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Toddlers and preschoolers, as well as older children, need to learn about limits. One of the developmental tasks of toddlers is to explore their surroundings. One of the tasks of parents is to consistently set limits.

Discipline is sometimes perceived as punishment — this is not correct. Discipline means parents teaching children which behaviours are acceptable, and which are not. In doing so, parents are also teaching the child to develop his own self-discipline. As he grows older, he will more easily be able to maintain limits for himself. This then becomes the precursor for self-control which is such an important quality in children (and adults).

Physical punishment

Discipline is not about physical punishment. Smacking or hitting your child should be avoided. It is possible to have a well behaved child without the threat of physical punishment. There are a number of arguments for not hitting children:

• It may teach your child that physical punishment or aggression is an appropriate way to interact with others.

• It has the danger of being an outlet for parental anger, and you will find it difficult to remain calm and in control of the situation while hitting your child.

Try to minimise or avoid the use of physical punishment. Use alternate methods of discipline.

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This is a stimulant and is responsible for the lift most people experience after drinking these beverages, but too many cups may make you tense and irritable and keep you awake if you drink them late at night.

Caffeine tends to constrict the blood vessels and, when the effect wears off, a rebound dilation of the scalp arteries may cause a throbbing headache. Many of the combination analgesic tablets and powders also contain caffeine and can relieve the headache by causing further arterial constriction.

But, when this wears off, headaches may recur.

Analgesic abuse is often related to the regular taking of analgesic tablets and powders for the “lift” experienced, then a rebound headache provides the justification for taking more analgesics.

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Even if the cause is hormonal, it can still be corrected by proper dietary advice.

Once the periods have stopped and the woman has become post-menopausal, late changes may arise from the lack of oestrogen. The bones may lose their protein matrix and, with it, some of their calcium. This is called osteoporosis and the bone is thinner and weaker.

Lack of oestrogen may cause changes in the vaginal walls. The skin lining may become thickened and less moist. This may lead to irritation, infection, a discharge or an intolerable itch. Intercourse becomes difficult.

Similar changes may involve the urethra, the tube which carries the urine from the bladder to the outside. These changes may lead to frequency and pain on passing urine. This is commonly called cystitis but is due to irritation.

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Master David, usually a happy little fellow, was certainly not at his sparkling best. He slumped in the chair, looked morose and kept dabbing at his nose. Intermittently he gave a violent bark, which seemed to cause him some degree of pain in the chest.

‘I’ve got a sore throat too,’ David ventured, as I started to check him out, ‘And my skin feels all sore too.’ David was a sensible little lad, determined that I should know all the facts of his case. Very helpful.

There was little doubt about the diagnosis: an upper respiratory tract infection. Germs had obviously become established the day before, following his exposure and chilling, a common starting point. His nose was running and looked red and sore around the outer nostrils. Breathing through the nose was obviously difficult. His throat was a little inflamed, and the harsh cough had already started. As I listened to his chest with my stethoscope, I could hear a few abnormal sounds (called rales), indicating fluid was already starting to accumulate in the airways of the lungs.

‘What is the verdict?’ Jean asked as I completed my examination.

‘A straightforward case of acute coryza,’ I replied. ‘But don’t be alarmed. Its more popular name is the common cold. It is a simple upper respiratory tract infection, no doubt caused by viruses which he probably picked up yesterday when he got cold. The germs become rapidly embedded in the nasal passageways, in the linings, where they quickly multiply. This has caused a swelling of the lining and made normal nasal breathing more difficult. Against this the body’s reinforcements have been called, and the start of a mighty campaign is underway—the goodies versus the baddies. So, fluid is being secreted by the cells, and before long this turns to a pussy material as germs are killed and discharged.’

‘Sounds very gruesome,’ Jean commented. ‘What else is happening?’

‘Almost invariably the germs manage to penetrate further into the respiratory canals. So more swelling and discharges. Finally they reach the back of the nose and reach the pharynx, and track down to the next part, the larynx and voice box. Frequently a croaky voice occurs. Then they race on down the trachea into the bronchi and frequently into the lungs also. All this occurs with amazing rapidity, and before long there is a sore throat and a cough.’

