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Malta Joint Paediatric Clinic, Santa Lucija Pharmacy, Santa Lucija (2025)

23/10/2025

Rashes in Children: When to Worry

Dear Parents,

Skin rashes are common in childhood and can have many causes — from mild irritation to more serious infections. Most rashes are harmless and clear up with simple care, but some may need prompt medical attention.

Common mild rashes include heat rash, eczema, nappy rash, and viral rashes like roseola or hand-foot-and-mouth disease. These are usually itchy or spotty, but children otherwise feel well.

However, seek urgent medical help if a rash is accompanied by fever, lethargy, breathing difficulty, or if it spreads rapidly. A particularly concerning sign is a rash that does not fade when pressed with a glass — this could indicate meningococcal infection, which needs immediate emergency care.

Other warning signs include painful blisters, purple or bruised-looking spots, swelling, or if your child appears very unwell.

For mild rashes, keep the skin cool and clean, avoid scratching, and use gentle moisturisers or antihistamines if advised. Avoid new soaps or creams until the cause is clear.

Because rashes can look similar, it’s always best to have a doctor assess any unusual or worsening rash. Quick identification ensures the right treatment and peace of mind for parents.

Sincerely,
Joint Malta Paediatric Clinic

23/10/2025

Influenza (Flu) in Children

Dear Parents,

Influenza, or the flu, is a viral infection that affects the nose, throat, and lungs. It tends to spread quickly among children, especially in schools and childcare settings, and can make your child feel quite unwell for several days.

Typical symptoms include high fever, sore throat, cough, muscle aches, tiredness, and sometimes vomiting or diarrhoea. Unlike a common cold, the flu comes on suddenly and can make children feel weak and miserable.

Most cases of flu improve within a week with rest, fluids, and fever control using paracetamol or ibuprofen. It’s important to keep your child home from school until they are fever-free for at least 24 hours to prevent spreading the infection. Encourage plenty of fluids, healthy meals, and rest.

Complications are uncommon but can include ear infections, pneumonia, or worsening of asthma. Seek medical attention if your child has difficulty breathing, persistent high fever, chest pain, severe lethargy, or dehydration (dry lips, no tears, reduced urination).

The best prevention is the annual flu vaccine, which is safe and recommended for children, particularly those with chronic conditions like asthma or diabetes. Good hygiene — washing hands, covering coughs, and avoiding close contact with sick people — also helps protect your family.

With prompt care and prevention, the flu can usually be managed safely at home, helping your child recover comfortably and return to normal activities.

Sincerely,
Joint Malta Paediatric Clinic

23/10/2025

Constipation in Children

Dear Parents,

Constipation is one of the most common digestive problems in children. It simply means that stools are passed less often than usual or are hard, dry, and sometimes painful to pass. While it can cause discomfort, constipation is usually not serious and can be improved with simple lifestyle measures.

Common causes include not drinking enough fluids, a diet low in fibre, or ignoring the urge to go to the toilet. Stress, toilet training, or changes in routine — such as starting school — can also contribute.

You may notice that your child has infrequent bowel movements, complains of tummy pain, or avoids the toilet altogether. Sometimes, there may be small amounts of stool in the underwear (soiling), which happens when liquid stool leaks around harder stool inside the bowel.

At home, encourage your child to drink plenty of water and include more fruit, vegetables, and whole grains in their diet. Establish regular toilet times, especially after meals, and ensure your child sits comfortably with their feet supported. Positive reinforcement and patience go a long way in building healthy habits.

See your doctor if constipation persists for more than two weeks, is associated with vomiting, blood in the stool, severe pain, or weight loss. Medical treatment — often in the form of gentle laxatives — may be needed to help reset healthy bowel patterns.

With the right care and reassurance, most children recover fully. Preventing constipation early helps keep your child’s digestive system healthy and comfortable.

