Dr Willem Smit Paediatrician

20/03/2026

🤧🦷 Runny Nose & Teething: Are They Really Related?

One of the most common things I hear from parents is:
"It’s just teething… that’s why my child has a runny nose and fever."

Let’s clear this up 👇

🦠 A viral “snotty nose”

If your child has:

• A runny or blocked nose
• Thick yellow/green mucus
• Fever
• Cough
• Irritability
• Reduced appetite

👉 This is most likely a viral infection, not teething.

Viruses are extremely common in babies and toddlers, especially in crèche or school settings.

🦷 What teething actually causes

Teething can cause:

• Drooling
• Chewing on everything
• Mild irritability
• Gum discomfort
• Maybe a very slight temperature increase

👉 But teething does NOT cause:
• High fever
• Persistent runny nose
• Thick green mucus
• Cough
• A sick child

⚠️ Why this matters

If we assume everything is “just teething,” we may miss an actual illness that needs attention.

It also has an impact on others 👇

🏫 A quick note for parents

If your child has a viral infection, they are contagious.

Sending a sick child to school or crèche:
• Spreads infection to other children
• Leads to repeated illness cycles
• Affects vulnerable children more severely

👉 If your child is unwell, it’s always best to keep them at home until they improve.

🧠 A simple way to think about it:

👉 Teething = local symptoms (mouth & gums)
👉 Viruses = whole-body symptoms (fever, snot, cough)

🚨 When to take your child seriously

Don’t ignore symptoms if your child has:

• Fever
• Thick nasal discharge
• Cough
• Poor feeding
• Lethargy

These are signs of illness — not teething.

Teething can make babies uncomfortable, but it does not make them sick.

If your child seems unwell, trust your instinct and have them checked.

Dr Willem Smit
Paediatrician

19/03/2026

💉❄️ Winter Prep: 2 Vaccines Parents Should Know About

Winter brings the usual wave of coughs, colds, flu and chest infections and while we can’t prevent everything, we can reduce the risk of severe illness and hospitalization.

Here are two VERY important vaccines to consider this season 👇

🫁 1. RSV Protection (New Option Available)

RSV (Respiratory Syncytial Virus) is a very common winter virus, but in babies and young children it can cause serious illness like bronchiolitis and pneumonia.

👶 Babies under 1 year are at the highest risk.

There is now a new preventative option (Beyfortus) available for infants entering their first RSV season.

✔ Helps protect against severe RSV illness
✔ Especially important for young babies
✔ Protection lasts for the peak RSV season which is mid March until mid August in the Western Cape and April until September in some other regions.

🤧 2. Flu Vaccine against Influenza
including Swine Flu.

Influenza (Flu) is more than just a bad cold , it can lead to high fevers, sinusitis , chest infections like bronchitis and pneumonia and other complications, especially in young children and senior citizens.

✔ Recommended yearly for children from 6 months and older
✔ Reduces severity and complications
✔ Helps prevent hospitalisation

You can’t prevent every illness this winter, but you can reduce the risk of your child becoming seriously unwell.

If you’re unsure whether these vaccines are appropriate for your child, have a discussion with your doctor.

Dr Willem Smit
Paediatrician

16/03/2026

🧠 ADHD in Children: Why Medication Can Help

ADHD (Attention Deficit Hyperactivity Disorder) is one of the most common neurodevelopmental conditions in children.
Yet it is also one of the most misunderstood.

Many parents worry that medication will “change their child” or make them feel sedated.

In reality, the goal of treatment is the exact opposite, to help children be the best version of themselves.

🧠What happens in the ADHD brain?

ADHD is not a discipline problem.
It is related to how certain parts of the brain regulate attention, impulse control, and activity levels.

Children with ADHD often have differences in the brain chemicals dopamine and norepinephrine, which help the brain manage focus, motivation, and self-control.

This is why children with ADHD may struggle to:

• Stay focused
• Sit still for long periods
• Control impulses
• Organise tasks
• Complete work they know they are capable of doing

💊Why medication can help

ADHD medication works by improving the communication between brain cells in areas responsible for attention and self-regulation.

When medication is working well, parents often notice that children:

• Can focus better in class
• Complete tasks more easily
• Feel less overwhelmed
• Control impulses better
• Experience fewer emotional outbursts

Importantly, medication does not give children new abilities, it helps them access the abilities they already have.

