Prevention is better than cure

By Dr Martie Conradie
MBChB (UP), Diploma in Child Health (SA), Diploma in HIV Treatment (SA), Diploma in Occupational Health (UP)

This old adage is known to all of us and is certainly true when it comes to our children’s health.

Anyone who has been in an Emergency Unit late at night and has tried to keep an ill child calm will definitely agree that it would have been much better to avoid a hospital visit altogether. Unfortunately, not all problems can be prevented, but there are many things you can do as a parent to improve your child’s health and immune system.

CURRENT STATE OF CHILD HEALTH IN THE WORLD

Here are some interesting (and shocking) facts:

Vaccinations currently prevent 2-3 million deaths each year, yet more than 1.5 million people worldwide die each year from diseases that could have been prevented by vaccinations.
Diseases that can be prevented include the following: Diphtheria, Tetanus, Pertussis (Whooping Cough), Polio, Measles, Mumps and Rubella (German Measles). Some of these diseases are now so rare due to vaccinations that medical students hardly learn about them.
Obesity in children is becoming a big problem. Worldwide, the number of people who are overweight has almost tripled since 1975. Almost 14% of 2 to 5 year olds, 18.5% of 6 to 11 year olds and 20% of 12 to 19 year olds are overweight.
The American Psychiatric Association says that 5% of American children have Attention Deficit Hyperactivity Disorder (“ADHD”), but it is suspected that it is actually closer to 10%. In the US, there are more than 6 million children between 2 and 17 years old (9.4%) who have been diagnosed with this. Among the possible causes are the frequent exposure of children to screens and unhealthy eating habits.

THE MOVEMENT TO PROLONG THE “HEALTHY YEARS”

In the past, the focus in the health industry was to extend people’s lifespan, but after it became clear that extending life expectancy did not necessarily mean a good quality of life, the focus shifted to extending one’s healthy years (“healthspan”). The goal is not to take a hand full of pills every day for 30 years or struggle to move around on your own. That is why it is very important to make healthy decisions from an early age. While your children are still too young to make those decisions themselves, the responsibility rests on you as their caregiver to give them a boost in life by normalising the idea of a healthy lifestyle.

WHAT CAN YOU DO?

It is a big responsibility to make healthy decisions on behalf of your children, especially if you are not even making them for yourself. Most parents will admit that it is actually impossible to live a healthy life all the time. Luckily the human body is wonderful and can in many cases counteract damage, as long as the damage is limited and does not occur too much. Try to make the following things part of your child’s lifestyle where possible:

Healthy eating habits

There are so many resources that differ on what to give your child or what to avoid at all costs. For children, it can be dangerous to cut out food groups completely and I would recommend that you shouldn’t, or that you do it under the close supervision of a doctor or dietitian. In most cases, you just need to start doing the following:

Eat more vegetables: at least 2-3 cups full, especially raw vegetables
Eat more fruit: 1½-2 cups full, especially fruits that are low in carbohydrates, such as berries
Drink more water: if soft drinks can be avoided completely, that’s a good thing
Eat as little sugar and processed foods as possible
Eat healthy protein: especially fish, which contains healthy omega fatty acids that are essential for brain development.

Vaccinations

As mentioned earlier, there are a number of diseases that can be prevented by vaccinations. Unfortunately, there are several social media campaigns against vaccinations. The speculations about the relationship between autism and vaccinations are false, but it still instils fear in many parents as a diagnosis of autism is so serious. I was a researcher on a study on autism and can say with conviction that even though the cause of autism is still very uncertain, vaccinations are NOT one of the causes. By the time a vaccine hits the market, there is an awful lot of data available to prove what dangers it can pose.

For moms who may already know that the vaccinations sometimes make their babies feel bad for a few days, I just want to give reassurance: It is normal for a vaccination to stimulate an inflammatory response and cause cold-type symptoms, because what a vaccine actually does is teach your body how to fight a germ by making antibodies so that you have the right antibodies to fight with if you might be exposed to the germ. It is therefore not recommended to give an anti-inflammatory the day before the vaccination, but to rather give paracetamol if your child has a slight fever after receiving the vaccination.

If your child is older than 9 years, the vaccination against human papilloma virus (Human Papilloma Virus in English) is also important, for boys and girls. It is a very common virus that is transmitted mainly through sexual contact and is the leading cause of cervical cancer in women. Cervical cancer is currently the most deadly cancer in women in South Africa. Vaccinating boys can reduce the spread of the virus.

