What is bronchiolitis? Bronchiolitis is an infection in the lung (in the breathing tubes) caused by a virus. How does bronchiolitis start? Bronchiolitis can start as a cold, with a runny nose and a slight fever for two to three days. Then your child may begin to cough, breathe fast and wheeze (noisy breathing). The 2nd or 3rd day of the illness is usually the worst. The wheezing and difficulty breathing lasts for several days and then the child gradually improves. The cough usually lasts 10-14 days but may last as long as a month. Who get bronchiolitis? Children under one year often get this illness. Bronchiolitis is most common in the winter months, especially in July and August. Some things you can do at home to help your baby are: Give your baby plenty to drink e.g. breast milk, formula. If your baby is getting tired while feeding try offering smaller feeds more often. Keep your baby's nose clear by using saline nose drops (from a pharmacy). One to two drops can be placed in your baby's nose before feeds. Keep your baby warm and comfortable. Give your baby as much rest as possible. Don't smoke around your child. If your baby has a fever give Paracetamol (Panadol or Pamol). (Do not give more than four doses in 24 hours). Go and see your GP early, or call your GP or an after hours doctor if any of the following warning signs develop: Your child is vomiting or your child is having trouble drinking fluids. For example, if your child is drinking less than half their normal amount, or your child has no wet nappies for 6 hours. Your child is making a grunting noise when breathing. You can see your child's skin pull in between the ribs with each breath. Your child has a blue colour around the lips. Your child has problems staying awake when they aren't normally sleepy or your child appears floppy. Your child stops breathing sometimes. You child develops a rash.

What is cleft lip and cleft palate? A cleft lip is an opening in the lip. A cleft palate is an opening in the roof of the mouth. Clefts result from incomplete development of the lip or palate while the baby is forming before birth. What causes a cleft lip and cleft palate? In most cases, the cause of cleft lip and cleft palate is unknown. These conditions cannot be prevented. What can be done to help our baby? A cleft lip can usually be repaired in the first few months of life. A cleft palate can usually be repaired some months later. The exact timing of these repairs depends on the baby’s health and considerations of his or her future development, and is determined by the doctor who performs the surgery. Can our baby be fed properly? Some babies with clefts have very few or no problems feeding, while others have more difficulty. Use of special bottles and careful positioning of the baby are sometimes helpful modifications. Your doctor will give you proper guidance. What’s the treatment for cleft lip and cleft palate? A cleft lip may require one or two surgeries depending on the extent of the repair needed. Surgery can be while your baby is very young. Surgeries are performed by the Plastic Surgery Team. For more detailed information about cleft lip and cleft palate please click here. Repair of a cleft palate often requires multiple surgeries over the course of 18 years. The first surgery to repair the palate usually occurs when the baby is between 6 and 12 months old. The initial surgery creates a functional palate, reduces the chances that fluid will develop in the middle ears and aids in the proper development of the teeth and facial bones.

Clubfoot is when babies are born with one foot or both feet pointing down and in; their toes point toward the opposite leg. This happens because the tissues that connect muscles to bone (called tendons) in your baby’s leg and foot are shorter than usual. We do not know why children have club feet. What problems does clubfoot cause? Clubfoot isn’t painful, and it doesn’t bother a baby until they begin to stand and walk. Clubfoot does not get better on its own; if it is not treated, children may have problems walking properly. Your doctor or nurse may be able to tell before your baby is born that they will have a problem, by doing an x-ray or ultrasound. How is clubfoot treated? A doctor with special training in bone conditions called an orthopaedic surgeon will help you understand what needs to be done to care for your child. This may mean that your baby has to go to hospital for an operation at some time.

What is Gastroenteritis? Gastroenteritis (Gastro) is an infection in the gut, causing diarrhoea and sometimes vomiting (sickness). Diarrhoea means frequent runny or watery poo. The vomiting may settle quickly, but the diarrhoea can last up to 10 days. The infection may also give your child a high temperature and crampy tummy pains. Gastroenteritis is usually caused by a virus, which the body clears on its own without treatment. It affects all age groups but is more common and can be worse in babies and young children. The most serious problem in gastroenteritis is dehydration (too much water lost from the body). What is dehydration? Dehydration is the loss of fluid, due to vomiting and diarrhoea. The younger the child, the easier it is for them to become dehydrated. The important signs of dehydration are: Dry mouth and tongue Sunken eyes Cold hands and feet Unusual sleepiness or lack of energy Fewer wet nappies than usual. If your child has any of these signs see your doctor. When to see a doctor: Your child shows signs of dehydration (see above) Your child has a lot of diarrhoea (8-10 watery poos per day) Vomiting is increasing or your child is unable to keep fluids down Your child develops severe stomach pains The diarrhoea has blood in it The diarrhoea continues for more than 7 days If you are concerned for any other reason.

