Health in the headlines

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Health in the headlines

It’s natural that parents will be concerned when they read news stories about risks to their children’s health, but pharmacy can help them separate the facts from the fiction

A new report from the Royal College of Paediatrics and Child Health (RCPCH) says the health of children in the UK is falling behind that of their peers in many other European countries.

Raising particular concerns over rates of obesity, mental health issues and mortality among the younger generation, the report, entitled The State of Child Health, emphasises that poverty is at the root of many child health problems, despite pledges from UK health ministers that money is being invested in services to help tackle health inequalities.

While this is undoubtedly an issue to be taken seriously, we come across scaremongering headlines and clickbait tactics in the news every day, which can make health stories overwhelming, not to mention confusing, especially when they concern children.

Community pharmacy staff are essential members of every family’s healthcare toolkit, which is why it is always worthwhile trying to find out the truth behind these kinds of stories. Armed with the facts, you will be able to advise customers on how to look after their children’s health, and allay any fears that news reports have stirred up.

This round up of recent stories will help you reassure parents and carers that not everything they read should be taken at face value, but that there are some stories they should take notice of.

Ibuprofen and chickenpox

Reports surfaced last year suggesting that giving ibuprofen to children who were suffering with chickenpox led to an increased risk of a serious skin infection called necrotising fasciitis.

Although the precise reasons for this are unknown, researchers think that by reducing the body’s inflammatory response to chickenpox spots, ibuprofen may reduce the body’s ability to fight infections on the skin and that certain bacteria might hijack this vulnerability. It is also thought that ibuprofen might mask the signs of serious infection.

Dr Donald Macgregor, president of the Scottish Paediatric Society, consultant paediatrician, senior lecturer in child health, and RCPCH spokesperson, says that although fasciitis is very rare, the evidence is “pretty good that there is something in these claims”. The NHS also says that paracetamol is the preferred painkiller for children with chickenpox. 

However, for Dr Macgregor, there is a different angle to consider: that of giving painkillers to children in the first place. He says: “The main issue is that too many children get ibuprofen or paracetamol. We don’t think children with fever should be given paracetamol, because fever is good for you. We’ve learned that fever helps to fight bacteria and viruses, so a fever should be left to run – unless it’s distressing the child, in which case it is reasonable to try ibuprofen or paracetamol.” 

This is because the biggest myth around fever is that controlling it reduces febrile convulsions, says Dr Macgregor. “It doesn’t,” he explains, “because febrile convulsions are not caused by fever, but by having the illness that causes the fever.” 

Spotting sepsis

A campaign to raise awareness of sepsis by Public Health England (PHE) and the UK Sepsis Trust was reported as potentially being able to prevent 37,000 deaths a year – a figure which could shock many parents into panic about the prevalence of the condition.

The campaign urged parents to take immediate action if their child looks mottled, bluish or pale, appears lethargic or difficult to wake, is abnormally cold to the touch, is breathing rapidly, has a rash that does not fade when pressed, or has a fit or convulsion.

Dr Macgregor says this is indeed worth taking seriously because although parents “mainly worry about fever and cough in children, they are missing serious illnesses like sepsis”. In fact, he says: “Half of all children who die or nearly die from sepsis will have looked like they had another illness a few hours beforehand, and have usually been seen by a competent health professional in the previous 12-24 hours.” 

His advice to parents is to look out for how quickly their children’s symptoms change. “Ask yourself what they are like now compared to 10 minutes ago, compared to an hour ago,” he advises. 

He also believes that A&E isn’t always the best place to take children with signs of sepsis. If parents are at all worried, they should make contact with their emergency GP service and discuss it with them first, he advises. “We’d much rather see a child who didn’t have sepsis,” he says, “so we would always rather parents bring them in.”

Car seat safety

Another story that stood out last year was one which said that long periods of sleeping in car seats could be dangerous for young babies.

Researchers simulated the effects of sleeping in a car seat during a 30mph journey and claimed that newborn babies can slump forward in the seats, blocking off their airways and reducing their oxygen supply, with potentially fatal results within as little as half an hour.

Dr Macgregor says this is true. “Babies have big heads and although they can maintain position pretty well for 10-15 minutes, eventually they will let them drop forward,” he says. “This is more of an issue in some babies than others, as most will wake up and cry, but there are some who won’t.”

He says that the solution is not to put a baby in a car seat and leave them for long periods without someone sitting next to them to keep an eye on them. For parents travelling on their own, he suggests making frequent stops to check on the baby. 