Vitamin supplements

As a result of our food processing, many nutrients are lost from food, especially micro-nutrients (vitamins and minerals). That is why vitamin supplements are important. Every child has different requirements and therefore it is good to discuss supplements with a doctor. Generally, a good multivitamin is recommended. Supplements with omega-3 fatty acids may be valuable in children who are struggling with concentration, but they should not be given without the approval of a doctor for children under 3 years of age.

Iron deficiency is common among children, so watch out for signs such as pallor or if children want to eat soil (“Pika”). Iron deficiency, as well as other nutrient deficiencies, can negatively affect the physical and mental development of children.

Exercise

It is not necessary to have your toddler join a gym or to have your child participate in every sport at school, but an active lifestyle prevents many diseases such as weight problems and diabetes and it strengthens muscles and bones. Remember that it will be almost impossible for your child to be active as an adult if it was not part of their lifestyle as a child.

Toddlers burn a lot of energy by just running around outside. Make it as interesting as possible to be outside so that it is preferred over sitting in front of the television.

Less screen time

It is important to expose our children to technology so that they understand it and also so that we can teach them how to work responsibly with it.

Sources differ greatly in the times they recommend as maximum exposure to screens, but all the reliable sources agree on the following: screen time should be reduced for all ages. Furthermore, it is almost as important that our children are exposed to the right type of technology. It is recommended that young children be exposed exclusively to high quality educational programs. Almost half of children under the age of 8 in developed countries have their own tablet or phone and spend an average of about 2 hours on it.

A recommendation is as follows:

Age	Screentime in hours
Younger than 18 months	Avoid completely, except for video calling of people known to the children
18-24 months	<1 hour Only high quality educational software/programs watched by parents with children and explained to them
2-5 years	1 hour Only high quality educational software/programs watched by parents with children and explained to them
6-12 years	The less the better but no definite cut-off point Apply strict rules about screen time. It should not interfere with schoolwork or physical activity and the content should be chosen carefully.
12 years and older	By this age, the focus should be on having media-free times like mealtimes as well as media-free places like bedrooms

Healthy sleep

What a great time for parents when the little ones are finally in bed! But sleep is also very important for children. The following is a guideline by age and refers to total sleep, which includes naps throughout the day:

Age	Hours sleep
0-3 months	14-17 hours
4-11 months	12-15 hours
1-2 years	11-14 hours
3-5 years	10-13 hours
6-13 years	9-11 hours

Brain development takes place especially during the night and the amount as well as the quality of sleep must be sufficient to ensure optimal development.

The following things negatively affect the quality of sleep:

Screen time and blue light exposure in 1-2 hours before bedtime: blue light inhibits melatonin released by the brain and needed for sleep
Watch or listen to stories that are disturbing
A big meal in the hour before bed
Caffeine before bedtime (but hopefully your child only starts drinking coffee when he or she finishes school)
Underlying health problems (young children in particular, cannot always say exactly what is bothering them, so even something like a stuffy nose or sore tooth can disturb sleep)

For teens and adults, a lack of good quality sleep will also affect behaviour and lead to impaired cognitive function which can lead to learning difficulties and even depression.

Deworming

I have yet to meet a child who has not eaten sand or put something in their mouth which would make their parents squirm. Sometimes the unfortunate result of these actions are worms. In the government’s health system, deworming is done as a routine every year for young children. Deworming is done less frequently in the private sector, but it should also be part of your child’s annual doctor’s visit. Worms can do a lot of damage, especially if the infection becomes chronic and it can also lead to nutritional deficiencies. Medication for deworming is available over the counter and you can simply ask your pharmacist for it.

Dental hygiene

This lesson I learned the expensive way. Teeth, as well as baby teeth, need to be cared for properly to prevent cavities and even more important than toothbrushing and flossing is how you feed your children. Here are some tips on dental care:

Brush twice a day with fluoride toothpaste in circular motions: with only a rice grain-sized amount for children aged 18 months and then with a pea kernel size for children older than 3 years.
Floss every day as soon as there are 2 teeth next to each other: you get “Flossers” which makes it quite easy with little ones.
Eat less sugar: sugar is converted by the bacteria in one’s mouth into acid which then eats through the enamel of teeth.
Snacks: the important thing to remember is that there should be no pieces of food between teeth during times when one is not eating and that there should not be regular sugar in the mouth that causes plaque to form. Therefore, snacks like dried fruits or cookies are not good. What does help is to have children rinse their mouths with water after snack time.

Even you as a parent can benefit greatly from applying some of this counsel in your own life. It is important take care of yourself so that you can be there for your child in the years ahead. May you have the strength and patience to raise your child or children as healthy as possible.