Children

The ritual of weekly baby weighing clinics is unlikely to end anytime soon, and so I am delighted to learn that – at last- the old World Health Organisation baby weight charts are being ditched in favour of more evidence-based ones.  Previously, the charts “smoothed over” the differences in normal childrens’ weight gain in the first two weeks of life: now, the fact that “all infants show different patterns of weight gain” in these two weeks is accepted and instead the weight gain relative to birth weight is more important. Additionally, there are now charts specifically for pre-term infants.

I am sorry to say that I never knew the old infant weight charts to be contentious until I (or my child) was on the wrong side of them. The old charts were based on forumula-fed babies. Breast-fed babies, having a different pattern of weight gain, tended to look malnourished on the old charts rather than thriving.

The charts are free to download from the Royal College of Paediatrics website.

Autism is not the only developmental disability that a child can be born with. It does, however, garner a lot of attention. Part of the reason is that we still don’t understand the condition as well as we would like. And we still have no way of testing for it through prenatal screening.

Recent research has, however, raised the possibility of such a test. A study published in the British Journal of Psychology showed an association between higher levels of testosterone in amniotic fluid samples and autistic traits in the older child. In light of this information, Simon Baron Cohen, professor of developmental psychopathology at the University of Cambridge, has called for a debate on the ethics of prenatal screening. He is against the practice, as he made clear in an online article in Community Care magazine.

If there is one absolute about screening tests – where testing is done in the absence of symptoms – it is that one has to be extraordinarily careful. The prenatal tests currently available – for Down’s syndrome and spina bifida – are meant to be performed only after appropriate discussion of the potential problems. Yet these tests are still limited in the information they can give us. They do not tell us how disabled the child will be, or what his or her life would be like.

The remainder of the article can be read here. Please post comments below.

Medical lore has created something of a cult around the measurement of children’s temperatures.

A fever seems to be something which is suspected and then recorded, swiftly followed by the administration of medicine to “bring it down”.

Some confessions. My home medical kit isn’t up to much. At one point it did contain a thermometer, which came free with a purchase at a petrol station and subsequently broke. It was a complement to what I saw as the only vital medical accessory for a household with children: infant paracetamol.

The remainder of the article can be read here. Please post comments below.

There are few things quite so embarrassing as being phoned by the school to be informed that your child, whom you saw just a few minutes earlier, is too ill to be at school.

Then there is also the issue of the semi-miraculous recovery whereby a child claims severe symptoms in the morning, requiring room service, extra pillows, continuous supply of warm drinks, etc, but then ends up feeling well enough to rollerskate to the school gate later in the day to collect siblings.

I can only be certain that here my medical degree does not help.

Margaret McCartney’s Blog

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A forum on healthcare policy and professional issues, by Glasgow-based GP and FT Weekend columnist Margaret McCartney.

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