Many children describe it as:
"My brain feels quieter."

💊 What medication does NOT do

ADHD medication does not:

• Change your child’s personality
• Make children “zombies”
• Replace good parenting or structure

Medication is only one part of treatment, together with:

• School support
• Structure and routine
• Behaviour strategies
• Emotional support

💊Why early treatment matters

Untreated ADHD can affect:

• School performance
• Self-esteem
• Social relationships
• Emotional regulation

When treated properly, many children with ADHD thrive academically and socially.

In fact, many successful entrepreneurs, athletes and innovators have ADHD.

💊The goal of treatment

The goal is not to create a “perfect child”.

The goal is to reduce the daily struggles that prevent a child from reaching their potential.

🤍 Every child is different, and treatment decisions are always made together with parents.

The most important thing is understanding that ADHD is a real neurological condition — and effective help is available.

Dr Willem Smit
Paediatrician

11/03/2026

☀️🥵 Heat Exhaustion vs Heat Stroke: What Parents Must Know

During very hot days, children can overheat much faster than adults.
Their bodies produce more heat and sweat less efficiently, which means they are at higher risk for heat-related illness.

Two conditions parents should know about are heat exhaustion and heat stroke.

One is serious.
The other is a medical emergency.

🥵 Heat Exhaustion (Early Warning)

Heat exhaustion happens when the body loses too much fluid and salt through sweating.

Common signs include:

• Heavy sweating
• Pale, cool or clammy skin
• Headache
• Dizziness
• Nausea or vomiting
• Muscle cramps
• Weakness or fatigue
• Thirst
• Fast pulse

What to do:

✔ Move your child to a cool shaded area
✔ Remove excess clothing
✔ Offer cool fluids or oral rehydration
✔ Use cool cloths or a fan

If treated early, children usually recover quickly.

🚨 Heat Stroke (Medical Emergency)

Heat stroke occurs when the body can no longer control its temperature and begins to overheat dangerously.

Body temperature can rise above 40°C and this can cause damage to the brain and organs.

Signs include:

• Very hot skin (may be dry or sweaty)
• Confusion or unusual behaviour
• Severe headache
• Vomiting
• Rapid pulse
• Difficulty breathing
• Seizures
• Loss of consciousness

What to do immediately:

🚑 Call emergency services or go to the ER immediately

While waiting:

✔ Move the child to a cool place
✔ Remove clothing
✔ Cool the body with water, ice packs or wet towels
✔ Fan the child

Do not delay medical care.

🛡️ Prevention Tips for Parents

• Encourage children to drink water regularly
• Avoid outdoor play during the hottest part of the day (11am–3pm)
• Wear light clothing and hats
• Take frequent shade breaks
• Never leave children in parked cars

Remember: cars can heat up dangerously within minutes.

💡 A simple rule for parents:

If your child becomes confused, very lethargic, or stops sweating in the heat seek medical help immediately.

Dr Willem Smit
Paediatrician

10/03/2026

☀️ Durbanville is Sizzling! Heatwave Survival Guide for Parents & Schools 🍦

Local parents, it’s a scorcher! With temperatures hitting the high 30s, we need to be extra clever about keeping our kids hydrated, especially in schools with older buildings and no aircon.

Children heat up 3x faster than adults, so let’s turn hydration into a game and keep them safe with these “cool” pediatrician-approved hacks.

🍎 The "Coolest" Hydration Hacks

If your child thinks plain water is “boring,” try these:

• The Frozen Apple Juice Trick:
Fill a reusable water bottle 1/3 with apple juice and freeze overnight.
Top up with water in the morning. As it melts, they get chilled flavoured water all day.

• Fruit-Tea Ice Lollies:
Brew Rooibos tea, add berries or a splash of honey, and freeze into ice lollies.

• Hydrating Snacks:
Watermelon slices, cucumber sticks, oranges, strawberries, and frozen grapes
(slice grapes lengthwise for toddlers).

• “Spa Water” Trick:
Add lemon, mint, strawberries, or orange slices to water. Kids love “fancy water.”

• Freeze the Lunchbox Fruit:
Frozen pineapple, mango or berries act as natural ice packs and thaw by snack time.

