Kids’ health handbook

By at home

kidshealLearn to spot the tell-tale signs of child sickness so you can act fast – and know when to see the doctor…

However much you look after your little ones, they will, unfortunately, fall ill at some point. Usually the symptoms are short-lived and they will be back to full health in no time, but sometimes the problems are more complicated and may need lengthy treatment. Here are some of the more familiar health issues your baby, child or teenager may experience, from relatively controllable and familiar conditions such as colds and flu, chickenpox and eczema, to more serious ones like meningitis and eating disorders.

Whatever the age of your children, be they just a few months or a robust 16-year-old, we detail some of the ailments that can affect them. We describe the conditions and their symptoms, and advise on the quickest, safest and most effective treatments.

babyappleBabies (up to age 2)

This is an inflammation of the membranes that cover the brain and spinal cord. The condition can be caused by a bacterial or viral infection. Bacterial meningitis tends to affect children (80% of cases happen in under-16s with the majority being under the age of five), while viral meningitis affects older teenagers and young adults.

Bacterial meningitis symptoms tend to appear within hours, whereas viral meningitis may take a few days to develop. Symptoms in babies and small children include: jerky or floppy movements, shrill crying, refusal to feed, rapid breathing, and a sunken or tense fontanelle. A rash with purple spots that doesn’t disappear when pressed with a glass is another symptom.

What should you do?
Bacterial meningitis is a medical emergency. Get the child to hospital quickly. In most cases intravenous antibiotics will be used and continued if tests confirm the bacterial form. Viral meningitis needs no treatment and clears up in a week or two. The bacterial strain can cause loss of hearing and nerve damage.

Cleft lip and palate

Babies can be born with either a cleft lip or palate. This birth defect occurs in the womb with both defects often occurring at once. A cleft lip is a vertical split in the upper lip, which extends to the nose, while a cleft palate is a gap that extends from the back of the palate to behind the teeth leaving the roof of the mouth open to the nasal cavity.

A cleft lip and palate can mean that infants have problems eating. It may lead to hearing loss because it causes a build-up of fluid in the middle ear. And it may also cause dental problems – often children with a cleft lip and palate have small teeth.

What should you do?
The condition can be diagnosed with an ultrasound scan, or picked up at birth. A cleft lip is usually repaired surgically
in the first few days and a cleft palate between six and 15 months. If an infant is having feeding problems before surgery is possible, feeding teats are available.

Colds and flu
The common cold and flu are infections that affect the nose, throat, ears and sinuses. There are many cold and flu viruses and they’re highly contagious.

A cold causes a stuffy or runny nose, sneezing, sore throat, cough and mild fever, which get worse over a day or two. Flu symptoms include a fever, headache and muscle pains.

What should you do?
Colds and flu usually clear up within seven to 10 days. Painkillers, such as children’s liquid paracetamol, decongestants and vaporisers can all help to ease symptoms. Give your baby plenty of liquids to keep him hydrated. Antibiotics won’t help because colds and flu are viral infections.

Most of the time, vomiting in young children is caused by gastroenteritis, usually due to a virus infecting the gastrointestinal tract, which can also cause diarrhoea in babies and toddlers. It can also indicate an ear, urinary tract or respiratory infection. Vomiting can also be caused by food intolerance, or travel.

It usually starts with your baby going off food and looking pale before bringing anything up.

What should you do?
Keep a bucket nearby so he doesn’t have to be taken to the toilet. Clean his teeth to take away the nasty taste. When he hasn’t vomited for a few hours, offer bland food, but crucially make sure he drinks lots of water. If it persists for more than six hours, is prolonged and violent seek medical help at once. Remember, kids (especially infants) who are unable to take in fluids can easily become dehydrated.

littleonessLittle ones (age two to five)
Febrile convulsions
These happen when there is a rapid increase in body temperature, and it affects one in 20 children usually between the ages of two and five. Children may inherit the tendency to have febrile convulsions or may be susceptible if they have frequent infections, including high temperatures.

