Common Illnesses in Children

Allergies

An allergy can occur when the body’s immune system reacts to the presence of an allergen (foreign protein or other substance).  This allergen may be something the child has eaten or it might be from an insect bite or some substance that has been in contact with the skin.  Some allergy problems, such as hayfever, asthma and eczema, often run in families.

Very rarely, an allergic reaction needs immediate medical attention due to anaphylaxis causing breathing and circulation collapse.  If your child’s lips swell, or they have difficulty breathing (stridor, like croup, or wheeze, like asthma) or they faint or collapse, call 111 for an ambulance and get your child to a doctor as soon as possible. Read more about Allergies.

Asthma

Asthma is due to inflammation of the bronchial tubes, the airways leading to the lungs.  This inflammation leads to swelling of the lining and increased mucus which obstruct normal airflow in and out of the tubes.  Difficulty moving air in and out of the lungs is frightening and this itself can make breathing even worse.  In most children, asthma starts with a runny nose and then wheezing with coughing bouts.  Other triggers can include smoke, cold air, specific allergens, or even exercise.  Symptoms are often worse at night.  sometimes the child needs hospital treatment. Antibiotics are not needed, but other effective treatment is available both for asthma attacks and for prevention long term.

If you are concerned that your child has asthma, talk to your doctor.  If he is having difficulty breathing, seek help from a doctor immediately.  There are very effective ways to control most asthma, usually with relieving inhalers, sometimes with regular preventer inhalers, and with breathing exercises.

Eczema

Eczema is an inflammation (rash) of the skin, which is often red, dry and itchy.

What causes eczema is not known but there appears to be increased reactivity of the immune system, and children affected by eczema often have other allergic conditions.  Some ‘triggers’ which make symptoms worse in some children including dietary factors (such as cow’s milk, peanuts, fish, eggs), stress and contact with chemicals such as certain perfumes, lanolin and some detergents.  Woollen clothing can irritate eczema while continuing with breastfeeding can delay the onset of eczema.

Some ideas that may help:

  • Try to work out what triggers make your child’s eczema worse.
  • If wool makes it worse, try putting cotton singlets or cotton tops under woollen jerseys.
  • If perfumed soaps make it worse use a non-perfumed soap or a bath oil instead.  You can discuss bath oils with your health professional.
  • Avoid overheating which can often make eczema worse.
  • If your child scratches eczema, try to keep his fingernails short.  Putting gloves on your child may help at night or at sleep times.  If the eczema is on your child’s arms or legs, dress him in long pants or tops with long sleeves.
  • Discuss creams to improve eczema with your doctor.  Moisturisers are the usual form of treatment.  They can be applied several times a day and the greasy ones trap water in the skin.  Sometimes steroid creams are used for red inflamed areas.  Weepy crusted areas may be due to infection and may need oral antibiotics.

The symptoms of allergic reactions range from mild to severe to life-threatening.  They can include hives, facial swelling, hay fever symptoms, nausea, vomiting and diarrhea.  More serious symptoms include coughing, wheezing, bronchospasm, feeling faint, going pale, floppy (particularly in infants), and collapse.

Common Colds

The common cold is caused by a virus and usually lasts for 5-7 days.  On average young children may get between 6 and 12 colds a year.  As colds are caused by a virus, antibiotics make no difference to how quickly your child gets better.

If your baby has a blocked nose or is snuffly, applying cool (previously boiled) water nose drops may help.  This moistens the mucus in the nose and it is then able to be sneezed out. Try putting one drop in each nostril every four hours or so using a nose dropper or by squeezing a drop from a piece of cotton wool or cloth.  This should also help baby’s breathing while he feeds.

To help stop the infection passing onto others, teach older children to cover their mouth and nose with a tissue when coughing and sneezing, and then to wash their hands after blowing their nose or if they have sneezed into their hands.

See your doctor if you are concerned about your child: if he is breathing quickly, wheezing, having difficulty breathing (lower chest and stomach sucking in when breathing), has a chesty cough, a green runny nose, is not feeding or drinking well or is not getting better.

Coughing

Coughing helps to clear the airways in the throat and chest.  It is usually the body’s best way of clearing the airway passages.  Cough mixtures are not recommended for young children as they may stop the cough that is helping to clear their airways, or they may have side effects.  Talk to a doctor or a pharmacist before giving young children cough mixtures.  A cough which persists can have many causes, for example, whooping cough, or bacterial infection, or asthma, or some other lung condition.  If the cough persists for more than two weeks seek medical help.

Bronchiolitis

Bronchiolitis is an inflammation of the bronchioles (the smallest airways in the lung).  It is caused by a viral infection and usually occurs in babies and children under 2 years.  They usually have symptoms of a cold first then can develop a cough, sound wheezy, breathe quickly, they may find it hard to breathe.  The coughing and breathing problems can make it hard for baby to drink and feed.  A baby may need feeding more frequently to make sure he is getting enough to drink.  Bronchiolitis can cause young babies to become very unwell.

See a doctor if your child is having difficulty breathing, is breathing fast, is grunting when breathing, is sucking in his chest or tummy when breathing, or if he is getting worse even if you have recently seen a doctor.

Vomiting

Usually, babies and children do not choke on their vomit unless they are unconscious or have a serious underlying medical condition.  Although usually due to a tummy virus, vomiting (especially without diarrhoea) may be a sign of underlying illness or bowel obstruction.