🎒 School Survival: No Aircon? No Problem!

If your child’s classroom is feeling like an oven, pack these:

• The Double Bottle Strategy:
Send two bottles
One frozen solid + one chilled to drink immediately.

• Cooling Mist Bottle:
A small spray bottle with water for a quick cooling spray on face and wrists.

• Frozen Yoghurt Tubes:
Freeze yoghurt tubes — perfect by first break.

• Cooling Cloth:
A small wet facecloth in a ziplock bag can be placed on the neck at break.

• Hat in the School Bag:
Even if the school has hats, having a backup hat helps on playground duty.

• Salt Balance:
A small pinch of salt or electrolyte powder in water after sports can help replace salts lost in sweat.

⚽ Sports & Playtime Tips

During heatwaves children should:

• Take extra water breaks
• Avoid midday sports if possible
• Wear light, loose clothing
• Play in shade whenever possible

A quick rule for parents:
If the ground is too hot for your bare feet, it’s too hot for children to run on.

👶 Babies & Toddlers in the Heat

• Dress babies in light cotton clothing
• Keep rooms well ventilated
• Avoid overdressing during naps
• Offer more frequent feeds (breast milk is perfect hydration)

Remember: babies cannot regulate temperature well.

🩺 Signs of Dehydration (When to Call the Doctor)

Watch for:

• Dark urine (apple juice colour)
• Dry lips and mouth
• Headache
• Dizziness
• Lethargy or unusual sleepiness
• Fast pulse
• Not urinating for several hours

If you notice these signs, increase fluids and contact your doctor if symptoms persist.

PARENT TIP🌡️
ALWAYS CHECK YOUR BACKSEATS TWICE BEFORE CLIMBING OUT THE CAR (To avoid forgetting kids in the car)

☀️ Remember:
Kids don’t always realise they’re thirsty.
They get distracted by playing and forget to drink.

So hydration sometimes needs a little creativity.

💬 What’s your best school lunchbox cooling hack?
Share your tips below, parents learn best from other parents.

Dr Willem Smit
Paediatrician

09/03/2026

💤 Safe Sleep 2.0: The Tech, The Sniffles, and the "Hidden" Risks
We’ve covered the ABCs (Alone, Back, Crib), but I know many of you have questions about the gadgets and "what ifs."

Let’s dive into a few more ways to keep your little one safe while they drift off to dreamland.

📱 The Gadgets: Snuza, Owlet & Monitors

Many parents ask: "Do these actually help?"

The short answer: They are a great secondary safety net, but they don't replace the ABCs.

* The "False Alarm" Silver Lining: If your Snuza or movement monitor goes off because it slipped or lost contact, it can be heart-stopping—but remember: A false alarm means the system is working. It’s better for it to be "too sensitive" than not sensitive enough. Think of it as a smoke detector for your peace of mind!

🤒 When Baby is Under the Weather

Did you know that sick infants can be at a slightly higher risk?

When your baby has a cold or respiratory bug, it’s more important than ever to stick to the "Back to Sleep" rule.

* The Cough Reflex Myth: Some worry that a baby on their back might choke if they cough or spit up.

Actually, sleeping on the stomach lessons the cough reflex, making it harder for them to clear their airway.

Back-sleeping is the safest way to keep those airways open, even with the sniffles!

🚭 The "Air" Around Them (Smoking & Va**ng)
We know the "No Smoking" rule, but this includes va**ng, too.

* Nicotine—in any form—is a major risk factor for SIDS. It affects how a baby’s brain controls breathing during sleep.

* Pro-Tip: If there is a smoker/v**er in the house, try to keep the baby's sleep environment a "pristine zone." Changing your shirt after you v**e/smoke before holding the baby (Third-hand smoke) makes a huge difference!

🛡️ The Golden Rule:
Tech is amazing, but Safe Sleep Practices (Firm mattress, no blankets, back-sleeping) are your baby's best defense.
Use the monitors for your own peace of mind, but lean on the ABCs for their safety!

Is your nursery "SIDS-Safe"?
Take a quick look today and let’s keep those babies dreaming safely! 🌙✨

Dr Willem Smit Paediatrician

05/03/2026

👂🔥 3am Ear Pain? It’s Probably an Ear Infection… Here’s What Parents Should Know

If your child has ever woken up crying in the middle of the night, holding their ear, you are not alone.

