Hypertension in children

I am sure most of you know the importance of checking the blood pressure of adults as high blood pressure can have serious consequences such as stroke and heart attack.

You may be wondering, should I get my childrens’ blood pressure checked? Can they get hypertension?.
Answer, is yes.Children can get high blood pressure , fortunately, not as common as adults. However since they can get hypertension their blood pressure should checked.
Hypertension can be either “essential”, where precise cause is not detected or can be secondary where underlying cause is found.

Children under 3 years of age usually have secondary hypertension so in their cases thorough investigation should be done to find the cause and treat it. Secondary hypertension are due to diseases affecting the kidneys, blood vessels, endocrine glands, heart or brain.
While children above 3 years of age can have essential hypertension just like adults but of course they can have secondary hypertension also, so their hypertension should be termed essential only after excluding secondary hypertension.

So for all the children blood pressure should be measured once a year. However if any child has any disease that can cause high blood pressure their blood pressure should be measured more frequently.

There are two factors one must know while measuring the blood pressure in children.
1. The cuff that is used to measure the blood pressure, need to be of appropriate size for children.
2. Value of normal blood pressure in children varies with age.

The table below gives normal blood pressure in children according to age.
(This is for children who have average height. The blood pressure will be a bit more for taller children and a bit less for shorter children.)

Age. Systolic. Diastolic
Years
1. 98. 52
2. 100. 55
3. 101. 58
4. 102. 60
5. 103. 63
6. 103. 66
7. 105. 68
8. 106. 69
9. 107. 70
10. 108 72
11. 110 74
12. 113 75
13. 120. 80

Treatment
For children where there is an underlying cause for hypertension, beside treating the hypertension underlying cause need to be treated also.
For older children in whom essential hypertension is diagnosed and who have mild hypertension, life style changes should be attempted especially for obese children.
However if this does not help in reducing the blood pressure do not hesitate to give drugs that your doctor will prescribe for your child.
In children with moderate to high hypertension, drug therapy should be started as soon as hypertension is confirmed. The treatment will need to be continued for a very long time.
Blood pressure of children with hypertension should be monitored at home, 2 to 3 times a week and the results should be noted in a diary.
This will help the doctor to adjust the treatment for your child.

















Now in India weather is very hot and with that comes the germs (viruses, bacteria and parasites) that can cause diarrhea and vomiting. The youngest children, less than 2 years, are most vulnerable to diarrheal diseases. Fortunately if we take proper precautions we can prevent these diseases. So today we will talk about the measures for prevention of diarrheal diseases.

Prevention in infant

Breast feeding is natural protection for most of the diseases especially diarrhea. World Health Organization recommends that babies should be exclusive breast fed until 6 months of age.

Those who are not breast fed should be fed with breast milk substitute that is infant formula milk. It is important that certain precautions should be taken in preparing the feeds when formula milk is used. The bottles and nipples should be sterilized in a commercial sterilizer (follow the manufacturer’s instruction) or boiled in a pan. The water that is used for preparing the feeds should be boiled even if you are using bottled water. After boiling the water it should be cooled for less than 30 minutes (to not less than 70c) and then should be mixed with measured amount of powder. The reason is that the milk powder may not be sterile, however when it is mixed in hot water the germs in it will be killed. The prepared feed should be cooled down quickly in running cold water or in a pan of cold water. If not consumed within 2 hours it should be thrown away. The prepared formula feeds can be refrigerated for 24 hours. After taking out from refrigerator it can be warmed in a bowl of hot water and then used.

Babies can get germs from the hands of those who touch them; so those who handle them should wash their hands with soap and water or use hand sanitizer before touching them.

Prevention in older children

Using Safe water is most important to prevent diarrheal diseases. Bottled water is usually safe but be sure to check the seal that it is not tampered with. If one is not sure about the water supply then it should be boiled. If boiling is not possible then micropore filtering or disinfecting agents like iodine tablets should be used especially while one is travelling outside the country. Bottled or properly packed beverages are usually safe; again the seals should be checked.

