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Be like BannatyneQuit smoking and change your family’s lifestyle today
Real-life stories How to avoid letting eczema rule your life
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Practical advice on the measures you can take to safeguard your child’s health
PLAN FOR THE FUTURE
No.3 / March. ’11
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Taking action early is key to the health of all children. Huge advances have been made but much of children’s health depends on the healthy living adopted by their parents – and we can all make decisions that help
‘I want to end the isolation eczema brings’
LuluO’HaganCoping with eczema
Quit smoking p. 41. Duncan Bannatyne’s advice on how you can quit
Dealing with asthma p. 62. How understanding the condition and environment around your child can help
CHILDREN’S HEALTH, 2ND EDITION, MARCH 2011
Managing Director: Willem De GeerEditorial Manager: Katherine WoodleyBusiness Development Manager: Dominic Webber
Project Manager: Amanda RobertsPhone: 0207 665 4407E-mail: email@example.com
Distributed with: The Independent, March 2011Print: The Independent
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We make our readers succeed!
We are at a time when the politi-cal empha-sis is on the Health and
Social Care Bill and GP commission-ing, but we must not lose sight of the issues that are important to the health of children. Sir Ian Kennedy’s report into health services last year emphasised the need for children to have “joined-up” care within the NHS, a concept which the reforms may make more diffi cult unless very carefully thought through.
Children’s diseases are constant-ly changing. When I fi rst started my training to be a doctor in 1976, deaths from epiglottitis, leukaemia, prematurity and cot death were fre-quent and tragic. Thirty-fi ve years later and epiglottitis (a life threat-ening infl ammation of the wind-pipe) has disappeared thanks to the Hib vaccine. Survival from child-hood leukaemia is above 70 per cent thanks to new chemotherapy treat-ment and most babies born even three months early now survive due to advances in newborn inten-
sive care. Cot death has fallen by more than half following the “Back to Sleep” campaign.
However, we have new diseases. In 2009 the RCPCH found that al-most 23,000 children and young people had diabetes in England. Although most cases were Type 1 diabetes, there are an increasing number of adolescents with Type 2 diabetes in the UK. Type 2 diabetes has traditionally been a disease of adults due to obesity in middle age. Diabetes is a serious lifelong condi-tion that can lead to multiple com-plications. The perils of childhood obesity and also passive cigarette smoking were not on the public health radar until recently. I would like to focus on these last two issues since they are not diseases but haz-ards to children from the 21st-cen-tury environment in which they are growing up.
Thirty years ago, less than one in 10 children were obese or over-weight. Today, it is one in three. Obesity damages children’s phys-ical and mental health. Four out of five obese children become obese adults, and adult obesity is
associated with heart disease, dia-betes, strokes, arthritis and some cancers. Overweight parents tend to have overweight children - un-doubtedly, this is a combination of genetic, dietary and lifestyle fac-tors, and children often model their behaviour on that of their parents.
Second-hand smoke has been found to be strongly linked to chest infections in children, asthma, ear problems and Sudden Infant Death Syndrome, or cot death.
We should, for instance, be mak-ing cars totally smoke-free if there are children travelling in them. We should always consider the health issues related to our actions, the ex-ample we are setting and the con-sequences that our behaviour may have on our children throughout their adult lives.
Those of us in the medical pro-fession, who see the results of pas-sive smoking first hand, need to be ready to lead and make a convincing case.
We want parents and children to start to lead healthier lifestyles – instead of storing up problems for the future.
‘We should always consider the health issues related to our actions, the example we are setting’
Professor Terence StephensonPresident of the Royal College of Paediatrics and Child Health (RCPCH)
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Question: What made Duncan Bannatyne a crusader against the danger of exposing children to passive smoking?Answer: The entrepreneur is an ex-smoker who is passionate about preventing the damage wrought by smoking to others – here, he tells how it can be done
How to prevent the puff“I smoked for 10 years in my twen-ties – I tried to quit four times and could never manage it” says entre-preneur Duncan Bannatyne. “Then I got a really sore throat and didn’t go out for three days and I suddenly re-alised that I hadn’t smoked while I was stuck in the house. So I carried on not smoking and never looked back. I feel so much better now and healthier. I go to the gym and it costs less to go than to smoke!”
“It is important that you don’t smoke in front of your children – and that you explain the harm that it does,” he says. “If your chil-dren do smoke, give them support and help them quit. My children have a trust fund and they have been told that they will lose it if they smoke and they have actually thanked me for encourag-ing them not to smoke.”
“The consequences of passive smoking for children can be cat-astrophic,” says Dr Chris Steele MBE. “Children who are exposed to
second-hand smoke are more prone to asthma and ear, nose and chest in-fections. About 17,000 children un-der fi ve years old in England and Wales are admitted to hospital each year due to illnesses caused by their parents smoking.”