Ear infections are one of the most common reasons children visit the doctor, especially in babies and toddlers.

The good news? Most of them get better quickly with the right care.

🦠 What actually causes an ear infection?

Most ear infections happen after a cold.

When children have a runny nose, the tiny tube that connects the ear to the back of the nose (the Eustachian tube) can become blocked. Fluid builds up behind the eardrum and sometimes becomes infected.

Because children’s ear tubes are shorter and more horizontal, infections happen much more easily than in adults.

👶 Signs your child might have an ear infection

• Ear pain
• Pulling or rubbing the ear
• Fever
• Crying or irritability
• Trouble sleeping (very common!)
• Reduced appetite
• Fluid draining from the ear
• Temporary hearing difficulty
• Problems with balance

In babies, the signs are often subtle,sometimes just being unsettled or refusing feeds.

💊 Do all ear infections need antibiotics?

No.

Many ear infections are viral and will improve on their own within a few days.

Antibiotics may be needed if:
• The infection is clearly bacterial
• The child is very young
• Symptoms are severe
• Fever persists
• The infection is not improving

Your doctor will decide based on the examination.

😴 Why ear infections hurt more at night

When children lie down, pressure inside the ear increases, which makes the pain worse.

That’s why many parents notice symptoms late at night or in the early hours of the morning.

🌟 Fun facts parents often don’t know

• 80% of children will have at least one ear infection before age 3
• Ear infections often follow a simple cold
• Temporary hearing loss during infection is very common
• Most children outgrow frequent ear infections as their ear anatomy develops

🛠 What helps your child feel better?

✔ Pain relief (paracetamol or ibuprofen when appropriate)
✔ Fluids
✔ Rest
✔ Keeping your child comfortable

Pain control is usually the most important treatment in the first 24–48 hours.

🚨 When to see your doctor

• Severe ear pain
• Fever lasting more than 2–3 days
• Fluid or pus coming from the ear
• Your child seems very unwell
• Repeated ear infections

Ear infections are very common in childhood, and the vast majority of children recover completely without long-term problems.

If you are unsure whether your child has an ear infection, it’s always reasonable to have them checked.

Dr Willem Smit
Paediatrician

03/03/2026

💩 Toddler Constipation: Why It Happens (and What to Do About It)

Constipation is extremely common in toddlers, especially between ages 1 and 4.

It often starts very simply:
One hard, painful stool…
Your toddler remembers…
And then they start holding it in.

And that’s when the cycle begins.

🚼 What does constipation look like in toddlers?

It’s not always “not going.”

Signs include:
• Hard, dry stools
• Crying or straining when passing stool
• Very large stools
• Hiding, standing stiff, crossing legs
• Refusing to sit on the toilet
• Tummy pain
• Skid marks in underwear
• Loss of appetite

That “dance” toddlers do?
That’s often stool withholding.

🔁 Why the cycle continues

When a toddler holds stool:
• It stays in the bowel longer
• It becomes harder and bigger
• The next bowel movement is more painful
• Fear increases

Over time, the bowel stretches and toddlers may:
• Lose the urge to go
• Leak stool without knowing
• Develop chronic tummy pain

This is not stubbornness. It’s physiology.

🥛 Common triggers in toddlers

• Too much dairy
• Not enough fluids
• Picky eating
• Starting crèche
• Toilet training pressure
• A previous painful bowel movement

🛠 What helps?

✔ Encourage regular water intake
✔ Increase fibre slowly (fruit, vegetables, oats, whole grains)
✔ Don’t force toilet training
✔ Create a calm toilet routine (after meals is best)
✔ Use a footstool so knees are slightly higher than hips
✔ Praise effort — never punish accidents

In many cases, stool softeners are needed for a period of time to allow the bowel to recover. These are safe when prescribed and monitored correctly.

🚨 When to see your doctor

• Blood in stool
• Severe tummy pain
• Vomiting
• Weight loss
• Constipation starting in infancy
• Ongoing problems despite dietary changes

🤍 The most important thing to remember:

Constipation in toddlers is common.
It is manageable.
And the earlier we treat it, the easier it is to break the cycle.

If your toddler is struggling, don’t wait months hoping it will pass.

