Tips and tricks for tummy bug troubles

Unfortunately, it’s the time of year where stomach bugs are rife. I was recently in the hospital twice in the space of two days, as my little one had a severe case of gastroenteritis. While I was there, I had many in depth conversations with paediatricians, nurses and the matron, who gave me many materials and ideas about the prevention and management of gastroenteritis, and how to recognise the signs of dehydration.

Gastroenteritis (or more commonly known as the ‘tummy bug’) is an infection of the intestines and stomach which causes vomiting and diarrhoea (D&V). It is often caused by infections like the norovirus, or rotavirus, though it can also be bacterial.
D&V caused by tummy bugs is common in children younger than 5, however lots of diarrhoea and vomiting can cause dehydration, which is a serious complication. This is unusual, and most children can be cared for at home following advice from a qualified healthcare provider.  In most cases, diarrhoea usually lasts 5-7 days and has come to an end by 2 weeks, while vomiting usually only lasts between 1-3 days.
While we were at the hospital, the paediatrician told me that parents should avoid taking their children to the GP if they suspect gastroenteritis, as it is spread so quickly and easily. Instead, parents should call 111 (UK) or their GP if they are concerned. Just to recap, the symptoms of gastroenteritis are:
  • feeling sick
  • sudden, watery diarrhoea,
  • mild fever
  • vomiting, which can be projectile
  • abdominal craps
  • poor appetite

When to seek medical advice for your child

As gastroenteritis is spread so quickly, it is best to care for your child at home to avoid infecting others. However, you should seek medical assistance if your child:
  • has blood in their poo, or green vomit
  • has been vomiting for three days or more
  • has had diarrhoea for more than a week
  • has a serious underlying condition and also has D&V
  • has symptoms of dehydration –
    • sunken eyes
    • cold extremities
    • mouth and lips appear dry
    • seems to be getting worse, will not take fluids or vomits immediately after drinking
    • are floppy, unresponsive or lethargic
    • skin appears to be more baggy than usual
    • much higher pulse rate than usual
    • they have had more than 8 loose nappies per day
    • they do not have more than 2 wet nappies per day
    • no tears when crying
    • sunken fontanelle in babies

Preventing the spread

  1. Children should not attend any kind of childcare or school while they have vomiting or diarrhoea, and should not return until at least 48 hours have passed since the last episode of vomiting or diarrhoea.
  2. Hand washing is the best way to prevent the spread of gastroenteritis. This includes the obvious times, like after using the toilet, changing nappies, or touching food. Do not rely on alcohol hand gels.
  3. Towels and other personal items should not be shared between children or other members of the family while someone is suffering with gastroenteritis.
  4. Children should not use a swimming pool for 14 days after their last episode of diarrhoea.
  5. Disinfect any surfaces and items that could be contaminated.

Treatment

Most cases of gastroenteritis can be treated at home, with supervision from medical professionals in more severe cases.
Children should be encouraged to drink plenty of fluids, even if it is only small sips at a time. Breastfed babies should continue to be breastfed as long as they are tolerating the breast milk.
Oral Rehydration Solutions (ORS) such as dioralyte may be used, which is available without prescription from a pharmacy or supermarket.
A note on liquids – liquids are absorbed by the body very quickly, so if your child vomits ten minutes after drinking, it is highly likely that most of the fluids have already been absorbed by the body, and fluids should continue to be given.

Children who are vomiting

Small sips of liquid should be given to begin with, and if this is not vomited, the amount can be increased. Generally the amount of liquid a child should aim for in this phase is 1.5 to 2.5 oz per lb of body weight in a 24 hour period – for example we were told to aim for 1oz per hour for my little one. Once the vomiting lessens, a more normal diet may be trialed the next day. We found it easiest to start giving 5-10mls every 5 minutes, and did so using a bottle we would have usually used for milk – ORS can be kept in the fridge for 24 hours after mixing it from a sachet, and it is both easier to monitor intake, and less messy on your child’s part!

Children who have diarrhoea but little vomiting

These children should be given more liquid to combat the liquid lost through loose stools. However, this liquid can be given in larger, less frequent amounts, and children can attempt to continue their normal diet. If your child has significant diarrhoea, it is advisable to stop dairy products during this time as these foods can make diarrhoea worse.
 