‘You’re so right. It is incredible how quickly it happened,’ Jean replied. ‘David started coughing this morning, not much more than 24 hours after his drenching. Those bugs move fast,’ she continued.

‘Right,’ I answered.

‘Then, what to do? What is the advice we should follow?’

Treatment

‘First of all, he will do quite well within a few days, I feel sure,’ I started, giving a note of reassurance.

‘There are several simple measures to take which will help. We don’t have a specific mixture that will immediately kill the germs, for these are usually viruses which do not respond to antibiotics. If serious chest infections or other infections and complications occur, then we will use them. But we’ll commence with simple measures.

‘I’d suggest you put David to bed for a day or two. He’s already complaining of feeling off-colour and tingly all over, and he is running a mild fever. Bed at least gives the body a rest and helps the body to conquer the invading germs. I think he is feeling sufficiently off-colour to be happy with this for a short time. What do you say, David?’ I asked my youthful patient.

‘I’ll go to bed for a day or two. But only while I’m feeling sick,’ he replied, giving himself the opportunity to opt out early. (How typical of youngsters. I love ‘em all.)

‘Plenty of liquids is a good idea,’ I said. ‘Water, fresh fruit juices (the best, in my opinion), aerated beverages such as lemonade— although I’m not keen on fizzy sugary drinks, as you know. But for a day or two they are all right. Flavoured ice-blocks are also good, and I’m sure David would like those.’

‘That’s beaut!’ David said, listening from the sidelines.

‘A quick warm bath each morning is also a good idea. It will get rid of the sweat that accumulates and dries on the skin and makes his skin feel sore. Use a soft towel and dab his body dry afterwards. And make sure he doesn’t get a fresh chill whilst you are doing this.’

‘What about his temperature?’ Jean asked.

‘Simple paracetamol elixir is a good mixture to take. The usual dose for five-year-olds is five to ten millilitres every four hours, ideally after food. It tastes reasonable.

‘We don’t like giving aspirin to children under six years, for it is a severe gastric irritant and can cause stomach bleeding. For any colds that David catches when he is a couple of years older either paracetamol or aspirin tablets can be used for reducing fevers and relieving aches and pain, which are often severe; they can also reduce the tingly skin sensitivity which is often quite unpleasant. But in the meantime, try paracetamol elixir for David’s cold.’

‘Should I give him something for the cough?’ Jean queried.

‘Yes. Simple pholcodine elixir is good, and may be repeated if and when the cough troubles him. There are plenty of brands around. Personally I like a nice red one—it looks like raspberry, and most children love it. But use it only when necessary, for the cough is there to rid the lungs of phlegm, dead germs and unwanted fluids which could otherwise be damaging.

Home remedies

‘An easy do-it-yourself one is to squeeze a lemon into a glass. Then add half the volume of honey. Let David sip this as often as he likes. Lemon cuts back the phlegm and irritation in the back of the throat. The honey is very soothing. It is a simple old-fashioned remedy which many people still use with good effect. It is cheap too. How’s that in this overpriced world of inflation?’

‘Great, simply great,’ Jean answered, with a grin.

‘How about his blocked-up nose?’ she continued.

‘Simple steam inhalations are a good idea,’ I replied. ‘You might find that adding 15 drops of friar’s balsam to a pint of boiling water will work wonders. But if David finds it a bit messy, an alternative is simple blowing plus the use of some vasoconstrictor drops. They will reduce swelling in the nasal linings. Use the drops two to three times a day but only when necessary.’

‘Should I starve his cold?’ Jean queried.

‘No. Let David have what food he likes. Small meals attractively served is the best advice I can offer. Simply prepared foods, stewed fruits, mashed vegetables, soup, toast, eggs lightly cooked, jelly, ice-cream, that sort of thing. There is plenty to choose from. For a few days he might not be keen on food at all, so stick to fluids. Add some powdered glucose D, a teaspoon per glass, for this equals food and is an easy way of sustaining nutrition. Very soon he will come back to normal food intake, I am certain. Ideally his room is best kept warm and free from cigarette smoke—but then, of course, you don’t smoke. Great!’

‘That all sounds pretty straightforward,’ Jean said. She had been writing a few notes on a pad whilst I spoke, an excellent idea. I am happy to see parents writing down suggestions so they will not forget.

