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Over 200 viruses can cause a cold; hence it is called the “common cold”. Colds are caused by a group of viruses with the Rhino virus being the most common. These viruses have the ability to change, making it difficult to build 100% immunity. Children average 3 to 8 colds per year and they will continue getting them throughout childhood. Colds can occur year-round, but they mostly occur in the winter. The 3 most frequent symptoms of a cold are: Nasal congestion, runny nose and sneezing. Young children also often run a fever. Depending on which virus is causing the symptoms, the virus may also cause the following: Sore throat and/or Cough Decreased appetite Headache Muscle Ache Post nasal drip Blocked and runny nose (clear, watery and profuse discharge) Watery eyes Symptoms start two days after contact with the virus and most colds last 7-14 days. Sneezing, nose-blowing, and nose-wiping spread the virus and one can catch a cold by inhaling the virus if sitting close to someone who sneezes, or by touching your nose, eyes, or mouth after you have touched something contaminated by the virus. You cannot catch colds because of not wearing shoes or running around outside in the evening! Use a cream or petroleum jelly under the nose to help with chafing. Use Nasal Drops to soften the mucous Cough syrups can be helpful. Vapour gel on the chest and back can give relief to blocked noses Throat Pops help soothe sore throats Antibiotics do not kill viruses. Syrups containing antihistamines to lessen the mucous production should be used sparingly. Viruses are fought by the body’s own immune system. Boost your little ones’ immune system with adequate nutrition and Vitamin & Mineral supplements. Give your little one lots of fluids. Treat the fever with Paracetamol. Never use Aspirin (Salicylates) for fever in young children as it can lead to Reyes Syndrome and death in susceptible children! Wash hands frequently Cough/sneeze into a tissue and not hands Discard used tissues "When to seek medical attention?"> If breathing difficulties develop High fever – if your little one’s temperature is higher than 38°C and is not responding to efforts to bring it down High fever – consistently over 39°C or lasts longer than 2 days Ear infection with severe pain Very sore throat, smelly breath and yellow pussy discharge from the nose Vomiting If symptoms worsen or do not improve after 7 to 10 days This article is brought to you by Purity; a 2015 Johnson’s Baby Sense Seminar sponsor.

Minor scrapes, bumps and bruises are part of your little one’s development as he starts to crawl or walk. Most scrapes and grazes are minor and will not need medical attention. Toddlers are especially driven by the urge to discover new things and regularly take a little tumble as they do so, despite your carefulness. If your little one falls and bumps himself, take particular note of any injury to the head of back of the head. Falling backwards and banging the base of the head can be dangerous. If he is nauseous, vomits or is listless within 48 hours of the incident, take him to your health care professional immediately. If there is any bruising behind the ear or you are concerned about a possible fracture, then seen medical help immediately. If you feel your toddler bruises too easily and more than his friends, a visit to the healthcare professional can be reassuring and important. How to treat scrapes, bumps and bruises: Remember to wash your hands properly before treating your little one’s cut/grazed skin. In cases of minor bumps, a cold compression (ice in a cloth) can help to reduce the bruising and then apply Arnica Gel. If the cut is not bleeding heavily, clean the wound under running tap water. Pat the area dry with a clean towel and apply an Antiseptic Spray or Cream If the graze is bleeding heavily you need to stop the bleeding before applying the dressing. Apply pressure gently to the area with a bandage or towel. If the cut is to the hand or arm, raise it above the toddler’s head; if to the leg, let your little one lie down and raise the affected area about the level of the heard so the bleeding slows down and stops If your little one has been cut on a rusty object or accidentally grazed by your dog’s teeth, consult your healthcare professional immediately as a tetanus injection and specialized sterilization of the wound may be required. This article is brought to you by Purity; a 2015 Johnson’s Baby Sense Seminar sponsor

