Wednesday, February 29, 2012

Children and tummy aches.

Children of all ages often complain about having tummy aches. Frequently it's just one of those things that disappears by itself. (When my 3 year old complains of having a tummy ache, it's normally because he needs to do a poo.) But how do you know if it's something serious?  Or, what most people want to know is, why? What is causing my child's tummy ache?

Well, the interesting thing about medical science is that it may be able to do amazing things like face transplants and brain surgery, but often it can't tell you why your child has a tummy ache. Even if children are admitted to hospital and lots of tests done on them, often we don't find out what the cause is. What you as a parent wants to know is 'what is it' but what your doctor wants to know is 'is it serious'? Two slightly different questions.

So, let's start by thinking about things that might make us think it's serious. Firstly, how is your child? Are they well or unwell? If they're unwell, fever, not eating, vomiting, that sort of thing, your doctor will want to know if they have appendicitis. Appendicitis is an infection of a little bit of your gut that sits in the lower right hand bit of your tummy (in the majority of people). The appendix isn't really thought to be used for much in humans, apparently rabbits have large appendices, something to do with digesting all that grass but don't quote me on that.  Anyhow, the point is it can get inflamed and infected and then it needs to be removed with an operation. Your doctor will do lots of prodding and poking your child's tummy to help them decide if they may have appendicitis.

What else would make your doctor concerned? If the tummy pain had been going on for a long time, if your child wasn't eating or growing well. If it was associated with symptoms such as diarrhoea (over a long period of time, not just for a day or two) or blood in your poo.

There are lots and lots of causes of tummy ache and some are easily diagnosed. For example, constipation, urinary tract infections and diarrhoea are all common causes of tummy ache. Sometimes children get inflamed lymph nodes in their tummy when they have an infection somewhere else ('abdominal lymphadenitis'). But sometimes it has to be put down to 'one of those things' and hope that it doesn't last too long.

Monday, February 6, 2012

Getting children to eat fruit and vegetables.

Most parents wonder how to give their children a healthy diet, how to make them eat fruit and vegetables and how to reduce the amount of cake, crisps and biscuits that they eat. Well, help is at hand. Recent studies by City University and the School Food Trust has found that cooking clubs and classes has a positive effect on children's eating habits. They found that more children ate fruit and vegetables after the classes and were able to recognise healthy food.

Given the growing epidemic of childhood obesity this is fantastic news. Getting children involved in cooking is a 'fablious' idea, as my 3 year old son says. The up sides are huge, learning what goes into food, how long it takes to prepare, giving them skills for later life (not just being able to cook but impressing the fairer sex according to my husband who claims I fell for him thanks to his amazing risotto.) Let's not mention the mess and the amount of extra time needed! When they're old enough, they might even cook the meal by themselves.

From a personal point of view, I find that my children are much more likely to eat something new if they've helped make it. I use the word 'helped' in the loosest sense. My 3 year old 'helped' me to cook mussels the other day. I de-bearded them, passed them to him, he dabbed a few of them with a sponge and put them into a colander. Anyhow, he ate the mussels and was very proud to have helped. A few weeks later I cooked mussels again, this time he was watching tele. He wouldn't touch them. Yuk yuk, I'm not eating those! This 'helping' tactic has also worked with curry and other new and unknown foods. 

In my clinics, I often recommend that children get involved with cooking, especially those who are slightly over weight and constipated (a frequent flyer in many paediatric clinics.) Many parents try to hide vegetables in dishes and this is certainly one way of getting children to eat vegetables in the short term. But I wonder whether it is a good tactic for the long term, when the child is able to decide themselves what they want to eat (which happens very quickly). If they are used to eating fruit and vegetables they will often opt to have a healthy piece of fruit as a snack instead of a piece of cake or a biscuit. (Not all the time I grant you.) I leave bowls of fruit on the kitchen table and both my 1 and 3 year old will help themselves to it. "Norange, norange" grunts my 1 year old.

Feeding children, of what ever age is not easy. Just when you think you've got it nailed, your perfect eater turns into a fussy eater overnight. They don't have to have a perfect diet. Cakes, biscuits and other treats are fine in small quantities. However, it is important that they eat fruit and vegetables, not just today but as they grow and continue into adulthood. If you're having problems getting your child to eat healthily it may feel like a steep slope to climb, but take it one step at a time. Get them involved, don't loose heart and keep presenting them with healthy options.