Doctor at Hand
Imagine you’re struggling to juggle work and family but can fit in a GP’s appointment when it suits you. It’s why we’ve developed our Doctor@Hand service.
1. First aid
AXA PPP healthcare asked: We have a question from Lena, a blogger from amumonamission.co.uk who asks: if the people at AXA PPP healthcare could recommend one crucial item that was needed in a first aid box what would it be?
Health at Hand nurses: Hi Lena if I had to recommend one crucial item in a first aid box it would be a sterile surgical/dressing pad.
Paul H asked: If you were in a situation where someone needed attention in a park, street or other public space. Would you accept first aid and help/assistance from a 12 year old first-aider? (Asking as my son is a young carer and a qualified first-aider)
Health at Hand nurses: Hi Paul H it is a question of individual responsibility and understanding, and as your son has taken a first aid course and has qualified I would welcome his input and assistance in the scenario you describe. It might be useful for him to carry some verification of his qualification to show should if he felt it necessary. Well done to your son!
The Zoo asked: What basic items should I have in my first aid kit?
Health at Hand nurses: Dear zoo a first aid kit should be very simply stocked and should include plasters, a few dressing pads, an eye pad, a couple of bandages and some sterile saline solution. The Health and Safety Executive recommend that we do not include creams, lotions, medication or scissors for safety reasons, but obviously this is a matter of personal choice if the kit is for personal or family use only. There is a full list on the HSE website if you would find this helpful.
Joanne L asked: Whilst climbing trees it is not uncommon for my daughter to get a splinter… she screams on trying to remove it. Any suggestions on helping to ease the discomfort, and if it would come out by itself in the end?
Health at Hand nurses: Hi Joanne L splinters are always distressing for young children; I would suggest you soak the hand in warm water for a while and then try to tease the splinter out by pressing down on the embedded end and pushing outwards. It often helps if you use something that doesn't look 'surgical' such as a plastic spoon. If it won't come out easily you might put some magnesium sulphate paste on (you can buy this over the counter), cover this with a plaster and let it work it's way out.
SRich asked: I have a choice to make between keyhole and open surgery shortly and I am concerned about MRSA and infection possibilities…..although I have great confidence in my (probable) choice of surgeon.
Health at Hand nurses: Dear SRich I would suggest that you ask your surgeon for information about MRSA levels at the hospital you will be attending and what measures they have in place for screening and prevention. I suspect that keyhole surgery carries a slightly smaller risk than open surgery but it would be advisable to discuss your concerns and questions directly with your consultant.
SRich: Yes…..I have done a lot of research on the various levels of infection..and although minimal in private facilities it would appear….it is still a concern. Thanks for your help and I will speak again with my consultant.
AXA PPP healthcare asked: Thanks, we have a question from blogger Gilla who asks: Do children need to drink more in very hot weather? If so, how much should they drink?
Health at Hand nurses: Hi Gilla, we should all increase our fluid intake in hot weather, and children tend to dehydrate that much quicker so encouraging them to drink more is a very good idea. It will also get them in to the habit of drinking healthy levels all year round. Recommended intake levels will vary according to age, size, general health status and climate, but to sip at a drink every hour during the day to avoid thirst and to maintain good urine output is a good start.
Giordana asked: Hello. My question is about travelling abroad - very often when I've travelled by air in the past I've ended up with a mild viral infection and even have an elderly neighbour who contracted influenza type B on a flight back from Europe. Now that I have young children (who haven't yet flown) I am extremely worried about taking them on holiday. My partner says I am over-worrying. Do you have any advice on young children and air travel?
Health at Hand nurses: Hi Giordana I can understand your concerns but do try not to worry. If your children are in good general health they will not be more vulnerable to picking up viral infections during air travel than they would be in the classroom or any other crowded place. You might choose not to activate the overhead air 'nozzle', but otherwise I am sure the benefits of your holiday will outweigh any possible disbenefits from air travel. Obviously, if any of your children are particularly vulnerable healthwise you should chat to your doctor before making any plans. Have a lovely holiday!
Alfred asked: Hi - there's been quite a few warm, stuffy nights recently - it's difficult to get a child to sleep all the way through! Any tips on how to manage this would be appreciated.
Health at Hand nurses: Hi Alfred these warm nights are hard on children! The only things that I can suggest are lighter nightclothes and less covers on the bed (a single sheet will allow them greater freedom to regulate their own body temperature), an open window and/or a fan in the room. If they are old enough they might find it helpful to have a cool drink to hand.
Carolin asks: What's the best way to help a toddler with travel sickness? All medication is for children 3 years or older...
Health at Hand nurses: Dear Carolin; there are some practical things you can do that might help, including taking plenty of breaks in the journey, seating your child near a window, encouraging them to either sleep or watch the horizon and avoid books and electronic games. An antihistamine might be suitable and help (check with your doctor or pharmacist first), and many people find ginger effective, either in a biscuit or as a tea. Good luck!
Bethany asks: Can you give me some advice to prevent blocked ears/sinuses for a toddlers first flight? I know how painful 'popping ears' can be!
Health at Hand nurses: Dear Bethany; slowly sipping fluid will encourage your little one to keep those eustachian tubes patent, especially during take off and landing when the problems most commonly occur. Sadly, crying also helps with this process! If you are worried about blocked sinuses then do seek advice from your GP prior to travel as there may be something he/she can prescribe that will help.
Dee asks: Any ideas on how to treat travel sickness in children? I don't like to use tablets if it's possible to avoid them.
Health at Hand nurses: Hi Dee; there are some practical things you can do that might help, including taking plenty of breaks in the journey, seating your child near a window, encouraging them to either sleep or watch the horizon and avoid books and electronic games. Many people find ginger effective, either in a biscuit or as a tea. Good luck!
Lastkisstoo: My 8yr old daughter has suffered chronic tonsillitis over the last few years. GP reluctant to operate because of anaesthesia risk. Is there anything I can do to help her fight it and minimise symptoms? She's missing a lot of school and is on antibiotics too regularly for my liking.
Lesley B asks: My 8 year old suffers frequently from tonsillitis. This is very debilitating for her and she misses out on quite a bit of school as a result. GP reluctant to refer her for surgery due to the risk of death from anaesthesia… so we continue to hope that she will eventually grow out of it. Is there anything I can be doing to avoid her getting it, or reduce her symptoms when she does? She seems to be on antibiotics every few months - which I am sure reduces their effectiveness as well as worrying me that she needs so much medication.
Health at Hand nurses: Dear lastkisstoo and Lesley your daughter will almost certainly grow out of this eventually but I understand your concerns. Your GP is making a sensible point but I think it might be a good idea to ask them for a referral to an Ear Nose and Throat specialist for a second opinion, as you are also concerned about the amount of antibiotics your daughter is taking and the affects of this chronic condition on her life generally. If the ENT consultant recommends not having tonsils removed, then you could go back to your GP to discuss additional measures such as possible supplements of vitamins etc.
