What is the chickenpox?

Chickenpox is a very common childhood infection where symptoms are mild and complications rare. Almost all children develop immunity to chickenpox after infection, so they only catch it once. Chickenpox is less common but more severe in adults.

The Chickenpox Vaccine

The chickenpox vaccine contains a weakened chickenpox virus that encourages your body to produce antibodies against the varicella zoster virus. Antibodies are proteins produced by your body to destroy disease and infection. The vaccine protects you from becoming ill if you are infected with chickenpox.

The chickenpox vaccine requires two doses, which are given four to eight weeks apart, and usually involves an injection into the thigh or upper arm. It is suitable for adults and children aged over 12 months old and should either be given at the same time as other live vaccines (i.e. MMR or Yellow Fever) or be separated from them by more than one month.

The chickenpox vaccine is not part of the childhood immunisation schedule. You can vaccinate your child against chickenpox, but it will incur a fee.

Please contact reception on 091 740340 for more information or to book you appointment.

Who should get the vaccine?

Anyone can choose not to vaccinate their child against chickenpox, but it may be of particular value in certain circumstances. For example, the vaccine is recommended for anyone who is likely to encounter people living with a weakened immune system due to illness or treatment such as:

• People living with HIV/AIDS.
• people undergoing treatment for cancer or organ transplant.

The chickenpox vaccine is also recommended for:

• Healthcare works who have no previous history of chickenpox.
• Children who may meet people with a weakened immune system.
• Children living with severe disabilities who have never had chickenpox and are living in residential care.
• Women of child-bearing age who have never had chickenpox.

Side-effects of the Chickenpox Vaccine

Like most vaccines, you may experience some mild side-effects including:

• a mild fever
• redness, itching, pain, hardness and swelling around the site of injection
• muscle ache, headache, and
• feeling tired.

Aside from an extremely small risk of serious allergic reaction, there are no serious side-effects associated with the chickenpox vaccination. The side-effects usually pass within a few hours.

How much does it cost?

The chickenpox vaccine requires two doses, which are given four to eight weeks apart. The vaccine costs €95 per dose for Medical Card, GP Visit Card and private patients alike. This cost includes administration of the vaccine by the Nurse and brings the total cost to €190 for both doses. ( Please note fee is subject to change)

Please contact reception on 091 740340 for more information or to book you appointment.

Useful Links

Patient – More information on chickenpox-in-under-12s

Patient – More information on chickenpox in adults and teenagers

Patient – More information on chickenpox during pregnancy

HSE– More information on the chickenpox vaccine

It is important to understand that bedwetting is not the child’s fault and often occurs for no obvious reason. Sometimes, it runs in families. In other cases, bedwetting may be caused by

• The bladder producing more urine than it can hold
• An overactive bladder in which the bladder can only hold a small amount of urine
• Your child being such a deep sleeper that they don’t react to signals telling their brain their bladder is full
• Untreated constipation – sometimes treating the constipation alleviates the bedwetting
• Emotional distress such as bullying, or moving to a new house/school

In rare cases, bedwetting may be the symptom of an underlying health condition, such as type 1 diabetes. Learn more about the causes of bedwetting and diagnosing bedwetting.

Top Tips for Parents

As a parent, there are several things you can do to help your child, such as limiting the amount of liquid they drink before bedtime, and ensuring the go to the toilet before sleep.

It is also important to reassure your child that everything is okay and that it will get better. Telling them off or punishing your child for wetting the bed will likely make the problem worse.

In some cases, a bedwetting alarm may be recommended. A bedwetting alarm is a moisture-sensitive pad your child wears on their pyjamas. An alarm sounds if the child begins to pee. Over time, the alarm should help train a child to wake once their bladder is full.

We are here to help you to understand and manage your child’s bedwetting. We are happy to discuss any worries or questions you may have. The links below provide evidence-based guidance and care and are particularly useful for helping you to understand your child’s issue and how best to manage it.

Useful Links:

HSE – Bedwetting

NHS – Bedwetting information and advice

Content developed from HSE www.hse.ie, NHS Choices www.nhs.uk and is adapted for Galway East Medical Practice by Galway East Medical Practice.

Constipation occurs when your child is unable to pass poo regularly or completely empty their bowl. Your child’s poo can become hard and bulky, as well as unusually large or small.