Infants and children of parents who smoke are twice as likely to suff er from serious respiratory in-fection than the children of non-smokers, Steele points out – while smoking during pregnancy can also increase the risk of asthma in young
children, as well as be-ing a major risk factor for low birth weight. The more ciga-
rettes a woman smokes during preg-nancy, the less well the foetus grows and develops. Smoking during preg-nancy is a big concern: in England, 13 per cent of mothers-to-be continued to smoke during pregnancy – this fi gure may be higher because the da-ta relies on self-reporting, Dr Steele points out.
“More than one quarter of the risk
of Sudden Infant Death Syndrome (cot death) is attributable to ma-ternal smoking and smoking dur-ing pregnancy,” says Dr Steele. “The risk of cot death is trebled in infants whose mothers smoke, both dur-ing and after pregnancy. There is al-so a risk of babies being born earli-er – if you are a smoker, you are two times more likely to have a pre-term labour.
“There is increased risk of con-genital defects on the off spring of smokers, as well as some evidence that there is a link between mater-nal smoking, early childhood ex-posure to second-hand smoke and the development of emphysema in adulthood,” says Dr Steele. “There is increased risk of developing chronic obstructive pulmonary disease and cancer as adults.
“Crucially, children of smoking parents are more likely to become smokers themselves – and the like-lihood increases when both par-ents smoke, and if older siblings smoke too.”
“I think the next step is to look at smoking in confined spac-es, including cars,” says Duncan
Bannatyne. “It is dam-aging and horrible for our children to sit in a car with smokers, or to walk through a cloud of smoke outside shops, res-taurants or in airports.”
There are many so-lutions to giving up, from electronic cigarettes to medication. Duncan’s top tip for giving up smoking? “You have to understand that you want to stop, you can stop and you will stop! Look yourself in the mirror and say ‘I will not smoke’ – and you won’t. Stopping smoking is the single best thing you can do for your health.”
For tips on how to quit visit: www.wequit.co.uk
‘You have to understand that you
want to stop, you can stop and you
MARCH 2011 · 5A SUPPLEMENT BY MEDIAPLANET DISTRIBUTED WITHIN THE INDEPENDENT
How we chose to fi ghtW
ith former careers as a stockmarket trader (the 10th wom-an amongst
1500 men), and a fl oor manager for live television shows, Lulu O’Hagan is used to challenges. But her biggest ordeal has been something she’s had her whole life: her eczema and how to combine it with motherhood.
“My life has been completely overshadowed by my skin . My mum even thought I would never be able to work,” Lulu, from Kingston, Sur-rey, explains.
“I was very scared about having children – I really didn’t want to pass it on. Plus, I was needle-pho-bic and scared of everything to do with hospitals. The renowned al-lergy specialist Professor Jonathon Brostoff told me it was very likely I’d pass it on but a blood test would tell him more – but I couldn’t bring myself to do that!”
Lulu went on to have her fi rst daughter, Poppy, 13 years ago. Pop-py didn’t develop eczema though, “she developed dry skin in patch-es which can also turn very red, she doesn’t get the dreaded itch,” Lulu says. Two years and eight months later, Lulu had Belle. She seemed fi ne at fi rst but at six weeks old had to go into intensive care with bron-chiolitis, where the sticking-on of the nasal cannula gave Belle red, ag-gravated skin on her cheeks: “From then on, the eczema worsened, until by fi ve she was obliterated by it.” In desperation, they went to Great Or-mond Street: for fi ve years, neither Belle nor I had slept through, as she scratched for two hours every night.
“I didn’t want her to live the life I’d had, and at Great Ormond Street they saw the stress that eczema brought on the whole family”says Lulu. “Unbelievably, we took a month to consider the medica-tion they off ered”. She had previ-ously used alternative therapies
for herself and Belle, from Chinese herbs to homeopathy “all pret-ty much to no lasting avail.” Belle was prescribed immunosuppres-sants for two years, with month-ly blood tests. By the time she was seven, amazingly, Belle was clear of all eczema – and for Lulu, immu-nosuppressants have made a “life-changing” diff erence to her, too, which she says she admits grudg-ingly.
Lulu now runs an eczema sup-port group that attracts people from as far afi eld as the New For-est: “I want to end the isolation ec-zema brings. I know how to help parents who have never had ecze-ma deal with their children and I know how to relate to the children. I reassure adults who turn up, feel-ing suicidal (as I have), that they are not alone.”
Lulu’s support group’s contact details: email@example.com and Facebook page: http://goo.gl/0WhSW
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‘My life has been completely overshadowed by my skin – my mum even thought I would never even be able to work’
Lulu O’Hagan with daughters Poppy and Belle
Question: Why did a mother from Surrey decide to found a support group for people with eczema and their families? Answer: Having felt isloated by her condition for most of her life, Lulu O’Hagan learnt to overcome her fears and then helped her daughter do the same. Now she wants to help others too
What are the key signs of
eczema a parent should look
!The main symptom of atopic eczema is itchy skin.