The attack often begins with your child losing consciousness, and shortly afterwards the body, legs and arms go stiff. The head is thrown back and the legs and arms begin to jerk. The skin goes pale and may turn blue briefly. The attack ends after a few minutes and the shaking will stop. The child will go limp, then normal colour and consciousness will slowly return.

What should you do?
Turn your child’s head to prevent choking. Don’t intervene until the fit stops, then lay your child in the recovery position on his side. If it’s his first fit, call an ambulance to take him to hospital. If not, call your GP, as hospitalisation may be unnecessary. The convulsions don’t cause lasting damage and almost all children stop having them by the time they start school.

This common viral infection is caused by a strain of the herpes virus. Spread in airborne droplets inhaled into the respiratory tract, it’s most prevalent in late winter and early spring. Most children have had the infection by the age of 10.

These include a mild fever and headache. Within hours spots may appear, which will quickly become fluid-filled and intensely itchy. These will scab over after several days and dry up. The rash mostly affects the trunk, but may appear anywhere on the body.

What should you do?
Talk to your doctor if your child is particularly unwell, has a cough, a headache or if his skin is particularly inflamed or infected. Give pain-relieving syrup and also plenty of fluids. Calamine lotion and certain antihistamine medicines may relieve the itching. Keep your child’s hands clean and his fingernails short, and try to discourage him from scratching the spots as they can scar. The spots may be infectious until they have fully scabbed over, but no child should need to be kept from school for more than five days.

Overreaction of the immune system to a variety of normally harmless substances called allergens can cause an allergy. A chemical called histamine is released causing swelling and inflammation. Common conditions include hay fever and asthma. Common allergens include cows milk, nuts and pollen.

Itchy skin, swelling and wheezing. Severe cases can lead to anaphylactic shock.

What should you do?
Keep your house dry and well ventilated. If your home is fairly humid, a dehumidifier will help to air it. If you have central heating, turn it down a few degrees. Have your child tested for food allergies.

scholageSchool age (six to 12)
In this disease of the lungs, the airways become inflamed and narrowed, causing breathing difficulties. Its cause is not clear, but genetics and environmental factors such as allergens and air pollution could play a part.

Coughing, wheezing, tightness in the chest and shortness of breath. In school children, there may also be symptoms of other allergic conditions, such as eczema.

What should you do?
See your GP if your child has these symptoms. A more severe attack will require a visit to A&E. Treatment includes medication usually given through inhalers. Relievers are used to open restricted airways, while preventers (steroids and other drugs) stop further attacks.

Ear problems
Earache is usually caused by a viral infection. If the middle ear becomes inflamed this is known as otitis media. It can progress to a chronic condition called glue ear, where the middle ear fills with sticky fluid, and can result in hearing problems.

Ear infections cause pain and fever. Small children who can’t tell you about the pain may be irritable and cry persistently. The child may point at or pull the affected ear. Discharge from the ear may indicate the eardrum has cleared, which will relieve the pain.

What should you do?
Earache can be eased with painkillers, but with infection, antibiotics can be prescribed. The majority of cases of  acute otitis media clear within a few days without treatment.

Otitis media infusion, also known as glue ear, can cause hearing loss. An indicator of this might be your child turning up the volume on the television or talking loudly.

By the age of four, up to 80% will have been affected by glue ear. It often settles down without treatment, however there are occasions when surgery is required.

Atopic eczema is a common rash that affects one in 20 children. Certain factors, such as cows milk and stress, can make it worse.

A dry, red, itchy rash may become scaly and cracked, ooze yellowish fluid and form crusts. In young children it tends to affect the face, scalp, front of legs and forearms. In older kids, the rash usually appears on the inside of the elbow and knee joints.

What should you do?
Use creams or ointments advised by your GP. Applied to the skin they will keep it as supple as possible and prevent cracking. Steroid creams may also be used to calm inflammation and itchiness, but care must be taken with long-term use.

