Symptoms to watch for

Food allergy symptoms can vary widely but typically include:

• Mild to moderate reactions: Hives, minor swelling, and itching or tingling around the mouth, digestive issues, such as stomach pain and vomiting. Small children may become floppy and/or pale.
• Severe reactions: Anaphylaxis may involve difficulty breathing, cough, hoarseness, tightness in the throat, tongue swelling, dizziness, a sudden drop in blood pressure and collapse.

How should parents approach exposure to allergenic foods?

Introducing allergenic foods early, around six months of age BUT not before four months, may prevent the development of food allergies. It’s important to introduce allergenic foods like peanut butter or cooked egg gradually and continue to include them regularly if no adverse reactions occur.

In the past, some people thought it might be better to hold off on allergenic foods even longer- till after 12 months of age- but this is not a recommended approach, as it may actually increase the risk of developing allergies. Parents are advised NOT to avoid exposing their kids to potentially allergenic foods between 6 and 12 months of age, unless there is already known evidence of an allergy.

What does a hernia look like?

The main symptom of an inguinal hernia is the lump or bulge in the groin. These can be painless, intermittently sore or severely painful depending on triggers and size.

The hernia can also cause discomfort in the scrotum or feel like a nag in the tummy or hip. Sometimes men describe a dragging sensation in the pelvis.

You can have an inguinal hernia on one or both sides.

Most hernias are mildly uncomfortable but in extreme cases, they can twist and cause severe pain which is a medical emergency. In this instance, you need an operation to untwist the hernia and you must call 000 or go to a hospital urgently.

What causes a hernia?

Indirect inguinal hernias are caused by an anatomical defect from birth. Nothing can be done to prevent this.

Sometimes, there is no obvious cause or trigger for inguinal hernias. As you age, other triggers for inguinal hernias include anything that increases pressure in your abdomen, such as:

• Obesity
• Heavy lifting
• Chronic cough
• Chronic constipation

How is Phimosis managed?

 A swab to check for infections may be performed by a doctor, and less commonly a skin biopsy if an autoimmune condition or cancer is suspected.

In those with no underlying cause for their phimosis ( i.e. it has just persisted from childhood and there is no recurrent infection or autoimmune condition) treatment involves a trial of steroid cream to loosen the foreskin, good genital hygiene. In those whose foreskins still don’t retract past the glans, surgical treatment (a circumcision) may be offered.

Phimosis is a common condition, and the prognosis is generally excellent for people who don’t delay seeking help from their doctor.

How to treat Head Lice

There are two main options- wet combing and chemical treatments:

Wet combing to treat Head Lice

This is similar to the wet combing technique used to check for Head Lice. It may be a preferred option in certain situations where chemical treatment is not suitable- e.g. in babies, pregnant women or people with sensitive skin or allergies.

• As described above, apply conditioner liberally to dry hair, covering the scalp and hair from root to tip, then untangle the hair with a wide-toothed comb.
• Draw a fine-toothed comb through each section of hair from the roots to tips, wiping the comb onto a tissue to check for lice or eggs at the end of each stroke.
• Each section of hair should be combed through at least 5 times.
• The amount of time involved will depend on how long and thick the person’s hair is.
• After combing, wash the hair as normal.
• Scrub the comb clean with an old toothbrush, to remove eggs and lice.
• If head lice are found during wet combing, the above steps should be repeated every 2 days until no lice are found for 10 days.

Chemical treatments

• Various chemical treatments are available without prescription from pharmacies.
• Some treatments are not suitable for certain groups, such as children under the age of 2, people with sensitive skin, or women who are pregnant or breastfeeding. Your pharmacist can advise you on the best option for you.
• It may be necessary to treat a second time, after a week, because eggs are not always killed by the first treatment.
• If lice are still present after a second treatment, another product should be tried, or wet combing.

If neither wet combing nor chemical treatments work, speak to a doctor- sometimes oral medication can be prescribed, in difficult cases.

Further Patient Resources

betterhealth.vic.gov.au

sahealth.sa.gov.au

What are the complications of Measles?

Measles is a severe illness with many potential complications.

• Otitis Media (Middle Ear Infection) affects about 9% of people
• Diarrhoea (in 8% of cases, particularly younger children) and vomiting
• Respiratory infections. Pneumonia occurs in 6% of cases.
• 1 in 1000 of people who get Measles will get Encephalitis (inflammation of the brain), which leads to death in 10 to 15% of cases. People who survive Measles Encephalitis often suffer permanent brain damage.
• A late complication of Measles is Subacute Sclerosing Panencephalitis (SSPE). On average, this starts about 7 years after a person recovers from Measles. It is an incurable degenerative brain condition that leads to death.
• Pregnant woman who get Measles are at higher risk of miscarriage or premature labour, but it does not lead to congenital malformations in the baby.