Scratching in response to this may be the cause for many of the changes seen on the skin. Itch-ing can be bad enough to inter-fere with sleep, causing tired-ness and irritability. In areas that are repeatedly scratched, the skin may thicken up (a proc-ess known as lichenification) and become even more itchy.
What are the essential tips for
children suffering with eczema?
!While eczema can’t cur-rently be cured, there are
several treatments that can help to control it. Your GP will be able to tell which type of treatment is most suitable for your child. The most common way to treat atop-ic eczema is with a combination of moisturisers (emollients), which keep the skin hydrated, and topical steroid creams, which help to ease the redness and itching of a fl are-up.
QUESTION & ANSWERNina GoadBritish Association of Dermotologists
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“Initially you do panic – but as time goes on you tend to be in more con-trol of the illness and you learn to cope,” says Allison, who’s nine year old son Thomas shares her condi-tion. They live in Fort William Scot-land, with her husband, who doesn’t have the respiratory condition.
“Now our house is Hoovered twice a day, so although we have carpets and curtains, two cats and a dog, there is very little dust or pet hair to aggravate.” Both she and Thomas soon notice a difference if they Hoover less, says Allison, quickly getting a tight feeling in their chests. “But although we like to keep a healthy house if it’s too clean that can cause problems too.
“It’s about being preventative – you get into a routine of doing things to stop flare-ups happen-ing,” she says. “For instance, during the change in seasons, such as from winter to spring and autumn to
winter, which causes flare-ups, we tend to go out only if we have to and we keep the windows tightly shut so that the temperature indoors is regulated.”
“A healthy home is different for everyone,” says Joy Smith, asth-ma nurse specialist at Asthma UK. “But avoiding known triggers and
allowing children to be exposed to a certain level of ‘dirt and germs’ so they build up a natural resistance to infections are easy ways to cre-ate a healthy home.
“A warm, well-ventilated home will not be friendly to mould or house-dust mites, so having central heating is helpful. Good
ventilation benefits people with asthma. It reduces humidity, which reduces the number of dust mites and moulds. It also helps to disperse gases produced by heat-ing and cooking.”
Allergy testing will help iden-tify what is causing allergic rhin-itis and thus allow strategies to reduce exposure to the allergen, points out Dr Adam Fox, consult-ant paediatric allergist, St Thomas’ Hospital, London.
“For example, dust mites are the most commonly identified cause of perennial allergic rhinitis. Symp-toms may be reduced by using spe-cially designed bedding and regu-lar damp dusting, while in pollen allergy (hayfever) desensitisation can help reduce symptoms and the need for medication. Reducing the inflammation in the nose, reduc-es the inflammatory signals sent down to the lungs and in some cas-es can help reduce the inflamma-tion in the lungs that causes the symptoms of asthma.”
Asthma UK has a series of fact sheets which can help parents children of asthma: www.asthma.org.uk
The power of knowledge is essential for better health
Question: How has one mother learnt to manage her son’s asthma through actions taken at home?
Answer: Her solution to a more comfortable life has evolved from experience that’s enabled her to develop a strong strategy focused on prevention
NEWS Asthma and allergies at homeExpert advice from Dr Adam Fox, consultant paediatric allergist, St Thomas’ Hospital, London
Allergic rhinitis, which causes a congested, runny and itchy nose, as well as sneezing, is inextricably linked to asthma. The condition, which includes hayfever as well as allergies to dust mites and pets, is found in more than half of asth-matics, although in some studies this has been found to be as high as 80 per cent. The symptoms of rhinitis may be subtle or passed off as a cold – hence the diagnosis goes unrecognised.
Children who suffer from aller-gic rhinitis are dramatically more likely to develop asthma as they grow up. This progression of one allergic disease to another is often referred to as the “allergic march” – seen in children who have inher-ited a genetic tendency towards al-lergy and often develop eczema and sometimes food allergy in infancy before going on to develop respira-tory problems in later childhood.
However, the link between asth-ma and rhinitis runs deeper as there is evidence that poorly con-trolled rhinitis will often lead to a worsening of asthma and like-wise, where both are present, treat-ing rhinitis can improve the symp-toms of asthma.
For more information: www.adamfox.co.uk
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One in 11 children has asthma
and it is the most common long-term
On average there are two children
with asthma in every classroom in
The UK has among the highest
prevalence rates of asthma symptoms
in children worldwide
If one parent has asthma, the
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of children whose parents don’t
Every 17 minutes a child is admit-
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Only 65 per cent of parents are
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SOURCE: ASTHMA UK
‘Good ventilation benefits people with asthma’
Joy SmithAsthma UK
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