In cases of chronic constipation, your child may experience soiling. Soiling is common place with constipation and occurs when loose poo seeps out around the hard poo. This scenario can often be an embarrassing and upsetting experience for the child, so it is important to help your child understand why this is happening and more importantly that it not their fault.

Other signs of constipation include:

• loss of appetite,
• lack of energy,
• being irritable, angry or unhappy,
• foul-smelling wind and stools,
• abdominal pain and discomfort,
• soiling their clothes, and/or
• feeling unwell.

Most childhood constipation is idiopathic. This means that no disease or illness has caused constipation. However, there are several factors that may contribute to the development of childhood constipation, or possibly make it worse. Poor diet, fear about using the toilet, poor toilet training and a lack of understanding on how bowels work can all be responsible for constipation in children.

We are here to help you understand and manage your child’s constipation. As a parent, there are many things you can do to help alleviate their condition. Treatment for constipation requires a committed and positive approach as more than half of children suffering constipation will relapse and may need repeated doses of clear-out medication. Together, we will create a plan to ease your child’s worry, discomfort and pain.

Top Tips for Parents

Understanding constipation

Take the time to explain to your child how their body works. Help them understand how and why poo is made and why it is important to go to the toilet. The following two videos can help you explain the pooping process and constipation to your child.

Video for older kids: https://www.youtube.com/watch?v=SgBj7Mc_4sc

Video for younger children: https://www.youtube.com/watch?v=Mq4bAVhvGHw

Balanced diet

Providing your child with a balanced and healthy diet can significantly ease your child’s constipation. Begin by keeping a food diary of what your child eats and drinks over a few days. This diary will help you gain a greater understanding of meals/foods you need to change. A high fibre diet and water intake can make a big difference to your child’s constipation. Children can be fussy eaters so changing to a high-fibre diet may be much easier said than done. But any change is a good change.

Fibre

Fibre comes in two forms: (1) soluble fibres which dissolve in water and help to slow your child’s digestion and absorb nutrients in food and (2) insoluble fibres which add bulk to your child’s poo, helping the poo to pass more quickly through the intestine. Fibre-rich foods include:

• fibre-rich cereals,
• dried apricots, prunes or figs,
• baked beans,
• black beans,
• porridge oats,
• brown bread,
• sweet corn, and

For children over two years, you can calculate the amount of daily fibre they need by adding the child’s age in years to 5 grammes. For example, if your child is eight years old, then you calculate it as 8 + 5 = 13. Therefore, an eight-year-old should be eating 13 grammes of fibre a day.

Water

Dehydration is one of the most common causes of chronic constipation. As explained in the videos above, the large intestine soaks up water from the food passing through. If your child is dehydrated, this will lead to a hardening of the food waste (poo) and increase the chance of constipation.

To encourage your child to drink more water why not get them a special cup and straw to make it more fun. Fruit juice such as prune, apple or pear juice may be useful from time to time as they have a laxative action and may loosen the bowel.

Make a reward chart for your child and give them a sticker at the end of the day if they reach their daily target of fluid and fibre intake, and passing a poo (see below). Again, it is important to explain to your child what you are doing and how to play along. At the end of the week, if they reach their goals, reward them with a treat.

Toilet training and habits

Some children can feel stressed or anxious about using the toilet. Toilet training too early, painful pooping or constant intervening when they are trying to go, can increase stress when using the toilet. Constipation can also happen if your child ignores the urge to poo (withholding) because he or she is afraid of the toilet. In other instances, they may simply not want to break away from play, or maybe they feel uncomfortable using public toilets, for example, at school.

Timed toileting is an essential part of the treatment for childhood constipation and must be carried out as a daily routine. It is vital to help your child to feel relaxed and at ease about using the toilet during this time.

