Every child gets ill occasionally, and every parent has experienced the feeling of anxiety brought about by seeing their normally active child looking sad and listless. Most parents will have spent at least one night nervously watching over their sick child.
First, it’s important to remember that most bouts of illness pass quickly, and serve to build up the immune system so it’s ready to fight and resist its next attacker. However, sometimes it can be difficult to tell just how unwell your child is. Babies and toddlers in particular cannot properly express their discomfort. You’ll need to learn to trust your feelings. As a parent, you know your child better than anyone, and you can usually tell if something is unusual.
Some signs of illness are:
- Persistent cough
- Decreased appetite
- Repeated vomiting
- Repeated diarrhoea
- Skin rash
- Runny nose or watery eyes
And some unusual behaviours in your child that may also indicate illness include:
- Inconsolable crying
- Unexpected drowsiness
Very often, these signs are more worrying in babies or young children because their immune system is not yet mature. If you are concerned, visit your doctor. If it turns out that nothing is wrong, that’s good news.
Now, let’s look at a few illnesses that are particularly common in children and how you should handle them.
This is probably the most common symptom that worries parents. Your child has a fever when his or her temperature is greater than 38° Celsius or 101° Fahrenheit when taken from the ear or the armpit.
A fever itself is not an illness, but a sign that your body is responding to an underlying infection. A fever actually helps us fight against germs or viruses by stimulating our body’s defence mechanism. Children often develop a low-grade fever after a vaccination, and even teething can raise the body temperature slightly.
The degree of fever does not necessarily indicate the degree of illness. If your child has a high fever but is still playing and eating well, and is alert and cheerful, you can feel reassured that there is no immediate concern. However, for infants under three months, a fever of around 38° Celsius should be checked by a doctor as soon as possible.
Fever should be treated only if it causes discomfort. The following steps can help make your child feel more comfortable:
- Give plenty of cool, clear fluids, in small quantities and often. Fever causes increased water loss from the body and dehydration can result in a higher temperature.
- Take off extra layers of clothing and use a fan or air conditioner to cool the immediate environment.
- Sponge your child’s body, arms and legs with lukewarm water. Never use ice-cold water or ice packs, as they constrict the blood vessels and prevent heat loss. They will also make your child uncomfortable.
- If your child is unable to settle, you can give her or him paracetamol in the correct recommended dose for your child’s age and weight. Remember that this will not cure the underlying illness, but it will make him or her feel more comfortable. Do not give aspirin (salicylate) to children as it may cause liver damage.
If you are unable to control a fever, or if your child is suffering from any of the symptoms below, consult your doctor straight away:
- Signs of dehydration
- Inconsolable crying
- Neck pain or severe headache
- Refusing to walk or limping
- Involuntary twitching
- Severe abdominal pain
Always keep the following on-hand at home:
- Antiseptic wipes
- Plasters (assorted sizes)
- Mosquito repellent
- Insect bite relief cream
- Calamine lotion
- Sterile gauze
- Adhesive tape
- Crepe bandages
One of the most recurrent reasons that children visit doctors and take leave from school is the common cold. The name is not a misnomer; children can get eight or more colds per year, especially just after starting school. Remember that it’s through simple viral infections that our children’s immune systems develop and strengthen. Colds are infectious and symptoms will usually appear two to three days after exposure to the virus. The most common symptoms are: sneezing, stuffy or runny nose, itchy or sore throat, cough, headache and fatigue. Most colds will clear up within one week, although some may linger for as long as two weeks.
Colds can easily be spread through droplets in the air from sneezing, coughing or touching surfaces that have been contaminated with the cold virus. The most effective way to prevent spreading is to ensure that your children thoroughly wash their hands, particularly after blowing their nose or coughing. A person who has a cold is most contagious during the first two to four days of illness, so you and your children should try to avoid anyone who has early symptoms of a cold.
The old adage that “time cures” still holds true. However, although medicine can’t cure colds, it can help relieve some symptoms like fever, headache and nasal congestion. You can try simple things like saline water spray to relieve nasal congestion and a humidifier to relieve coughing. Panadol or Nurofen can lower a fever and relieve a sore throat. Follow the dosage recommended for your child’s age and weight.
