December saw an outbreak of Norovirus, or winter vomiting bug almost approaching epidemic proportions, and unfortunately it continues on its rounds.

Norovirus is a highly contagious stomach bug, it spreads easily because exposure to as few as 10 virus particles can inubate infection, and also because the virus can survive on open surfaces for a long time.

As with any contagious virus, the key to avoiding it is to practice good hygiene:-

• Wash hands before handling food, before eating, after touching animals and after going to the toilet
• Take care if you are treating sick people around you, wash hands after being with them
• Use an antibacterial handwash
• Use a tissue to contain coughs and sneezes, then dispose of the tissue and wash your hands again
• Isolate sufferers until 48 hours after recovery
• If you catch the virus, remember that you remain contagious for a further 48 hours after you recover, don't prepare food on that time, and be cautious interacting with others

Hospitals and surgeries are keen to prevent contagion amongst the most vulnerable so try to avoid visiting them, telephone for advice if required.

Sadly there's no treatment for Norovirus and you have to let the bug run its course.  Symptoms vary but can include severe vomiting and diarrhoea. The biggest danger comes from dehydration so try to keep hydrated even in the event of vomiting.  Young children (and the elderly) are particularly vulnerable to dehydration and may require hospital treatment, but check with your hospital first as many have shut their doors to Norovirus admissions on health grounds.

Hopefully we all practice the hygiene measures outlined here routinely, this won't prevent catching Norovirus but it will help to contain its spread.

As with any illness that your children might suffer, if you can recognise the symptoms of tonsillitis then you can act quickly should your children go down with it. Tonsillitis is a disease which involves the inflammation of the tonsils at the back of the throat.  It is usually associated with children but adults can get it too.  It can be caused by a viral or bacterial infection. Viruses that cause common colds are also responsible for tonsillitis.

Where are the tonsils?
Tonsils are the red, fleshy part of the back of the throat.  They normally look red and clear.  When you have tonsillitis, they become bigger, more vibrant red and can be covered in a white/grey substance or yellow spots.  The tonsils actually form part of the body's immune system.

Symptoms of Tonsillitis:
Sore throat or neck
Swollen glands
Fever
Tiredness
Painful swallowing
Nausea and being sick
Headache

Is it contagious?
Yes.

Precautions:
Wash plates cups and cutlery in very hot water and do not share.
Throw away toothbrush as it may carry the infection.
Wash hands frequently.

Treatment:
Take the patient to the doctor for diagnosis, and to have a course of antibiotics prescribed.  Things usually return to normal after a week or so but tonsillitis can recur.  Encourage children to rest and to sip warm or room temperature drinks.

Art enables us to express ourselves both symbolically and emotionally, so it should not be surprising to learn that art therapy offers a good way to help children overcome personal or emotional problems.  Young children may not be able to communicate verbally, and if they can, they may not be able to express what they are trying to communicate in a comprehensive way.  Art therapy offers a way for a therapist to work with children, or indeed adults, to explore personal issues, especially ones hidden deep beneath the surface of consiousness.

Art therapy is used on people who have suffered trauma or grief, who are suffering severe illness or who may have mental health problems or learning difficulties.  It is nothing to do with learning to draw or be artistic, but about exploring personal problems through art as a medium.  If a child has problems nagging at their subconsciousness, they may not be able to talk about it.  They may not even be able to understand how underlying feelings are affecting them.  Feelings harboured as a child can have a profound impact on future development and behaviour in later life if left untreated.  A therapist can bring these suppressed problems and emotions to light simply by working with the child, talking with them, encouraging to express themselves through art and then talking about the results.

It's always alarming when your baby is unwell, especially if they are really tiny, but what signs should you look out for to determine whether calling the doctor is the right course of action?

Every baby is different and responds differently. For brand new parents it hard to know what is normal and what is not... here are some signs to look out for which might indicate you baby needs medical help. But remember, a baby's state can deteriorate quickly, so if you are concerned in any way, don't hang around, call for medical advice immediately if your baby or child...

• Is unresponsive: you know what they are normally like, so if they seem unresponsive to a favourite game or toy then they may be ill.
• Has a persistent high temperature: if they seem warm and the temperature won't reduce despite cooling them.
• Refuses feeds: if your baby is still feeding and refuses one feed and then refuses a second feed.
• Vomits: if they vomit up their feed twice in a row or the vomit seems discoloured in any way (ie is greenish or has blood in it).
• Has diarrhoea; if it is blood stained or persistent.
• Shows signs of lethargy: very tired all the time and weary.
• Has a rash: any kind of rash.
• Is irritable or restless: if they won't settle or relax or sleep.
• Has breathing difficulty: if they are struggling to breathe or are breathing in an unusual way.
• Is coughing: unusual or painful coughing
• Has a bulging fontanelle: if there is a bulge at the forehead.

You know your baby best.  If in doubt, call the doctor or NHS Direct!

Doctors are being advised to take parent's fears seriously when it comes to sick children. A parent's instinct is to be considered and taken into account when diagnosing a sick child. The idea that "Mother knows best" may be laughed at by some professionals, but parents can offer important information when discussing their child and doctors should listen, according to research published in The Lancet.

Why should doctors listen to untrained, non-medical parents?

• A parent can be trusted to want the best for the child so are more likely to convey a concern if they think it's important.
• They have probably nursed their child before through other ailments.
• They know the child's 'normal' character and can tell when something is not right.

Previously a parent's view was not officially (or routinely) taken into account, but things may change and guidelines my encourage doctors to listen more to the parent; especially when it comes to serious childhood diseases.

Doctors themselves sometimes use 'gut feeling' for some diagnoses. Rapid detection of serious diseases (such as meningitis and pneumonia) can be vital and quick diagnoses can mean saving a life. If a parent's instinct says its serious, this could help get the child rushed into hospital for medical treatment.

Keep an eye out for:

• Rapid breathing
• High temperature
• Poor blood circulation to the skin especially on fingers and toes
• Lethargy and tiredness

If you feel you're not being heard by your doctor and that your concerns are not being taken seriously - GET A SECOND OPINION!