George C asked: Should we really be worried about wrapping up our kids in cotton would this summer to protect them from the elements? As a child I would bather in the mud outside, eat food off the ground and be constantly filthy. Do you think today's more common clean freak culture with antibacterial everything in products and the fear of dirt within homes is causing the increase found in allergies and illnesses such as asthma?
Health at Hand nurses: Yours is a popular view, George, and one borne out in a certain amount of research. However, it is also understood that the ability to diagnose more accurately goes some way to explaining the apparent statistical rise in allergies and illnesses such as asthma.
Katy M asked: How do you handle a child who claims they have a headache? How can you work out the severity and/or potential medication?
Health at Hand nurses: Hi Katy, it might be useful to introduce your child to the notion of pain scoring using their own experience as a benchmark, e.g. "is it as painful as the time you shut your finger in the door?" or something like that. A scale of 0 (no pain) to 10 (the worst ever), in conjunction with a headache diary, might help you to get a clearer picture. Good luck!
Caroline J s asked: What is the best way to prevent head lice in children, as my youngest is forever picking them up at school?
Health at Hand nurses: Hi Caroline; head lice prevention is so difficult! It is not recommended to use any of the lotions or treatments available on the market unless you see a moving living louse, but I suggest you get into the habit of using copious amounts of conditioner after each hair wash and then comb your little one's hair through with a lice comb (you can buy this in a pharmacy). This way, if there are any newly-adopted lice in their hair they will not be able to cling on. Check the results on a piece of kitchen towel, and if you see a louse (the size of a sesame seed), you can get on with treatment really quickly.
Rebecca asks: School is about to start again and my 2 kids seem to BREED Nits, a child with them only has to be in the same room and they seem to catch them….what is the best way to treat them and rid their heads of them because I can't seem to get rid and keep them away
Health at Hand nurses: Hi Rebecca; this is such a frustrating problem for you! Prevention and early detection are the best way forward, so I suggest that you invest in a big bottle of hair conditioner and a nit comb and put lashings of the conditioner on your children's hair after each hair wash. Comb through thoroughly in sections with the nit comb and check the comb contents against a piece of white kitchen towel or similar. You should only start treatment if you see a moving living louse. Tie long hair up with scrunchies OR keep hair short and try to discourage head-to-head contact wherever possible. Use a hot wash for pillow cases etc, and send hats, cycle helmets and favourite cuddly toys for regular trips to the freezer (in knotted plastic bags, of course). Good luck!
Sonya asks: Chickenpox is doing the rounds in my neighbourhood, obviously should he get it, he just turned one year old and is too young to understand not scratching, what is the most effective way to reduce the itches?
Health at Hand nurses: Dear Sonya; if your son gets the chicken pox he might benefit from some antihistamine liquid but obviously you would have to check with your doctor or pharmacist first. Otherwise, make sure his nails are as short as possible, get in a supply of calamine lotion and maybe even consider a pair of mittens, at least for night time when he is sleeping.
Melanie asks: I have been told to come over to a few people's houses when their kids had chicken pox but was unsure whether I should as my youngest has only just turned two. Would it be ok if she got it now or would it pose any extra problems because of her age?
Health at Hand nurses: Hi Melanie; there's no good time to get chicken pox, but it is often observed that younger children tolerate it better. It shouldn't pose any extra health problems as long as she is in good general health.
Collette asks: My niece has just had chicken pox and has little red spots left, what is the best natural product to help the scars heal up?
Health at Hand nurses: Dear Collette; there are a number of preparations available that claim to help with scarring; I suggest you call in to your local pharmacist for advice.
Julie A asks: Any alternative therapies to cure psoriasis?
Health at Hand nurses: Hi Julie; there are a number of alternative therapies that claim to help psoriasis sufferers, but I am not able to recommend anything. Why not get in touch with the Psoriasis Association for some ideas?
Lily asks: what is the best way of dealing with diaorrhea in the under two's?
Health at Hand nurses: Dear Lily; diarrhoea in children is usually self-limiting but this obviously depends on the cause. Most infectious diarrhoea is viral in origin and therefore active medical treatment is rare. The most important thing is to guard against dehydration, so small amounts of fluid regularly, preferably with a rehydration solution (ask your pharmacist for something suitable). Keep diet bland and avoid fatty or spicy foods and talk to your doctor if you are worried.
Lisa asks: When children and adults get dehydrated either due to a tummy bug or hot weather what is the best natural remedy? All too often dioralyte is advised, but this is not always on hand or available unless a prescription is obtained from a doctor.
Health at Hand nurses: Hi Lisa; the key issue in such situations, as you rightly say, is to guard against dehydration, so small amounts of fluid frequently is the key. You should be able to purchase rehydration fluid or sachets over the counter, and it's a good idea to keep some in your medicine cabinet or travel first aid kit. If in doubt, Lisa, particularly with children, seek a doctor's advice.
4. Health and nutrition
Roz asked: My little boy is 4 and a half months old. I haven't started weaning yet. He is on high calorie formula prescribed from a dietician as well as breast milk. He seems to be really focussed on people when they are eating and tries to grab your hand. Should I start introducing baby rice/purees or wait the recommended 6 months?
Health at Hand nurses: Dear Roz, your little boy sounds wonderfully alert and lively! However, if he is already being supported by a dietician and you have no specific new concerns about his weight and general health status I think you should aim to wait for the six months target. If in doubt, why not chat to your health visitor?
Boo Roo and Tiger too asked: Both of my children are fussy eaters, would you recommend giving them a multi-vitamin each day to help them gain the vitamins and minerals they are not gaining though their food intake?
Sara O asks: My daughter is a very fussy eater and refuses a lot of healthy foods. What is the best supplement I can give her that isn't too expensive. She is 3 years old.
Health at Hand nurses: Hi BooRoo and Tiger too and Sara O; certainly if you are in any doubt about their development and general health I would consider a vitamin supplement, although I would run that past your GP or health visitor first, ideally. However, if they are fussy in the sense that the foods they will eat are limited, as long as they will eat something from each main recommended food group I would try not to worry. Eventually, they will develop their palate to encompass all sorts!
Attachment Mummy asked: My 2.5 year old is petite and skinny, weighing only 24lb. She wears 12-18 month or 18-24 months cloths. Dad and I are both average. We have never been concerned about her size, but lately friends and family have been raising concerns. Should we be worried?
Health at Hand nurses: Dear AttachmentMummy; a lot depends on where your daughter is on her centile chart and if she is continuing to follow a pattern from birth. If you and her Dad are not worried, and you are happy that your daughter herself is happy and thriving, I should try not to worry. A chat with your GP or health visitor, though, might help to allay any lingering concerns.
Clare asked: As an eco-friendly shopper, I wanted to know if there are any environmentally friendly anti-histamine products already on the market or any soon to be released?
Health at Hand nurses: Dear Clare, I've spoken to our pharmacist and he has advised that environmental concerns with medicinal products tend to apply to things such as aerosols (e.g. needing to ensure that the propellant gas does not damage the ozone layer). Antihistamines however tend to be supplied as tablets or liquids, and so I feel you can use them with a clear 'eco-conscience'!
