....Fast breathing.........Breast feeding ילד חולה.......... נושמה מהירה.......הנקה Resent form 2009 As we slowly get some colder weather I thought it might be useful to resent this article for those who forgot about it or for those who were not yet on the mailing list ילד חולה.......... נושמה מהירה.......הנקה Date: Wed, Oct 21, 2009 8:28 pm Sick child............Fast breathing.........Breast feeding As winter is approaching and infants / children might start having all kind of coughs and fever, it might be useful to repeat some facts which most of my patients already know. Some details will be new to you. In order not to make the mail to long, I will send more then one mail about this subject. Is a cold /cough [in]significant [chashuv] , is it a sign that a doctor should be consulted? I wrote you already-and I will sent a repeated article in the next mail[s]-about breathing-frequency.[tadirut ha-neshima] That one of the most important things to do in a sick child is to count the breathing!! First some words about infants under two to six months: Any baby in the first few days of life having difficulty with breathing should be considered to have a pneumonia [daleket re-ot] or bronchiolitis [to know the difference is not important for the parents] The following signs [any of them] may be found:[ this refers especially to the first two months, but also to older children.] Fast breathing [see next e-mail]........future Chest in drawing [see next e-mail].........future Grunting [neshima ne-enachat]: breathes in and the stops a bit and breathes out with a grunt [interrupted breathing] Cyanosis [kichalon] Refusing [to weak] to nurse[if the baby nurses and refuses to eat ,even it he/she was eating before already, this is of no significance] Vomiting ], but even without this : less wet diapers in itself may be a sign of a more serious problem. Lethargy [ lo magiv tov]: more difficult to wake and less active and a weak cry. Fever or even more significant then a fever :low body temperature [hypothermia] An axillary temperature below 35.5 is certainly a sign of hypothermia. Hypothermia is dangerous!! [Should be normally between 36.5 to 37.5][Don't bother to take the rectal temperature] Convulsions [hitkafsuot] Young children easily become cold, so prevent heat loss by wrapping them in enough warm and feel the hands and feet often to see if they are warm. Cold legs are certainly not a good sign, certainly from the foot to the knee [ a sign of a poor circulation ] IF THE BABY PERFORMS HIS NORMAL FUNCTIONS THEN FOR SURE THERE IS NO SERIOUS ILLNESS GOING ON. Please, remember the golden rule: any child which is nursing normal, never has a serious disease at that VERY moment, even with a high temperature!! If a baby feeds less then half as usual in the preceding 24 hours is likely to be seriously ill. Difficult breathing with a respiratory grunt [neshima kasha meluwa be-neshima ne-enachat] is also a sign of a serious respiratory problem. Vomiting ,diarrhea/diarrhoea and cough are not by automatically signs of serious disease. Far more important are signs of drowsiness, much more sleepiness then normal or a weak cry. If the temperature is low then take special care to cover the head in a baby!! Keep the room temperature at 25 degrees at least. Overheating is also not advisable [sweat], the baby may become restless, irritable and crying a lot Rubbing the chest or breast of a baby with olive oil or sesame oil may be a good idea to keep it warm at night. A small baby [ especially when born with a low weight] may be warmed very well by keeping it close to the mother, between her breasts ["kangaroo"]