ILLNESS IN CHILDREN

This page is written to offer you our patients some advice on how to manage your children’s common illnesses and make the best use of your health team at the practice.  The health team for children comprises the doctors, nurses and health visitors.  Between us we have raised over 15 children and thus have plenty of direct experience, from the parents point of view.

Fevers / Febrile Fits

A fever is most commonly caused by a virus and sometimes it can be quite sudden and very high.  The body produces a fever to help fight the virus and children who get high fevers tend to get better faster.  We use paracetamol to reduce the fever mainly to make it more comfortable but also in children under age 6 to reduce the risk of fits.  Very few children get febrile fits and in the vast majority, therefore, the fever is a benefit.   Fevers often come and go with worsening in the evening.  When the body temperature is rising, the child will say they feel cold and shiver.  When the fever is coming down, the child will look red, sweat a bit and complain of the heat, throwing off their covers and clothes to get rid of the excess body heat.

Febrile fits or convulsions are extremely frightening but not dangerous and the child suffers no permanent effects.  The main danger is inhalation of vomit, so the safest position for a fitting child is lying over an adult’s knees with their head down facing the floor.   Once recovered, cool the child by undressing & giving paracetamol, then phone the doctor for further advice & reassurance.

Cough

This is common with viruses and can be dry or productive of mucus.  A dry cough doesn’t produce mucus or catarrh, but may sound like a bark, when it is called croup, or may be wheezy and mimic asthma.  A productive cough will produce a rattly chest and it sounds as if stuff is being brought up, but most infants swallow it.  It then sits in the stomach and may be vomited up with the next coughing bout.  This is normal.  Some coughs can go on for many weeks.  This may be due to a persistent virus in babies, or in older children tends to be due to the lining of the windpipes being sensitised or itchy.  In both cases, it will disappear with time and patience.  The only time that antibiotics are helpful is when a bronchitis develops and the clue to this is the production of large amounts of yellow or green phlegm.  White or clear phlegm is due to a virus and as antibiotics have no effect on viruses, we tend not to use them for white or clear mucus.   Steaming the bedroom, with wet towels on radiators, vaporisers or even boiling a kettle (carefully!) will soothe a cough.  Vallergan elixir acts as a sedative and will help a coughing child (and their exhausted parents) to sleep better.

Earache

This can be very painful so we are keen to supply you with stronger painkillers than simple paracetamol for your affected child.  It is wise to have a small supply of suitable painkillers at home, because earache often arises in the night.  Most (9 out of 10) cases of earache do not need antibiotics, getting better within a day or two by themselves.  The child gets a virus that causes a "bunged up" head and this raises the pressure inside the ear.  Lying down makes the pressure rise higher which is why the pain gets worse at night and eases by day.  There is no benefit in calling the emergency doctor for antibiotics during the night- the child needs to be propped up in bed and given painkillers which provide more immediate relief.  The doctor can then examine the ears the following morning.  Sometimes the eardrum will rupture, causing a sudden flow of pus and maybe slight blood, but with immediate relief of the pain.  This is nature’s version of having a grommet.  It cures the earache, the drum repairs itself within a month and there is minimal risk of any resulting ear problem.

Diarrhoea & Vomiting

This is usually due to a virus.  The important thing is to avoid dehydration by ensuring an adequate intake of the right type of drink.  Avoid pure or boiled water and milk and instead use fruit juice or flat lemonade (or use Dioralyte / Rehydrate avaliable at the chemist).  The reason for this is that sweet liquids are more rapidly absorbed- about half will be absorbed within 20 minutes.   Also salts and ions such as potassium are needed and fruit juice is a perfect source of both.  Vomitus and diarrhoea contain a lot of salts and sugars which need replacing as well as the more obvious water loss.  If the child continues to pass urine, it is an indication they are not too severely dehydrated.  As long as you can keep an adequate fluid intake, your child will not come to any harm, even if the vomiting goes on for more than 24 hours.  We would be happy to check the child, preferably in surgery hours to exclude rarer causes of vomiting and to assess the degree of dehydration.

Meningitis

Many common viruses will cause a headache.  The signs that a more serious infection may be present are:

1. The child is unable to curl up and touch their chin to the knee.

2. Marked drowsiness.

3. Grey, cold skin.

4. Most serious of all is a rash that looks like a 'lovebite' with blood under the skin.  This rash does not blanche when pressed with something transparent such as the edge of a glass.

Colds and Flu

They usually start with a runny nose, cough, temperature and aches.  They are caused by viruses and antibiotics are of no use in their treatment.  Treatment consists of taking recommended doses of Paracetamol for temperature and aches and drinking plenty of fluids.  Do not worry if you do not eat for a few days, you will come to no harm.

Viral Illnesses / Whooping Cough

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