We all want to do our best when it comes to our kids’ health, but there’s plenty to keep us on our toes. School brings them into contact with all sorts of bugs and germs and Hong Kong’s lifestyle and climate presents its own challenges. We talked to local doctors at some medical centres and outpatient clinics in Hong Kong about key paediatric medical issues to consider when it comes to keeping your children fighting fit.
Has my child had regular full physical examinations?
There are many benefits to doing a paediatric full physical examination for children from kindergarten age to early adolescence, according to Dr Charlene Kulenkampff of Dr Lauren Bramley and Partners. These include detecting disease and promoting health to giving advice on preventing future problems.
Dr Kulenkampff says a physical considers your child’s health history, looking at lifestyle habits such as diet, physical activity, hours of sleep, dental care, vaccinations and even screen time. School performance is also discussed to detect if there are underlying vision or hearing problems.
“A full physical exam is done at each visit,” she says. “This usually involves looking at growth parameters such as weight, height and blood pressure and then evaluating various systems like the ears, nose and throat, teeth, chest, heart, abdomen, skin and neurological system.”
A physical also includes ensuring the child’s vaccination schedule is up-to-date and an assessment of your child’s diet. “Evaluation of a child’s diet is also vital as this dramatically influences their health, energy, concentration and immune system,” she says.
Dr Kulenkampff says some parents also request age appropriate screening blood tests as part of a physical. A blood sample allows evaluation of key organ function and vitamin status.
When is a rash in my child a cause for concern?
Rashes are common in children and most are harmless and transient, says Dr James Lynch, a general practitioner based in the Discovery Bay clinic of OT&P Healthcare. A rash, which is a noticeable change in the texture or colour of the skin, has a number of possible causes. The most common is a virus, and other causes include bacteria, fungi and allergic reactions.
When to seek medical advice when your child has a rash is one of the most common kids’ health questions a parent asks. Most parents question when to seek medical advice if their child has a rash. Dr Lynch says it can be safe to take a wait and see approach if the child is otherwise well and there are no other obvious symptoms. In this case, keep an eye on the rash until you can see a doctor.
“If there is an associated fever, then Ibuprofen and Paracetamol can be given in an alternating regimen to control these symptoms,” he says. Dr Lynch says if your child has a fever of more than 38C, is vomiting, has diarrhea, is lethargic or generally unwell, you should take them to a doctor. The younger a child is, the sooner they should be seen, particularly if they are younger than 6 months old.
“If in doubt it is prudent to have a medical practitioner examine the child as the causes of rashes are so diverse,” he says.
Is my child’s vaccination schedule up-to-date?
When you have young children and you move countries it is often disruptive to your child’s vaccination schedule. One thing for expat parents to be mindful of with their kids’ health is that different countries or regions have different childhood immunisation programs.
Dr Eddie Cheung, a specialist in paediatrics at Hong Kong Adventist Hospital – Stubbs Road, stresses the need for vaccinations to ensure your child’s natural defences are increased so that their bodies can fight the invasion of various diseases.
Dr Cheung says a key kids’ health issue is for parents to be aware of the vaccination schedule for children from birth to 11 years in Hong Kong.
“The decision of which diseases to be included depends partly on the prevalence, or how common, a particular disease is in that locality,” he says. “In Hong Kong, as recommended by the Department of Health, children from birth to 11 years of age should receive vaccinations against 10 diseases.”
These include tuberculosis, polio, hepatitis B, diphtheria, pertussis (whooping cough), tetanus, measles, mumps, rubella and pneumococcal infection. “There are many different types of vaccine on the market and parents should seek advice from doctors on the suitability and timing for their children,” Dr Cheung says. “Some vaccines, recommended in other countries, may also be available in Hong Kong. Parents can discuss with their paediatricians the indications and availability of such vaccines, and to see if they also want to get their children vaccinated.”
Does my child need their tonsils out?
This one is a classic kids’ health issue. But did you know that problems with your child’s tonsils could be the cause of sleeping problems and repeated throat infections? Tonsils, which are the lymphoid tissues on both sides of the throat, can be easily infected and swollen for people of all ages, including children. Usually most of us can recover from a case of tonsillitis with antibiotics and rest within a week.
However, some kids seem to be prone to getting the infection quite often, says Dr Terry Hung, ear, nose and throat specialist at Matilda International Hospital. In these cases the infection is accompanied with symptoms such as fever, sore throat, tiredness and bad breath. He says recurrent infections should be evaluated by a doctor who may recommend tonsil removal – a tonsillectomy – for children aged over 3. This involves the child being put under general anaesthesia for a 30-minute procedure. An overnight hospital stay is usually required, with a soft diet for 5-6 days. Dr Hung says in addition to removing the cause of repeated infection, the procedure can also help improve air flow and sleep quality for children who have obstructive sleep apnoea.
“Good hygiene practice is key to preventing throat infection as the source of tonsil infection is air-borne,” he says. “If any family member has a cold or a flu or an infection, wear a mask. In addition, small children should never share food at school.”
Does my child get enough sleep?
“Kids’ sleep is important!” This is the message from Optimal Family Health‘s Dr Nichola Salmond, who says kids need ten to 11 hours sleep when they are between the ages of five and 12. She warns a lack of sleep can lead to growth issues and attention problems. A recent study also showed it increases your child’s risk of obesity, as the likelihood of a child becoming overweight lowered by 9 percent for each additional hour of sleep they got. Poor sleep can interfere with a child’s school performance, ability to focus and behaviour and can cause or mistakenly be diagnosed as Attention Deficit Disorder.
“Often lack of sleep is just due to getting off to sleep too late and poor sleep habits,” Dr Salmond says. “Encourage early bedtimes and ban TV, mobiles and computers in bedrooms at night. Instead encourage a wind-down period with chatting or reading.”
She says another problem is interrupted sleep due to nocturnal cough and snoring. This can be due to allergic rhinitis, asthma and enlarged adenoids. “Allergic respiratory problems are common in Hong Kong due to air pollution, high concentrations of respiratory allergens and atypical infections such as mycoplasma,” Dr Salmond says.
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