Complications of Measles tend to be worse in children under the age of 5. They are also more severe in adults and in people who have chronic health conditions or a weakened immune system.

Can you die from Measles?

Yes, several of the complications caused by Measles can lead to death- including Pneumonia, Encephalitis and Subacute Sclerosing Panencephalitis (SSPE). Pneumonia is the most common cause of death from Measles, accounting for 60% of fatalities.

How is Measles diagnosed?

Measles is diagnosed by history and examination. Swabs and a blood test may also be performed.

What is the treatment for Measles?

There is no specific treatment for Measles. Rest, fluids and pain relief are usually advised, as well as avoiding other people for 4 days after the rash starts.

How is Measles prevented?

• The risk of getting Measles is reduced dramatically by being immunised.
• All children are offered 2 doses of the MMR vaccine in early childhood, under the Australian National Immunisation Program.
• The Measles vaccine is combined with vaccination against Mumps and Rubella at 12 months and Mumps, Rubella and Chicken Pox at 18 months.
• However, children under 18 months travelling to high risk places or living in areas where outbreaks occur may be able to get earlier vaccination, starting at 6 months.
• People born before 1966 tend to have natural immunity, but it is now recommended that anyone born during or after 1966 who is not immune to Measles should get 2 doses of the MMR vaccine.

Who should get the Measles vaccine?

Measles immunisation is recommended for:

• children aged 12 months and 18 months (free under the National Immuniation Program)
• anyone born during or since 1966 who has not had 2 doses of the measles vaccine
• healthcare workers, people working in early childhood education & childcare, long-term care or other residential facilities (if they have not had 2 doses of the MMR vaccine)
• people who are travelling overseas (if they have not previously had 2 doses of the vaccine)
• People under 20 years old, refugees and other humanitarian entrants of any age, can also receive vaccination against Measles for free under the National Immunisation Program, if they have not previously been vaccinated.

What should you do if you think you have Measles?

If you or a family member, are showing symptoms of Measles, it is important to seek medical advice. It is best to contact your local GP or hospital in advance of attendance, as they may wish to quarantine you from other patients, to prevent spread.

Article Resources

https://health.gov.au

How is a UTI diagnosed?

• Your doctor may suspect a UTI based on your child’s symptoms
• They may perform a dipstick test on your child’s urine, and a sample may be sent to the lab for further tests.
• Sometimes an ultrasound scan of the urinary tract may be advised, particularly if a child has had several UTIs.

Why do children get UTIs?

A UTI is usually caused by bacteria getting into the urinary tract through the urethra (the tube where pee comes out), which can then spread into the bladder and further up into the kidneys. These bugs most often come from the bowel or from traces of poo on the skin. Children in nappies may be more prone to this.

Less commonly, a child may have an underlying medical condition that leads to UTIs (such as urinary reflux, also known as vesicoureteric reflux). If a child gets repeated UTIs, your doctor may recommend tests, such as an ultrasound scan of the urinary tract. They may also refer your child to see a paediatrician.

When should you bring your child to the doctor?

You should bring your child to the doctor if you think they have a UTI or if they have a fever with no obvious cause. As mentioned above, any baby or younger child who is generally unwell, off their feeds, irritable or sleepy should be seen by a doctor, as it could be a UTI or some other underlying infection.

What is the treatment for UTI in children?

A course of oral antibiotics will clear infection in most cases. More severe infection may require antibiotics through an intravenous drip.

Read more about UTIs in kids at the RCH website, or speak to your GP if you have any concerns.

Further Patient Resources

Urinary Tract Infection (UTI) rch.org.au

Article Resources

Desai D, Gilbert B, MacBride C. (2016). Paediatric Urinary Tract Infections: Diagnosis and Treatment

Larcombe J. (1999) Urinary Tract Infection in Children

Robinson J, Finlay J, Lang M, Bortolussi R. (2014). Urinary Tract Infections in infants and children: Diagnosis and Management

What else could it be?

GORD (acid reflux), lactose intolerance or cow’s milk protein intolerance can sometimes cause babies to be unsettled during or after feeds, but the pattern of symptoms tends to be different to colic. These conditions may have a clear pattern relating to feeds, and there will usually be other symptoms such as diarrhoea, constipation, flatulence, poor weight gain or vomiting.

What is the best treatment for colic?

At first, it’s important to see your doctor at make sure nothing else is wrong.