Sincerely,
Joint Malta Paediatric Clinic

10/10/2025

𝐓𝐡𝐞 “𝐁𝐚𝐜𝐤 𝐭𝐨 𝐒𝐥𝐞𝐞𝐩” 𝐏𝐨𝐬𝐢𝐭𝐢𝐨𝐧: 𝐖𝐡𝐲 𝐈𝐭 𝐌𝐚𝐭𝐭𝐞𝐫𝐬 𝐟𝐨𝐫 𝐘𝐨𝐮𝐫 𝐁𝐚𝐛𝐲’𝐬 𝐒𝐚𝐟𝐞𝐭𝐲

When it comes to caring for a newborn, one of the simplest and most important things parents can do is place their baby on their back to sleep. This position, known as the “Back to Sleep” position, has been a major breakthrough in infant safety and has helped save thousands of lives worldwide.

What is the “Back to Sleep” position?

Quite simply, it means always placing your baby on their back—never their side or stomach—every time they sleep, whether it's for a nap or at night. This sleeping position is recommended from birth up to 12 months of age.

Why is sleeping on the back so important?

Research has shown that placing babies on their backs to sleep reduces the risk of Sudden Infant Death Syndrome (SIDS)—the sudden and unexplained death of a baby under one year of age, often during sleep. When babies sleep on their stomachs, they are more likely to rebreathe their own exhaled air, which can lead to low oxygen levels. Sleeping on the back keeps the airway open and clear.

Since the “Back to Sleep” campaign started in the 1990s, SIDS rates have dropped by more than 50% in many countries. It’s a simple change that has made a huge difference.

But what about choking?

Many parents worry that babies might choke if they spit up while sleeping on their back. In fact, healthy babies have natural reflexes that prevent this. Studies have shown that babies are actually less likely to choke when on their backs than on their stomachs.

Tips for safe sleep:

- Always place your baby on their back to sleep.

- Use a firm mattress with a fitted sheet.

- Keep the crib free of pillows, blankets, toys, or bumpers.

- Have your baby sleep in the same room (but not the same bed) for at least the first 6 months.

- Give your baby tummy time while awake to help with development and avoid flat spots on the head.

By following these simple steps, you can help your baby sleep safely and reduce the risk of SIDS.

Malta Joint Paediatric Clinic

09/10/2025

Understanding Positional Plagiocephaly in Infants

Positional plagiocephaly, often referred to as “flat head syndrome,” is a condition where an infant develops a flat spot on one side of the head. It is most commonly caused by prolonged pressure on one area of the skull, which is still soft and malleable during early infancy. Unlike craniosynostosis, which involves the premature fusion of skull sutures, positional plagiocephaly is purely positional and typically not associated with brain development issues.

Causes of Positional Plagiocephaly

The most frequent cause is a baby consistently lying in the same position—especially on their back—for extended periods. While the "Back to Sleep" campaign significantly reduced sudden infant death syndrome (SIDS) by encouraging back sleeping, it also led to an increase in positional head flattening. Other contributing factors include torticollis (tight neck muscles causing head tilt), restricted movement in utero, premature birth (softer skulls), and limited tummy time while awake.

Prevention and Correction

The key to preventing positional plagiocephaly lies in regularly varying an infant's head position and promoting movement:

1) Tummy time: Supervised time on the stomach while the baby is awake helps strengthen neck and shoulder muscles, relieving pressure on the back of the head.

2) Positional changes: Alternating the direction the baby faces during sleep, feeding, and playtime can prevent constant pressure on one area.

3) Limiting time in reclined devices: Reducing time spent in car seats, swings, and bouncers when not necessary can help avoid constant head pressure.

4) Physiotherapy: If torticollis is present, physical therapy can help correct neck muscle imbalance and encourage a full range of head motion.

In moderate to severe cases, where repositioning doesn’t resolve the flattening by around 5 to 6 months, a cranial orthotic helmet may be recommended. These custom-fitted helmets guide the skull into a more symmetrical shape over time.

