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Various treatments can avoid that the ENT infections doesn't reproduce too often at the small child. But their efficiency is limited, recall the Dr Martine François, hospitable practitioner in the service of ENT of the hospital Robert Debré (Paris). The parents must learn to accept these unavoidable rhino-pharyngitises and other infections, that will affect the child on average sixty times before his six years. Doctissimo: Some children are embarrassed very by ENT infections to repetition. Are there the life styles that would permit to decrease the recidivisms? Dr Martine François: Yes, but one has little action unfortunately on the child's environment. It is already difficult to convince the parents that to smoke is dangerous for their own health. It is even harder to make understand them than that is harmful for their children. In the same way for the lodging. A child having some rhinites would be better in a pavilion or an elevated floor that in an apartment to the ground floor. But people are not masters of the choice of their dwelling for economic reasons. Sometimes, one is brought to counsel to change fashion on duty. The ideal remains at home the care or the nurses who have few young children to keep, because the transmission of the viruses makes itself by the very young children. Doctissimo: Do some efficient preventive treatments exist? Dr Martine François: One can help these children while trying to reinforce their immune defenses by non "specific vaccines". One has for it in France four products, managed by the mouth or by nasal way, very well tolerated. But it is necessary to know that if their efficiency is not hopeless, it is only light, and that they don't have an effect at the children who have few colds, because they already have a good immunity. One also has Finally the association sulfur-vitamin A. one can have resort to the surgery, heavier and whose efficiency is very far from being guaranteed. She is just a little superior to the one of the non specific vaccines. Doctissimo: For what children is it necessary to consider these interventions? Dr Martine François: The ablation of vegetations is discussed in case of otitis or frequent rhino-sinusitises, and only when one exhausted the other therapeutic resources. She is generally achieved between one and five years. The ablation of the tonsils is proposed for the children having more than six anginas treated by antibiotic per year, or then for those having some tonsils so voluminous that they embarrass them to breathe the night. The operation is generally considered between five and ten years, but there is not any age limits. Technically, the operation is always possible. But it is necessary to be sure that one helps to the child, that means that the respiratory hindrance is very important or that the recidivisms are very frequent. For it, one controls the notebook of health. It is very important that all episodes are marked there. Doctissimo: Are there a means to avoid that the cold gets settled, when one notices the first signs?  Dr Martine François: No. There is not medicine that permits to accelerate the recovery. The treatments only have for goal to improve the comfort the time that the cold dims of himself. Doctissimo: Is there care of hygiene individual to warn the rhino-pharyngitises? Is it necessary to counsel, for example, of the washings of regular noses by drops of physiological serum? Dr Martine François: No. One doesn't make this care that when the child is sick with a cold. As soon as the child knows how to blow, he is better than he even blows him. Washing with the physiological serum is only recommended if the secretions are dry because washing facilitates the mouchage then. One can try to make sneeze quite the small while tickling the inside of the nose with a small piece of cotton. Otherwise one makes a washing to sweep the secretions. It is not the pain to put the physiological serum in a systematic manner. It is not pleasant for the child and it can transform the reports with the adult. It is necessary to keep the pleasure of the relation with the child. One sometimes has the impression that, for the parents, the least cold, the least fever is a failure, that it is something that should not have occurred. However one knows that the child, ineluctably, will make about sixty rhino-pharyngitises before six years. Once it was accepted better. These are the worries that all the mothers know. Therefore it is necessary to relieve the child progressively and to consider more drastic methods, as medicines, an intervention or a change of fashion on duty, that if it passes some limits.                                                                                                        2008-12-10
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