Visit your doctor if your child has any of the following symptoms:
- Persistent high fever for more than a day
- Inability to take any fluid or signs of dehydration
- Phlegmy cough or wheezy breathing
Ear infections sometimes develop three to four days after a cold or sore throat. Children are much more susceptible to these infections because they have shorter and flatter Eustachian tubes (the tube connecting the ear to the back of the throat), which allows bacterial and viral infections to enter more easily.
Your child may complain of pain and pull at their ear, and the ear may become red and have a yellow discharge. Earache is often accompanied by a fever. You can manage the fever and pain with Panadol or Nurofen. Then visit your doctor for advice on the need for antibiotic treatment.
Cuts and bruises
It is inevitable that children will, at some point, cut themselves or end up with a colourful bruise. You can treat minor cuts and grazes with a local antiseptic cream and a simple dressing such as a plaster.
If your child sustains a more severe cut (i.e. if it’s bleeding profusely), try to raise the area where the cut is. Hold a clean cloth against the cut and apply pressure. If the bleeding continues for more than a few minutes or the blood is pulsing from the wound, visit an emergency room or your doctor, as further measures may be required to close the wound. If your child is in pain following a cut or bruise, both Panadol and Nurofen can help.
Diarrhoea and vomiting
Most young children have occasional loose stools. Diarrhoea means the frequent passage of unformed watery stools. Diarrhoea, together with vomiting, is called gastroenteritis. Gastroenteritis often causes cramp-like tummy pain, loss of appetite, nausea, vomiting and diarrhoea, and sometimes fever.
A common cause of gastroenteritis is viral infection. In general, it is often mild and lasts for no more than a few days. But, it is very contagious and can be spread from dirty hands or contaminated food. Therefore, regular hand-washing and good general hygiene is vital for prevention.
Babies have a smaller reserve of fluids and can become easily dehydrated if diarrhoea or vomiting continues for more than a few hours.
Signs of dehydration include:
- Passing very little or no urine for four to six hours in babies and young children, or six to eight hours in older children
- A dry mouth
- Lack of energy
To prevent or treat dehydration, your child will need extra fluids, together with electrolytes, to restore lost liquids. Your doctor can prescribe oral rehydration fluids.
Your doctor may further advise you to:
- Give rehydration fluids in addition to breast milk or formula, either in between feeds or after each watery stool.
- Feed small amounts frequently, such as 15ml every 30 minutes.
- Feed older kids a “plain” diet. But, if diarrhoea continues or is frequent, it’s best to stick to the BRAT diet:
B – Banana
R – Rice
A – Apple
T – Toast (white)
- Reduce high-fibre or wholemeal foods during this time.
- Avoid fried or spicy foods.
- Avoid citrus fruits, including tomatoes.
- Avoid dairy, other than routine feeds.
- Wash the bottom gently with water and consider using a barrier cream.
If the following conditions occur, it’s best to see your doctor:
- If your child has high fever
- Has blood in the diarrhoea
- Vomiting is persistent
- Any signs of dehydration
- Has bad tummy ache or you feel there is no improvement
Dial 999 or visit an accident or emergency department if your child has:
- Fast, noisy or laboured breathing.
- Unusual drowsiness, disorientation or is hard to wake.
- A fit or convulsion, or if your child turns blue or very pale or seems floppy.
- A purple-red rash anywhere on the body that appears suddenly, especially if accompanied by a high fever.
Call your doctor if your child has:
- Signs of dehydration
- Repeated vomiting and refusal to drink
- Severe abdominal pain
- Persistent high fever (102°F/39°C or higher)
- Blood in the stools
- Prolonged diarrhoea
Minor head injury and knocks to the head are common, particularly in children. Following an injury, if the person is conscious (awake), and there is no deep cut or scalp bruise and increasing swelling, it is unusual for there to be any damage to the brain.
It is normal to have a mild headache after a knock to the head. Sometimes there is also tenderness over the bruising or a mild swelling of the scalp. Some paracetamol will help (such as Calpol or Children’s Tylenol). If it is a headache that becomes worse and worse, please consult your doctor straight away.
See a doctor quickly if any of the following occurs after a head injury:
- Increasing drowsiness
- Worsening headache
- Confused or strange behaviour
- Two or more bouts of vomiting
- Loss of use of part of the body – for example, weakness in an arm or leg
- Dizziness, loss of balance or convulsions
- Any visual problems, such as blurring or double vision
- Blood or clear fluid leaking from the nose or ear
- Unusual breathing patterns.