General Anaesthetic (GA)

I frequently do endoscopies on children with abdominal complaints. This procedure is done under a general anaesthetic in children. For many years this was done under sedation, as is usually the case in adults. The experience from the patients and the doctors was not encouraging. The failure rates (due to distress caused to the child) were very high and so all major units moved on to using a general anaesthetic with uniformly positive results, patients and parents much preferred the experience and…

Milk allergy in Children

This is a common problem in infants (under 1 year of age). This note should be read in conjunction with the note on food allergy. The milk allergy can be either an IgE allergy, a non-IgE allergy or mixed. Immediate (<5 minute) skin reactions producing nettle rash (urticarial), swelling and redness (erythroderma) are almost certainly of an IgE mediated. More commonly an allergy will be a non-IgE type.

Food Allergy in children

There are two categories of food allergy, based on the clinical features, which follow on from the biological process leading to the allergic reaction. Effectively the doctor is asking the question, is this an anaphylactic type of reaction or not? I emphasise the word type, as a milder reaction can have many of the features of anaphylaxis, if it shares the same biological process. The two categories of allergic reaction are: IgE mediated. Non-IgE mediated.

Failure to thrive

This is a situation that refers to slow rate of weight gain, or more broadly periods of poor weight gain, that lead a child's measured body weight to fall through the UK growth centiles (the ones at the back of the red, parent held, child health record for example). These charts are very useful tools for doctors, and enable a very quick comparison to be made to the expected weight of other boys or girls (as they do differ even from a young age) at any age. In addition these charts enable doctors…