Conditions that afflict most children include the common cold, bronchitis and bronchiolitis, gastroenteritis (stomach flu), constipation, hand, foot and mouth disease, chickenpox and asthma.

Dr Barathi Rajendra, Senior Consultant with the General Paediatric Service, Department of Paediatrics at KK Women's and Children's Hospital (KKH), a member of the SingHealth group, answers the questions most parents have about childhood illnesses.


Question by ssy

Hi, I'm new here, so apologies if I posted this question in the wrong place.
For asthma, it is well known that a mitigation measure would be to remove the asthmatic triggers like pet dander, or dust, and often caretakers or patients resort to cleaning measures. However, after some research, I have felt certain concern regarding such measures.

Are vacuum cleaners, air conditioners, air purifiers, or cleaning devices of the like helpful in mitigating asthma attacks? Or could they actually be harmful?

It is my understanding that some of these measures can actually increase allergen exposure in the household, for example, there have been studies on how vacuum cleaners aerosolise dust and spit dust back out, which is indeed rather concerning.

Hope that Dr Barathi Rajendra would be available to help address my concerns. Thank you!. 

Answered by Dr Barathi Rajendra​​, a Senior Consultant with the General Paediatric Service, Department of Paediatrics, at KK Women’s and Children’s Hospital.

Thank you for your questions.

In certain patients, an asthma attack can be triggered by pet hairs or dust, hence the advice is to keep the home environment clean. All vacuum cleaners in general will emit some dust. It is important to keep the vacuum cleaner clean and to open windows or ventilate the room that is being cleaned. Better-quality vacuum cleaners or air purifiers will have a HEPA (high efficiency particulate air) filter that aims to remove a high percentage of pollen, pet dander and particles from the air.

In general, a vacuum cleaner will clean up more dust than it emits. Just remember to service or keep all these devices in good working condition, so that they do not contribute to the problem and they operate efficiently.


Question by ycfong1008

Dear Dr. Barathi,

Could you kindly advice on my child, son of 13 year-old, who is still bed wetting. We have tried various methods to train him but he still bed wetting as he used to be deep sleep symptom which he himself also unaware he's wet. I would like to seek you professional advice on whether to administer him with medication & any therapy that could help him overcome.

Many thanks in advance for reading my question & look forward to hearing from you soon.

Answered by Dr Barathi Rajendra​​, a Senior Consultant with the General Paediatric Service, Department of Paediatrics, at KK Women’s and Children’s Hospital.

Thank you for your question.

Bedwetting is a fairly common problem in childhood. Once it persists into later childhood, it can become quite stressful and unpleasant for the affected child as well as the parents.
You should bring your child to a paediatrician for further assessment. There are two options that can help your son - medication or the use of an enuresis (bedwetting) alarm. Before selecting any of the options, your son should be examined to make sure there are no other underlying health problems which may be contributing to the bedwetting. A urine sample would be checked and an ultrasound scan of the bladder may be performed.

If medication is prescribed, this will reduce excess urine production. Up to 70% of children respond to medication and would have treatment for three months or longer.

As you mentioned that your son is a deep-sleeper, enuresis alarm training may work for him as the alarm trains the child to wake up when the bladder is full. Most children who use the night time alarm show some improvement within one or two weeks of training.


Question by Indian1971

My school going son 9 years often complains of unbearable headache. He wears specs. I have got his eyes rechecked. The doctor has given anti congestion nasal drip. But his problem continues. Please advise.

Answered by Dr Barathi Rajendra​​, a Senior Consultant with the General Paediatric Service, Department of Paediatrics, at KK Women’s and Children’s Hospital.

Thank you for your question.

Headaches in children is a fairly common issue that we manage at KK Women’s and Children’s Hospital. Poor or deteriorating eyesight can often cause headaches, so it is good that your son had repeated an eye check to exclude this possible cause. Another common cause for headaches is allergic rhinitis or “sensitive nose”. Your son may have this condition, hence he was prescribed a nasal spray.

Excessive screen time (computer, tablet or mobile phone) can also contribute to headaches. Poor or insufficient sleep is another factor. Sometimes stress from school or other factors can also contribute to headaches. Eating nutritious and regular meals, as well as drinking sufficient water regularly will help with mild headaches.

In summary, the cause of headaches is often multifactorial and likely due to simple lifestyle factors. Try to make lifestyle adjustments as detailed above, and monitor for improvement. If your child wakes up at night due to the headache or vomits in the early morning, please bring him to see a doctor to reassess his condition.