While it can seem really daunting to care for your child while they’re unwell, rest assured that gastroenteritis is very common. There are around 5 billion cases of it every year worldwide, so you’re not alone.
What have your experiences of the tummy bug been like?
 
Sources:
Cochran, W. (2018). Gastroenteritis in Children – Children’s Health Issues – MSD Manual Consumer Version. [online] MSD Manual Consumer Version. Available at: https://www.msdmanuals.com/en-gb/home/children-s-health-issues/digestive-disorders-in-children/gastroenteritis-in-children [Accessed 14 Oct. 2018].
 
Nhsinform.scot. (2018). Gastroenteritis. [online] Available at: https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/gastroenteritis [Accessed 14 Oct. 2018].
 
Nice.org.uk. (2009). Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management | Guidance and guidelines | NICE. [online] Available at: https://www.nice.org.uk/guidance/cg84 [Accessed 14 Oct. 2018].
Technology, H. (2018). Home. [online] East Sussex Healthcare NHS Trust. Available at: http://www.esht.nhs.uk/ [Accessed 14 Oct. 2018].
 
With thanks to helpful conversations for the staff on Kippling ward, ESHT.

Pyloric Stenosis: when vomiting isn’t just reflux

If you’re reading this, chances are you have (or have had) a very ‘sicky’ baby. Chances are, your friends and family told you ‘it’s just reflux’. And fair enough, it might be. But it might not be. If you’re not convinced, read on to find out more.

My little monkey was always a very ‘sicky’ child. Ever since she was born, she’d be sick after every feed. While that sounds normal, the amount of sick wasn’t. She’d always vomit up at least half of her bottle, and then cry because she was hungry. We endured it for 3 weeks before we insisted on her having a medical assessment. She was diagnosed with a dairy allergy, and we were told that a hypoallergenic milk prescription would fix the issue. It didn’t. We took her back to our doctor countless times, and were berated for wasting GP time as she just ‘had reflux’. We tried countless reflux medications, but everything just seemed to make the issue worse.

Once my little one had reached 7 weeks, I’d had enough. After an evening of being covered in around 18oz of projectile vomit, I took her to A&E and insisted they run blood tests on my daughter. Sure enough, they diagnosed her with Pyloric Stenosis.

Pyloric Stenosis is a condition in which the valve allowing food to pass from the stomach to the intestine becomes too thick, and the hole closes. This means that nothing can get through, which leads to malnutrition, dehydration, and even death. Symptoms include extreme vomiting, lethargy, constipation, and less wet nappies.

Once admitted to hospital, we had to watch an NG tube be placed into our little one, to drain her stomach. She had an IV inserted to keep her fluid intake up, along with some vitamins, but she wasn’t allowed to eat. We were in hospital for 3 days in total before she had her operation, and we weren’t allowed to feed her anything, which was torture when she cried.

Eventually, we were transferred by blue light ambulance to a specialist children’s hospital for her to have laparoscopic surgery. The surgery took around an hour, and my little soldier had 3 doses of infant paracetamol in total during recovery. (What a brave little thing, adults have doses of morphine after similar surgeries).

Luckily, after having her surgery, the Pyloric Stenosis was cured and we never had to return to hospital for the same issue, however, others aren’t so lucky. PS can recur in 1% of cases, and for some people, it becomes a chronic issue which requires constant returning to hospital.

All in all, we were very lucky. Honestly, I think my stubborn nature went a long way in getting her diagnosed, as before I put my foot down, doctors were dismissing me as the ‘hypochondriac mum’.

What can we take away from this? Well,

1) Trust your instincts.
Mother’s intuition is REAL, and it can save you so much bother if you listen to it. If you think something is wrong with your little one, get them checked. The worst that can happen is that a qualified professional can explain to you (at length, if needed) that your baby is healthy, and reassure you.

2) Know your stuff.
While doctors often chastise patients for having a look at good old Doctor Google, sometimes it is your ally, and a tool to be used. Before Mini Me was diagnosed, a doctor incredulously asked me “what do you think is wrong with her then?” When I replied ‘Pyloric Stenosis’, a lightbulb obviously went off for him. He ordered several blood tests and an ultrasound, and sure enough, she was diagnosed. While I’m not saying that you should use Google for everything, but when you’ve been having the same issue for weeks, nothing seems to be helping and things aren’t adding up, maybe you should consider it.