Dr Willem Smit
Paediatrician

27/02/2026

🧠 Meningococcal Disease: Understanding the Real Risk

There has been a lot of discussion recently about meningococcal disease and the timing of vaccination. Let’s look at the facts calmly and objectively.

📊 How common is it?
The overall incidence of invasive meningococcal disease (IMD) in South Africa is low — less than 1.6 per 100 000 population.

However, risk is not equal across age groups.

👶 Who is most at risk?

Data from South Africa shows:

• Infants under 1 year of age have the highest incidence
• A second peak occurs in adolescents and young adults (16–23 years)
• Approximately 52% of infant cases are caused by serogroup B

This means that although adolescents are at risk, infants carry the greatest vulnerability.

⚠️ Why is meningococcal disease taken so seriously?

Even though it is rare, it can be:

• Rapidly progressive (can become critical within 24–48 hours)
• Fatal in approximately 17% of cases despite best medical care
• Associated with lifelong complications in around 20% of survivors
(hearing loss, limb loss, neurological damage, cognitive impairment)

This is why it receives so much attention in paediatrics.

💉 What about vaccination timing?

There has been discussion about delaying MenB vaccination until after 2 years of age to reduce the number of doses required.

The important consideration is this:

The highest risk period is under 1 year of age.

Delaying vaccination reduces doses — but it also leaves infants unprotected during their most vulnerable period.

This is an individual risk-benefit discussion that parents should have with their healthcare provider.

🧾 Is this an outbreak?

No.
Recent reported cases in South Africa are not classified as an outbreak.

However, they serve as a reminder for parents to:
• Review vaccination status
• Understand who is at highest risk
• Make informed decisions based on accurate data

🤍 My aim is not to create fear, nor to minimise risk, but to present balanced, evidence-based information so parents can make informed decisions.

Every recommendation I make is based on age-specific risk and the best interests of my patients.

Dr Willem Smit
Paediatrician

25/02/2026

🧴☠️ HOUSEHOLD POISON SAFETY: The dangers parents often don’t think about

We baby-proof plug points and cover sharp corners… but many poisonings in toddlers happen in seconds— often in places parents don’t expect.

Here are a few everyday dangers I see in practice 👇

🚪 Toddler “Counter Surfing”

Once toddlers can stand on tiptoes or climb, no counter is safe anymore.

Common hazards left within reach:
• Painkillers (paracetamol, ibuprofen)
• Vitamins & supplements
• Cleaning products
• Dishwashing tablets & pods
• Hand sanitiser & alcohol
• E-liquids / v**e refills

🔹 Tip: Keep all medicines and chemicals in locked cupboards, not just “high up”.

🔋 Small batteries & 🧲 magnets (very dangerous!)

Button batteries (small round batteries found in toys, remotes, watches, car keys, musical greeting cards) can cause severe internal burns within hours if swallowed.

High-powered magnets (often in toys or fridge magnets) can cause life-threatening bowel injuries if more than one is swallowed.

Common sources:
• Remote controls
• Toys & novelty items
• Key fobs
• Musical cards
• Fridge magnets

🔹 Tip: Secure battery compartments on toys and remotes.
If you think a battery or magnet was swallowed, go to ER immediately.

🐶 Pet medications = big risk

Pet meds are often much stronger than human doses and can be extremely dangerous for children.

Common culprits:
• Flea & tick treatments
• Deworming tablets
• Pain medication for pets

🔹 Store pet meds separately from human medication and completely out of reach.

🌿 Poisonous plants in your home & garden

Some beautiful plants can cause vomiting, mouth burns, heart rhythm problems, or serious poisoning if chewed.

Common risky plants:
• Peace lily
• Dieffenbachia
• Oleander
• Sago palm
• Philodendron

🔹 If your toddler puts everything in their mouth, consider removing toxic plants from areas they can reach.

🛠️ Garage & outdoor hazards (often overlooked)

Garages and storage areas are a major source of accidental poisoning, and are often where the most dangerous substances are kept.

Common risks:
• Paints, paint thinners & turpentine
• Paraffin (kerosene)
• Petrol and car products (antifreeze, brake fluid, windscreen washer fluid)
• Garden chemicals & pesticides
• Drain cleaners
• Pool acids & pool cleaning products

🔹 Tip: Lock garage cupboards and never store chemicals in drink bottles.
Dads are often (lovingly!) guilty of leaving these products within reach in garages and sheds, please double-check these spaces.