Bladder and bowel control can only occur once the nerves and muscles involved are fully developed. This occurs at approximately 24 months of age. Your toddler will begin to make the connection between her inner sensations and the physical reality of passing a stool or urine. The nerves to the bowel and bladder need to get messages from the brain (via the sensory system) to the muscles of the bladder and bowel so that effective emptying can take place. The muscles of the bowel and bladder also need to be strong enough to hold onto their contents until they can be emptied. Some children do have motor control problems, so may take longer to develop control the sphincter (the valve at the opening of the bladder). Some children are under-reactive to sensations, so may not even notice that they are urinating till much later. On the other hand, if your toddler is over-reactive to sensation, the feeling of something leaving her body may be intense and frightening. Your toddler may simply not enjoy the feeling of sitting on the potty or toilet, after becoming accustomed to having the closeness and warmth of the nappy to push against. Developmental requirements For optimal control, it is obvious that your toddler needs to be able to sit, stand and walk in order for this function to take place. She also needs to be able to follow simple instructions, so obviously you will need the full co-operation of your child in order to succeed. You should therefore not feel pressurised to rush into toilet training from an early age (definitely not under 18 month of age), otherwise it is doomed to fail. Two years of age is a good time to begin to prepare your toddler for this big milestone in her life. Most children are indifferent to their bodily functions, so it is a good idea to accept this and follow their cues. What is amusing to note is that around this age (24 months), when most children are developed enough to begin to gain control of their bowel and bladder function, a strange paradox occurs. Their ‘lower end’ becomes ready, but at around the same time, the ‘upper end’ becomes unwilling, as this is the typical age of wilfulness and stubbornness, so often your toddler will resist your sudden interest in her bodily functions! Keep a level head and a sense of humour and all will be well. Her sensory system indicates readiness Because it is easier to ‘hold onto’ stools than it is to a full bladder, your toddler will most likely achieve bowel control first. However, it doesn’t mean that anything is wrong if bladder control is achieved first. The first sign that your toddler is ready to become toilet trained, is when she begins to show awareness of what is happening either before or after a bowel movement. She may understand and say words such as “poo”, “wee” or “toilet”, squirm and touch her bottom, or may stop what she is doing. If she takes her nappy off continuously, and can pull her pants down, it may be a sign that she is getting ready for this big milestone in her life. The connection is finally there! Her sensory system is giving her the message that something is happening. It is also prudent to take note of the climate at the time that your child may be ready for toilet training. It is far easier to let your toddler potter around the garden completely naked in hot summer months, than in the middle of winter! Having to change countless pairs of corduroys and change socks and shoes each time she has an accident is frustrating and tiresome. If your toddler is younger than 26–28 months in winter, delay toilet training until the weather improves, if possible. Don’t leave it too late however, as delaying training for too long can make it worse. Practical and healthy guideline Toilet or potty training can be as easy and relaxed as you make it. Not putting any pressure on your little one to perform at any stage improves your chances of success dramatically. Follow these practical suggestions: It is a good idea to get a potty well before you think you may need it. Place it in the bathroom near the toilet, and explain what it is even if your toddler is not yet ready. Let her accompany you to the toilet from an early age, so that she can get used to the idea, and learn from watching you – this will take the mystery and fear out of this new idea. Always tell her, “Mommy is having a wee”. Invite her to tear off the toilet paper for you, and help you flush. If you have a son, ask your husband to invite him to accompany him to the toilet. This way, he will learn that boys do it differently to girls. Place a piece of toilet paper in the bowl and show him how to aim at the paper. If he prefers to sit down to pass urine, reassure him that it is fine and try to avoid putting pressure on him to do it ‘the right way’. Some children prefer to sit on the ‘big’ toilet as they find sitting on a potty uncomfortable. Either way, it does not matter whether you start your child off on a potty or on a toilet. If your child prefers to sit on the toilet, invest in a special toddler inner toilet seat (available at most baby shops and supermarkets) for a more comfortable and stable sit. If your toddler is frightened by the noise of the toilet flushing, wait until she has left the