Off to the paediatrician?

Posted on 4 January 2022

Dr Okwudili Edward-Pascal Akarue, a paediatrician at Mediclinic Highveld, shares the top reasons why parents visit him.

Ideally, all children should be checked at birth, six weeks, and then as discussed with your paediatrician, possibly at six months and one year. From then on, routine visits should happen as discussed with your paediatrician.

Here are common concerns parents discuss with their paediatrician.


Reason #1: My child has a fever

Fever occurs when your child’s internal ‘thermostat’ raises their body temperature above its normal level. “An elevated body temperature is one way your child is able to fight the germs that are causing the bacterial or viral infection,” says Dr Okwudili Edward-Pascal Akarue, a paediatrician at Mediclinic Highveld. He adds that if your child is younger than three months, you should take them to the paediatrician, as babies have a higher risk of serious bacterial infections than older kids.

“In most cases, your child’s fever is harmless and will go away on its own in three days,” says Dr Akarue. “If it lasts longer, or if they show signs of a headache, drowsiness, breathlessness, skin rashes, dehydration, diarrhoea, a stiff neck or vomiting, take them to your paediatrician.” It can be frightening when your child has a febrile seizure (a convulsion that’s triggered by fever) – but don’t panic. These are often caused by an upper respiratory tract, ear, or urinary tract infection. They usually last from a few seconds to 15 minutes and don’t cause any cognitive damage. “However, if your child has a fever, severe headache, is vomiting, complaining of a painful neck and is sensitive to light, take them to the doctor immediately as these are possibly signs of meningitis.”


Reason #2: My child is not reaching milestones

Though all children develop at their own pace, most children reach developmental milestones at or about the same age. If you’re concerned about your child’s development, don’t wait. Acting early can make a real difference for your child and you.

“Early intervention can help your child improve their abilities and learn new skills,” says Dr Akarue. “The connections in a baby’s brain (neural circuits) are most adaptable in the first three years of life and are the foundation for learning, behaviour, and health. Over time, these connections become harder to change.” Dr Akarue adds that many diagnoses can’t be made until the child’s older. “As a paediatrician, my goal is to continue to screen and assess the entire clinical picture,” he says. “Having delayed milestones frequently does not imply a bigger or intellectual issue. Depending on the degree of delay or other signs, I might recommend evaluation by an educational therapist or hearing specialist.”


Reason #3: My child is due for vaccinations

Vaccines are a very important means of keeping your child healthy and protecting them from serious childhood diseases. They work by imitating infections in the body, allowing the immune system to develop antibodies against disease. When these antibodies have developed, future infection or complications can be prevented. Vaccines protect children from serious illness and complications which can include pneumonia, hearing loss, convulsions, brain damage, and death.

“Ideally, children should have all their vaccinations on time, according to the recommended schedule, but unfortunately many children either miss a couple of doses or do not get any for a number of reasons,” says Dr Akarue. When the opportunity arises, the schedule should be completed. “Each situation involving a catch-up is unique and needs to be evaluated on an individual basis,” he adds. “Decisions need to be made on how best to protect the child with what is available.” Scientific evidence shows that giving several vaccines at the same time has no adverse effect on your child’s immune system. “Children are exposed to several hundred foreign substances that trigger an immune response every day,” says Dr Akarue. “The simple act of eating food introduces new antigens into the body, and numerous bacteria live in the mouth and nose. Your child is exposed to far more antigens from a common cold or sore throat than they are from vaccines.”

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.