Oil that spoils the child
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《印度儿科学杂志》
How to cite this article:
Adhisivam B, Mahadevan S. Oil that spoils the child. Indian J Pediatr 2006;73:544-544
How to cite this URL:
Adhisivam B, Mahadevan S. Oil that spoils the child. Indian J Pediatr [serial online] 2006 [cited 2006 Jul 14];73:544-544. Available from: http://www.ijppediatricsindia.org/article.asp?issn=0019-5456;year=2006;volume=73;issue=6;spage=544;epage=544;aulast=Adhisivam
Sir,
As the number of infectious diseases is on the rise and different patterns of drug resistance are emerging constantly, treating the affected children is a real challenge for the pediatrician. To add to this burden, the socio cultural practices involved in child rearing, mostly irrational cause a great impact in childhood morbidity and mortality. One such harmful practice is the instillation of vegetable oil (usually gingili oil) in the child's nose and mouth as a cure for respiratory infections. This is a widespread custom in rural Tamilnadu. Healthy children probably having a viral respiratory illness when subjected to this practice eventually develop more serious complications like lipoid pneumonia usually accompanied by bacterial sepsis. The custom of nose blowing and manual removal of the phlegm from the throat during these episodes of oil instillation, are always septic procedures enabling direct inoculation of bacteria into the child's lungs. Occasionally when neem oil is used for the same custom, children present with encephalopathy and seizures. Laboratory tests usually show peripheral blood polymorphonuclear leukocytosis with an elevated erythrocyte sedimentation rate. X-ray findings are nonspecific which include alveolar consolidation and ground glass opacities. The cytologic demonstration of lipid-laden macrophages in the broncho-alveolar lavage is a characteristic feature.
During a period of 10 months (December 2004 to September 2005), 228 infants were admitted in the Pediatric ward for either pneumonia or bronchopneumonia. Among them 69 infants (30.2 %) had history of oil instillation within one week prior to onset of symptoms. All of them had cough, tachypnoea and dyspnoea at presentation. The chest X-ray was abnormal in 88% and neutrophilia was noted in 82%. Among these infants 8 required mechanical ventilation and 3 of them died.
This oil instillation practice is an unnecessary health hazard and a significant contributing factor for persistent pneumonia in children. Though, this issue was highlighted way back in 1973 by Balakrishnan S,[1] Oil-aspiration pneumonia is still a health problem in countries where infants are forced to receive vegetable or animal oil due to traditional habits.[2] Appropriate and intensive health education of the rural population by the health personnel and the media is probably the only solution to solve this problem.
References
1. Balakrishnan S. Lipoid pneumonia in infants and children in South India. Br Med J 1973; 4 : 329-331.
2. Furuya ME, Martinez I, Zuniga-Vasquez G, Hernandez-Contreras I. Lipoid pneumonia in children: clinical and imageological manifestations. Arch Med Res 2000; 31 : 42-47.(Adhisivam B, Mahadevan S)
Adhisivam B, Mahadevan S. Oil that spoils the child. Indian J Pediatr 2006;73:544-544
How to cite this URL:
Adhisivam B, Mahadevan S. Oil that spoils the child. Indian J Pediatr [serial online] 2006 [cited 2006 Jul 14];73:544-544. Available from: http://www.ijppediatricsindia.org/article.asp?issn=0019-5456;year=2006;volume=73;issue=6;spage=544;epage=544;aulast=Adhisivam
Sir,
As the number of infectious diseases is on the rise and different patterns of drug resistance are emerging constantly, treating the affected children is a real challenge for the pediatrician. To add to this burden, the socio cultural practices involved in child rearing, mostly irrational cause a great impact in childhood morbidity and mortality. One such harmful practice is the instillation of vegetable oil (usually gingili oil) in the child's nose and mouth as a cure for respiratory infections. This is a widespread custom in rural Tamilnadu. Healthy children probably having a viral respiratory illness when subjected to this practice eventually develop more serious complications like lipoid pneumonia usually accompanied by bacterial sepsis. The custom of nose blowing and manual removal of the phlegm from the throat during these episodes of oil instillation, are always septic procedures enabling direct inoculation of bacteria into the child's lungs. Occasionally when neem oil is used for the same custom, children present with encephalopathy and seizures. Laboratory tests usually show peripheral blood polymorphonuclear leukocytosis with an elevated erythrocyte sedimentation rate. X-ray findings are nonspecific which include alveolar consolidation and ground glass opacities. The cytologic demonstration of lipid-laden macrophages in the broncho-alveolar lavage is a characteristic feature.
During a period of 10 months (December 2004 to September 2005), 228 infants were admitted in the Pediatric ward for either pneumonia or bronchopneumonia. Among them 69 infants (30.2 %) had history of oil instillation within one week prior to onset of symptoms. All of them had cough, tachypnoea and dyspnoea at presentation. The chest X-ray was abnormal in 88% and neutrophilia was noted in 82%. Among these infants 8 required mechanical ventilation and 3 of them died.
This oil instillation practice is an unnecessary health hazard and a significant contributing factor for persistent pneumonia in children. Though, this issue was highlighted way back in 1973 by Balakrishnan S,[1] Oil-aspiration pneumonia is still a health problem in countries where infants are forced to receive vegetable or animal oil due to traditional habits.[2] Appropriate and intensive health education of the rural population by the health personnel and the media is probably the only solution to solve this problem.
References
1. Balakrishnan S. Lipoid pneumonia in infants and children in South India. Br Med J 1973; 4 : 329-331.
2. Furuya ME, Martinez I, Zuniga-Vasquez G, Hernandez-Contreras I. Lipoid pneumonia in children: clinical and imageological manifestations. Arch Med Res 2000; 31 : 42-47.(Adhisivam B, Mahadevan S)