When one is eating in restaurants and is not sure whether proper food hygiene precautions are taken in that place, then be sure that the food you eat is well cooked and steaming hot. The food items that are not cooked like salads should be avoided.

One can get diarrhea from home made food also if one does not take certain precautions. While buying food from stores check the “use before date”. The frozen food should be brought home within one hour of buying and should be placed in the refrigerator immediately. Food once thawed should not be frozen again. Raw food and ready to eat items should be kept separately. Food especially poultry, meat, and fish should be cooked thoroughly. No part of it should remain pink. Uncooked eggs should not be eaten unless they are pasteurized. Cooked food if not consumed immediately should be cooled quickly(within 1 to 2 hours) and kept in the refrigerator. Do not keep hot food in the refrigerator, as with this the temperature in the refrigerator will rise and thus bacteria will grow in the other food items. Cooked food can be kept in refrigerator for 2 days. In the freezer as long as it remains frozen, but the texture and taste will change with prolong storing. Food once taken out of the refrigerator and warmed or kept out for a length of time should not be kept back in the refrigerator.

In the kitchen the sinks, work tops and utensils should be cleaned thoroughly. Dish clothes should be washed in hot water frequently or disposables ones should be used. Hands should be washed after touching uncooked food. The knife and chopping board which is used for cutting uncooked food should be thoroughly washed. It is better to use separate knife and chopping board for cutting salads and fruits. If you are taking the cooked food to be eaten outside home then it should be transferred in a cool bag with ice trays. Lastly hand washing is must before eating. Taking above measures will keep the germs away from you and your loved ones to a great extend. 

Use of budecort inhaler in children

Easy Baby Care

Dear Doctor,
my daughter is two and half year now. She started getting cough and cold frequently when she was 1 year old. doctor gave ger DERIPHYLLIN syrup and she was better after that. but since than her cold , cough , fever become a monthly routine and my paediatrician suggested to test the total IGE serum. it was found elevated around 400 while the normal range was 19. Seeing the report my paedia suggested to keep her on budecort for two years and mont LCZ for three month. I was not in the favour of giving the medicine for so long continuously, so I stopped them in between. but the problem is, she is countinue with her monthly. Should i put her on budecort for two years or not, i am confused.
Dear Kusum
Frequent fever, colds and cough occurs in all the children till they are 5 years…

View original post 219 more words

Prevention of Gastroenteritis (Diarrhea and Vomiting) in Infants and children

Easy Baby Care

We are in the middle of summer now and with this comes the germs (viruses, bacteria and parasites) that can cause diarrhea and vomiting. The youngest children, less than 2 years, are most vulnerable to diarrheal diseases. Fortunately if we take proper precautions we can prevent these diseases. So today we will talk about the measures for prevention of diarrheal diseases.

View original post 701 more words

Prevention of diarrhoea in summer

Easy Baby Care

Now in India weather is very hot and with that comes  the germs (viruses, bacteria and parasites) that can cause diarrhea and vomiting. The youngest children, less than 2 years, are most vulnerable to diarrheal diseases. Fortunately if we take proper precautions we can prevent these diseases. So today we will talk about the measures for prevention of diarrheal diseases.

Prevention in infant

Breast feeding is natural protection for most of the diseases especially diarrhea. World Health Organization recommends that babies should be exclusive breast fed until 6 months of age.

Those who are not breast fed should be fed with breast milk substitute that is infant formula milk. It is important that certain precautions should be taken in preparing the feeds when formula milk is used. The bottles and nipples should be sterilized in a commercial sterilizer (follow the manufacturer’s instruction) or boiled in a pan. The water that is used…

View original post 599 more words

Hey

Happy new year to all my readers.

I am in Kolkata until 7 th January, enjoying the weather.