Early intervention and parental awareness are key. With proper care, most cases of positional plagiocephaly improve significantly without invasive treatment.

Malta Joint Paediatric Clinic

08/10/2025

Dear Parents,

You may have noticed that your child has small, rough bumps on their arms, thighs, cheeks, or bottom that feel a bit like sandpaper. This common skin condition is called keratosis pilaris—often nicknamed “chicken skin.” It is completely harmless, though it can sometimes cause concern because of its appearance.

Keratosis pilaris happens when dead skin cells block the tiny hair follicles on the skin’s surface. This blockage leads to small, hard bumps that are usually white or skin-colored. In some children, the skin around the bumps may look slightly red or feel dry and rough. The condition is not contagious, does not itch in most cases, and is not due to poor hygiene.

It is especially common in children and teenagers, and often runs in families. The bumps tend to be more noticeable during cold or dry weather, when the skin loses moisture, and they may improve during the summer months when humidity is higher.

Although keratosis pilaris has no cure, it can be managed easily to keep the skin smoother and more comfortable. The most important step is moisturising. Regularly applying a gentle, fragrance-free moisturiser helps to soften the skin and prevent dryness. Products containing mild exfoliating ingredients like urea, lactic acid, or salicylic acid can help loosen the dead skin cells that block the pores—but these should be used only under guidance from your paediatrician, especially for young children.

It’s also best to avoid harsh soaps and long, hot baths, as these can dry the skin further. Instead, use mild, non-soap cleansers and lukewarm water, followed by moisturiser right after bathing. Gently patting, not rubbing, the skin dry also helps to reduce irritation.

Keratosis pilaris usually improves gradually with age and often fades completely by the late teenage years or early adulthood. In the meantime, consistent skincare can make a big difference in how the skin looks and feels. It’s important to reassure your child that the condition is common, harmless, and nothing to be embarrassed about.

If the skin becomes very red, itchy, or inflamed, or if over-the-counter creams are not helping, your doctor may suggest prescription creams or further advice from a dermatologist.

With simple care and patience, most children’s skin becomes much smoother over time.

Yours sincerely,

Malta Joint Paediatric Clinic

07/10/2025

Dear Parents,

It can be worrying to see small pimples or spots on your baby’s face, especially when their skin is otherwise so soft and delicate. The good news is that in most cases, these spots are harmless and temporary, and they usually disappear on their own without any treatment.

One of the most common causes is newborn acne (baby acne). This usually appears within the first few weeks of life and looks like small red or white pimples, often on the cheeks, forehead, or chin. The exact cause isn’t fully understood, but it’s thought to be related to hormones passed from the mother to the baby before birth. These hormones can stimulate the baby’s oil glands, leading to small pimples. Baby acne often clears up by itself within a few weeks or months.

Another possible cause is milia, which are tiny white spots that appear on the nose, cheeks, or around the eyes. These are simply trapped skin flakes under the surface and are completely normal in newborns. They don’t cause any discomfort and fade naturally without treatment.

Sometimes, small red pimples can also appear due to heat rash, especially if the baby is dressed too warmly or the weather is hot. This happens when sweat glands get blocked. Keeping the baby cool and avoiding thick clothing usually helps the rash disappear quickly.

Less commonly, rashes and pimples may appear as part of skin irritation or a mild allergic reaction, for example to creams, detergents, or saliva from frequent drooling. In these cases, the skin may look a bit red or dry. Using mild, fragrance-free baby products and keeping the face clean with plain water can help.

Parents should seek medical advice if the rash spreads rapidly, develops yellow crusts, looks swollen, or if the baby seems unwell or has a fever. These could be signs of an infection that needs attention.

In most cases, however, facial pimples in infants are completely normal and short-lived. The best approach is gentle care, patience, and avoiding the urge to squeeze or apply harsh creams. Your baby’s skin will soon settle and return to its smooth, soft state.

