritional information available to the mother. On the other hand, one of the two treatments may be sufficient for improving weight. A separate set of centres form the control group where no intervention is assigned.

Results show that malnutrition is reduced significantly in three months for children in the combined treatment group by 4.2% but there are negligible effects in the individual treatment groups. The combined treatment effect persists for a year even after the incentives are removed after three months. One estimate suggests that the country gains Rs.20 for every rupee spent on the combined treatment in terms of increase in future wages for these children due to an improvement in health and attendance.

Policy recommendations should be based on evidence from experiments and that increasing fixed wages to child care workers will not solve the problem. Similarly, offering performance pay is likely to be ineffective unless mothers have nutritional information available to them. Not only does this empower them, but it also facilitates communication between mothers and workers which enables a behavioural change to occur. Mothers receiving the combined treatment feed their children more protein and calories. A small push is required on both the demand side as well as the supply side to target child malnutrition in India. Further experimentation in development economics can bring us closer to understanding how this serious problem can be fixed efficiently and permanently.

 

Source Hindu Times