Ghostwritemummy asked: I'd like to know how best to deal with toddlers and hayfever. Is it linked to eczema and cow's milk allergies? What is best to use for under 3s?
Health at Hand nurses: Dear Ghostwritemummy this is a tricky one! There is often a connection between hayfever and eczema, and in turn there are links between eczema and cows milk allergy, but there is no evidence to suggest a direct link between hayfever and cows milk allergy. As for managing hayfever with your toddler, your GP or local pharmacist will advise you as to suitable preparations (a liquid will be preferable to tablets I would think).
Nikki asked: All of my children suffer with hayfever, I give them anti histamine but should I be keeping windows shut to prevent symptoms or does having the windows open help?
Health at hand nurses: Hi Nikki it would probably help to keep windows and doors shut, or at the very least keep curtains shut if it is too hot to shut yourselves in completely.
Elaine L asked: My Grandson (6) finds his eyes get very red, sore, itchy and mucky when out in the sunshine. Other than keeping him in (not fair) over and above him wearing sun glasses what would you suggest?
Health at Hand nurses: Good morning Elaine L I am wondering if your grandson suffers from hayfever or other seasonal allergies as all the symptoms you describe would fit in with this. If so, he would probably benefit from some antihistamine, so you might want to suggest he sees his doctor. Other than this, if his problem is hypersensitivity to sunlight it might be worth investing in some good quality sunglasses. It might also help if your grandson gets in to the habit of splashing cool water on his face and in his eyes; he'll have to get in to good handwashing habits first!
Karen asked: Is there an age where hay fever can develop, or can it affect any age?
Health at Hand nurses: Hi Karen, hayfever can develop at any age although it is more common in teenagers. It is slightly more common in boys than girls although affects adults equally. It will usually resolve after a few years although in some it persists.
Julie W asked: Julie W asks: My 10 year old son has been sneezing all the time for about the last fortnight, but he doesn't seem to have a cold. There's no sore throat or runny eyes, or yellow discharge from his nose. Could it be hay fever or an allergy?
Health at Hand nurses: Hi Julie W pollen counts have been unpredictably high recently and this might signify the onset of hayfever. However, this could be allergic rhinitis of a different origin and as such it would be well worth checking with your doctor, if only to discuss appropriate symptom management.
Vita asked: Can you get anti-histamine for children under 6? My 4 year old has been getting hay fever symptoms the last few weeks where the pollen count has been high.
Health at Hand nurses: Hi Vita restrictions on antihistamines for young children have increased in recent years, and if you are uncertain as to the cause of your little one's symptoms it would be a good idea to check with your GP first, but they are available over the counter. I suggest you take advice from the pharmacist as to a suitable product.
Jenny asked: How can you tell if an 8 month old has hay fever or not? She has clear mucus running from her nose, red eyes and sneezes a lot. My husband has hay fever so I'm not sure if she has it or a cold/is teething!
Health at Hand nurses: Hi Jenny the fact that your husband suffers from hayfever does increase the chances that your daughter might be suffering from it, although commonly the onset of hayfever is in older children (and more boys than girls). As the mucus is clear it is probably not related to infection (assuming she is in good general health), but it would be a good idea to discuss these symptoms with your GP or health visitor, particularly as she is still so little and any potential symptom management would have to be very carefully prescribed.
Marina asks: My partner has signs of hay fever allergy, he's taking blood pressure tablets. Can he take hay fever tablets too?
Health at Hand nurses: Dear Marina; this is a question that a doctor or pharmacist needs to answer for you.
Olivia C asked: What's the best home remedy for toddlers with hay fever?
Health at Hand nurses: Hi Olivia; it is very difficult to recommend anything as a treatment for hay fever, particularly in toddlers, from the complimentary therapy point of view, but in terms of symptom management you can try and avoid exposure during peak times, when grass is being cut, wear wrap around sunglasses and change clothes after exposure. You might also consider keeping windows and doors shut and avoiding fresh cut flowers in the house.
Gemma asked: Can local honey help with the symptoms of hay fever?
Health at Hand nurses: Hi Gemma, there are differing views on this, and little in the way of research evidence, so I can really only observe that you would not be exposing the individual to any risk by trying it, assuming there are no underlying health issues that would preclude eating honey.
Emma R asked: What's the best way to deal with hayfever in small children? My 1 year old seems to suffer very badly with it and I'm not sure the best anti-histamines for young ones.
Health at Hand nurses: Dear Emma R, there are a number of preparations available over the counter for young children with hay fever but I would strongly recommend that you talk to either your GP (preferably) or your local pharmacist for more specific advice in view of your child's age.
Danielle A asked: My son is always sneezing during the summer months which we presume is hayfever…he is only 2 and a half… is there anything safe enough to give him to ease the symptoms?
Health at Hand nurses: Hi Danielle, I think it would be a good idea to see your GP first just to check the diagnosis; they will then be able to recommend a suitable preparation to manage your son's symptoms. Good luck!
Trish asked: My daughter suffers quite badly from hayfever but the anti-histamine tablet effects have started to wear off quite quickly. Should I switch from brand to brand or take her to the GP?
Health at Hand nurses: Hi Trish, do take her to the GP first in order to be sure that you effect the change-over in the safest possible way.
Sandy asked: Is sneezing and coughing during summer always to do with hayfever?
Health at Hand nurses: Hi Sandy; these can be symptoms of asthma or allergic rhinitis, so it would be worth a visit to your GP to discuss.
Jon asked: What is the best way to combat hayfever without drugs?
Health at Hand nurses: Hello John, prevention is your best approach I think; try and avoid exposure during peak times, when grass is being cut, wear wrap around sunglasses and change clothes after exposure. You might also consider keeping windows and doors shut and avoiding fresh cut flowers in the house.
Herb asked: what is the best way of testing for hay fever in an under two?
Health at Hand nurses: Dear Herb; I suggest you ask your GP for a referral to a paediatric allergy specialist.
Ramblings of a suburban mummy asked: What's the best way to treat heat rashes in children?
Health at Hand nurses: Hi suburban mummy; you might try some calamine lotion to soothe the skin, and if it's really troublesome or distressing then antihistamine might help (although you should check this with your doctor or pharmacist first). Other than this it's just keeping them cool and well hydrated.
Sarah R asked: What is the best way to treat heat rash? Have tried after sun with aloe vera and hydrocortisone.
Health at Hand nurses: Hi Sarah R; you might try some calamine lotion to soothe the skin, and if it's really troublesome or distressing then antihistamine might help (although you should check this with your doctor or pharmacist first). Other than this it's just keeping them cool and well hydrated.
Kayleigh asked: My brother is hitting 14yrs old and has started to come out in awful spots across his forehead, he is washing more and using "freederm" but it isn't working. What do you recommend?
Health at Hand nurses: Hi Kayleigh; there are lots of preparations available that might help your brother and it would be worth chatting to your local pharmacist. Alternatively, your brother might well benefit from a GP visit to discuss possible low dose antibiotics (particularly if the problem is causing him distress).
