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Children's Medical Services - Special services for children with special needs
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Infant Toddler Development Training
Module 6, Lesson 2

Acute Illnesses, Child Care, Prevention and Intervention Acute Illnesses

Acute illnesses are those that have a sudden onset and generally have a short duration if treated properly. The ITDS should be knowledgeable about some of the most common acute illnesses seen in infants and toddlers.

Allergies

Allergies are a response of the body to foreign agents that are usually proteins. The response is specific to the allergen or agent to which the child is allergic and does not have immunity. The body's response is a mediated reaction using parts of the immune system to ward off the offending allergen. Allergy responses may include a runny or itchy nose and eyes, a cough or wheeze, and airway obstruction if the allergen is airborne and has an affect on the respiratory system.

little boy playing with grillSome of the common allergens of early childhood include food allergies that may manifest in early infancy. Infants and toddlers may also have allergic reactions to pollen, dust mites, and wasp or ant stings. If the digestive system is affected, the response could include vomiting and diarrhea. If the child has handled or been in contact with an allergen that affects the dermal or skin system, the response may be rashes and welts. A single symptom in isolation does not usually indicate an ongoing allergy.

Infections often appear to mimic allergy symptoms. Whereas an allergic reaction is immediate there may be a gap between the exposure to an infectious agent and the onset of illness. Unless there is an association between an allergen and the response, it is often difficult to ascertain if the child is having an allergic response or is getting ill. The best course of action is to suggest that the child visit the primary medical provider. The ITDS should remember that allergies and infections are both common in early childhood.

If one parent has allergies the chances of a child developing allergies is about 30%. If both parents have a history of allergies there is a 70% chance for the child to develop allergies.

Allergy Treatment

Treatment of allergies includes the following:

  • Removal of the allergen. For example, if a child is allergic to cat fur, it would be recommended to the family to consider another pet.
  • Desensitization to the culprit allergen especially if the allergy has the potential to be life threatening. An allergy specialist who is a doctor that has expertise in this area provides the process of desensitization.
  • Medication may be given to regulate the immune system.
  • Medication may be given to decrease the response symptoms.
  • Medication may be given to repair damage.

Note: The ITDS does not recommend medications. This is the role of the primary medical provider and/or medical specialist.

Asthma

Asthma or reactive airway disease is common. Asthma is generally a chronic condition recognized by tightening of the muscles of the bronchial tubes and increased sensitivity of the bronchial tubes or airways. Certain risk factors may be present such as exposure to tobacco smoke pre or post-natally, a family history of asthma or allergies, or being black or male. Symptoms generally appear at night with a cough and with increased expiratory effort as the airways constrict and swell. Normally the child breathes in longer than breathing out; however, as the episode persists, breathing out becomes more difficult and wheezing occurs. This is because the air is trapped and causes hyperinflation of the lungs.

A trigger is something that creates the onset of symptoms. The trigger may be an allergic trigger or a non-allergic trigger. Non-allergic triggers include infections, dust, smoke and certain smells. Individuals may trigger because of previous experiences such as an infection or bronchopulmonary dysplagia. Once the wheezing starts it is important to minimize inflammation. The airway remains very sensitive to the trigger for several days to weeks after the initial trigger.

Asthma Treatment

Treatment of asthma includes:

  • immune system mediators such as cytokine inhibitors and inhaled steroids
  • bronchodilators
  • oral steroids
  • intravenous steroids and oxygen therapy that would be provided in a hospital

All episodes of asthma should be reported to the primary medical provider who will monitor the child and prescribe as needed. Most pediatricians now develop an "Asthma Action Plan" to describe specific actions to take when asthma is present. This plan should be shared with all caregivers, especially childcare staff.

What is the role of the ITDS when working with an infant or toddler who has asthma?

 

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