room before flushing. Always encourage her to help you flush, but if she doesn’t want to, don’t force her. If your child gets ‘stage fright’, try turning on the taps – the sound of running water often helps them relax. Teach your daughter how to wipe from front to back, and your son to wait till the drips stop. Make it a rule that the toilet seat always goes down after finishing on the toilet. Teach your children by example that their hands must be washed and dried after a potty or toilet session, regardless of success or not! Consider singing a special song such as “this is the way we go to the loo, go to the loo, go to the loo…” to encourage reluctant toddlers to co-operate. Story books explaining what is happening are also most useful. Expect some regression if she is stressed in any way such as starting a new school, the arrival of a sibling or illness. Let her go back into nappies, and with loads of love and encouragement, try again after a short while. Sense-able secret: Invest in a toilet seat with an inner and a built-in step and hand rail. This way, your toddler will be able to sit comfortably on the toilet and will always have her feet on a firm surface as well as have something to hold onto. By Sr Ann Richardson

Image Source: finds.hellobee.com Why is it that just when your baby is able to start sleeping through the night, and may in fact, already have started doing so, that teeth decide to make an appearance! Ann Richardson looks at the effects of teething on sleep. Teething, per se, does not cause a sleeping disorder. Rather accept that when your child is teething, sleep may be disrupted temporarily. Avoid falling into the trap of blaming “teeth” for bad sleeping habits that never seem to go away. It is important to recognize some important facts about teething, so that you can have a clear understanding of what your child is feeling when he is cutting his precious new teeth. Teething, by definition, is when the actual tooth cuts through the gum and appears in your baby’s mouth. This may occur anytime from 3 months of age (very unusual) up to 1 year of age. Early teething (in babies younger than about 7 months) usually follows a family history of early teething. Late teething (after one year of age) is also unusual, and also follows a family history. Check with your parents when you cut your first tooth, and invariably, your child will follow suit. On average, most babies cut their first tooth at around 7 months of age. However, it is not unusual for your baby to celebrate his first birthday with no sign of teeth! This actual “cutting” may be preceded by a period of discomfort (may last weeks) as the teeth settle into the gums and prepare to start pushing upwards. This is usually when your baby drools excessively, and loves to chew and bite down on objects. This period is seldom characterized by fever, loss of appetite and other illness such as diarrhea and ear ache. If your baby is 15 months or older with no sign of teeth, consult your Dentist who may want to X ray his mouth to check that his teeth are present. Signs that your baby may be ready to cut his first tooth include the following: Excessive drooling and biting down on objects Loss of appetite, especially sucking on the breast or bottle A low grade fever, or periods of intense fever A red and spotty rash around his mouth Nappy rash – may be severe Frequent, loose stools A runny nose Ear ache There is a theory that teething may “weaken” your baby’s general immune system and make him more susceptible to illnesses such as otitis media (ear infections), bronchitis (chest infections) and tummy upsets. This, however, has not been scientifically proven. Many parents confuse normal developmental milestones (such as chewing on fingers and hands, and blowing bubbles) with teething. Remember that at around 3 months of age, your little one will find his hands (Oh joy!) and chew excessively on them, creating plenty of drool and bubbles! Don’t confuse this exciting developmental milestone with teething or hunger! If your child is feeling unwell whilst teething, please treat him with teething medication that is available from your pharmacy. Do you remember when your wisdom teeth started appearing? This is what your little one is experiencing whilst he is cutting his teeth. He may have a headache, and have a sore mouth, especially with eating. If your nights are becoming difficult, medicate with the prescribed medication at bedtime, and repeat the dose at prescribed intervals during the night if needs be. Keeping your babies dummies and teethers in the fridge is also a good idea, as the coolness helps to soothe inflamed gums. Accept that teething is a normal part of your baby’s development. You (and your baby) may be lucky and sail through the teething stage, or there may be some seriously wobbly days (and nights) ahead. Either way, rest assured that teething is a temporary phase, and that peaceful days and nights will occur again! By Ann Richardson

