Kids' health concerns ease with age
Your child is coughing and has a fever—again. You begin to worry: Didn't they just get over a cold?
When children are young, it's normal for them to have a variety of childhood illnesses and problems. Most go away as the child gets older. Here are some common health hurdles and when you can expect improvement.
Preschoolers tend to get six to 12 colds a year. That number drops to two or three a year by school age. The reason: Kids come into the world with no immunity to the 200 or so rhino viruses that cause the common cold. Immunity develops only after infection. Expect improvement by age 7.
Why do infants and toddlers get ear infections more frequently? Blame it on the eustachian tube, a tiny passage between the middle ear and the back of the nose (nasopharynx). It is supposed to drain and ventilate the middle ear. When an adult stands, the eustachian tube is angled upward from the throat to the ear at a 45-degree angle. This allows gravity to pull fluid downward toward the throat and discourages fluids in the throat from moving upward toward the middle ear. When a child stands, the eustachian tube is almost horizontal. Fluid doesn’t drain with the aid of gravity. In addition, the size of the opening of the tube in a child is relatively large in respect to its length. Because fluid drains less easily and it is easier for contaminated fluid to enter from the throat, the fluid collects more readily in the middle ear, resulting in increased ear infections. Expect improvement between ages 3 and 6.
The tonsils, two symmetrical masses of lymph tissue in the back of the throat, work to combat infections in young children. Unfortunately, they frequently become infected themselves. Streptococcal infections are the most common bacterial infection of the tonsils, and are commonly called strep throat. These bacteria, however, make up less than 15 percent of all cases of tonsillitis or sore throats; more than 80 percent of cases are caused by viruses.
Strep throat responds well and quickly to antibiotics. Viral tonsillitis or sore throat (pharyngitis) does not respond to antibiotics and must run its course.
Removal of the tonsils (tonsillectomy) is not recommended as frequently as in years past, but doctors may still recommend it if tonsillitis has been a recurring problem for several years. It is also recommended if the tonsils are so large that they interfere with breathing, particularly while sleeping.
Tonsils reach their peak size around age 9. After that, they usually begin to shrink, their function as disease fighters declines, and infections become less frequent. Expect a decrease in streptococcal tonsillitis by age 6 and tonsillitis, in general, by age 10.
Bed-wetting (also called enuresis) is common, and it is more common among boys than girls. It is frustrating for both parent and child and can lead to a loss of self-esteem. It may affect social interactions, especially when the child reaches the age where sleepovers are common. Fortunately, many commercial products are available to help with this problem. Relatively effective medications are available by prescription for cases that do not respond to a child’s increasing age. It is very important to have your child evaluated by a pediatrician if bed-wetting occurs on a regular basis.
These are possible causes for bed-wetting:
- Genetics. Bed-wetting can run in families.
- Deep sleep. Some children have difficulty waking up to use the bathroom.
- Developmental delay. A slower development of the link between the central nervous system and the bladder can lead to bed-wetting. This link stops the bladder from emptying at night.
- Hormonal problems. The antidiuretic hormone controls the amount of urine the kidneys make. If production of this hormone is out-of-cycle, bed-wetting can occur.
- Urinary tract infections.
- Structural abnormalities in the urinary tract.
- Children's bladder control increases as they get older. Expect improvement by age 6 for girls; a little later for most boys.
Rashes are common in children. Fortunately, most rashes are not associated with serious illness.
Common infectious childhood rashes such as measles, rubella, and chicken pox have almost disappeared thanks to immunizations. Diaper rashes caused by Candida albicans are infrequent because of improvements in disposable diapers; newer diapers keep the infant's skin drier and subsequently healthier.
Infectious rashes that are still common and for which there are no vaccines include hand-foot-and-mouth disease (not the same as hoof-and-mouth disease in cattle), roseola, and erythema infectiosum (slapped cheek disease).
Noninfectious rashes of childhood that are common include eczema, infant cradle cap, contact dermatitis, and prickly heat.
Expect improvement between ages 10 and 12, although conditions such as eczema may last into adulthood.
So the next time your child comes down with an ear infection, cold, or rash, remember that you should see these illnesses a little less with each passing year.
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