🧠 Why toddlers are most at risk

• They explore with their mouths
• They don’t understand danger
• They move fast
• They can open containers surprisingly easily

Poisoning often happens when a parent turns away for a moment.

🚑 What to do if your child may have swallowed something

❌ Do not induce vomiting
❌ Do not give food or drinks unless advised

📞 Call your doctor or the Poisons Information Helpline immediately:
0861 555 777 (24 hours)

🚗 If your child is drowsy, vomiting repeatedly, seizing, or struggling to breathe, go to ER urgently.
👉 Take the product container with you when seeking help.

🛡️ Simple prevention that saves lives

✔ Lock cupboards
✔ Use child-resistant caps
✔ Never call medicine “sweets”
✔ Keep handbags out of reach
✔ Educate grandparents & caregivers
✔ Store chemicals in original containers
✔ Lock garages and outdoor storage areas

🧡 These are things paediatricians advise daily but many parents only realise the danger after a scare.
Save this post. Share it with another parent.
It might prevent an emergency.

Dr Willem Smit | Paediatrician

23/02/2026

🫁 Preventing Bronchiolitis Caused by RSV – What Parents Should Know

(See our previous post on RSV for non-vaccine ways to reduce infection risk.)

Bronchiolitis is one of the main reasons children are admitted to hospital in winter.
In the Western Cape, RSV season usually peaks from mid-March to August.

What causes bronchiolitis?

The most common cause is RSV (Respiratory Syncytial Virus).
RSV can also increase the risk of bacterial co-infection, which may lead to pneumonia.

Since the introduction of pneumococcal vaccines (Prevenar or Synflorix) into the routine immunisation schedule, we’ve seen a significant decrease in severe RSV-related bronchiolitis admissions.

How common and serious is RSV?

* Most infants will be infected with RSV at least once. Approximately half a million children will be infected each year in South Africa.
* Many will need medical care, and some will require hospital admission. Infants under 6 months have a very high risk of developing severe symptoms and complications .
* Globally, over 100,000 children die each year from bronchiolitis.
* More than 3.6 million children are hospitalised annually due to RSV.
* Sadly, most RSV-related deaths occur outside of hospital.

RSV Prevention: Vaccine Options

🧴 Synagis (Palivizumab)

* Reserved for high-risk babies (premature infants, babies with heart or lung disease, or immune deficiencies)
* Given monthly during RSV season
* Very expensive
* Not routinely given to healthy babies”

🤰 Abrysvo (Maternal RSV Vaccine)

* Given to pregnant mothers in the third trimester
* Transfers protective antibodies to the unborn baby
* Reduces the risk of severe RSV infection by 70–82%
* Protection lasts 90–180 days after birth
* Cost: up to ± R5,500

👶 Beyfortus (Nirsevimab – RSV injection for all babies and infants)
Older children and adults can also have it.

*Now available for the first time in South Africa!
Reduces:
* Hospital admissions by ± 80%
* ICU admissions by ± 90%
Recommended for:
* All newborn babies
* All babies entering their first RSV season
* Older infants who are high-risk
* Provides immediate protection lasting up to 150 days
* Cost: ± R6,500 (excluding clinic fees)

✅ Take-Home Message for Parents

👉 In the Western Cape, I recommend that all babies entering their first RSV season receive RSV protection (ideally mid-March to end of March).

⚠️ RSV can occur outside of the typical season, so remain vigilant year-round.

💉 RSV vs Meningitis Vaccine – If You Have to Choose

If you must prioritise between:

* Bexsero (meningococcal meningitis vaccine) and
* Beyfortus (RSV protection)

👉 I would prioritise RSV protection for all babies under 1 year (and especially under 6 months), as RSV is far more common in this age group.

📊 Risk comparison:

* Risk of meningococcal meningitis in the Western Cape: < 1,6 per 100,000 people.
* Risk of RSV infection in young children: much higher, especially in winter. Country wide : 443 000 cases per year in children under 5 years old!

So if you have to choose , choose RSV vaccination but if you can , do both.

Dr Willem Smit
Paediatrician

23/02/2026