Soothing a new baby can be a real challenge and if you are confronted with an unsettled little one, you will be looking for any tool to help you calm your baby. One of the tools available to us is a dummy or pacifier and although there is a heated debates on the merits of having or not having a dummy, for many parents it becomes a sanity saver. The reason that many of us swear by dummies (pacifier, binkies and soothers) is that many babies simply sooth best when sucking. This is true from a physiological perspective. Your baby’s mouth has more touch receptors than any other part of the body in the early days. For this reason, even in utero, babies derive great pleasure from sucking. In the womb, your baby may have sucked his hand, umbilical cord or simply sucked and swallowed the amniotic fluid. Once born, almost all babies love to suck and use their mouths to settle. There are really only three options you can offer your baby to suck on Their hand or thumb; Your nipple or a bottle; Simply a dummy (pacifier). Although some parents have the preconceived idea before birth that their baby will not have a dummy, suck their thumb or be fed to sooth, they usually find themselves caught short and urgently looking for a solution to help their fussy little one settle. In the early days many babies are unsettled and colicky. Some babies have reflux and/or mild lactose intolerance. All these babies really do benefit from non- nutritive sucking – e.g. sucking a dummy. This non-nutritive sucking is invaluable in those long niggly hours. Even older babies and toddlers may need to suck when tired and irritable. The big question is at what age and how can you ditch the dummy? There are two ages when you can relatively easily get rid of the dummy: If you have a settled little one who is not too irritable and is a good sleeper, you can get rid of the dummy at or before 6 months of age. At this time, you are certainly through the worst of the unsettledness and a dummy may not be necessary any more. For other slightly more needy little ones, a dummy is useful well into the toddler years. There is nothing wrong with this choice but toddler with a dummy does need to be managed slightly differently to younger babies. Getting rid of a dummy at or before 6 months At around 3 to 4 months of age, even the fussiest babies begin to settle significantly. If your baby is settled, only fusses briefly when hungry and is a good sleeper, this is a good time to ‘ditch the dummy’. It is also an easy age to get rid of any habits, as they really are not very firmly entrenched. To get rid of a dummy at this age, stop offering it at all during awake times and only offer the dummy just as your baby falls asleep for four days. Once he is a sleep, take the dummy from his mouth and do not offer it again at all at night. If your baby wakes and is unsettled at night and more than 5 hours have passed since a feed, feed him - don’t dummy him. During this time, encourage a different sleeper soother – such as a teddy or Taglet blanky. This will become your baby’s tool to fall asleep. Once this is set up, it is time to go cold turkey and loose the dummy altogether. You may find a few days of unsettled behaviour at sleep time but continue to encourage the ‘doodoo’ blanky or teddy as the tool to fall asleep. Managing and getting rid of a dummy in the toddler years There is nothing wrong with a toddler sucking a dummy, as long as it is done around sleep time and your toddler does not walk around with his dummy in his mouth all day. The main reason for this is that walking around with a dummy in his mouth all day is just not a pretty sight. In addition, some people do feel that dummies can affect speech and the pronunciation of some sounds. The fact is that most toddlers remove their dummies when speaking and so it should not hold them back but nonetheless, if your toddler is still using a dummy, I encourage you to only let him use it at bedtime. To ditch the dummy in the toddler years, follow these three steps: Only let him use the dummy in or around his bed. Even if he is really miserable, your toddler should have to go to his room if he needs a ‘quick suck’. Connect the dummy to his pillow with a dummy clip and create a boundary of dummy in bed only. Once he has accepted this and you have decided it is time to ditch the dummy, tell your toddler a story about his dummies – a story that revolves around something that simply needs the dummy more than he does. A great idea is to take him to a zoo and show him a tiny baby animal. Preferably an animal that makes a noise (we used a hyena). Tell your toddler that the animal’s baby really needs a dummy. Over the course of the next few days broach the idea that ‘it is time to give your dummies to the baby animal’. The offer a reward. Yip – good ol’ bribery! On the set date, take your toddler to the zoo or where ever it is and offer up the dummies. That night a reward – preferably of a soft toy animal similar to the animal he gave his dummies to will complete the story. Thereafter, a few nights of unsettledness may ensue. Use loads of love and a bit of water in a bottle to suck on if he is distressed. While ditching the dummy is not the easiest part of being a parent, neither is it rocket science. Hang in there and stick with calm, caring consistency for a few days. By Meg Faure