Most burns occur at home, usually in the kitchen and bathroom. Generally younger children suffer more scalds; older children more flame burns. Children’s skin is thinner so they get hurt faster than adults. You can start treatment that can help a burn injury by cooling the burn: Apply tap water at room temperature onto burned area for at least 20 minutes Never use ice or iced water Keep the non burned area dry and warm Don’t put anything on the burn except water Stop cooling if core body temperature is <35°C Burns are identified by depth of the burn: Superficial or epidermal Partial thickness Full thickness Each of the different depths of burns will be treated differently, sometimes this means that your child may have to stay in hospital.

What is rheumatic fever? Rheumatic fever is an illness. It often starts with a sore throat (a streptococcal infection). A few weeks after the ‘strep throat’ your child may develop: Sore or swollen joints (knees, elbows, ankles, or wrists) A skin rash A fever Sore stomach Jerky movements How can rheumatic fever affect the heart? If your child has a bad attack of rheumatic fever it may cause permanent damage to their heart valves. This is called rheumatic fever disease. A heart valve acts like a one-way door; it makes sure the blood that is pumped by the heart flows in one direction only. When the heart valve is damaged it can cause breathlessness and tiredness. What happens when my child is in hospital? Your child will usually need to stay in hospital for 1 – 2 weeks, but it is sometimes longer if their heart is affected. They will have regular examinations and blood tests to check their condition. If they have rheumatic heart disease your child may need to stay in hospital for longer, may need to have regular penicillin injections and have a special visit to the dentist. Your doctor will speak to you about the care and treatment your child needs while they are in hospital.

What is a urine infection? A urine infection is the presence of bacteria in the urinary tract (bladder and kidneys). Urine should be sterile (free of bacteria). Why did my child get a urine infection? Approximately 1% of boys and 3% of girls get a urine infection in the first ten years of life. Bacteria can enter the urinary tract from the skin around the urethra (where the urine normally comes out), or occasionally from infection within the body. Constipation can contribute to a urine infection and children who hold on to their wees for long periods are also at risk of developing a urine infection. Some children will have a blockage in the urinary tract, or a back flow of urine from the bladder towards the kidneys (called vesico-ureteric reflux VUR) which has cause the infection. How is the urine infection treated? A course of antibiotics will treat a urine infection. If your child is vomiting or too unwell to take antibiotics by mouth, hospitalisation for intravenous (in the vein) antibiotics may be needed. Antibiotics should improve symptoms within 48 hours. If they have not, see your GP. Why does my child need to have tests done? All babies and very young children should have tests done to check their urinary tract. In up to 40% of young children with a urine infection, there is a back flow of urine towards the kidneys, and in a very small percentage there is a blockage in the urinary tract. These conditions stop the urine flowing normally and make children more likely to have repeated urine infections. Blockages and severe VUR may need to be repaired with surgery, and VUR may need long term treatment with antibiotics to help prevent kidney scarring and possible kidney failure. It is important therefore to take antibiotics until the tests are done, in case VUR is diagnosed. What tests will be done? The tests your GP has referred you for may include: kidney ultrasound: this is similar to the ultrasound to check the baby in the womb during pregnancy. It shows the size and shape of the kidneys and is usually done about one month after referral micturating cystourethrogram (MCUG): this test uses x-rays to see dye moving out of the bladder. It will detect back flow of urine (VUR) and blockages in the urinary tract. The dye is put into the bladder through the urethra using a thin tube called a catheter. Your child is then held still for several minutes while x-rays are taken. Inserting the catheter can be uncomfortable, and hands-on support by the accompanying adult may be needed. Arranging child care for any other children in your care is advisable for this test. In children older than about 18 months, sedation may be offered to make your child sleepy and less aware of the test. The MCUG is done approximately one month after the referral. What if the tests show an abnormality? You should see your GP after these tests have been done. Your GP may refer your child to a children’s doctor (paediatrician) at a hospital clinic. Antibiotics should be continued unless you are told otherwise. Will my child get further urine infections? Repeated urine infections can occur even when antibiotics are being taken. It is important to have your child’s urine checked if the following symptoms develop: fever; strong smelling or discoloured urine; pain on passing urine; your child is “not well” or has unsettled behaviour. To prevent further infections, avoid constipation, avoid bubble baths (or other irritating soaps), take antibiotics when prescribed, change soiled nappies quickly, and wipe the bottom from the front to the back.

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