Notes from the clinic

Antibiotics do not bring fever down

Most fevers in children need no antibiotic at all. Giving one when it is not needed does more harm than good.

• Viruses cause most fevers in children.
• Antibiotics work against bacteria only. They do nothing for a viral illness.
• In a healthy child, bacteria are a rare cause of fever.
• Always ask the doctor before your child takes an antibiotic.

Fever is a friend, not a foe.

Watch: fever in children →

Breast milk is the best feed for your newborn

Every mother knows this, yet many find it difficult. The reason is almost never the mother's fault.

Usually it is not the making of milk that is the problem, but the flow. A new mother is tired and under stress. The baby wakes at night. People around her raise doubts. Our customs stop her from eating many foods. All of this works against the flow of milk.

For how long?

Only breast milk, not even water, for six months. Then continue breastfeeding alongside food until two years.

When a mother should not breastfeed

• If she is on treatment for cancer, and in some instances of mental illness or thyroid problems, but not all.
• Flat or inverted nipples can make direct feeding hard. This can be managed — please ask us.

When a baby should not feed at the breast

• A baby with true lactose intolerance.
• A very small or premature baby, until the doctor allows it. Expressed breast milk can be given until then.
• A baby with a cleft palate may need help to swallow.

Watch: breastfeeding →

Asthma cannot be cured, but it can be controlled

The body reacts to things in the air around it, and that cannot be changed. Medicines control it well over the long term.

We prescribe inhalers because the dose is much smaller and side effects are fewer. Please use the inhaler exactly as shown — the method matters as much as the medicine.

Tuberculosis in children

TB has not gone away. A child almost always catches it from an adult at home who has been coughing for weeks. Children with TB are usually not infectious to others themselves.

Bring your child in if you see

• A cough lasting more than two weeks
• Fever lasting more than two weeks
• Weight loss, or not gaining weight as expected
• Poor appetite and unusual tiredness
• A painless swelling in the neck that does not settle

TB is harder to confirm in a child than in an adult, because young children cannot bring up sputum. We go by who the child has been in contact with at home, a chest X-ray, and other tests.

It is curable

• Treatment usually runs for six months. Diagnosis and medicines are free under the government programme.
• Your child will feel better within a few weeks. Do not stop the medicines then. Stopping early is how TB becomes drug resistant and much harder to treat.
• If an adult at home has TB, every child in the house should be checked. Young children may be given preventive treatment even when they seem perfectly well.
• The BCG given at birth protects against the most severe forms in small children, but it does not prevent all TB.
• Good food matters throughout the treatment.

Children get stressed too

Most parents do not realise it. Any symptom that has no clear cause may be stress.

It can show as pain anywhere in the body, tiredness, poor marks at school, or difficult behaviour. A trained psychologist can help.