Guidelines for timed toileting

• Use the body’s natural abdominal reflex, which is strongest in the morning and about 20-30 minutes after main meals
• Although it’s important to keep a routine, always encourage your child to go when they feel to urge to use the toilet
• 5-10 minutes is usually long enough
• Keep your child company and teach them how to position themselves on the toilet to poop properly
  • Ensure your child feels relaxed and comfortable. Smaller children may need an add-on seat or a footstool to help them feel supported
  • When sitting, help them to lean forward and rest their elbows on their knees. Their knees should be higher than their hips
  • Always discourage straining
• After a poop, encourage your child to look at their poo in the toilet and use the Bristol Stool Chart to help them identify and understand different types of poo.
  • The goal is poo type 3 and 4 which are generally easy to pass without being to watery
  • Poo type 1 and 2 generally indicates constipation
  • Poo type 5 and 6 generally indicates diarrhoea
• Promote good hygiene habits by encouraging them to flush the toilet and wash their hands after using the toilet.
• Avoid computer games, mobiles or anything that may distract them from concentrating on making a poo.

Medication

In cases of chronic constipation, medication may be necessary to clear out the build-up of poo in the bowel. This medication may cause cramps, and your child will poo a lot, but that’s the outcome we are looking for.

After the initial clear-out of poo with a high dose of medication, maintenance medication is required. Maintenance medication may need to be taken regularly for some time before your child’s bowel return to normal. At this point the maintenance medication can be slowly reduced, but not stopped suddenly.

Please do not stop using the medication until you have discussed it with your GP who will advise you how to reduce the medication.

We are here to help you to understand and manage your child’s constipation. We are happy to discuss any worries or questions you may have. The links below provide evidence-based guidance and care, and are particularly useful for helping you to understand your child’s condition and how best to manage it.

Useful Links:

• NHS Living Well – Constipation in young children
• Patient – Constipation in children
• ERIC – Let’s talk about poo game

Children who are very overweight tend to grow up to obese adults, and this can lead to serious health conditions such as heart disease, type-2 diabetes and some cancers in later life.

Children with a healthy weight, however, are shown to be healthy, fitter, better able to learn and more self-confident. They are also less likely to be bullied or suffer from low self-esteem.

As a parent, there are many things you can do to help your child to achieve a healthy weight and lifestyle.

1. Show them the love

Ensure your child knows you love them just as they are, whatever their weight and size. This love will help your child to be strong and have confidence in the changes you and they need to make to become a healthier weight.

2. Get them active

Physical activity is an important part of being healthy. It is recommended that children take part in at least 60 minutes of physical activity every day.

The easiest way to do this is to help them choose an activity that is fun to do. If your child isn’t used to physical activity, help them build up to 60 minutes of activity every day.

One suggestion is to try to work the activity into their daily routines such as walking or cycling to school. Maybe make the activity a family event and do it together – go for a walk, dance around the living room or just play some ball.

3. Eat well

You can eat your way through any amount of exercise, so it is important to get the food right. It is also important to take the time to teach your child what it means to be healthy and how food can impact their health and wellbeing. You can do this by explaining:

• what healthy food portion sizes look like,
• why they need to reduce sugar intake and treats,
• how to read food labels,
• how to make healthier food choices, and
• how to make healthy meals.

Safefood provide a helpful meal planner and lunch box ideas to help you create a healthy food plan for your child. We have also included several guides in the useful links section to help you and your children eat well.

Please link image to: http://www.safefood.eu/Childhood-Obesity/Your-Tools/Meal-Planner.aspx

Useful Links

• Living Well – What can I do if my child is overweight?
• Living Well – Get healthy as a family
• Living Well – How to involve your child in being healthy
• Safefood – Let’s take on childhood obesity
• Safefood – Healthy eating guide
• Safefood – Healthy meal planner
• Safefood – Healthy lunchbox ideas

Gastroenteritis can be very unpleasant for your child, but it usually clears up by itself within a week. You can look after your child at home until their feeling better. However, if the symptoms don’t improve or you feel your child may be at risk of a more serious condition it is important you contact us and make an appointment to see your Doctor.

Our best advice is for you to help your child rest up and keep hydrated. If you child is hungry, let them eat plain food such as toast, rice or pasta. If they complain of a fever or aches and pains, give them paracetamol. Your local pharmacist can recommend the most appropriate medication for your child. If you think your child is dehydrated, use special rehydration drinks made from sachets you can buy at your local pharmacy. Unless advised by your GP, do not give your child antidiarrhoeal and anti-vomiting medication.