Sharon G asked: What is the best way to relieve and soothe a nettle rash in children?
Health at Hand nurses: Dear Sharon G; nettle rash is very distressing to children and luckily the ill effects are short lived! Calamine lotion is very soothing, but it is a good idea to get them to bathe the area with cool water first.
Anonymous asked: What can you do if your child has hives while on holiday and there is no pharmacy? Any way of treating them until you can get creams etc. It's happened to me!
Health at Hand nurses: Dear anonymous; in such instances it's probably a good idea to go prepared with something you have bought in this country following discussion with your local pharmacist re suitability. If you have any idea what is causing the hives it would be well worth avoiding it or them!
Becky asked: How can you prevent/reduce the symptoms of eczema? Feel so sorry for my poor 10 year old!
Health at Hand nurses: Hi Becky; I feel sorry for them too! I think you need to talk this through with your GP, and perhaps even consider asking for a dermatology referral?
Alison asks: my little one has eczema, and the heat makes her skin itch really badly, is there anything i can do to help her during the day?
Health at Hand nurses: Hi Alison; it's really only the common sense things like loose light clothing, cool fluids, avoid excessive heat, but you might want to discuss giving them an antihistamine with your GP.
Emma asked: I find my son's eczema flares up with sun cream use, how can I reduce the irritation and still keep him protected from the sun? Its on the back of his knees and inside of arms, and I've already tried organic, more natural sun creams.
Health at Hand nurses: Hi Emma; this is a very specialised area, and I would be happier if you discussed this with either your GP or your local pharmacist.
Lana asks: Whats the best way of treating eczema?
Health at Hand nurses: Hi Lana; you need to consult your doctor for this as it depends on the type of eczema, your child's age and general health.
Domestic Goddesque asks: I went to a pharmacist on a recent trip to the States when LBg came up with a rash on her arms- from wrists to where your t-shirt would come to. They were no help. I ended up buying Clarityn for children and some analgesic cream but would appreciate suggestions for what to do if it happens again….
Health at Hand nurses: Dear Domestic Goddesque; if this happens again try washing your little one's arms as this sounds like a possible contact dermatitis. Where possible keep the area covered, and it might be worth arming yourself in advance with a more appropriate antihistamine so a trip to your local pharmacist would be a good idea.
The fairy and the frog asks: The Frog recently tried peanut butter for the first time (he's 10 months), about half a hour afterwards he had a rash that looked like heat rash, is it coincidence (as it was a hot day it could be heat rash) or do I need to be worried/ do anything special? He had no other symptoms (his breathing was fine etc) and the rash had gone by the next day.
Health at Hand nurses: Dear fairy; I think you should err on the side of caution and be very watchful the next time your little frog is exposed to peanut butter as this might well be an allergic reaction. Classically, the very first reaction is very mild, but the second can be more severe as the body now mistakenly thinks the peanut is an invader and throws lots of histamine at it.
Tracey asks: I have a young girl who always gets a rash after swimming. Can the chlorine in a swimming pool really affect sensitive skin? Is there anything that I can apply prior to swimming to help to prevent the rash and after itch?
Health at Hand nurses: Hi Tracey; many people suffer this way and there are a number of lotions on the market that claim to block the chlorine from the skin. Why not ask your local pharmacist or research on the internet? Do make sure your daughter takes a good shower as soon as she gets out of the pool.
Attachment mummy asks: My daughters are both fruit mad, and after a few days of heavy fruit consumption get nappy rash. It goes away with air time and occasional use of cream, but is this indicative of a bigger intolerance/allergy?
Health at Hand nurses: Dear attachment mummy; this is quite normal, although perhaps you could vary the fruit types to avoid some of the more acidic ones?
Claire JB asks: What is the best way of treating dry, itchy, scalp in young kids? Are there any suitable medicated shampoos for children which aren't too harsh? What would be the most likely cause of dry itchy scalp? Could it be an allergy or intolerance to a foodstuff or something in the environment?
Health at Hand nurses: Hi ClaireJB; I think if your child had a food allergy or intolerance the itching and dry skin would be more widespread. It seems more likely that this is a contact dermatitis; that is, a localised allergic reaction, so a very gentle hypoallergenic shampoo is indicated. Why don't you drop in to your local pharmacy and chat over your options?
Yasmine asks: great prize these answer & question sessions are very useful
my question is that she is always getting nappy rash aged 1 any advice to beat this
Health at Hand nurses: Hi Yasmine; thank you for that comment! Hopefully you are taking full advantage of this better weather and letting your little one go 'commando' whenever possible to allow the air to get to the nappy area. More frequent nappy changes and a good barrier cream are otherwise the mainstay of management. It might be worth keeping a chart to see whether the problem relates to any particular foodstuffs that she is eating (or you, if you are breastfeeding!).
6. Hot weather
Brian asked: Hi I'm unsure about the difference between sun block and different levels of sunscreen - my family are extremely fair skinned, what do you suggest?
Health at Hand nurses: Hi Brian fair skinned people generally need a sun protection product with a higher sun protection factor (SPF). The confusion is understandable, but essentially the word 'block' simply indicates the degree of protection afforded by the product and is therefore the same thing. Total sunblock is helpful in particularly sensitive areas.
EmmaR asked: You hear such conflicting stories in the press these days about protecting children from sun damage but at the same time that the Vitamin D you'll get from sun exposure is good for you. What is the happy medium?
Health at Hand nurses: Hi EmmaR it is difficult to get this balance right! Clearly, protection from the harmful rays the sun emits is essential, so perhaps the way to tackle this is to concentrate on greater protection from the sun during the central part of the day (11 to 3ish ) with cream, hats and sleeves etc, then reducing this when the sun is less strong. Don't forget your child will still absorb the healthy effects of sun exposure even with appropriate sun protection in place.
Laura F asked: What should you do if your toddler has become sunburnt? I do try to put factor 50 on his face but I still worry and there's the odd time I forget.
Health at Hand nurses: Hi Laura; your best bet is to get him in the habit of wearing a floppy hat or legionnaire's cap at all times, and maybe also putting suncream application in to your daily routine in the summer regardless of the weather, i.e. whilst dressing him in the morning. If he does get burnt, use calamine lotion or a good after sun preparation specific to his age and condition and make sure he drinks lots of fluids to help rehydrate him. Sunburn can be quite dangerous in small children, so if in doubt, take him to get checked out.
Lucia asked: What can you do about toddler sunburn if you are unlucky enough to have been caught out, despite sun screen, etc???? Is calamine lotion the only option?
Health at Hand nurses: Hi Lucia, it is so difficult to keep little ones safe in the sun! Your best bet is to get him in the habit of wearing a floppy hat or legionnaire's cap at all times, and maybe also putting suncream application in to your daily routine in the summer regardless of the weather, i.e. whilst dressing him in the morning. If he does get burnt, use calamine lotion or a good after sun preparation specific to his age and condition and make sure he drinks lots of fluids to help rehydrate him. Sunburn can be quite dangerous in small children, so if in doubt, take him to get checked out.