3) Be kind to yourself.
While we were in hospital, I went through a phase of blaming myself for my monkey’s illness. As a mum, its only natural to want to fix things, but some things can’t be fixed by guilt. No, most things can’t be fixed by guilt. I felt awful for the fact I hadn’t put my foot down sooner, but eventually, I was just glad that I had done it at all. I often think about what would have happened if I hadn’t said anything to our doctors, and I’m so glad I did, because the outcome could have been so much worse.

Unfortunately, Pyloric Stenosis can’t be prevented, but it can be cured, and more new mums should know that it exists. If your little one is struggling with vomiting, especially in the first few weeks, please get them checked out, and if you’re unsure, get a second opinion. While Pyloric Stenosis is rare, it isn’t worth excluding as an option.

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Hyperemesis Gravidarum Awareness Day

HG Awareness Day, also known as Hyperemesis Gravidarum Awareness Day, is being observed today! It has been observed annually on May 15th since 2012 to raise awareness of a dangerous and chronic condition that plagues many pregnant women.

Here is Mummykind’s H to G (well, more A-Z!) of Hyperemesis Gravidarum for HG awareness day! 

H Hospitalisation – In more severe cases of HG, a woman may require hospitalisation. Treatment for this may include tube feeding and intravenous fluids to restore lost nutrients and hydration to both mother and baby.
Y– You. As an individual you know the limit that you can get to before needing help- bare in mind that with another little life thrown into the mix, you may need to seek help more quickly than you would do if you only had yourself to look after. A good rule to stick to, is if you’d need a doctor for a condition if you weren’t pregnant, you definitely need one if you’re are pregnant. Self care is important, look after yourself!
P– Peppermint – Interestingly peppermint tea can be used to combat nausea and often can alleviate sickness symptoms, even if only for a short while. However using mint toothpaste is one of the biggest triggers for nausea in pregnant women!
E– Everybody – HG does not discriminate , an body can fall victim to Hyperemesis and it’s debilitating symptoms.
R– Royalty – Kate Middleton, the Duchess or Cambridge has suffered with HG and Severe morning sickness with all three of her pregnancies. Although I hate to think about how unwell she must have felt and how hard it must be to suffer HG in the public eye- I’m very grateful for the awareness she has raised for this debilitating condition!
E- Emotions – Hyperemesis gravidarum can make sufferers unable to do even the most basic of tasks, simply going to work can be impossible for some women. This makes many sufferers feel depressed and unhappy. These feelings could develop into postnatal depression, so it’s a good idea to seek support with a counsellor or see a doctor for anti-depressants.
M– Morning Sickness – 80% of all women experience morning sickness in the first 3 months of their pregnancies. only 2% of pregnancies are affected by Hyperemesis Gravidarum.
E-  Empathy – If someone in your life is experiencing HG try hard to be empathetic. Offer to help when and if you can. I faced so much stigma when I had HG because people around me just didn’t understand. The last thing a lady suffering from HG wants to hear is “well, I had morning sickness and I was fine.”… HG and morning sickness are worlds apart!!!

S- Sickness – About 45% of pregnant women suffer from nausea with vomiting while an additional 25% suffer with nausea only.
I- Impact – Thankfully there are no known links between HG and adverse effects for the foetus.
S – Safe – There is a significant decreased risk in fetal loss among women with HG versus women who do not vomit during pregnancy.
G- Go Galllll! – Hyperemesis is debilitating, if you’ve had HG and you’re here to tell the tale (or been brave enough to go on and have another baby!)- give yourself a massive pat on the back. You’re so much stronger than you know!
R- Rest – Bed rest is commonly prescribed to women with the HG and can be vital in helping to regain strength.
A- Amy – Mummykind’s own Amy and Harriet have experienced HG first hand.
V- Vomiting – Lightheadedness, nausea, fatigue, exhaustion, dehydration, vomiting and fainting are the most common symptoms and characteristics of HG.
I- IV – In severe cases of HG intravenous fluids have to be administered under inpatient conditions to keep ladies and their unborn babies hydrated.
D- Differences – Those with morning sickness suffer from nausea, but may not always experience vomiting. Usually, the condition lasts during the first trimester, yet some women experience it beyond the initial 12 weeks of pregnancy. Women who do vomit are unlikely to become dehydrated. In contrast, HG results in severe vomiting and, for some women, constant nausea. The condition can last for the entirety of pregnancy and can lead to extreme dehydration. It can also result in the loss of 5 percent or more of a woman’s pre-pregnancy weight and aversions to certain foods.
A- All associated symptoms – A full list of symptoms consists of… dehydration, malnutrition
weight loss, slowed metabolism, increased heart rate,
bloodshot eyes,
stress and depression,
heartburn, reflux, stomach ulcers, constipation, ketosis,
deep vein thrombosis,
hallucinations,
low birth weight in the baby and premature birth.