If your child is experiencing any of the following, please bring them to the surgery

• Symptoms of dehydration, such as passing less urine than normal, being unusually irritable or unresponsive, pale or mottled skin, or cold hands and feet.
• Blood in their poo or green vomit.
• Vomiting constantly and are unable to keep down any fluids or feeds.
• Diarrhoea for more than a week.
• Vomiting for three days or more.
• Signs of a more serious illness, such as a high fever (over 38C or 100.4F), shortness of breath, rapid breathing, a stiff neck, a rash that doesn’t fade when you roll a glass over it or a bulging fontanelle (the soft spot on a baby’s head).
• A serious underlying condition, such as inflammatory bowel disease or a weak immune system, and have diarrhoea and vomiting.

In some instances, we may suggest sending a sample of your child’s poo to a laboratory to confirm what’s causing their symptoms. Antibiotics may be prescribed if this shows they have a bacterial infection.

Galway East Medical Practice are here to help you to understand and manage your child’s health. We are happy to discuss any worries or questions you may have. The link below provides an evidence-based guidance and care and is particularly useful for helping you to understand your child’s condition and how best to manage it.

Useful Links:

• NHS Living Well – Vomiting & Diarrhoea (Gastroenteritis)

Asthma is a narrowing of the airways so much so that it becomes difficult to breathe. Symptoms include coughing, wheezing and shortness of breath. Many children with asthma experience mild symptoms that are only triggered by a viral infection such as a cold or flu, or during times of physical activity and excitement. Other children may have symptoms that are more frequent and persistent, especially when not receiving the right treatment.

We are here to help you to understand and manage your child’s asthma. We are happy to discuss any worries or questions you may have. The links below provide evidence-based guidance and care and are particularly useful for helping you to understand your child’s condition and how best to manage their asthma. We suggest you read through the information supplied in these links and visit us to discuss how we can work together to manage your child’s specific health needs.

Useful Links

• Asthma Society of Ireland – Asthma and your child
• NHS Choice – Living well with asthma
• Asthma Society of Ireland’s Asthma app for iPhone
• Asthma Society of Ireland’s free four week (12 hours) programme for parents/carers of children living with asthma is designed to help improve your skills and confidence in managing your child’s asthma

A cold can be very unpleasant for your child, but it usually clears up by itself within a few days, and without medical care. Symptoms for the common cold include:

• Coughing
• Sneezing
• Runny or blocked nose
• Headache
• Sore throat
• Slight fever

Our best advice is for you to help your child rest up, eat well and keep hydrated. Some over the counter medicines may help if your child has a headache or slight fever. Your local pharmacist should be able to advise you on appropriate medication for your child. At this point, there is very little we can do for your child as the virus simply needs to run its course.

If you have any questions about the best treatment for your child you are welcome to get in touch. Contact us if your child:

• or you have a chronic medical condition such as asthma, heart disease or diabetes,
• has a very high temperature, severe headache or abdominal pain,
• is vomiting but doesn’t have diarrheoa,
• has a rash in addition to a fever,
• stops drinking and is unusually sleepy or listless,
• shows other signs of illness as well as a fever.

Always contact us if your baby’s temperature is 38C (100.4F) or higher if they are under three months, or 39C (102.2F) or higher they are three to six months.

We are here to help you to understand and manage your child’s health. We are happy to discuss any worries or questions you may have. The links below provide evidence-based guidance and care and are particularly useful for helping you to understand your child’s condition and how best to manage it.

Useful Links:

• NHS Living Well – Coping with Cold & Flu
• Cardiff University – The Common Cold
• HSE – Flu vaccine

Chickenpox is a very common childhood infection where symptoms are mild and complications rare. Almost all children develop immunity to chickenpox after infection, so they only catch it once. Chickenpox is less common but more severe in adults.

The chickenpox vaccine contains a weakened chickenpox virus that encourages your body to produce antibodies against the varicella zoster virus. Antibodies are proteins produced by your body to destroy disease and infection. The vaccine protects you from becoming ill if you are infected with chickenpox.

The chickenpox vaccine requires two doses, which are given four to eight weeks apart, and usually involves an injection into the thigh or upper arm. It is suitable for children aged over 12 months old and should either be given at the same time/at least a month after the MMR, as both vaccines contain a live but weakened version of the virus.

The chickenpox vaccine is not part of the childhood immunisation schedule. You can vaccinate your child against chickenpox, but it will incur a fee. Please contact reception for more information.