Liz asked: I'd like to ask about heat/sun stroke. What are the signs to look for and what action should you take? Of course, understanding that prevention is better than cure.
Health at Hand nurses: Hello Liz, the main symptoms to look out for are headache, excessive thirst, disorientation or confusion, and possible fainting/collapse. Any suspected sunstroke should be treated as a medical emergency. You're quite right about the prevention; sun and hot weather is so welcome, it's a shame it can be so harmful!
Kelly asked: My daughter has sunburn on her shoulders which we are constantly applying after sun to, however I wondered if giving her paracetamol may east her discomfort. She is 8 years old.
Health at Hand nurses: Hi Kelly, Paracetamol or an anti-inflammatory such as Ibuprofen will help to ease her discomfort, assuming she can take one or both of these safely and she takes it within the normal safe administration guidelines. Additional fluids and rest in a cool place will also help.
Cressi asked: Any suggestions for heat exhaustion? I know it's not a problem in this country very often but it does happen sometimes in mine.
Health at Hand nurses: Hi Cressi, heat exhaustion can be quite serious, so if in doubt seek urgent medical attention. The sufferer should be encourages to take additional fluids and to rest in a cool dark room. Headache can be treated with over-the-counter medications as appropriate and per safe administration guidelines.
Craig asked: What can I do with my 4 year old, he has sun burn and won't stop pulling at this peeling skin?
Health at Hand nurses: Dear Craig; your poor son must be so uncomfortable! A good after sun moisturiser would probably help (I suggest you chat with your local pharmacist for product advice). He may even need an antihistamine, but again, I would recommend seeking advice first. If suitable, perhaps he could wear clothes that will stop him peeling his skin or at least make it less accessible.
Mandi asked: Are there any sun creams suitable for psoriasis sufferers, my children's psoriasis is cleared up by the sun, but I obviously want the rest of their body to be protected from the sun, what would you suggest?
Health at Hand nurses: Dear Mandi, I think you probably need to speak to a pharmacist about this or even visit your GP as it is so very specific to your children's medical condition.
Suki asked: My daughter is 4, she gets awful peeling in the sun despite my putting sun cream on. How can I keep her skin hydrated?
Health at Hand nurses: Hi Suki; a good after sun moisturiser would probably help (I suggest you chat with your local pharmacist for product advice). She may even need an antihistamine, but again, I would recommend seeking advice first. If suitable, perhaps she could wear clothes that will stop her peeling her skin or at least make it less accessible.
Bex asked: My son is 12 months and I struggle to keep him cool and hydrated during the summer months as he doesn't seem to want to drink any water. What advice can you give?
Health at Hand nurses: Dear Bex; I think you will have to be as inventive as possible with his fluid intake! Try tempting him with different drinks or give him 'sloppier' meals containing more fluids. If he would tolerate spoonfuls of soft semi-defrosted ice lolly or ice cubes that might work.
Lorraine asked: How can I achieve a balance of getting enough sunlight for my young children to help with Vit D production and still keeping them safe from the sun rays?
Health at Hand nurses: Hi Lorraine; this is indeed a difficult balance to achieve! I suggest you avoid exposure at the hottest part of the day, then allow them to absorb the sun's healthy rays earlier and later in the day in conjunction with a good sun protection preparation to screen out the harmful rays, plus a hat and an increased fluid intake.
Bloggomy asked: When I apply sun cream to my children's faces they get a rash under the skin that looks like heat rash but skin coloured not red rash. What is this and how do I treat it???
Health at Hand nurses: Dear Bloggomy, it sounds as if your children might be allergic to the cream in this most sensitive of areas, so I think you need to talk to your local pharmacist to discuss what other preparations might be suitable.
Juanita asked: What is the best thing to put on a child's sunburn to cool it down and to make them more comfortable?
Health at Hand nurses: Hi Juanita; calamine lotion or a good after sun preparation specific to their age and condition should help. You could also make sure they drink lots of fluids to help rehydrate them. Sunburn can be quite dangerous in small children, so if in doubt, take them to get checked out.
Elaine L asked: Any hints and tips for keeping children on the beach in hot weather from burning apart from sunscreen?
Health at Hand nurses: Hello Elaine; a well-fitting floppy hat or legionnaires cap is a good start, one that they will keep on their head! Additionally, an extra (light) layer is good if they will tolerate it; there are some good textiles available these days with this in mind. Other than this, activities that will tempt them to stay under the shade of an umbrella are your best bet. Good luck!
Angela s asked: My 8 year old gets a lot of headaches in the sun. Is there anything I can do to help prevent this? I don't want to keep giving him painkillers.
Health at Hand nurses: Dear Angela s; the only thing you can really do is keep him well hydrated and doesn't get over heated. If the headaches persist, perhaps a word with your doctor might help in terms of symptom management.
Michaela asked: My daughter recently got sunburn at the beach even though I had her in the shade at all times. If this happened again what would be the best way to treat it immediately? I used Sudocreme and after sun which didn't help and eventually resorted to Savlon which seemed to do the trick, but is there anything else which would help sensitive skin?
Health at Hand nurses: Hello Michaela; it sounds as if you are doing everything right. You might try calamine lotion; I would certainly have a word with your local pharmacist as there are so many preparations on the market to choose from. Other than this, I can only suggest that you review the practical skin cover, i.e. hats and sleeves etc.
Rosie C asked: IS regular baby sunscreen ok to use if my baby has eczema or do I need to buy specialist type?
Health at Hand nurses: Hi Rosie; I would be happier if you would discuss this with either your GP or local pharmacist in view of your baby's eczema.
Jennifer S asked: Can you put sun cream on a head full of cradle cap? My daughter is 1 year old and still has bad cradle cap which is only just slowly starting to come off, she will not wear a hat, we have been trying for months, it lasts 3 seconds before being pulled off! Last week she burnt the top of her head; it didn't seem to bother her but was quite red. We're going to America very soon and I don't know if I can put a sensitive sun cream on top of the cradle cap or if this will irritate it!
Health at Hand nurses: Dear Jennifer S; this is really difficult for you! I can understand your frustration at not being able to get your daughter to keep a hat on; I think in that case you will have to resign yourself to staying out of the sun. I think you should discuss appropriate sun cream with your doctor or local pharmacist as she needs something quite specific.
Kendel asked: My son is diagnosed as Vitamin D deficient as I know it's important that he is exposed to sunlight, how much sun does he need and how do I do this safely without the risk of sun burn?
Health at Hand nurses: Dear Kendel; this is indeed a difficult balance to achieve! I suggest you avoid exposure at the hottest part of the day, then allow him to absorb the sun's healthy rays earlier and later in the day in conjunction with a good sun protection preparation to screen out the harmful rays, plus a hat and an increased fluid intake.
Allison asked: My son gets very hot and sweaty; he wears t-shirts even in the cold weather and goes bright red in the face. How can I stop him from overheating in the warm weather?
Health at Hand nurses: Dear Allison; there are some good textiles on the market these days that allow a good airing of the body; it might be worth looking at a supplier of sportswear for children. In addition to this encourage him to stay cool by taking plenty of fluids and staying in the shade.
