Tips to Manage Your Child’s Health

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Many parents will find themselves seeking answers to the same old questions about their children’s health.

• How can I find a good doctor for my child?

While a pediatrician is the most obvious choice, family practitioners often make equally good doctors for children.

Carefully interview different types of doctors, then pick one that meets your requirements one with a pleasant, caring attitude a willingness to talk directly with your child as well as with you a clean, orderly office and a good system for fielding after-hours phone calls. Make sure your child gets along with the doctor and that the doctor accepts your health insurance plan.

Caution: If the doctor belongs to a group practice, ask that you be allowed to make appointments specifically with him/her.

Ask if the doctor can provide you with educational materials regarding specific health issues. They’re a big help when illness strikes or during puberty.

• Does my child need an X-ray?

In addition to being costly, X-rays, CT scans, magnetic resonance imaging and other diagnostic tests are typically frightening to children, risky and unnecessary.

They should be administered only if their findings will have a direct bearing on your child’s treatment. If your child has a cough, for example, a chest X-ray is generally unnecessary unless the doctor has reason to suspect a serious lung ailment.

Before agreeing to any test, question the doctor thoroughly to make sure it is necessary. Key questions

  • What’s the name of the test?
  • Why is it necessary?
  • What will it reveal that you don’t already know?
  • What will happen if the test is not performed?
  • What are the possible side effects?
  • Is a less-invasive test available?
  • Will the test results change your method of treatment?

• Are childhood immunizations safe?

Most states require that all children be immunized against the following diseases diphtheria, pertussis (whooping cough), tetanus, measles, mumps, rubella (German measles), poliomyelitis and Haemophilus influenza type B (bacterial meningitis). Experts are also now recommending varicella (chicken pox) and hepatitis B.

These vaccinations are typically administered between the ages of two months and 16 years. They are generally quite safe.

Exception: Pertussis. Half of all children who receive this five-dose vaccine develop fever, and, in rare cases, children have developed mental retardation or another permanent disability. However, because pertussis is such a serious disease, it is still prudent to have your child immunized.

To minimize risk

Insist that your child receive the a cellular pertussis vaccine. It’s less likely to cause dangerous reactions than the old vaccine, which remains in use.

The pertussis vaccine should never be given to any child who is over age six, who has a fever or has already had pertussis. Any child who experiences fever, shock, persistent crying, convulsions or neurological problems after the first pertussis shot should not receive any of the additional pertussis boosters.

• My child has recurrent throat infections. Should his tonsils be removed?

Tonsillectomy is neither necessary nor particularly effective at curing recurrent ear or throat infections, even though doctors often urge surgery.

When it’s appropriate: Only if the tonsils become so swollen that they interfere with the child’s breathing, or if lab tests indicate the presence of abscesses behind the tonsils. In all other cases, it’s best to treat such infections with antibiotics.

• What about chronic ear infections?

Ear infections (otitis media) are common among children of smokers. If you smoke stop. New mothers should avoid bottle-feeding their children. Research suggests that breast-feeding helps prevent earaches. Beyond this, there’s no real consensus on treatment.

The American Academy of Pediatrics recommends use of oral antibiotics (usually amoxicillin), although some research casts doubt on their effectiveness. The surgical insertion of drainage tubes through the child’s eardrums (tympanostomy) can cause serious complications, including severe infections and hearing loss.

Conservative approach to discuss with your doctor: At the first sign of pain, give your child acetaminophen (Tylenol) or another non-aspirin painkiller. Also helpful: A heating pad held against the ear.

• Do children’s hospitals offer better pediatric care than general hospitals?

The standard of care in children’s hospitals is no better than that in general hospitals with good pediatric sections. If your child requires inpatient surgery, pick a hospital that performs that surgery on a routine basis.

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