Yours sincerely,

Malta Joint Paediatric Clinic

07/10/2025

Dear Parents,

One of the causes of frequent vomiting in young babies that can worry parents is a condition called pyloric stenosis. This simply means that the muscle at the lower end of the stomach – the part that connects to the intestines – becomes too thick, making it hard for milk to pass through.

This condition usually shows up in babies between 2 and 8 weeks old, and it happens more often in boys. At first, parents may notice that their baby vomits small amounts after feeding. As days go by, the vomiting can become strong and forceful, sometimes even shooting out several inches. Even after vomiting, these babies are often still hungry and want to feed again right away.

Other signs parents may notice include:
- Poor weight gain or weight loss
- Fewer wet nappies, showing dehydration
-Tummy movements after feeding, as the stomach struggles to push milk through

The vomit in pyloric stenosis is not green, which helps doctors tell it apart from other problems.

If your baby has repeated, forceful vomiting—especially if they are not gaining weight—it’s important to see your paediatrician or visit the emergency department. Doctors can usually feel a small lump in the upper tummy and will confirm the diagnosis with a simple ultrasound scan.

The treatment is a small operation called a pyloromyotomy, where the thick muscle is gently loosened to allow milk to flow through normally again. Before the operation, your baby will get fluids to replace what was lost through vomiting.

The good news is that babies recover very well after surgery. Most can start feeding again within a day or two and go home soon after. With timely treatment, pyloric stenosis has an excellent outcome, and your baby can go back to growing and feeding normally.

Yours sincerely,

Malta Joint Paediatric Clinic

24/09/2025

Dear Parents,

It is common for babies to show some difficulty when trying to pass stool, and many parents worry that their little one may be constipated. One of the frequent concerns we see in infancy is a condition called dyschezia. This is when a young baby strains, cries, and sometimes even turns red in the face for several minutes before finally passing a soft stool. It can look uncomfortable, but in reality, this is not constipation. It simply happens because your baby is still learning how to coordinate the muscles needed to push stool out. Dyschezia is normal in the first months of life and usually improves on its own with time.

Constipation, on the other hand, is different. A baby is considered constipated when the stools are hard, dry, or infrequent, and when passing them seems painful. In infants, constipation is more likely when formula is used, when there are changes in feeding, or later when solid foods are introduced. Signs that your child may be truly constipated include very hard pellet-like stools, blood on the stool due to straining, or your baby appearing in significant pain.

If your baby is otherwise feeding well, gaining weight, and the stool that eventually comes out is soft, then what you are seeing is likely just dyschezia and nothing to worry about. However, if stools are consistently hard, if your child is refusing feeds, vomiting, or if there is persistent blood in the stool, it is important to seek advice from a paediatrician.

We encourage parents not to rush to use medications or suppositories unless advised by a doctor. Most of these issues resolve with time and gentle care.

Sincerely,

Malta Joint Paediatric Clinic

06/09/2025

ᴛʜᴇ ᴍᴇᴀsʟᴇs, ᴍᴜᴍᴘs, ᴀɴᴅ ʀᴜʙᴇʟʟᴀ (ᴍᴍʀ) ᴠᴀᴄᴄɪɴᴇ: ᴀ ʟɪꜰᴇ-sᴀᴠɪɴɢ ɪᴍᴍᴜɴɪᴢᴀᴛɪᴏɴ

The Measles, Mumps, and Rubella (MMR) vaccine is a combination shot that protects against three highly contagious viral diseases: measles, mumps, and rubella. These diseases, though once common, are now largely preventable thanks to the widespread use of the MMR vaccine. This article explores the importance of the vaccine, dispels common fears, and highlights why getting vaccinated is crucial for both individual and community health.