Emma asks: How can I prevent eczema flare ups aggravated by heat?
Health at Hand nurses: Hi Emma; It's really the same as at any time, i.e. avoiding known triggers, but it will be especially important to keep your child's skin well moisturised. Your local pharmacist should be able to advise you on suitable preparations.
Sammie asks: My son (aged 3) suffers from Eczema and it seems a lot worse in the summer months. Is there anything I can do to stop it coming up so bad in the summer? We are prescribed E45 but would really appreciate any advice on what else I could be doing to help him.
Health at Hand nurses: Dear Sammie; The heat and sun are so difficult for children with eczema, but it's really the same as at any time, i.e. avoiding known triggers, but it will be especially important to keep your child's skin well moisturised. Your local pharmacist should be able to advise you on suitable preparations.
Jo asks: What is the best way of preventing and treating heat rash? My 6 year old just started to get it this year and it looks terrible!
Health at Hand nurses: Hi Jo; heat rash can look quite alarming and make children feel so uncomfortable! Lots of cool drinks, calamine lotion or an appropriate moisturiser on the skin, loose non-irritant clothing and possible a fan, particularly at night, will all help. You might want to consider using an anti-histamine liquid, but please discuss with your pharmacist first.
Melissa B asks: My son gets terrible heat rash when it's hot and sunny and we've been applying a lot of sunscreen. Can you recommend any remedies to help soothe his itchy spots? The spots seem to linger for a few days as well, I tied calamine but it didn't help.
Health at Hand nurses: Dear Melissa B; lots of cool drinks, an appropriate moisturiser on the skin, loose non-irritant clothing and possible a fan, particularly at night, will all help. You might want to consider using an anti-histamine liquid, but please discuss with your pharmacist first.
Domestic Goddesque asks: Having just returned from a holiday where one child got prickly heat and the other an allergic reaction (which manifested in a rash all over her arms but nowhere else), I would ask what are the best ways to treat these complaints.
Health at Hand nurses: Dear Domestic Goddesque; calamine lotion should soothe their skin, in conjunction with cool drinks, loose non-irritant clothing and perhaps an anti-histamine lotion (although please talk to your pharmacist first).
Nicola asks: I would love to know if there is any form of medication I can give a 2 year old to relieve the effects of prickly heat as my little man suffers badly from it.
Health at Hand nurses: Hi Nicola; children can be given antihistamine medication from the age of one so you might like to discuss this with your local pharmacist. I do hope that helps him!
Jamielee asks: My daughter suffers severely from prickly heat when she goes out in the sun and I apply sun cream to her skin. However I'd hate to stop her going out in the sun, yet she ends up so itchy and it keeps her awake at night as she is very uncomfortable. Is there anything I can do to prevent it or help treat it when she has it?
Health at Hand nurses: Hi Jamielee; your poor daughter! Calamine lotion should soothe her skin, in conjunction with cool drinks, loose non-irritant clothing and perhaps an anti-histamine lotion (although please talk to your pharmacist first).
Cheryl asks: my son suffers heat rashes ~ can you suggest a non medicated (alternative remedy) for helping with the itch?
Health at Hand nurses: Hi Cheryl; it's difficult to recommend anything specific to you for your son, but I'm sure your local pharmacist will be able to.
Ann asks: What's the best way to treat heat rashes?
Health at Hand nurses: Hi Ann; Lots of cool drinks, calamine lotion or an appropriate moisturiser on the skin, loose non-irritant clothing and possible a fan, particularly at night, will all help. You might want to consider using an anti-histamine liquid, but please discuss with your pharmacist first.
Emma J asks: what can you put on prickly heat?
Health at Hand nurses: Hi Emma J; Calamine lotion or an appropriate moisturiser should soothe the skin, in conjunction with cool drinks, loose non-irritant clothing and perhaps an anti-histamine lotion (although please talk to your pharmacist first).
Emma P asks: Is there anything to prevent getting heat rash?
Health at Hand nurses: Dear Emma P; Try to keep your child cool and well hydrated, wearing loose clothing made from 'breathable' material.
Julz asks: How much is too much to drink when it's particularly sunny/hot?
Health at Hand nurses: Hi Julz; the amount of fluid a person needs to remain adequately hydrated during hot weather varies according to age and weight so a single figure is difficult to set. As a general rule, a child should be drinking enough to keep them passing normal amounts of urine with normal regularity that does not appear unduly concentrated. Fluids should be sipped regularly rather than taken in single large boluses.
Maggy, a blogger from www.redtedart.com asks: what first aid do you apply to a child that is allergic to a bee sting - of course call the ambulance, but what else can you do and what should you do if your child has fallen from a tree or climbing frame? What things should you watch out for over the next 1-2 days?
Health at Hand nurses: Dear Maggy; in answer to the first part of your question, if you know that your child is definitely allergic to bee stings you should carry some antihistamine around with you at all times; obviously type and dose should be determined by your doctor. If she has had a full-blown anaphylactic reaction previously then you may well be prescribed an adrenalin auto-injector. You don't say how old your daughter is, but it is a good idea to notify school, if appropriate, or anyone who looks after her in your absence about her allergy and what they need to look out for and do. Any child who falls from a height should be seen by a doctor; regardless of this, any change in behaviour, persistent complaints of pain or unexplained drowsiness should be treated as a potential medical emergency and urgent advice sought.
Stephen H asks: In relation to stings, if your child gets stung for the first time by a wasp or a bee what are the first signs to look for in case they're allergic? and what point should you ring for an ambulance.
Health at Hand nurses: Dear Stephen H; allergic reactions can be quite frightening, and in a very small percentage of sufferers very serious. If the reaction to the sting remains localised then observe it and, more importantly, your child. If attempting to remove a stinger from a bee sting use the credit card method to push it up and out rather that attempt to pull it. If your child becomes breathless or has difficulty swallowing, complains of generalised itching or develops hives, complains of acute stomach cramps, vomiting or diarrhoea, becomes faint or collapses, you should call an ambulance as any combination of these (not necessarily all) might signify the onset of an acute allergic reaction. If you know your child is definitely allergic to bee or wasp stings you should carry some antihistamine around with you at all times; obviously type and dose should be determined by your doctor. If they have had a full-blown anaphylactic reaction previously then you may well be prescribed an adrenalin auto-injector.
Rebecca asks: I would like to ask about insect bites... I've noticed this year we have all been bitten several times, including the twins... They are terribly itchy, is there anything I can do to ease their discomfort?
Health at Hand nurses: Dear Rebecca; there are a number of preparations on the market, both topical and oral, that might help, so I suggest you go and have a chat with your friendly local pharmacist.
Snafflesmummmy asks: Anything else I can do to prevent insect bites? My son must be very tasty. I have some wipes which are supposed to prevent you being bitten however they don't work. I have a pen for instant bite application but it really stings and makes him cry? HELP
Health at Hand nurses: Dear Snafflesmummy; there are a number of different lotions available, some designed specifically to protect younger children from insect bites, so pop down to your local chemist and have a word with the pharmacist.