Question by Farah (reposted by Forum Admin)

Hi,

I would like to ask about my son’s constipation. He is formula fed. He is 11 months now but he’s been having constipation since the first time I gave him solids at 6 months. The food may have contained too much fibre. I have since tried different food to give him instead of carrots, peas. I fed him dragon fruit and it seems to get better. But there are still days when his stool is really hard and I think he may have developed a phobia of pooping. What else can I give him to ease the bowel movements?

Another question, he has eczema too, and usually flares up when it gets a little hot. But could food intake contribute to it too? Thank you.

Answered by Dr Barathi Rajendra​​, a Senior Consultant with the General Paediatric Service, Department of Paediatrics, at KK Women’s and Children’s Hospital.

Thank you for your questions. Constipation is a very common problem even in young children. It is most commonly due to inadequate fibre and water intake. As young children tend to eat small portions of food, they often cannot consume an adequate amount of dietary fibre to enable a regular and painless bowel movement.

Consider increasing your son’s water and dietary fibre intake, and it should resolve shortly. However if the constipation persists, you should consider taking your son to see a specialist to assess his condition. There might be another medical or surgical cause for the constipation, though very rarely. There are many types of medications that can be prescribed for the constipation – the most common medication is lactulose which softens the stools and makes it easier to be passed out. Your son may need to be on laxative medication for many months before he may be able to wean off the medication.

Eczema is the most common rash we see in childhood. There are various triggers such as changes in climate, house dust mites, pet hairs, carpets, stuffed toys, viral infections, and stress. However the role of food allergy in triggering eczema is not well-established yet. If you strongly suspect that your son might have a food allergy which is making his eczema worse, then you may want to consider seeing a specialist to decide if any further testing is required.


Question by Casslyn (reposted by Forum Admin)

Dear Dr Barathi
I hear ear infections are quite common in young children. But will they leave any damage to the ear as the child grows up? My son who is now 4, loves to swim and he’s had ear infections a 2-3 times – ear pain, mild fever and just grouchy. And seems like after a swim. Should he stop swimming or swim less often? He doesn’t’ like wearing a swim cap but I make sure he does. Is there anything I can do for him? Thanks in advance.

Answered by Dr Barathi Rajendra​​, a Senior Consultant with the General Paediatric Service, Department of Paediatrics, at KK Women’s and Children’s Hospital.

Thank you for your question.

You are right in saying that ear infections, in particular, middle ear infections are common in young children. However the earache associated with swimming is different from a middle ear infection – water exposure can cause irritation of the outer ear canal, which may cause the symptoms you have described.

If your son seems to get the symptoms after swimming, then he may not have a middle ear infection, but “swimmer’s ear” or otitis externa instead. Wearing a swim cap or ear plugs might help. Drying out the ear after swimming may also help to reduce water irritation in the ear canal.

You may want to consider taking him to see an ear, nose and throat specialist to determine what type of ear infections he has and to discuss further treatment and management options.


Question by Hussein (reposted by Forum Admin)

Hi Dr
My 3 year old daughter had conjunctivitis recently but we don’t know how she got it. No one else in her nursery had it. How can I prevent it from happening in the future again please? Thank you.

Answered by Dr Barathi Rajendra​​, a Senior Consultant with the General Paediatric Service, Department of Paediatrics, at KK Women’s and Children’s Hospital.

Thank you for your question. Conjunctivitis (sometimes known as red or pink eye) is a very common eye condition, usually caused by a viral or bacterial infection. Infectious conjunctivitis is highly contagious. Very occasionally, it can be due to an allergic condition. Conjunctivitis can cause red eyes, watery eyes, eye pain, swelling around the eye area, itchy eyes or blurred vision.

To prevent possible future episodes, you can teach your daughter to wash her hands regularly, especially when touching the eyes or face. Do not share any face or bath towels or even tissues with other children. Children with conjunctivitis should be kept away from childcare centres until the eye discharge has cleared up.


Question by Steven (reposted by Forum Admin)

Hi doctor
Does bedwetting mean something? My son is almost 3 and suddenly wets his bed. It’s been 4 times now. Recently we started giving him carton milk and he loves it. We don’t give him water before he sleeps now. My mother-in-law says there are other underlying issues but cannot explain what she means. Appreciate your reply.

Answered by Dr Barathi Rajendra​​, a Senior Consultant with the General Paediatric Service, Department of Paediatrics, at KK Women’s and Children’s Hospital.

Thank you for your question.

Bedwetting is a fairly common problem in childhood. However your son is still very young to have achieved full bladder control overnight. As your child grows older, the brain is constantly developing such that full bladder control is achieved by five to six years of age, in the majority of cases.

Rarely, a urine infection can prompt bedwetting in a healthy child, so you may want to bring your child to a paediatrician for further evaluation. There are other treatment options for bedwetting, such as medications or night time alarms, but we would not usually consider these options at such a young age.


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