This is a highly contagious skin infection common during hot weather. Breaks in the skin become infected by a bacterium called staphylococcus. It mostly occurs around the nose and mouth, but can spread around the body.

The skin reddens and then small red spots appear, which blister. The blisters often burst, releasing fluid that dries to leave pale brown crusts on the skin. In severe cases, the lymph nodes in the face or neck may become swollen.

What should you do?
See your doctor immediately if you think your child has impetigo. You will be given antibiotic cream or antibiotics. These will clear up impetigo in around 10 days. Because impetigo is so contagious, it is important to keep your child away from other children until it clears.

Frequent colds and the drying effect of central heating can irritate the mucous membrane that lines the nose causing it to become crusted or cracked, and likely to bleed. Vigorous nose blowing also causes bleeding.

Bleeding from one or both nostrils. Your child may also be aware of blood entering the throat from the back of the nose.

What should you do?
Tip your child’s head forward and tell him to breathe through his mouth while you pinch together the soft parts of the nose just below the bone. Press the pinched nose towards the face. Hold there for five to 10 minutes. If the bleeding doesn’t stop, apply a cold pack against his face and if the bleeding continues seek medical advice. If your child gets frequent nosebleeds, surgical treatment might be necessary.

girlteenTeenagers (age 13 to 16)
Painful and distressing, toothache is mainly caused by tooth decay resulting from excess sugar and acids in the diet.

Signs include constant, throbbing pain in a tooth, a tooth painful to touch, pain in a tooth that worsens with hot or cold foods or liquids. Sometimes the jaw in the area of the tooth is tender to touch.

What should you do?
Make an appointment for your child to see the dentist as soon as possible. However, in the short term, you can
also avoid giving him hot, cold or sweet drinks and foods which will aggravate the pain. A liquid painkiller will also give some relief. A hot saltwater mouth wash may also relieve symptoms in the short term.

Glandular fever
This is a viral infection associated with a high fever, which is caused by the Epstein-Barr virus and is common among teenagers. It is transmitted via close personal contact, such as kissing. Once you have the virus, it hides in the blood cells and throat, so it could develop again months or even years later.

The main symptom isa high fever (above 39°C/102.2°F). When your child is badly infected, a severe sore throat, tiredness and lack of energy, loss of appetite, weight loss, swollen tender glands in the neck and body, headache and muscle pain are also symptoms.

What should you do?
There is no specific treatment other than pain relief, rest and fluids. Recovery usually takes four to six weeks, but your teenager may feel sleepy during the day for two to three months after. Contact sport should be avoided for a month after recovering from the infection.

This is an infection of the gut usually caused by a virus, easily passed from child to child. Gastroenteritis can also be brought on by food poisoning.

It causes diarrhoea and may also cause vomiting, tummy pain and fever. The severity can range from a mild tummy upset for a day or two with some mild diarrhoea, to severe diarrhoea and vomiting.

What should you do?
The main risk is dehydration so it’s important to give your child lots to drink as well as special rehydration fluids. Encourage him to eat as normally as possible, but see a doctor if he appears dehydrated. The signs to look out for include: not urinating enough, a dry mouth or tongue, sunken eyes and cold hands and feet.

Eating disorders
These conditions are serious psychological illnesses but all are treatable with therapy. The three best-known eating disorders are anorexia, bulimia and binge eating disorder.

Anorexia is a terror of gaining weight, so your child will starve themselves and often rapidly become very thin. Bulimia is a disorder of over-eating and forced vomiting that is difficult to detect because body weight doesn’t always change. Binge eating disorders also involve over-eating but the sufferer isn’t sick and usually becomes obese.

What should you do?
Although these issues are psychological, serious physical damage, such as organ failure from anorexia or heart disease from obesity, can result if help isn’t found in time. Eating disorders are often a mask for low self-esteem or a child’s negative perception of their sexuality during puberty. These problems should surface during a course of therapy or counselling.

This article was first published in at home’s ’Ask the Doctor with Dr Chris Steele’ in April 2011.

Images: Getty

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