Jade asks: I would like to know if insect repellent is ok to use on children? If so, which is the best/safest?
Health at Hand nurses: Hi Jade; do talk this over with your local pharmacist as there are a number of good preparations available specifically for children.
Silvia asks: How would you stop a child scratching an itchy bruise, to avoid scars forming?
Health at Hand nurses: Dear Sylvia; I think you will need to make sure finger nails are kept very short and, if necessary, cover the bruise to prevent access.
Kairen asks: I fear my kids being sting whilst out and about by a bee, wasp, or horse fly (teen a keen horsy person and just about lives in the stables). As terrible as it is, I've not got a clue what I am supposed to do whilst said stung child is leaping around like their hands just been cut off. So what is the best way to deal with these sort of stings?
Health at Hand nurses: Hi Kairen; you have my sympathy! Children do not like to be stung! I suggest you put together a mini first aid kit (a separate one for horse-mad teen) containing an insect repellent spray, some soothing skin wipes, a reliever spray/stick and perhaps an instant ice pack. All these things are available in your local pharmacy; if in doubt, ask your pharmacist for advice.
Naomi K asks: In relation to bee stings, how do you know if you're allergic? Are there any tell-tale signs, or do you only find out if you get stung and have a bad reaction?
Health at Hand nurses: Dear Naomi K; unfortunately the first sign of an allergic reaction is just that, although conventionally the first reaction is quite mild. Tell-tale sign include itching (first localised and then more general), and possibly hives and some wheezing. Full-blown allergic reactions will lead to complaints of breathlessness or difficulty in swallowing, acute stomach cramps, vomiting or diarrhoea, fainting or collapse. Needless to say, these all constitute a medical emergency.
Jen asks: I would like to ask how best to treat insect bites on my children. We've been bitten quite a bit in the last month and it's hard to know how to ease their discomfort?
Health at Hand nurses: Hi Jen; there are a number of different lotions available, some designed specifically to protect younger children from insect bites, so pop down to your local chemist and have a word with the pharmacist.
Becky asks: What's the best cure for nettle stings??? Aren't dock leaves a myth?
Health at Hand nurses: Hi Becky; I believe there are some effective properties in the dock leaf that provide an antidote to the urticarial rash caused by stinging nettles, but the most common application is calamine lotion. It's worth washing the area first before applying the lotion. Application of a cool compress or ice pack can also prove soothing.
Jo asks: What is the best way to treat a nasty horsefly bite on a little one?
Health at Hand nurses: Dear Jo; these bites can be nasty; the horsefly cuts rather than pierces the skin and it can be painful and prone to infection. Wash the area with lukewarm soapy water, apply a cool compress or ice pack and some antihistamine cream. Some Calpol or similar might be necessary, and keep nails short to discourage scratching.
Hazel asks: I was bitten by something on my upper leg a few weeks ago. Over the following 24 hours I ended up with a red patch 4 cm across which was at the centre of a swelling which was 7 cm across (my husband was worried and measured it to make sure it wasn't getting any bigger). It took over a week to go down and fade completely (having gone a fetching shade of purple first). What is the best thing to put on the area if I am unlucky enough to get bitten again?
Health at Hand nurses: Hi Hazel; that sounds nasty! I suspect that was a horsefly bite, and my advice would be to arm yourself with an antihistamine cream and possibly tablets should this happen again. The nature of allergic reactions is such that the first reaction can be relatively mild, and the second one more aggressive so, if this does happen again, get yourself to a doctor or hospital if you experience any breathing difficulties, itching or tightness in the throat of a more generalised rash.
Charlotte asks: My toddler loves playing in the garden, but has had a few insect bites - what's the best thing to soothe these?
Health at Hand nurses: Hi Charlotte; wash the area with lukewarm soapy water and apply some soothing calamine lotion. You might want to ask your pharmacist to recommend other appropriate topical preparations.
Nikki M asks: My daughter gets no end of insect bites and they always get inflamed, is there anything I can put on her to hopefully keep the insects away?
Health at Hand nurses: Hi Nikki M; do talk this over with your local pharmacist as there are a number of good preparations available specifically for children.
Becky asks: Just want to know how you manage nettle stings... aren't dock leaves a myth?
Health at Hand nurses: Dear Becky; I believe there are some effective properties in the dock leaf that provide an antidote to the urticarial rash caused by stinging nettles, but the most common application is calamine lotion. It's worth washing the area first before applying the lotion. Application of a cool compress or ice pack can also prove soothing.
Cerys, a blogger from www.rainydaymum.co.uk asks: How can I prevent mossie bites and then treat them if needed and how can I help prevent hay fever like symptoms in very young children?
Health at Hand nurses: Dear Cerys; there are a number of different lotions available, some designed specifically to protect younger children from insect bites, so pop down to your local chemist and have a word with the pharmacist. They will be able to advise you on suitable hay fever treatment as well. To prevent the effects of hay fever you will need to keep little ones in side during peak pollen counts, with windows closed or at least curtains drawn. Wraparound sunglasses also help, plus changing clothes or showering after a period of exposure.
Lindy asks: If you're at the beach and your child steps on a weaver fish in the sand, what's the best way to treat the sting?
Health at Hand nurses: Hi Lindy; a weever fish sting can be quite serious and I suggest that if you suspect that your child has been stung by one you should ask the lifeguard, if available, for first aid advice. You may need to visit you local A&E; apart from anything else, the spines must be very carefully removed.
Laura asks: What is the safest insect repellent to use on small children? I never, ever touch the stuff with deet in it as I've read some terrible things, but my children are prone to getting bitten in the hot weather.
Health at Hand nurses: Dear Laura; there are a number of different lotions available, some designed specifically to protect younger children from insect bites, so pop down to your local chemist and have a word with the pharmacist.
Hannah asks: Are they any good natural on hand remedies we can use for nettle rash and bites rather than having to pop out to the pharmacy?
Health at Hand nurses: Dear Hannah; I believe there are some effective properties in the dock leaf that provide an antidote to the urticarial rash caused by stinging nettles, but the most common application is calamine lotion. It's worth washing the area first before applying the lotion. Application of a cool compress or ice pack can also prove soothing.
Kerry R asks: Is there any natural remedy's for treating insect bites and stings?
Health at Hand nurses: Hi Kerry R; I'm not able to recommend anything specific, but you might like to chat to your local pharmacist about this.
Florence C asks: What is the best remedy for treating nettle stings?
Health at Hand nurses: Dear Florence; good old-fashioned dock leaves do seem to work (by neutralising the pH of the sting, I believe), but it's a good idea to wash the area in warm soapy water first, whenever possible, or wipe over with a gentle wipe. Calamine lotion is very soothing, and little children can be wonderfully distracted by it's application as they need to flap the offending area around to dry the lotion off!
Jennifer S asks: Can you sue those little clickers that give off a really tiny shock for insect bites on 5 year olds? My son is happy to try it as half a Piriton is doing nothing for his itching (he got 7 bites on his thigh the other day then the little blighter got me 4 times- poor kid takes after his mummy for having tasty blood!) I'm just not sure on 'shocking' his delicate skin!