Why is my baby crying? Does my baby cry too much? What is normal? We know you want the answers to these questions, and here is some more info on “Crying through the ages”, covering crying from newborns to toddlers, talking about the REAL cause of colic and what to do about it and everything from hunger and separation anxiety to teething and temper tantrums. Newborn The newborn baby is typically much calmer and cries less than you would expect. Many parents are surprised that their baby does not scream at birth but rather makes quieter sounds and has a period of relative calm. Your hormones released in the birth process and the natural birth process itself results in a calm alert baby on the day he is born. Even after the initial 24 hours, the new baby is only really likely to cry when hungry, which once the milk comes in can be as often as two hourly or may be spread out to closer to four hours. It is important in the early days to feed your newborn on cue as this will not only settle him but also encourages your milk supply. The other time newborns cry is when being changed and bathed. Both changing and bathing result in feeling the cold air and new touch sensations, which can be disconcerting for the new baby. If a newborn (0-2 week old) cries a lot, it is important to have him checked by a doctor or clinic sister as this is typically a period of relative calm, which we call the honeymoon period. Most babies do not cry extensively during the early days. 2 weeks - 3 Months At around the two week mark, many babies become unsettled and begin to fuss more than during the honeymoon period. This is completely normal and in fact the ‘crying curve’ is well documented. This curve shows that babies begin to cry seemingly without reason at around 2 weeks old and by 12 weeks old this crying has almost entirely abated. This unexplained early baby crying peaks at about 6 weeks of age. Traditionally called colic, we now know that in fact this crying has nothing to do with the digestive system and remedies for tummy ailments make as much difference as sugar water. (St. James) Even if your baby tucks his legs up or kicks and screams for an extended period of time, you can rest assured that almost every crying baby of this age is healthy and normal. Colic is caused by over stimulation. Being alive in our busy sensory world can be overwhelming for many babies and this coupled with too little sleep will result in crying as your baby responds to the sensory input of the world and the little bubbles in his tummy with crying. The best ways to avert colic is to swaddle your baby and settle to him to sleep after only an hour of awake time. If your little one is very unsettled, do not worry about spoiling him at this age. Under four months of age babies do not have long term memory and so will not be ‘spoilt’ by being rocked or lulled to sleep. Try the baby sense cuddlewrap. 4 - 6 months The four to six month old is much less susceptible to overstimulation and therefore is more settled. But just as you think you are getting the hang of this parenting thing, you will find your baby become a little less predictable. Instead of remaining settled for a good three to four hours between feeds, many babies of this age begin to fuss and wake more frequently at night too. This relates to their new and growing nutritional needs. At this age you can choose to respond to the increased demand for nutrition with increasing the number and frequency or quantity of milk offered or you may choose to introduce solids. The latest research indicates the introduction of solids is safe and good for babies anytime between 4 and 6 months of age. Your 4-6 month old may still become crotchety if overtired or over stimulated. Watch your baby’s awake times (Baby Sense 2010) 6 - 12 months The older baby is a bundle of fun and laughs and will not spend much time crying. There are a few reasons that typically raise their heads: Illness – many babies get their first colds and illnesses at this age and an irritable baby with a fever is not much fun. Separation anxiety – as your baby develops object permanence and realizes he is separate from you, he will become increasingly irritable whenever you are out of site. A transition object