𝘈𝘥𝘥𝘳𝘦𝘴𝘴𝘪𝘯𝘨 𝘝𝘢𝘤𝘤𝘪𝘯𝘦 𝘊𝘰𝘯𝘤𝘦𝘳𝘯𝘴: 𝘍𝘢𝘤𝘵𝘴 𝘖𝘷𝘦𝘳 𝘍𝘦𝘢𝘳

Measles, mumps, and rubella are viral infections that can lead to serious health complications. Measles can cause severe respiratory problems, encephalitis (brain inflammation), and even death, especially in young children and immunocompromised individuals. Mumps can result in painful swelling of the salivary glands, and in rare cases, can lead to deafness, meningitis, and fertility problems in both males and females. Rubella, also known as German measles, is particularly dangerous for pregnant women, as it can lead to congenital rubella syndrome (CRS), which can cause severe birth defects like heart problems, deafness, and blindness in infants.

The MMR vaccine, which is typically given to children at 1 year of age with a second dose around 4 to 6 years, offers a safe and effective means to prevent these diseases. When the vaccine coverage is high, the transmission of these viruses is significantly reduced, protecting those who cannot be vaccinated, such as babies too young for the vaccine and individuals with certain medical conditions.

𝘈𝘥𝘥𝘳𝘦𝘴𝘴𝘪𝘯𝘨 𝘝𝘢𝘤𝘤𝘪𝘯𝘦 𝘊𝘰𝘯𝘤𝘦𝘳𝘯𝘴: 𝘍𝘢𝘤𝘵𝘴 𝘖𝘷𝘦𝘳 𝘍𝘦𝘢𝘳

Despite the overwhelming evidence supporting the safety and effectiveness of the MMR vaccine, some people remain hesitant. This is largely due to misconceptions about the vaccine’s side effects and an infamous but debunked study from the 1990s that falsely linked the MMR vaccine to autism. This claim has been thoroughly investigated and discredited by numerous large-scale studies and expert reviews.

In fact, a 2019 study published in Annals of Internal Medicine followed over 95,000 children and found no increased risk of autism linked to the MMR vaccine. The original study, which claimed a link between the MMR vaccine and autism, was retracted in 2004 due to serious ethical and methodological flaws, and its author lost his medical license.

Another common concern is that the MMR vaccine causes harmful side effects. While mild side effects like fever or a rash can occur, these are generally short-lived and far less serious than the diseases the vaccine prevents. Serious side effects, such as allergic reactions, are extremely rare, and the benefits of vaccination far outweigh the risks.

𝘗𝘳𝘰𝘵𝘦𝘤𝘵𝘪𝘯𝘨 𝘊𝘰𝘮𝘮𝘶𝘯𝘪𝘵𝘪𝘦𝘴: 𝘏𝘦𝘳𝘥 𝘐𝘮𝘮𝘶𝘯𝘪𝘵𝘺

One of the most important reasons to get vaccinated is to protect not just yourself, but also the broader community. When a large portion of the population is vaccinated, it reduces the overall spread of disease, which helps protect those who are vulnerable and unable to receive the vaccine. This is known as "herd immunity." For diseases like measles, which are highly contagious and can spread rapidly, achieving herd immunity through high vaccination rates is crucial in preventing outbreaks.

𝘛𝘩𝘦 𝘉𝘰𝘵𝘵𝘰𝘮 𝘓𝘪𝘯𝘦: 𝘝𝘢𝘤𝘤𝘪𝘯𝘢𝘵𝘪𝘰𝘯 𝘚𝘢𝘷𝘦𝘴 𝘓𝘪𝘷𝘦𝘴

The MMR vaccine is a safe, effective, and vital tool in the fight against measles, mumps, and rubella. By choosing to get vaccinated, you are not only protecting yourself and your loved ones but also contributing to the health of your community. The evidence is clear: the benefits of vaccination far outweigh the risks, and the MMR vaccine remains one of the most important public health tools we have to prevent serious illness and death.

Getting vaccinated helps keep these preventable diseases at bay, ensuring a healthier future for generations to come.