You need to contact your doctor if your baby or child has severe vomiting, vomits for more than six hours, the vomit is green in colour, he/she will not drink, appears ill (drowsy, floppy, not alert, or has a stiff neck), passes less urine, has a fever or rash or is difficult to settle.[

Give plenty of fluids.  Babies can lose a lot of fluid when vomiting and can become sick very quickly.  If you are breastfeeding, keep doing so.  If he is bottle fed, keep giving him his formula and give extra fluids.  For all babies and children, the best extra fluid to offer is an oral rehydration solution (electrolyte or similar solution) available from your chemist. Homemade sugar and salt solutions are not recommended.  Fizzy drinks, fruit juice or sports drinks can be dangerous with too much sugar which makes the dehydration worse.

Fruit juice can be given to an older child if diluted 4 parts water to 1 part juice (i.e. quarter strength).  If your older child is hungry and wants food, let him eat small amounts.  Otherwise, don’t worry about food.  Regularly offer drinks in small amounts, for example, every half hour, to prevent dehydration.

Diarrhoea

Diarrhoea is an increase in runniness and number of bowel motions (poohs).  A viral infection is the most common cause of diarrhoea but sometimes bacterial infection, or a reaction to something eaten, or other bowel problem can occur.

Young children can lose a lot of fluid and become sick quickly when they have diarrhoea.  If your child has vomiting and diarrhoea, or if the diarrhoea has not stopped in 24 hours, or your child shows other signs of sickness e.g. drowsiness, passing less urine, has stomach cramps, or blood in his poohs, see a doctor.

It is important to keep breast or bottle feeding your child and offer extra fluids.  The best extra fluid to offer is an oral rehydration solution (electrolyte or similar solution) available from your chemist.  Homemade sugar and salt solutions are not recommended.  There is no need to stop feeding your child, in fact continuing to feed helps to heal the bowel more quickly.

If your older child is reluctant to drink, try:

  • offering fluids in a special cup, or drinking through a straw.
  • offering ice blocks or jelly.
  • using a timer and making every 10 minutes sipping time.

To prevent passing the diarrhoea infection to others, wash your hands after changing nappies or helping your child on the toilet.  Washing your hands before preparing or serving food will also help stop the rest of the family getting sick.  Also, remember to encourage older children to wash their hands after going to the toilet.

Constipation

This is when your child’s motions (pooh) are hard and difficult to pass.  If the motions are soft your child is not constipated.  It is common for babies to go red in the face, push and seem to strain when they are doing poohs even when they are not constipated.  Constipation is rare in breastfed babies.  It is normal for breastfed babies not to do poohs every day, in fact, some babies go only once every 7-10 days.  Formula fed babies usually do poohs every day or every second day.

Babies usually pass meconium (the dark sticky first pooh) within the first 24 hours from birth.  If they have not done so, they will need close checking from your midwife or doctor in case there is a bowel obstruction.  In older bottle fed babies incorrect preparation of formula can lead to constipation if the milk is too concentrated.  Follow the formula’s instructions – always put the water in the bottle before the powder and do not add extra scoops of powder or add extra water.

Constipation in older infants can be helped by adjusting the natural diet, for example adding pureed kiwifruit or just increasing the amount of fresh fruit and vegetables.  Toddlers may need more grains, in addition to fresh fruit and cereals, and fewer refined or processed foods.

Ear Infections

Ear infections can occur in young babies and children of all ages.  Previous advice that every ear infection needs treatment is now challenged.  Most ear infections will heal themselves without the need for antibiotics.  Most result in some fluid behind the eardrum, with one in ten still having that fluid in place three months later. When some of the fluid remains trapped in the middle ear as it can lead to an ear problem called “otitis media with effusion” (OME) commonly known as glue ear.

Sore throat and tonsillitis are common with an ear infection, causing fever and feeding difficulties.  Viruses are the usual cause.

Your child may have an ear infection if he keeps crying, cries when laid down flat, is difficult to settle to sleep, wakes frequently from his sleep is reluctant or refuses to feed, is grizzly, keeps rubbing or pulling his ear, gets a runny ear or has a fever.  Often they have a cold at the same time.  You need to see your doctor if he has any of these symptoms. If the doctor prescribes antibiotics for a red bulging eardrum your child needs to finish the full course of medicine to make sure the infection is completely clear.  Antibiotics are not always needed but pain relief often is.  Keeping babies in smoke-free areas, breastfeeding and feeding baby in an upright position will help.

Glue Ear

Glue ear occurs when sticky fluid persists behind the ear drum causing the child to have hearing difficulties.  Often they appear to be “naughty” because they appear not to be listening to you.  If the glue ear is not treated, the child’s hearing may be affected and speech may be slower to develop.  Although not painful for the child, glue ear can result in a feeling of stuffiness in the ear, similar to being underwater.  If left undetected, it can sometimes result in significant hearing problems and associated learning difficulties.

Prevention of glue ear is controversial but research has found that the risk of glue ear is reduced if you:

  • keep baby in smoke-free areas.
  • breastfed.
  • feed baby in an upright position if bottle feeding (being fed lying down or propped can cause milk to enter his middle ear and make it inflamed).
  • do not put baby to bed with a bottle.
  • keep your home warm and dry.