or security blanket will help him to feel a little more secure. Nappy change time – all 8 month olds resist having their nappy changed and become very irritable. This is typical and is no reason to be concerned. Simply put the back position for nappy changes is way to passive and our little one will get very irate when placed on his back. Teething – typically your baby’s first tooth will emerge during this stage and you may have a day or two of irritability. Toddlers Your toddler has an opinion and mind of his own and generally this will impact on his mood. There are three main reasons for crying and tantrums A toddler may throw an almighty tantrum if he is overtired – we tend to overestimate our toddler’s ability to stay awake and be stimulated. The reality is that toddlers need at least one day sleep and an early bedtime. In addition, toddlers can only socialize for a limited period before becoming over stimulated and crying or throwing a tantrum. If your toddler feels misunderstood, you will have a tantrum on your hands. Toddlers understand more than you would believe and can process cognitively what they want to say or do. The problem is that it will be some time before your toddler can express himself adequately. When he feels like you do not understand him a tantrum may ensue. Some toddlers throw tantrums and cry simply to get their way. Again this is normal and is part of developing independence and autonomy. Finally, it is vital to realize that all babies are different. Some settled little ones cry very little and take each stage in their stride, while a sensitive baby cries for almost no reason and is a challenge for his parents. By Meg Faure

Being a parent is a daunting job, even when our babies are healthy. An ill or unsettled baby is always cause for concern and anxiety. Dr Simon Strachan, paediatrician, debunks some of the myths and gives insight to this thorny topic: Your baby’s health. The most common infectious diseases in children are those that involve the Gastrointestinal tract (GIT) and the Respiratory system. I bet most parents would think of Measles and German Measles and Chickenpox when asked about infectious disease and they would not be wrong. These last mentioned however are now much less common because vaccinations are available that prevent these diseases. The Common Cold The common cold is caused by Rhinovirus and this is most common in the winter months. It causes the typical snotty blocked nose with a slight fever for a few days. The nasal mucus changes from clear to yellow to green as the immune system clears the infection. The changing colour of mucus is not a reason to suspect another infection or the need for antibiotics. The common cold takes about 10 days to clear and always moves from the nose to the chest. Everyone will cough for about a week and you should use medications to control pain and fever and some nasal decongestants. The cough is a protective reflex so it is not a good idea to stop the cough with medications. Over the counter cough and cold remedies are not recommended for children under two and have little effect in older children. The Common Cold is referred to as an Upper respiratory tract infection. Bronchiolitis This wheezy chest infection occurs every year often in autumn and is usually caused by RSV (Respiratory Syncitial Virus). It occurs mostly in children less than one year and causes rapid breathing, wheezing, severe congestion of the nose and coughing for two weeks. The younger the child the worse the infection and about 10% of children will require admission to hospital for oxygen therapy. Home based therapy must aim at keeping the nose clear, keeping the fever down and ensuring adequate fluid intake. Pneumonia Pneumonia is an infection of lung tissue and occurs when germs travel down the airway from the nose and throat to the lungs. The infection is most often due to a virus and we have vaccines against the two most important bacteria: Haemophilus Influenzae (Vaccine - Hib titre - is included in the standard combination vaccine given three times in the first 4 months of life) and Streptococcus pneumonia (Vaccine – Prevenar is given with the combination vaccine as mentioned above). Fever, cough and rapid breathing are the three symptoms which together point to pneumonia. The diagnosis will require a visit to your doctor, a Chest X-Ray may be required and treatment with antibiotics is frequently necessary. Gastroenteritis Diarrhoea and vomiting which is caused by an infection is called Gastroenteritis. Three or more profuse watery stools per day are regarded as diarrhoea. Rotavirus is the most common cause and thankfully we now have a vaccine against this virus. The vaccine will prevent admission to hospital from severe dehydrating diarrhoea in about 98% of people. The children may well still contract the virus and get mild