Giving budecort and livolin as inhalers


Question from a father
Hi my baby is 6 month old she got cold,ccough and fever,after using Ascoril,mantra,Colpal she is ok,again after 2days she got fever and her voice was blocked due to coughf so we went to doctor he gave levolin respules 0.63mg for 18 days and budecort respules 0.5mg for 2months.can u plz tell me whether these medicines can be used or not and any side affects and how they work and I want to know why only these medicines are used is their any other solution to get rid of these medicines and by using these medicines will be addicted to the baby’s body and how long these medicines will be continued plz give me reply.

One more question my son he is 6years old he got allergy in lungs so doctor gave same medicines  in form of inhalers and montair LCD kid n budecort for 2months means till the season changes.but by using these medicines he is doing ok sometimes and after few days the same thing is repeating ,in his case can u say any other solution to this problem

 

Reply
Your children suffer from wheezing bronchitis\ mild asthma\ allergy.
Believe me, that we are fortunate that we can give medicines via inhalation instead of orally or by injections.
Children used to suffer from these diseases previously also. When l was an intern in 1967, we used to admit many babies in hospital for giving these same medicines by Intravenous drip, as inhalation therapy was not discovered. Giving these medicines by injections or orally have many side effects, so we used to give these only for 5 to 6 days, After that they would be better but not normal. The result is they could not play or lead a normal life.
Now days more children suffer from these diseases, but as I said, some children previously also used to suffer.
Giving budecort (steroids) and livolin(anti spasm), by inhalation is the best way of giving these medicines.The medicines go directly to lungs where they are needed. If you give them orally they go to stomach, then to blood and then to all the organs in the body and then to lungs, that is why they have so many side effects.
By giving them as inhalers these have no side effects as the medicines go to lungs and no where else.This therapy is not habit forming. Your children will need them as long as they suffer from these problems. Once they are better they will not need them.
You will find more information about this in my book in chapter Asthma,at easybabycare.net.
Do write to me if you have any further queries.

Roseola infantum (Exanthema subitum or sixth disease)

Easy Baby Care

Within last few days I have seen quite a few babies with this disease. The reason I am writing about this is because the rash which occurs in this disease resemble measles (khasra, gobri, haam, asba) so that many parents, especially grandparents mistake this for measles and naturally get worried. Fortunately now days measles do not occur in babies who are vaccinated. However this mild febrile illness with rash is very common.

Roseola infantum typically occurs in babies aged 6 months to 3 years of age .Initially they have fever which can range from 38c to 40 c. Baby also has running nose and mild redness of eyes and at times loose motions. In spite of high temperature baby is well except for slight irritation. On 4th or 5th day the fever subsides and rashes appear. Rash is rose colored and discreet. It appears on trunk and then spreads to face…

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TV watching by children

Most parents do realise that watching too much TV is harmful for their children but how much is too much?

AAP(American Academy of Pediatrics) have given some guidelines lines about screening time for children.

 

Guide lines given by AAP.
For children aged 18 months and under, no screen time apart from video-chatting.
For parents who choose to introduce screen time to their 18–24-month-olds, the AAP recommends choosing high-quality content and apps, and watching the content with their children.
For children aged 2–5 years, high-quality screen time should be limited to 1 hour per day.
Older children should have “consistent limits” on their screen time, with special attention to ensuring they get adequate physical activity (1 hour/day) and sleep (8–12 hours/night for school-aged children).

Repeated colds and coughs.

Dear Doctor
My daughter is 12 years old. She is suffering from cold and cough. Should I give her budecort or levolin?
Dear Priti

Repeated colds and coughs are usually viral or sometimes bacterial infections. Budecort or livolin are needed if child has wheezing with these infections. These two medicines will neither cure nor prevent colds and coughs.
All the children suffer from repeated colds and coughs.Some more others less.
There are few precautions you can take to try to reduce the no of these attacks.
1. See that you child gets well balanced diet, including fruits containing vitamin C.
2. Child should get plenty of rest.
3. Child also should get enough exercise.
4. As far as possible, see that your child avoids coming in contact with someone who has colds and coughs.
Do look up the book easybabycare available at easybabycare.net and read the chapter on diet. You will get an idea as to what sort of diet should be given to child.
Let me know if you have any further queries.