Please link childhood immunisation schedule to children’s health

Please link contact recpetion to phone number

Who should get the vaccine?

Anyone can choose not to vaccinate their child against chickenpox, but it may be of particular value in certain circumstances. For example, the vaccine is recommended for anyone who is likely to encounter people living with a weakened immune system due to an illness or treatment such as:

• people living with HIV/AIDS, or
• people undergoing treatment for cancer or organ transplant.

The chickenpox vaccine is also recommended for:

• healthcare workers who have no previous history of chickenpox,
• children who may meet people with a weakened immune system,
• children living with severe disabilities who have never had chickenpox and are living in residential care, and
• women of child-bearing age who have never had chickenpox.

The chickenpox vaccine is not recommended for:

• People with a weakened immune system
• People who have experienced as allergic reaction to any of the ingredients of the vaccine
• Pregnant women
• People who are already unwell, please defer until you recover

Side-effects of the Chickenpox Vaccine

Like most vaccines, your child may experience some mild side-effects, including:

• a mild fever,
• redness, itching, pain, hardness and swelling around the site of injection,
• muscle ache, headache, and
• feeling tired.

Aside from an extremely small risk of severe allergic reaction, there are no serious side-effects associated with the chickenpox vaccination. The side-effects usually pass within a few hours.

How much does it cost?

The chickenpox vaccine requires two doses, which are given four to eight weeks apart. The vaccine costs €80 per dose for Medical Card/GP Visit Card and private patients alike. This cost includes administration of the vaccine by the Nurse and brings the total cost to €160 for both doses.

Link contact reception to phone number

Useful Links

• Patient – More information on chickenpox-in-under-12s
• Patient – More information on chickenpox in adults and teenagers
• Patient – More information on chickenpox during pregnancy
• HSE– More information on the chickenpox Vaccine

The flu is a highly infectious and acute respiratory (breathing) illness that is caused by the influenza virus. It affects people of all ages and commonly occurs during the winter months.

Although anyone can get the flu, children living with a chronic medical condition are considered high-risk as they are particularly vulnerable to a severe reaction to the virus (see blow).

The flu vaccine encourages your child’s body to produce antibodies against the influenza virus. Antibodies are proteins produced by your body to destroy disease and infection. They protect your child from becoming ill if they are infected with the virus.

The influenza virus strain can change from year to year, so it is important to vaccinate your child against the virus every year. The flu virus strains vaccinated against each year are based on doctors and scientists’ best estimates of the active flu viruses going around that season.

Unfortunately, this means that the flu vaccine cannot provide 100% protection against all possible flu illness in any given year. However, vaccination against the flu virus significantly reduces the chance of serious or life-threatening illness even if you pick up a strain not specifically vaccinated against in that year. More information about flu viruse strains circulating this season.

At Galway East Medical Practice, we recommend you vaccinate your child against the flu virus between September and October each year for maximum protection. The flu vaccine is given in one single injection, usually in the upper arm.

Who should get the vaccine?

Although anyone can get the flu, but children living with a chronic medical condition are considered high-risk as they are particularly vulnerable to a severe reaction to the virus. As such the HSE strongly recommends the flu vaccine for:

• Children aged six months and older with a long-term health condition such as :
  • Chronic heart disease (this includes anyone who has a history of having a “heart attack” or unstable angina)
  • Chronic liver disease
  • Chronic renal failure
  • Chronic respiratory disease, including chronic obstructive pulmonary disease (COPD), cystic fibrosis, moderate or severe asthma or bronchopulmonary dysplasia
  • Chronic neurological disease including multiple sclerosis, hereditary and degenerative disorders of the central nervous system
  • Diabetes mellitus
  • Down syndrome
  • Haemoglobinopathies
  • Morbid obesity i.e. body mass index over 40
  • Immunosuppression due to disease or treatment (these include anyone on treatment for cancer)

• Children aged six months and older 
  • with any condition that can affect lung function especially those attending special schools/day centres with cerebral palsy or intellectual disability
  • on long-term aspirin therapy (because of the risk of Reyes syndrome)

Flu Symptoms

It can be difficult sometimes to tell the difference between a cold and the flu. The flu comes on quite suddenly with fever and muscle aches and pains. A cold is a much less severe illness than the flu, the symptoms are gradual and include a sore throat and a blocked or a runny nose.  The HSE have provided a chart to help you to distinguish between cold and flu symptoms.