gastroenteritis but they develop immunity after two bouts of infection even if not vaccinated. The GIT infections are spread by contact with stool or by spreading the virus on our hands. The virus does however live on open surfaces for up to 5 days. So it is important to disinfect, with alcohol based disinfectant, if you have a case of Gastroenteritis in your family. The illness starts with fever and vomiting for a day or two and then the diarrhoea follows. As long as the child is able to drink and keep liquids down and you can get more fluid in than is coming out the bottom, you will prevent hospitalisation and dehydration. The warning signs are dehydration, persistent fever and blood in the stool. You must use rehydration fluid when giving fluids to a child with gastroenteritis. The diarrhoea may well lat for 7 days. Remember that all viruses and bacteria are infectious, meaning that they can be spread from one person to the next. It does not follow however that if a child has one infection that the exact infection is spread. I mean that if someone has tonsillitis from virus A and spreads Virus A to someone else, the next person may get tonsillitis but may just as likely get an ear infection or pneumonia or just a mild snotty nose from the same Virus. The type and severity of infection you develop depends on how much of the virus is spread, how it was picked up and your state of health when you acquired the infection. When it comes to the other infectious diseases, they are significantly less common since vaccination has taken care of that. For instance, I have seen one case of Measles in 13 years in private practice because of effective vaccination regimes. The following are the other infectious diseases: Roseola Infantum - often called “baby measles” Remember it has nothing at all to do with Measles. It is a viral infection typically in children between 6 months and 4 years of age. The infection presents with a fever of >38.5˚C for up to 8 days usually 4-5 days. No other symptoms develop but a rash develops within 24 hours of the fever breaking. The rash occurs only on the face and the body and is made up of red dots that are not painful or itchy. The rash disappears with no therapy in 48 hours. This infection is not measles and has nothing to do with measles. Control the fever and .See your doctor if fever persists beyond 48 hours in children over 6 months of age. Any child under 6 months of age with a fever must be seen within 24 hours. Chickenpox - This starts with fever and upper respiratory symptoms for a few days starting 14-21 days after exposure to chickenpox. The spots start as red spots and then quickly become water or mucus blisters. The rash occurs on the body. Treat the fever with Paracetamol. The rash is itchy and creams and lotions to reduce the itch are useful e.g. Antihistamine creams or Calamine Lotion. Oral Antihistamines are used for the itch. Zidovudine can be used to treat the infection in children who have weakened immune systems. Vazigam injection can be given if the child has been in contact with chickenpox. If given within 4 days this may prevent chickenpox. Varilrix vaccination against chickenpox is available from 1 year of age. Natural infection confers life long immunity in more than 95% of cases. Chickenpox is a mild illness with few complications. Isolate infected children until all the spots have crusted over. Rubella is also called German Measles. The illness starts with the rash or a mild fever, sore throat and muscle pains and then the rash develops. The rash is blotchy on the face and then spreads to the body and limbs and disappears by the fourth day. Glands behind the ears and in the back of the neck are classical. Most cases are extremely mild and Rubella is now quite uncommon due to vaccination. Symptomatic treatment only. Incubation period 14-21 days and isolation is not recommended unless contact with pregnant women is possible. Then isolation should be until the rash has disappeared. Mumps is a mild infection causing swelling of the salivary glands. Usually the parotid gland on the face in front of the ear and under the ear lobe causing the ear to be pushed upwards a little. Swelling can be one sided or both sides. Fever and other symptoms are mild. Measles is now very uncommon because of the effective vaccine. Exposure to measles is essential for the infection to develop. Fever, croupy cough, runny nose, conjunctivitis and spots in the mouth for the first five days and then the rash develops. Diffuse red rash spreading down the body from the face and neck. Fever settles a few days after the start of the rash. Measles is a serious illness in malnourished children and is a notifiable disease. Pneumonia, ear infections and encephalitis are serious complications. See your doctor if your child develops a fever and a rash. By Dr Simon Strachan