R- Re occurrence – Around 80% of women who experience HG in their first pregnancy will go o
n to experience it in their next.

U- Untreated – Fortunately, unborn babies won’t be affected unless the nausea and vomiting goes untreated for an extremely long time period. The majority of babies will get the nutrients they need from the reserves stored in their mother’s body at the mother’s expense – this means her teeth and bones can become brittle, and her hair and skin can become dry and dull.
M- Motion Sickness – Traditional Motion / Travel Sickness remedies can often be beneficial to women suffering from HG. Peppermint and ginger teas. Ginger products like sweets, gum or biscuits and even anti travel sickness wrist bands have been used by women to ease HG symptoms.

Mental Health Monday: a poem for my daughter…

Depression is a friend of mine.

I know it’s hard to understand,
But there’s something that I must explain:
From the first moment that I first held your hand,
I was overwhelmed with pain.
I’m a mum without a mum,
And in a way I always was,
So meeting you on the outside
Was terrifying.
Your arrival meant her arrival,
Untimely, and unwanted
Just like me.
The loneliness consumed me…
I didn’t know how to be.
I was now a mother, determined not to let you down,
Spurred on to be the best I could with no role models around.
Two short weeks and your dad left, too,
Back to work he went.
I guess a part of me always knew
That I wouldn’t cope –
Would have no hope –
For anything getting better.
My dark days became darker.
I let you down, and couldn’t forgive myself.
I should have fought harder,
But a first-time mum is never believed,
Never listened to,
And never taken seriously.
My downward spiral became far worse,
And I didn’t know when it would end.
I felt like I had no-one,
No family. No friends.
And now I’m in that dark place once more,
But I’m trying to make a change.
I want to learn how to be my best
And to feel okay again.
I love you so much, with all my heart,
And I doubt that you’ll ever see
Just how important you are in my life,
For, without you, how could I be me?
I’ve learned to be your mummy
In spite of all the trouble
And I love you and myself now,
In fact, nothing can burst our happy bubble.
I may be facing darkness
But you give me light
And when my hope is flickering
It’s you that makes me fight.

 Monday Stumble Linky

Tales From Mamaville

Spotting the early signs of lung cancer

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Thank you very much to Chrissy, working with http://www.seniorsandhealth.com, for this guest blog post on how to spot lung cancer early! A difficult subject that nobody really wants to consider, so we hope these tips will help someone who is feeling a bit unsure about what is going on! 

Early Signs of Lung Cancer That Parents Should Never Ignore

We all know that when you’re a parent, you need to stay healthy. You need all the energy you can get, and you certainly don’t want to become ill – who’s going to look after the kids then? One of the best ways to maintain your health is to listen to your own body. This can help you to spot the early warning signs of a whole range of illnesses, including lung cancer. And the sooner you notice that something is amiss, the sooner you can get yourself checked out and, if it turns out to be necessary, begin treatment and start fighting back.

A model of the human body reflected in a window

The symptoms that will be experienced by someone with lung cancer can vary a great deal, and unfortunately, some people don’t notice any symptoms for quite some time, giving the cancer a chance to get out of control. This means that it’s doubly important to keep a close eye on any changes to your lung health. That way, you will notice if anything is amiss.

What are the early warning signs?

Here’s a guide to the warning signs of lung cancer that you need to be looking out for and that you should never ignore. If you can answer yes to any of the following questions, make an appointment with your GP as soon as you can. In most cases, the doctor will be able to reassure you that nothing serious is wrong, but in those cases where cancer does turn out to be present, it is much easier to treat, and there is a much higher rate of recovery, if it is caught early. Cancers that are left continue to grow, and spread throughout the body, so don’t delay making that appointment.

