Frequent Diseases In The First Years Of Life
For a parent, especially one who is in this position for the first time, the signals of child’s illness give him the creeps. Temperature, diarrhea, vomiting or skin rashes are among the first symptoms often encountered in children’s diseases up to 2 years.
Common diseases that often bring parents to the doctor with infants and young children (1-2 years) are: rotavirus infection, acute bronchiolitis and allergy to cow’s milk protein.
Bronchiolitis is an acute inflammatory disease of the lower airways, of small diameter, which are obstructed by a inflammatory processes. This disease has almost exclusively viral etiology, most commonly is involved respiratory syncytial virus. Peak incidence is close to the age of 6 months and the time of occurrence is in winter and early spring. The most common, are involved male infants, aged between 3 and 6 months.
Most often, the source of infection is represented by the family members who have a minor respiratory disease. The main causes of the disease are lack of natural food, overcrowded conditions at home and tobacco or cigarette smoke. Most affected infants have a positive history of exposure to infection through contact with older siblings or adults with minor respiratory symptoms in the week before the onset.
Initially, bronchiolitis presents signs of minor respiratory infection with serous nasal discharge and sneezing. This condition may be accompanied by loss of appetite and fever (38-39 degrees). In evolution of the disease, will appear cough, breathing faster and wheezing (whistling in expiration) – characteristic sign of this disease. Eating can become difficult due to the vigor of breath. Critical phase of the disease, in which the infant may seem to be severely affected is in the first 48-72 hours after the onset of cough and breathing difficulties. After the critical phase, there is a rapid improvement and recovery is complete within a few days.
Because is a viral disease, antibiotic therapy is not necessary. In cases of moderate and severe forms of disease, hospitalization is required, antibiotic treatment is necessary only to prevent bacterial superinfections. The baby usually feels better in a semi-sitting position at an angle of 30-40 degrees or sitting with the torso slightly raised and the head in extension. Food should not be changed, but often the fluid intake should be increased. Bronchodilator drugs (salbutamol) are frequently used in empirical aerosols and is accepted that if the therapy is improving the state, then it should be continued. Also, spray with adrenaline may be effective in bronchiolitis.
Rotavirus infection. Rotavirus is found with maximum frequency in children aged 4 to 24 months and is unusual in the neonate, because the newborn has the ability to excrete the virus without showing signs of illness. Symptoms begin with vomiting followed by four to eight days of diarrhea, which can cause dehydration. Self-limiting disease, like most viral infections, is lasting 7-14 days.
Allergy to cow’s milk protein. Between 5% and 15% of children have adverse reactions to cow’s milk protein, but the prevalence of allergy occurs in 2% to 7.5% of cases. Warning: do not confuse this condition with lactose intolerance or other adverse reactions to cow’s milk protein. The cause of allergy is a immunological reaction to one or more proteins from cow’s milk.
Allergy to cow’s milk protein presents gastrointestinal tract symptoms, such as regurgitation, vomiting and functional changes in the digestive tract, respectively dermatological symptoms such as atopic dermatitis and urticaria. Respiratory symptoms are less common.
Breastfeeding of the baby should be the only way to feed the baby, at least in the first 4 months of life. Breastfeeding significantly reduces the risk of developing an allergy to cow’s milk protein. If breastfeeding is leading to the appearance of symptoms, then the mother should eliminate from her diet cow’s milk, peanuts and eggs. This diet must be followed for at least 2 weeks after the appearance of the results, and 4 weeks if the baby has developed an atopic dermatitis or allergic colitis. If after such a diet there is an improvement in children condition, then the mother can reintroduce in her diet one food product a week. If there is no improvement after the diet, then should be considered a discussion with a specialist in children allergies.
Diagnosis begins with the infant history, complete physical examination to determine other causes of occurrence of the disease and to identify if the disease is mild, moderate or severe. Skin prick tests and radioallergosorbent testing does not confirm or refute the diagnosis of allergy to cow’s milk protein, so that elimination of cow milk from mother and children diet is the best method of diagnosis. However, serological markers may be helpful in predicting the development of the disease.
Gold standards for treatment are elimination of cow’s milk protein from mother and infant diet, then followed by its reintroduction in the diet. If symptoms recur after the dairy products are reintroduced into the mother’s diet, then is recommended extensively hydrolysed milk formula if the baby is aged between 9 and 12 months. Infants with mild or moderate symptoms should be fed, for 2-4 weeks or more, only with extensively hydrolysed formulas or amino acid formulas. In those who respond well to treatment, cow’s milk can be reintroduced in their diet, but under the supervision of a physician. In the opposite case, the child must be kept with hydrolysed formula or amino acid formula for 6 months, or more, or until it reaches the age of 9-12 months. Infants with severe symptoms should use the formula based on amino acids and must be supervised by paediatricians. Doctors warn that after a period from the elimination of cow’s milk from the diet, patients who previously had mild or moderate reactions may develop severe allergic reactions. Using the unmodified protein from milk (cow, sheep, goat etc.) or soy or rice is not recommended for infants because of the deficit of food nutrients and because it can lead to the risk of cross-allergies.