If the baby is diagnosed with colic, some techniques may help, such as

• Holding or gently rocking baby, applying gentle pressure to their tummy
• Wrapping them snugly in a blanket or sling
• Rule out anything else that might be bothering them- a nappy change or a feed may help
• Taking them for a walk in a pram
• Staying calm, speaking or singing softly may soothe the baby
• Offering baby a pacifier/dummy to suck
• A warm bath
• Establishing a regular daily feeding and sleep routine may help
• Baby massage
• Maintaining calm quiet surroundings, with soft low lighting in the room

It’s also very important for parents to get enough rest themselves, as the situation can become quite stressful and exhausting- and remembering to ask for support of family and friends if you’re struggling with a colicky baby. It’s worth checking in with your local maternal child health nurse, who will be able to advise about feeding and settling techniques. They may also be able to advise you about helpful local resources for parents. And obviously, speak to your doctor to make sure nothing more serious is underlying.

Things that don’t work for colic

• “Gripe water” is often sold in pharmacies but has no medical basis and is not recommended by doctors.
• There is no benefit in changing a breastfeeding mother’s diet
• Treatments by chiropractors or other alternative practitioners do not help

How is Bronchiolitis diagnosed?

• A doctor can usually make the diagnosis based on the typical symptoms of Bronchiolitis
• On examination, the chest will often sound generally wheezy and crackly
• If the baby seems breathless, oxygen levels may be checked by placing a probe on their foot or hand.
• Quite often, despite the cough and wheeze, a baby will still be happy and active
• Investigations such as a chest Xray, nasal swabs or blood tests are not usually recommended, but may be done if there is doubt over the diagnosis

What is the treatment for Bronchiolitis?

• Once the diagnosis is made, most babies with bronchiolitis can be managed at home
• If a baby is getting tired or fussy during feeds, it may help to give smaller, more frequent breast or bottle feeds- keeping them well hydrated is a priority.
• Paracetamol can be given for fever, according to age and weight.
• The baby should not be exposed to smoking
• Some parents use saline nasal drops to clear mucus from the nose just before feeds
• Antibiotics do not make Bronchiolitis better, as it is a viral condition
• There is no evidence than humidifiers or vaporisers make any difference
• Although the symptoms of bronchiolitis can seem a bit like asthma, asthma inhalers and oral steroids do NOT work for this condition.

When should you see a doctor?

• If you think your baby has symptoms of Bronchiolitis they should be assessed as soon as possible by a doctor- particularly if they were premature, are less than 12 weeks old, or have any underlying heart or lung conditions.
• It’s important to make sure it’s nothing more serious, such as pneumonia.
• If it is Bronchiolitis, and there are no signs of serious illness, your doctor will usually advise you how to care for your child at home and what to look out for.
• However, sometimes babies with Bronchiolitis need to be admitted to hospital for extra oxygen, fluids and observation until they get better.
• If the following symptoms arise at any stage, you should seek urgent medical advice- attend your nearest emergency department/medical centre:
  • Persistent high fevers
  • Rapid breathing
  • Dehydration (poor fluid intake e.g taking less than half usual feeds, dry nappies)
  • Worsening irritability
  • Lethargy or floppiness
  • Looking pale and unwell
  • Any unexplained or unexpected symptoms

• If at any point, your baby is struggling to breathe, is floppy or limp, their lips look blue, or they seem generally very unwell, you should call an ambulance.
• In rare cases, babies need to be intubated ( a tube passed into the airways to help them to breathe)

What are the complications of Chicken Pox?

• Scarring can occur if lesions are very inflamed or are scratched a lot
• The blisters can become infected with bacteria- leading to weeping sores, crusts and/or cellulitis
• Viral pneumonia
• Viral encephalitis (infection of the brain)
• Bleeding disorders can rarely occur
• In rare cases, death can occur

Who should get the Chicken Pox Vaccine?

• The Chicken Pox vaccine is recommended for children as part of routine childhood vaccination
• If a child has missed the vaccine they can get it later, though after the age of 14 two shots (at least a month apart) are required to get an adequate immune response
• If you are not immune to Chicken Pox and someone in your household or close contacts is immunocompromised (a significantly suppressed immune system due to certain illnesses or treatments- see below)
• However, the Chicken Pox vaccine is not safe for everyone – see below

Who should not get the Chicken Pox Vaccine?

As the Chicken Pox Vaccine is “live”, it should not be given to certain people as it may cause harm/ severe infection

• Pregnant women and women who intend to become pregnant within the next month
• People who are immunocompromised (a weakened immune system)- for example, due to chemotherapy, immunosuppressant medication for organ transplant, some cancers, long term steroid treatment, radiation treatment, HIV infection etc. This should be discussed with your doctor, as the advice may vary depend on individual factors.
• Anaphylaxis (severe allergy) to any ingredients in the vaccine
• If unsure, seek medical advice