Health at Hand nurses: Dear Jennifer; the ones I've looked at vary in terms of lower age level suitability from 6 months to 4 years, so you might want to go and peruse what's available in your local pharmacy or search online.
Martina asks: I have found a few tiny bites on my son's body recently (just red spots), could they be flea bites? What should I do about them? We are treating our cat for fleas. He is 16 months old.
Health at Hand nurses: Hi Martina; they may be flea bites but impossible to say without looking at them. You could put some calamine lotion on them or perhaps some insect bite lotion (check safe appropriate options with your pharmacist). If the problem persists, run it by your doctor.
8. Other Child Related Questions
Toni asks: When/how do I know what crying is normal for my 6 month old? I often panic when she cries for a while and whilst considering dashing down to the doctors, she stops and nods off and then I am left exhausted and baffled.
Health at Hand nurses: Dear Toni; I am certain you are far from alone with this dilemma! Try to remember that you are the expert on your child, and if something doesn't seem right to you, then it is worth monitoring and possibly following up with your doctor. If there has been no episode where your daughter may have sustained injury and she seems generally well (no fever, vomiting, unusual nappies, rashes) then remind yourself that a 6 month old baby communicates by crying and this is normal. Enjoy the cuddles!
Georgie asks: My 7 year old started getting body odour under her arms about 6 months ago. It is a definite BO smell and can be quite prominent even an hour after bathing. It doesn't seem to be just when the weather is hot either. She is not overweight and has no other puberty signs other than mood swings, but they could be down to just being 7. She is also not sweaty anywhere else and, in fact, has a bit of eczema on her legs. Should I be worried?
Health at Hand nurses: Dear Georgie; 7 is very young to be coping with this, and I think it would be worth a quick chat with your doctor to rule out any underlying causes. Otherwise, it's going to be a case of getting your daughter accustomed to a more stringent personal hygiene routine.
Heather asks: What childhood illnesses are 'notifiable' and what exactly does that mean? Who has to be notified? I ask because someone mentioned it in relation to impetigo but I was left confused.
Health at Hand nurses: Dear Heather; this is a confusing area, but let me clarify…..Doctors, and indeed laboratories, have a duty under the Public Health Acts of 1984 and 1988 to notify the Health Protection Agency of certain communicable diseases (such as acute bacterial meningitis, anthrax, cholera - a long list!). In addition to this, the HPA publish guidance on infection control in schools and other childcare settings to encourage prevention of spread of conditions such as measles, chicken pox and impetigo. They clarify any recommended periods of exclusion (for example with impetigo this is until lesions are crusted and healed, or 48 hours after commencing antibiotic treatment). The onus is on the doctor or laboratory, legally, to notify the HPA where necessary. The person who mentioned 'notifying' impetigo is referring to the best practice of informing school or childcare deliverer.
Cerys asks: How can I help to minimise bruising - my toddlers are very clumsy and tend to fall over a lot and are constantly covered in them?
Health at Hand nurses: Dear Cerys; there isn't a great deal you can do with this, but you might want to look into using arnica homeopathically. Do seek appropriate professional advice, though.
Mary asks: My daughter is 12 and won't take pills, but suffers from migraines. She is tall and I am not sure if I can giver he soluble aspirin or should I stick to children's remedies.
Health at Hand nurses: Hi Mary; please don't give your daughter aspirin as they are not recommended for children due to known links with Reye's Syndrome, a rare condition that causes liver and brain damage. There is absolutely no reason why she shouldn't continue to take medication in liquid form for some years yet; just take your usual care with dosage and frequency. If she needs a more specific anti-migraine medication then do talk to your doctor; he/she might also refer your daughter to a paediatric migraine specialist. One final thought; sometimes migraines respond quite well to diet control or to hormonal review…..worth discussing with your doctor also?
Geraldine R asks: What's the best product to buy for teething - my little boy just seems to lick the gel off!
Health at Hand nurses: Dear Geraldine R; the effects of teething vary so much from child to child, some finding it much harder to tolerate than others. If teething gels don't seem to work on your little boy, you could try encouraging him to chew on a teething ring or some raw carrot, a breadstick or a hard crust (only if this is age-appropriate and safe, obviously!). You could also give him additional cool drinks and might want to consider painkillers for the worst times (consult your doctor if uncertain). Most babies have all their deciduous or 'milk' teeth by the age of 2 and a half; hope that's not too long away!
Fionalynne asks: My doctor has told us that my daughter has Molluscom Warts, which have appeared on the back of her legs. There seems to be no treatment or cure - can you suggest anything please?
Health at Hand nurses: Hi Fionalynne; molluscum contagiosum is a viral skin infection and therefore is not easily treated. In fact, treatment in children is actively resisted by most doctors as the condition, whilst unsightly, does not generally cause distress and will usually resolve by itself within 18 months. Treatments such as bursting the lesions is painful and will leave scarring.
Mandy asks: What is the best way to diminish a wart on a 3 year olds head?
Health at Hand nurses: Hi Mandy; this isn't really something I can safely advise you on, sight unseen, and would recommend you discuss this with your doctor.
Emmys mummy asks: Emmy keep complaining of having a sore front bottom - it's not red and she has been checked for a water infection - could it be heat related? If so how is best to treat it - she still wears a nappy at night as is only 2.5 yrs old.
Health at Hand nurses: Dear Emysmummy; this could be heat related and perhaps she has thrush. I suggest you get your GP to take a look.
Laura asks: my little boy is 6 and seems to bruise easily and is very slender firstly is there anything i should worry about? would tonic help him heal his bruises quicker and how could i get him to put a little weight on healthy, he has a wonderful diet.
Health at Hand nurses: Hi Laura; if you haven't already done so, I would run this past your GP to rule out any medical conditions that might explain the high level of bruising. You can take the opportunity then to ask for advice about age-appropriate vitamin supplements.
Laura asks: My question is how long should a cough last for in a toddler, when should you get it checked out by a doctor?
Health at Hand nurses: Dear Laura; this depends on whether your toddler has other symptoms. If they have a cold then you can try to relieve the cough with linctus and only consult your doctor after perhaps a week or so. If the cough is an isolated symptom and is causing your child any breathing difficulties, consult your doctor sooner in order to exclude asthma.
Emma asks: Does steam inhalation actually help if a child has croup?
Health at Hand nurses: Dear Emma; this is certainly helpful in many cases, encouraging relaxing of the airways and dilution of mucus, making it easier to cough up.
Petra asks: What is the best way to deal with dead skin on baby's head?
Health at Hand nurses: Dear Petra; there are lots of preparations on the market for this. I suggest you ask your health visitor for advice of pop in and see your local pharmacist.
Elaine asks: My six year old daughter has 3 large warts on her hand, do i treat them with an over the counter remedy, or wait for them to drop off.
Health at Hand nurses: Hi Elaine; I think you should discuss this with your GP to be on the safe side.