  • Do you have a cough that you can’t seem to shake, or which sounds or feels different than coughs you’ve had before?
  • Are you getting more chest infections than you usually do?
  • Are you short of breath, or becoming wheezy, when you are doing things that you used to be able to do without any trouble?
  • Are you coughing up blood? If you do, don’t panic. There are several things that could cause this, but you do need to get checked out by a doctor.
  • Have you lost your appetite for no reason?
  • Have you lost weight for no reason, without dieting or doing more exercise
  • Are you feeling unusually tired or lacking in energy?
  • Do you have an ache or pain in or around your shoulder?
  • Are you having difficulty swallowing?

For many parents, the thought of not being around to see their kids grow up is the best incentive there is to stay fit and healthy. So, while many of these symptoms could be harmless and related to a common bug, it is always best to seek medical attention and get the necessary check-ups to diagnose if anything more serious is present.

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6 tips to help your toddler through a cold

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Winter is here and it brought my son the gift of a snotty nose and a sore throat. Toddlers end up suffering colds so badly because they don’t understand what is happening and they can’t dose up on cold and flu medicine.

1. Honey and lemon

This classic cold remedy is brilliant once your little one is over a year old.  If they are under one year old this is isn’t suitable because honey contains Clostridium Botulinum. Paired with their immature guts, there is a (very low) risk of them developing botulism.
The honey is good for sore throats because of its antibacterial and potentially antiviral properties and the lemon packs a nice punch of Vitamin C.

I struggled for ages to make it the right temperature quickly without making it taste gross. The answer? Frozen lemon. Buy a few lemons, quarter them and freeze them. Pop one or two slices into a hot water and honey mixture and wait a couple of minutes. Give them a little squeeze and voila! Perfect toddler temperature honey and lemon. We pop ours in a sippy cup with a lid so the lemon can stay in the drink without getting in the way.

2. Vapour rub

Maybe it’s obvious, but vapour rub is brilliant. Don’t just buy the normal strength one though, make sure you get the kids one; the adult one can be a little bit too potent. Most baby ones are fine from six months, but always check the label.

3. Vapour Oil

There are child strength ones available but they are just diluted versions of the normal one. We use Olbas oil  which has instructions for use with children from six months, they also make a children’s one which has a different ‘dosage’. As long as you follow the instructions either is fine.  When my son was still in his cot it we were able to put Olbas in his room in a bowl of boiling water but now he is in a bed we can’t do that. My solution is to put a drop or two on a little square of cotton or a tissue and put it under his mattress so he can’t get to it. It’s strong stuff so it will definitely work through that many layers. Please contact a qualified aromatherapist for advice if you have pets in the home as some essential oils can be harmful to animals.

4. Paracetamol

I try to avoid turning to infant paracetamol regularly, but I always have it on hand for those times it’s unavoidable. If his colds get really awful I know his sinuses are going to be hurting, easing one symptom can really help manage the others.

5. Muslins or Handkerchiefs

Tissues are a huge waste of time, resources and money just to make your nose sting when you blow it. We all know how sore your nose can get with a cold, now imagine if you had super delicate baby skin? Ouch. We opt for the muslins my son had as a baby – now he doesn’t spit up they may as well get some use. They are soft, gentle and reusable. We’re totally cool about germs, we’ve all been exposed to them if someone in the house has a cold but if it concerns you, a 15 minute soak in sterilising fluid or a 60 degree wash will kill any lurking nasties. If it’s a bug rather than a cold you’ll likely be doing some hot washes anyway.

6. Patience

This one can be so difficult, especially if you have a cold as well.

It’s 2am and your toddler is just crying at you, completely inconsolable and not listening to a word you say. They won’t calm down and it’s making them cough and rasp and you can see the more they cry the more upset they become. You’re freezing because you heard a cry, went straight to them without grabbing a dressing gown and you’re tired because…well it’s 2am (and they did this last night as well). It is so easy to get frustrated but I just think about how much I would panic if I woke up not able to breathe. They don’t understand and they don’t realise you’re trying to comfort them. The best thing I’ve found is to try and distract my son. If I can get him to laugh we are half way there. We already know we’ll be exhausted in the morning – that’s inevitable now, so we might as well have a giggle.

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