Head lice resistance

Head lice are a recurring problem for parents of school-age children, but recent stories claim that they are now “morphing into superbugs” that are resistant to popular over-the-counter treatments.

There is indeed strong evidence that the head lice population has already developed resistance to a number of traditional pesticides, partly because of their inappropriate and excessive use over long periods of time.

Because of this, Ian Burgess, parasite expert and president of the International Society of Phthirapterists, says: “Nobody in their right mind uses an insecticide-based product these days because there is too much resistance about.” 

Similarly, he says there is not much point in using herbal treatments such as tea tree or other essential oils, as “none of these have been clinically tested in a rigorous clinical trial”. 

That leaves mechanical removal using a comb, which can work if it is done rigorously, and physically-acting chemicals. “There are some that have published clinical evidence to support the claims made for them,” he says, “but other companies have not released data for public scrutiny. So the ones with data at least have evidence.”

Time online 

While head lice are an age-old problem, our modern, digital lifestyles are blamed for causing another set of problems when it comes to children’s health.

Researchers from King’s College London say that using phones and tablets before bed stops children from sleeping and can lead to health issues including obesity, reduced immunity and poor mental health. Scientists at Henry Ford Hospital in Detroit, America, also say that teens who spend hours online are at risk of high blood pressure.

On the other hand, an Oxford University study found that teenagers who use digital devices for up to four and a half hours a day are happier than those who get less screen time.

So what should parents believe, and how can they create a happy medium of online time and activity for their children? Dave Gibson, owner of The Sleep Site, says persuading teenagers to put appropriate boundaries around their technology is a growing problem.

“In the evening, modern teenagers now face a host of challenges: balancing ever-increasing amounts of homework, real life and online social demands, which is all on top of their natural changing body clock,” he says. “These challenges encourage teenagers to go to bed later, [and] poor boundary making around teenagers’ use of technology, especially in the hour before a set bedtime, is making them have less than the ideal eight to 10 hours they need. In fact, according to the American Sleep Federation, one study suggested that just 15 per cent of teenagers slept eight and a half hours on school nights.”

Dave suggests setting a “device curfew” for all the family. He says: “Put all devices to bed at least one hour before you go to bed. This makes it easier to enforce a boundary with teenagers that all phones are removed from the bedroom overnight in order to avoid the temptation to use them, and that technology is switched off early.”

Sugar for breakfast

As well as digital gadgets, another draw for children is sugary food. According to PHE, the average child is eating the equivalent of three sugar cubes for breakfast in products such as cereals, fruit juice and chocolate spread – or, in other words, half their recommended daily sugar allowance before they even go to school.

PHE has launched a new free app which parents can use to see how much sugar, salt and saturated fat is in everyday food and drink consumed by children. Something else that may help is the planned sugar tax, which experts from Oxford University say could reduce rates of childhood obesity by 10 per cent and halt spiralling rates of childhood diabetes and tooth decay.

However, Able Abel, superintendent pharmacist at Crossgates Day and Night Pharmacy in Leeds, is not convinced that taxing sugary products on its own is the answer. Instead, he says that if we are more honest with ourselves and our eating habits, the less likely we will be to increase our risk of type 2 diabetes and therefore fewer taxes will need to be invented.

Dr Macgregor adds: “Sugar, in the main, is not a very good carbohydrate and causes problems in a lot of people, so the less we have, the healthier we will be. As paediatricians, we think the less sugar children have, the healthier they’ll be in childhood, and certainly as adults. Also, in a lot of children, their appetite is switched off by sugar. This is not good as children need food, so the best choices are those that don’t contain sugar.”

Chocolate for coughs?

While many parents struggle to persuade their offspring that sugary foods should be an infrequent treat rather than a daily staple, we are now being told that chocolate could help with coughs.

According to Hull University’s Professor Alyn Morice – a founding member of the International Society for the Study of Cough – chocolate is better at treating coughs than ingredients such as lemon and honey because theobromine, an active ingredient in cocoa, acts as a cough suppressant.

A recent review of studies on cough medicine by the American Chemical Society found that in 15 of 19 cases, the medicine either had no benefit or the results were conflicting, and other remedies such as echinacea, vitamin C and zinc were not likely to help get rid of cough either.

The researchers said the best that expectorants and cough suppressants can offer is a good night’s sleep from drowsiness. John Smith, chief executive of the Proprietary Association of Great Britain, says: “It’s important to remember that cough medicines will not cure a cough”. Cough medicines can, however, provide some symptomatic relief and therefore, despite not curing the cough, they may provide some respite for the child and their parents.

Parents mainly worry about fever and cough in children, but they are missing serious illnesses like sepsis

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