PALLOR (PALENESS)
Pallor can be normal, or a sign of an underlying medical condition. Many children have a fair complexion and look pale, especially in the winter months. Most children look pale when they are unwell. Parents have the best idea of the health of their child. If your child is active, eating well, full of energy, and seems otherwise normal, it is most unlikely that his paleness indicates an underlying serious medical condition.
If, on the other hand, your child is pale and also appears tired, uninterested in eating or is otherwise unwell, you should consult your doctor. After a careful medical history and physical examination, he may order a blood test to see if your child is anaemic or has some other underlying condition.
THALASSAEMIA
Thalassaemia is an inherited disease where there is an abnormality of haemoglobin, that part of the red blood cell which carries oxygen around the body. It is seen much more frequently in certain ethnic groups, especially those from the Mediterranean countries and parts of East Asia.
In its severe form (Thalassaemia Major) the condition, if not treated, causes severe anaemia, growth retardation, and early death due to heart failure. Treatment consists of regular and frequent blood transfusions. In addition, a particular drug is given to mop up the excessive amounts of iron that are the result of the rapid destruction of the faulty red blood cells. With this treatment, children can live essentially normal lives.
There is also a mild form of thalassaemia (Thalassaemia Minor) which leads to a very mild anaemia but usually causes no symptoms at all. It is important for someone to know if they have Thalassaemia Minor: if they marry a partner with the same condition then there is a one in four chance that their children will be affected with Thalassaemia Major. Antenatal diagnosis is now available for this condition.
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September 11th, 2009 :: Filed under
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While this is a very uncommon condition (affecting approximately 4 in 100,000 children under the age of 14 years), it is the commonest cancer in childhood. In years gone by, leukaemia was invariably fatal, but now well over half the children afflicted with this condition can expect to be cured.
Cause
The cause of leukaemia is still unknown, despite many years of intensive research all over the world.
Clinical features
The child may present with features of anaemia (pallor, fatigue), easy bruising, pain in the back or legs, or enlarged but painless lymph glands in his neck or other parts of his body. He may be generally unwell, with poor appetite and overall lethargy.
Investigations
A blood test is performed initially, and this establishes the diagnosis, but then a bone marrow aspiration always follows to confirm it. Often other tests are necessary, including X-rays and CT scans.
Treatment
The child is admitted to hospital immediately — this is invariably to one of the major paediatric teaching hospitals. Treatment is highly specialised and the exact regime depends on the type of leukaemia. It includes drugs to kill the leukaemia cells (chemotherapy), as well as other drugs and blood transfusions. Close follow-up is important and takes place according to a carefully designed protocol or plan.
When to see your doctor
Even if your child has any of the symptoms described above, it is unlikely that he has leukaemia. There are many more common and less serious causes of all of these symptoms. Nevertheless, you should consult your doctor if you are worried. He may order a simple blood test to put your mind at ease.
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September 11th, 2009 :: Filed under
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BRUISING
Toddlers and school age children forever seem to have bruises, especially on the shins, as a result of their everyday activities. Their high energy levels and ceaseless activity mean that they often bump into things or fall over, thus bruising various parts of their body. Children with poor co-ordination may have more than their fair share of bruises. Bruises are usually just a normal part of childhood and are no cause for concern.
In very rare cases, bruising is due to an underlying blood disorder, such as a deficiency in the clotting mechanism. You may want to see a doctor if your child seems to bruise more readily than other children, or has bruises all over his body, or if you have a family history of blood disorders.
HAEMOPHILIA
This is an inherited bleeding disorder seen almost exclusively in boys. It is due to a deficiency of one of the substances in the blood (Factor VIII) which is essential for the clotting process. Boys affected with the condition usually present at an early age with bleeding (for example, recurrent nosebleeds which are difficult to stop) or easy and extensive bruising after seemingly trivial injuries.
Treatment of this condition is usually in a specialised unit. It involves the administration of Factor VIII after bleeding episodes. A child with haemophilia always needs to avoid contact sports.
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September 11th, 2009 :: Filed under
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The treatment of anaemia depends on its cause. If it is due to aplasia or haemolysis, then this is investigated and treated appropriately. Iron deficiency anaemia often requires iron tablets or medicines to be given by mouth, and, in rare cases, a blood transfusion. All children with iron deficiency need to be placed on a balanced diet with adequate iron intake. This usually means cutting down on milk and increasing the amount of iron-containing foods, such as spinach, meat, eggs and so on.
When to see your doctor
• if you suspect that your child may be anaemic because he is very pale;
• if your child is irritable yet lethargic and drinks large volumes of milk at the expense of solids;
• if you want additional information about what to feed your baby.
Prevention
Iron deficiency anaemia can mostly be prevented by making sure that your child has a balanced diet after the age of 6 months. Most health professionals now advise against giving babies cow’s milk earlier than 12 months of age. Your local maternal and child health nurse or doctor can give you specific information about nutritional intake.
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September 11th, 2009 :: Filed under
General health