Regards,

Malta Joint Paediatric Team

05/09/2025

Dear Parents,

One of the scariest things for any parent is to see their child suddenly stop breathing, turn pale or even blue, and sometimes go limp. These frightening events are often what we call breath-holding spells or, in some cases, syncope (fainting). While they look alarming, most of the time they are not harmful and children outgrow them with age.

What are breath-holding spells?
These are episodes where a child, usually between 6 months and 6 years old, will hold their breath—often after crying hard, being upset, scared, or in pain. The child may suddenly turn blue (cyanotic type) or very pale (pallid type). Sometimes they briefly lose consciousness or become floppy. The whole episode usually lasts less than a minute, although it feels much longer to a worried parent.

Why do they happen?
Breath-holding spells are not under the child’s control. They are a reflex response of the body and not a sign of bad behavior. In cyanotic spells, strong emotions or crying trigger the breath-holding. In pallid spells, a sudden fright, shock, or bump to the head may cause the heart rate to briefly slow down, leading to fainting.

What should you do?
The most important thing is to stay calm. Lay your child on their side in a safe place and ensure nothing is blocking their airway. Do not shake them or put anything in their mouth. The child will usually start breathing again on their own. After the episode, they may be tired or want to sleep for a short while.

When to see a doctor?
Although most spells are harmless, you should consult your paediatrician if:

Episodes are frequent or prolonged.

Your child has jerking movements or prolonged unresponsiveness.

Spells happen without any clear trigger.

There is a family history of heart problems or sudden fainting.

Your doctor may check for conditions like anaemia, as this can sometimes make spells more likely. Reassurance and understanding are often all that is needed, and most children grow out of these episodes by school age.

In summary: Breath-holding spells and fainting episodes are usually benign and self-limiting, but they can be terrifying to watch. Knowing what to expect, how to respond, and when to seek help can give you peace of mind.

Warm regards,

Malta Joint Paediatric Team.

01/09/2025

Dear Parents,

One of the exciting milestones in your child’s early years is the appearance of their first teeth. These “baby teeth,” also called primary teeth, not only help your child chew and speak but also guide the proper alignment of the permanent teeth that will follow later.

Most babies will start teething around 6 months of age, though this can vary widely. The first teeth to appear are usually the bottom front teeth (lower central incisors). Shortly after, the upper front teeth (upper central incisors) come through. From there, teeth usually erupt in a fairly predictable pattern:

6–10 months: Lower front teeth appear.

8–12 months: Upper front teeth erupt.

9–13 months: Upper side teeth (lateral incisors) emerge.

10–16 months: Lower side teeth follow.

13–19 months: First molars (back chewing teeth) appear.

16–23 months: Canines (pointed teeth) come through.

23–33 months: Second molars erupt.

By about 3 years of age, most children will have a complete set of 20 baby teeth.

Teething can cause fussiness, drooling, and chewing on objects. Cool teething rings, gentle gum massages, or a clean cold washcloth to chew on often help. Fever, severe diarrhoea, or rashes are not caused by teething—if these happen, it’s best to check with your doctor.

As for dental care, it is recommended to book the first dental check-up by age one, or within 6 months after the first tooth erupts. This early visit helps ensure teeth are developing properly and gives parents a chance to discuss brushing, fluoride, and cavity prevention.

Remember, even baby teeth need care. Brushing twice daily with a small smear of reduced fluoride toothpaste is important as soon as the first year. Good habits formed early will help protect your child’s smile for years to come.

Warm regards,

Malta Joint Paediatric Team

Malta Joint Paediatric Clinic

23/10/2025

23/10/2025

23/10/2025

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Monday	13:00 - 19:00
Tuesday	16:00 - 19:00
Wednesday	16:00 - 19:00
Thursday	13:00 - 19:00
Friday	16:00 - 19:00
Saturday	08:20 - 17:00