‘Anything else I should know?’

‘If there are any complications, please contact me. The germs may spread to other areas, and this could need extra treatment, such as antibiotics.’

‘How would I know when complications are setting in?’ Jean asked.

‘If pain develops in David’s ears, it could mean infected ears; under the eyes behind the cheeks, infected sinuses; a very sore throat, tonsillitis or pharyngitis or laryngitis; pains in the chest, pneumonia or pleurisy. If breathing becomes difficult or the cough really gets worse and causes distress, let me know promptly, and I’ll pop around and give you the next lot of instructions.’

‘Fine,’ said Jean.

‘Thanks, Doctor,’ echoed David, in his unhappy little voice. ‘See you round some time,’ he continued, as the pair prepared to leave.

Nice little bloke, I thought to myself … I really do like kids. So uninhibited, so honest with everybody.

*68\87\2*

Treatment

In most cases the situation is self-limiting and self-curative. In some cases, it persists into adult life, but this is unusual. Punishment, ridicule and strong measures will do more harm than good. Similarly, painting the fingers with vile-tasting chemicals is of little permanent value. More often, the child will wash or lick off the offending liquid, and enjoy the nail-biting session even more, possibly feeling a mark of achievement over non-understanding parents.

Efforts to detect any basis for emotional insecurity should be sought—is there some school problem or difficulty with peers that may be corrected? Correct any obvious problem. Otherwise, the less fuss that is made the better.

*20\87\2*

Aromatherapy may be helpful in treating neuralgia. Two drops of cloves, one of basil and one of eucalpyptus should be blended with a tablespoon of a carrier oil and applied when needed.

Acupuncture may be used to treat neuralgia with manipulation of points on the governor, gall bladder, bladder, large intestine, stomach and liver meridians.

Acupressure is particularly effective in the case of trigeminal neuralgia. Every half hour, points on the face should be pressed lightly for a period of 5-10 minutes. Pressure should be applied downwards with the index fingers close to the corners of the mouth, or inwards, using the index finger, at the inner end of the eyebrow on the side of the face which is affected.

Fresh chopped or grated horseradish mixed with a little water and applied as a compress may also relieve neuralgic pain.

*20\69\2*

Croup causes a tight, dry, barking cough and hoarseness. Difficult breathing develops quickly, with more trouble breathing in than breathing out. Efforts to breathe in cause the crowing sound that is typical with croup. (This is the opposite of the breathing difficulty that is seen with asthma. A child with asthma has more difficulty breathing out, and a wheezing sound is heard when the child breathes out.) Croup can be serious, but milder cases, especially repeated ones, can usually be safely handled at home.

There is a form of croup-epiglottitis- that is a life-threatening illness, a true emergency in which minutes count. It is an infection of the epiglottis (covering of the larynx) and surrounding tissues, caused by bacteria. It is most common in children between three and nine years of age. There is a rising fever to 39.4°Ñ and up to 40°C. Difficulty with breathing quickly becomes severe. The child drools and may have trouble swallowing, preferring to sit with the head forward, mouth open, and tongue partially out. The condition rapidly progresses to choking and convulsions; treat immediately.

Signs and symptoms

The key symptoms of croup are a barking cough, hoarseness, difficult breathing, and a crowing sound heard when the child breathes in. There may be no fever or a low-grade fever (38.3°C).

It is important always to consider the possibility of epiglottitis when any of these symptoms are present.

Choking on a foreign object may resemble croup, since both share the same symptom of frantic efforts to breathe. However, it is easy to tell choking from croup by one key sign. A choking child cannot speak or cry out; a child with croup can talk or cry. Fever may be another clue, since a child with croup may have a fever but a choking child does not.

Home care

If a child is having serious difficulty breathing, do not try to care for the child at home. Notify your doctor, and head for the nearest hospital emergency room.

Mild, repeated attacks of croup can often be cared for at home (if there is no serious difficulty breathing). However, it is best to call your doctor the first time you suspect your child has croup.

The basic home care for mild attacks is adding moisture to the air to relieve the cough and help the child breathe more easily.

Use steam from a vaporizer or humidifier. Steam also may be generated quickly and temporarily by running a hot shower in a closed bathroom. Sit in the room with your child for a short while. If the symptoms are not relieved, call your doctor.

