Health

Your baby receives an Apgar score at one minute and at 5 minutes after birth.  This score determines how doctors will treat your baby from that moment on to ensure that he gets the best medical care possible.

The higher the score out of a possible 10, the better is your baby’s general health condition. The score usually changes from the first to the second rating.  Doctors look at the following:

Appearance/ Color :

  • 0 = blue or pale
  • 1 = body is pink, limbs are blue
  • 2 = completely pink

Respiratory Effort:

  • 0 = absent
  • 1 = slow, irregular, weak cry
  • 2 = strong cry

Heart Rate:

  • 0 = absent
  • 1 = slow, less than 100
  • 2 = over 100

Muscle Tone:

  • 0 = limp
  • 1 = some bending of the limbs
  • 2 = active movement

Reflex Response to Flicking Foot:

  • 0 = absent
  • 1 = facial grimace
  • 2 = cry

A baby who scores 7 or higher on the first scoring is considered in good health. A low score however is not necessarily an indication that your baby is unhealthy, it may just indicate that he needs some immediate special care, for example suctioning. The majority of babies score 7 or higher at the 5 minute scoring.

Remember this scoring is no indication of your baby’s long term health.  It is just a tool for doctors to decide how to treat your baby.

Parents become extremely worried when a rash appears on their little one’s body. It is therefore important that parents can differentiate between the most common rashes and know when it is imperative to visit your doctor.

Rashes can often be attributed to an infection (viral or bacterial), a reaction to medicine taken or an allergic reaction.

The most common viral and bacterial causes of childhood rashes are the following:

  • Chickenpox: This rash is preceded with fever, a sore throat and fatigue. When the rash appears it is small blisters that eventually ruptures and form lesions with a crust. There is no treatment for chickenpox except medications that will alleviate the fever and extreme icthyness of the blisters.  It is important to know that no child with chickenpox should be given aspirin. A doctor should be consulted immediately if the little blisters form on the tip of your child’s nose or in their eyes.
  • Measles: Measles start with nasal congestion, red eyes, a cough, high fever and a decrease in activity and appetite.  The rash only appears 3 to 4 days after the initial symptom – it is a brown rash that starts and spreads down the body. Immunization is available against measles.
  • German Measles (Rubella): All pregnant should make sure that they are immune to the rubella virus, it can cause serious complications for an unborn baby.  In infants and older children it is not a serious illness and is usually better within 4 days. German measles starts as a pink rash on the face that spreads down the body and it is accompanied by swollen lymph nodes behind the ears and in the neck.
  • Scarlet Fever: Scarlet fever is a illness due to strep throat.  It is identified by a sore throat, fever, headache, swollen glands and sometimes abdominal pain.  The rash appears after 2 days as a superficial red rash with a sandpaper-like feel.  It usually look like the face is flushed.
  • Fifth Disease: Only about 1 out of 4 children infected by this virus will become ill and present with low grade fever, headache, sore throat, nausea and/or diarrhea, bright cheeks and sometimes sore joints.
  • Roseola Infantum: This is a disease that is most common with children under the age of two years.  It is often very upsetting to parents with small children, because the high fever can last for up to 8 days.  Children with “baby measles” have a high fever, small pink flat spots that start on their trunk and then spread to their extremities.  This will clear up without treatment, but the fever can be managed with acetaminophen. Aspirin and aspirin-like products should ALWAYS be avoided in children as it can cause a life-threatening condition called Reye’s syndrome.

If any rash causes you worry it would be better to consult your doctor. When your child have flat purple spots accompanied by high fever you should take your child to the emergency room or doctor as soon as possible to rule out the possibility of meningitis or other life-threatening diseases.

Is your child sick enough to take him to the doctor?  That is a question many of us ask ourselves, especially if you are sitting with your first babe in arms.  Years of visiting emergency rooms, pediatricians and house doctors have given me some confidence in judging when to and when not to. Please see this as a general guideline and rather trust your gut feeling then to strictly adhere to a list of indicators.

  • Fever : Most mommies become really concerned at the onset of fever. A fever shows us that the body is fighting an ailment. If the fever is more than 100.4 F in your newborn, more than 101F in your 3-6 month old or for older children more than 104F, I would definitely go and seek medical advice. A low-grade fever lasting more than 3 days indicates that it might be more than a viral infection that would clear up on it’s own. Any dramatic rise in temperature (5 degrees in an hour) merits a doctor’s visit.  I do not refer to a fever that rises four degrees over a period of 6 hours.
  • Rash: Rashes are the one thing in my experience that cause most predicaments. We all know that the presence of a rash might signal a childhood illness like measles, chickenpox, rubella or worst of all meningitis. Luckily most rashes are benign and only indicate an allergy. When a rash is painful, raised, warm to the touch, bright red/purple or spreads quickly over the whole body, it is time to visit your doctor.
  • Coughs : A persistent cough that does not clear up within two weeks needs a doctor’s inspection. Any cough or congestion that inhibits breathing is not something to wait out.
  • Colds and Flu: Cold and flu symptoms that do not respond to over-the-counter medications within 10 days, should be addressed by a doctor.
  • Focal Symptoms : When your child complains about something specific like earache, a soar throat or tight chest, I would recommend to go and visit the doctor as it might need some antibiotics. Any discharge from your child’s ear or eye should be looked at.
  • Vomiting and Diarrhea : A child who vomits and has diarrhea for more than 12 hours stands a chance to dehydrate. In a newborn dehydration can happen in less than an hour. If our child is not able to hold any fluids in it is necessary to seek medical advice. Vomiting blood is a danger sign and warrants immediate medical attention.

Other symptoms to look at include:

  • Loss of consciousness
  • Seizures
  • Terrible headaches
  • Extreme drowsiness
  • Loss of control of any body part
  • Stiff neck
  • Inability to walk normally
  • Blurred vision
  • Severe stomach pain
  • Blood or mucous in stool
  • Pus from a cut or scrape.

So what can be treated at home?  I feel that minor cut and scrapes and insect bites can be treated at home.  Mommies are more than capable to treat flu and colds at home.  Low fevers can be dealt with at home with Tylenol.

You know your child better than any doctor.  Do not feel bad for going to the doctor when you feel it is necessary and it is dismissed as nothing serious.  From personal experience I do know that in the end Mommies know best.  It might take a couple of visits to the doctor or a hospital stay to prove the point.

Mantality