Top Tips for dealing with the Flu

Most children recover from the flu within a week and without seeking medical care. However, if your child experiences severe symptoms or belongs to any of the high-risk groups listed above, you should contact reception and make an appointment to see your Doctor.

Link reception to phone number

Top tips for helping your child with flu

• Keep your child home for up to 7 days or until they fully recover – do not bring them to school while ill as this will likely spread infection
• Rest in bed as much as possible
• Take medicines such as paracetamol or ibuprofen to reduce the symptoms – your pharmacist should be able to recommend appropriate medication for your child
• Give them plenty of fluids to keep them hydrated
• Discourage any visitors

If you have taken the necessary care steps outlined above and your child starts to feel worse, you may need more advice from your family’s Doctor. Please contact reception to book an appointment to see your Doctor.

Lin contact recption to phone number

Side-effects of the Flu Vaccine

Like most vaccines, you may experience some mild side-effects including:

• a mild fever,
• redness, itching, pain, hardness and swelling around the site of injection,
• muscle ache, headache, and
• feeling tired.

Aside from an extremely small risk of sever allergic reaction, there are no serious side-effects associated with the flu vaccine.

Given the time of year that the flu vaccine is recommended (September/October), it is not unusual for patients to experience some “cold” type symptoms in the weeks following the flu vaccination. Such instances are unfortunate but coincidental and not related to receipt of the flu vaccine – the flu vaccine does not contain any active virus and cannot cause the flu.

How much does it cost?

The flu vaccine and its administration are free for children in high-risk groups who are covered under the Medical Card or GP Visit Card Schemes.

For private patients/children older than six years who are in high-risk groups, the flu vaccine itself is free, but vaccination incurs an administration fee of €30.

Other patients who are not in high-risk groups may still elect to have the flu vaccination; this will incur a €20 charge for the vaccine and the additional €30 administration fee.

Please contact reception to make your appointment for the flu vaccination.

Link contact us to phone number

Useful Links:

HSE – Patient information leaflet for the flu vaccine

HSE – Patient information leaflet for pregnant women and the flu Vaccine

HSE – FAQs on the flu vaccine

All children and young people in Ireland are entitled to vaccinations listed on the primary childhood immunisation schedule free of charge. Vaccinations are not mandatory, but they are strongly recommended by the health authorities for two reasons:

1. To protect your child from disease and
2. To protect the spread of disease among the wider community

At Galway East Medical Practice, we are happy to discuss any worries or questions you may have about your child’s vaccinations before they are vaccinated. Some parents like to complete a “vaccination passport” to help keep track of their child’s vaccinations and we are happy to provide a computerised printout of your child’s progress through the childhood vaccination schedule upon request. This useful guide for parents may also answer many questions you may have about your child’s vaccinations.

Childhood Immunisation Schedule

Babies born on or after 1^st October 2016

Babies born on or after 1^st of October 2016 will receive two new vaccines to protect them from meningococcal B disease and rotavirus disease. For more information on the MenB vaccine and rotavirus oral vaccine, please click here.

Children born BEFORE the 1^st October 2016 can also avail of the MenB vaccine. Please contact reception for more information.

Link contact reception to phone number

Babies born between 1^st July 2015 – 30^th September 2016

The schedule below is for babies born 1^st July 2015 – 30^th September 2016.

The HSE provide a useful leaflet on what to expect at each Doctor’s visit as well as what to do after your visit. Just click on the month relating to your child’s age below.

Babies born before 1^st July 2015

If your child were born BEFORE 1st July 2015, they would need an extra dose of MenC at six months of age.

School Vaccination Schedule

Children need to get several booster vaccines as they get older to continue to protect them from certain diseases. We have included some useful links to help you understand each of the vaccines recommended in the school vaccination schedule. If you have any worries or concerns about the following vaccinations, please book an appointment and we will be happy to answer any questions you may have.

Link book an appointment to phone number

Useful Links:

• HSE – Learn more about the childhood vaccination schedule
• HSE – Learn more about the 4 in 1 and MMRschool programme
• HSE – Learn more about Tdapschool programme
• HSE – Learn more about theMenC school programme.

HSE – Learn more about HPV school programme