Where There Is No Doctor 2011 321
Slow Development in the First Months of Life
Some children who are born healthy do not grow well. Their minds and bodies
are slow to develop because they do not eat enough nutritious food. During the first
few months of life the brain develops more rapidly than at any other time. For this
reason the nutrition of the newborn is of great importance. Breast milk is the best
food for a baby (see The Best Diet for Babies, p. 120).
Sickle Cell Disease (Sickle Cell Anemia)
Some children of African origin (or less often from India) are born with a
‘weakness of the blood’, called sickle cell disease. This disease is passed on from
the parents, who often do not know they carry the ‘sickle cell’ trait. The baby may
appear normal for 6 months, then signs may begin to appear.
Signs:
• fever and crying
• occasional swelling of the feet and fingers
which lasts for 1 or 2 weeks
• big belly that feels hard at the top
• anemia, and sometimes yellow color in the eyes (jaundice)
• child frequently sick (cough, malaria, diarrhea)
• child grows slowly
• by age 2, bony bumps may appear on the head (‘bossing’)
Malaria or other infections can bring on a ‘sickle cell crisis’ with high fever and
severe pain in the arms, legs, or belly. Anemia becomes much worse. Swellings on
the bones may discharge pus. The child may die.
Treatment:
There is no way to change the weakness in the blood. Protect the child from
malaria and other diseases and infections that can bring on a ‘crisis’. Take the child
for regular monthly visits to a health worker for an examination and medicines.
♦ Malaria. In areas where malaria is common, the child should have regular
malaria medicines to help prevent the disease (see p. 363). Add to this a daily
dose of folic acid (p. 392) to help build up the blood. Iron medicine (ferrous
sulfate) is not usually necessary.
♦ Infections. The child should be vaccinated against measles, whooping
cough, and tuberculosis at the earliest recommended time. If the child shows
signs of fever, cough, diarrhea, passing urine too often, or pains in the belly,
legs or arms, take him to a health worker as soon as possible. Antibiotics may
be necessary. Give plenty of water to drink, and acetaminophen (p. 379) for
pain in the bones.
♦ Avoid exposure to cold. Keep warm with a blanket at night when necessary.
Use a foam mattress if possible.