Diaper rash
The rash can be allergic or due to direct irritation of the skin by the chemicals like acid, ammonia etc. liberated from the urine and stools of the child. This rash may also be due to fungal infection (candida). Depending on the type of rash, specific ointments are prescribed. Some general measures are important. The diapers should be changed frequently.
The area of the rash should be kept clean and frequently washed with warm water and soap. If possible, it is preferable to keep the area open to air (i.e. without diapers). Exposure to the air and keeping the area dry hastens the healing of the rash. While cleaning, the raw area should not be rubbed with towel, which might cause more rawness; but instead should be patted dry. If possible, use cotton rather than towel for cleaning.
Hernias
An intermittent bulge that appears and disappears is typical of hernias. It is due to coming out (herniation) of some content (e.g. intestine) of the abdomen, most commonly into the scrotum. The treatment is surgical. Parents are sometimes scared of surgery and search for a medical cure. There is no medicine or device that can cure the hernia. Wearing trusses and belts in order to keep the abdominal contents in check may do more harm than good. The operation for hernia is a simple one. One should get it done.
Undescended testis
Parents sometimes discover that one or both sides of the scrotum seem empty and they cannot feel any testis in that. In many of these cases the testis has retracted into the abdomen (called “Retractile Testis”). These testes, off and on, automatically descend back into the scrotum and retract back into the abdomen. Testes that have been seen or felt in the scrotum at any time are retractile, and don’t require any treatment because it is normal. On the other hand, testes that are truly undescended and lie in the abdomen should be brought into the scrotum by operation.
This should be done before the child is 3-4 years old, as the testis may atrophy and lose its function. Sometimes children are born with one testis only. This is of no concern, if the other testis is normal. A single normal testis can carry on the function of reproduction and the person won’t be sterile.
Urinary tract infection (UTI): It is quite common in a child. Below the age of 1 year, the incidence is similar in boys and girls. After this it becomes more common in girls. It may present with discomfort and pain in passing urine, passing urine frequently, sudden bed wetting or lack of control over the passing of urine. It may also present with high fever with chills, i.e. shaking with fever. To diagnose UTI, a urine analysis and a urine culture is done. If the urine culture is positive i.e. it grows bacteria, it is a definite evidence that the child has got UTI.
The treatment is to give antibiotics, which is usually given for a period of 10 days. One week after the completion of the antibiotic course, a repeat urine check is done to see that no bacteria is grown i.e., the child is free from UTI. If he/she is free from UTI, repeat checks are carried at 3 months interval for a minimum period of 1 year. This is because recurrent i.e. repeated episodes of UTI should be detected and treated early as repeated attacks may lead to damage of the kidneys. But by and large if not neglected and promptly and adequately treated, it is a benign disease with an excellent outcome.
Many children pass white coloured (milky) urine, which if not associated with other complaints like pain, increased frequency of passing urine etc. is usually normal and is due to the presence of phosphates and urates being excreted out in the urine. Similarly, parents complain that the urine which has been passed, say on the floor, leaves a whitish deposit. This is again normal and is due to the reason mentioned above. If ants come near the urine passed and seem to like it, one should check for presence of sugar in the urine, which may sometimes signify a serious disease like diabetes.
Similarly, the colour of urine varies from colourless like water to amber coloured to pale yellow to deep yellow. It usually depends upon the amount of water intake. If water intake is good, the urine will be on the side of pale yellow while if there is decreased water intake, urine tends to become deep yellow (as is seen in fevers, where there is a lot of water loss from the skin due to sweating). However, if in doubt consult a doctor, particularly in case of deep yellow urine, as it may be due to liver disease.
Prevention of UTI: the child should be made to drink plenty of water so as to ensure that he/she passes adequate amounts of urine. It is recommended that the anal opening after the passage of stools should be washed from front to behind rather than in the opposite fashion (as is normally done). This is done to prevent the bacteria of the stools from coming in front and thus infecting the urinary passage (most of the UTI are due to the bacteria of the intestines, which gain entrance via the urinary opening and then ascend upwards to infect the urinary bladder and the kidneys). Thus UTI is mostly an ascending infection as compared to most other infections which are blood borne.