Precautions

• If your child has a high fever, difficulty breathing and swallowing, is drooling, or sits with the head forward, mouth open, and tongue hanging out, get medical help immediately.

• Never give any type of cough medicine to a child with croup or any difficulty breathing.

• Do not give ipecac as a home treatment for croup; ipecac may make breathing even more difficult.

Medical treatment

For croup, your doctor’s treatment will be the same as your home treatment. However, the doctor may hospitalize your child and use a croup tent with high humidity. The doctor may also order X rays, cultures, and a blood count. If the condition becomes severe, your child may be intubated (have a tube inserted in the airway).

Epiglottitis is always treated as an emergency. Your child will be intubated. If necessary, the doctor may perform a tracheotomy (opening the windpipe surgically through the neck). Intravenous fluids and antibiotics will be given, and the child’s condition will be carefully watched.

*44/84/5*

These researchers at the Imperial Cancer Research Fund in Oxford, England, and the Department of Public Health and Policy in London and the University of Wales in Cardiff recorded each person’s diet, illnesses, and deaths, when they occurred over the 17 years.

Two groups of people turned out to be the healthiest-that is, they had the lowest rates of debilitating diseases and were the least likely to die young. The winners were the apple-a-day folks-those who ate some fruit daily-and the garden-grazers-those who ate fresh salad daily. Salad-eating in particular was linked to a 26 percent lower rate of death from heart disease.

While this study was conducted in Great Britain, its findings apply to those of us here in the colonies as well. Want to spend more time on the planet? Then spend more time thinking about what you put on your plate.

Take control

We have more control over the grub we grab than about any other aspect of our lives. How we stuff our faces controls, to a great extent, the quality of our lives. It significantly influences our health, vitality, and longevity, notes Carla Wolper, R.D., a nutritionist at the Obesity Research Center at St. Luke’s-Roosevelt Hospital and the Center for Women’s Health at Columbia-Presbyterian Hospital, both in

New York City. Every cell in our bodies depends upon the proper supply of nutrients. We get our nutrients from the foods we eat.

Of course, you already know that. You know that you should eat right.

You know that experts recommend eating from five to nine servings a day of fruits and vegetables. But we know that if you’re a typical guy, you aren’t getting five to nine servings a day of fruits and vegetables.

We’re not here to yell at you about that (well, not too much, anyway). But we would like to reason with you or, at least, to give you some reasons to make sure that you’re eating a balanced diet-one that includes plenty of fruits and vegetables.

For starters, the doctors and scientists we spoke with emphasized over and over that plant life contains a whole arsenal of goodies that are known, without a doubt, to guard against all sorts of nasties – from premature aging to cancer. Among the most powerful weapons are:

•     Plant pigments: The stuff that causes plants to have color turns out to be chock-full of a veritable rainbow of beneficial vitamins and enzymes that our bodies crave.

•     Phytochemicals: These chemicals act as a plant’s natural defense system-its natural pesticides and disease-fighters. Some of these chemicals help us ward off the scourges that attack us, too.

•     Plant estrogens: These are plant hormones, sometimes referred to as phytogens that seem to enhance and balance hormonal activity in our own bodies. Estrogen? you ask. Aren’t we getting a bit girlish here? Not really. See, we need some of these so-called female hormones to cool down some of the male hormones-like the one that causes prostate cancer, for instance.

•     Flavonoids: The tasty stuff that gives fruits and vegetables their flavors turns out to be medicine in our bodies.

Then there’s the other stuff, like the assorted enzymes, vitamins, minerals, and fibers that we get from regularly eating a wholesome variety of vegetables and fruits. Many of these plant constituents act as antioxidants. That is, they help protect our cells from getting burned and deteriorated from too much oxygen and other destructive atoms showing up in the wrong place at the wrong time. Antioxidants slow the aging and dying process at the cellular level.

While it is certain that the healing compounds in plants work together when we eat a variety of them, often it is less clear how well they work alone. The research is still young. So the recommendation for now, Wolper says, is to mix it up. Go for variety. Still, there are at least a few super-foods for which the evidence is so strong that it would be foolish to ignore.

*50/36/5*