Written by Dr Martin Saweirs for Doctify
We seemed to wait longer than most for our daughter to get her first real illness. With my wife and I both being doctors we figured we’d be fine, but we somewhat underestimated things.
At about five months old she picked up one of the myriad of bugs that kids spread to one another. Putting our medical knowledge into practice turned out to be much harder than we expected. The crying was fairly relentless, and more like inconsolable screams at times. Trying to get some sleep and go to work with a functioning mind was nearly impossible.
So our daughter was coughing all the time, had a horrible runny nose, wouldn’t eat a thing, couldn’t sleep and screamed most of the day. That’s okay, we thought, we’ll give her paracetamol and ibuprofen and encourage her to drink plenty of fluid – but it turned out to be a LONG few days. The coughing was fairly incessant, and worse at night as it so often is with these things, but the lack of sleep was the real tough bit to deal with, making us all much crankier as a family! A lot of our friends also seemed to think we’d be fine as we “deal with sick children all day” – whilst true, we normally only see them for a few minutes, so when one is living with you there really is nowhere to hide!
The vast majority of common childhood illnesses are viral in nature, and this includes coughs, sore throats, ear aches, and diarrhoea and vomiting. As a result, unfortunately there’s not much we can do to speed up getting rid of them, but it all got me thinking about a few general things to consider when your child is unwell:
● Fever: to be clear, this means a temperature of 38C and greater. It is really common when kids get a cough, runny nose, sore throat or painful ears to get a temperature like this. Giving paracetamol or ibuprofen should bring it down to below 38C, but nevertheless it may spike back up again. Paracetamol and ibuprofen can be given together, or you can alternate between the two if this gives your child a bit more sustained relief from the fever. If this pattern is repeating and temperatures are going up and down for a few days, this can be quite normal, but it needs to be taken in the context of how your child is generally, which I talk about below.
● Eating and Drinking: when kids are unwell with a fever, their appetite vanishes rather quickly. It can be quite striking but it’s pretty normal for them to not want to eat for days, and sometimes this loss of appetite can linger on as the illness resolves. What is really important though is to encourage your child to drink plenty of fluids and stay hydrated. Don’t worry about the food and concentrate on the fluid. Having a fever is incredibly demanding for the body and can cause serious dehydration. One good way of making sure your child is well hydrated is by checking they are still wetting their nappies or going to the toilet regularly – this means their body has enough fluid and is not trying to retain fluid to compensate for losses.
● General behaviour: it’s normal and common for a child to be anything from clingy, cranky and irritable to a bit lethargic when they have a fever. You often notice them “perk up” and start running around or going back to their usual selves after some paracetamol or ibuprofen to bringing the fever down. However, if they’re rather floppy and somewhat unresponsive despite this, then it is a sign to seek medical help promptly.
● Other things to look for: with lots of viral illnesses it is actually rather common for kids to come out in a rash , which is often faint, light pink/red in colour and can be quite widespread over areas of their bodies. These rashes will lose the redness temporarily when pressed, unlike the more serious rash of bacterial meningitis, which stays red (see my meningitis blog on my website with some pictures of how to test for this). Another thing to look out for is the pitch or tone of your child’s cries. This is difficult to describe, but most parents know if their child’s cry sounds out of character – if this is the case, this is not something to be ignored and one should again seek medical help promptly if it is ongoing.
All of these little things need to be taken in the overall context of the child but if there is something you are concerned about it is always better to be safe than sorry, and seek medical help. A doctor should never make you feel silly or guilty about bringing an unwell child in to be seen. If they can tell you quickly that it’s viral then that’s great.
Sometimes though is can be difficult to tell viral apart from bacterial causes, even to a trained doctor examining your child. In these cases you may be given a prescription of antibiotics to start using in 24-48 hours if there is no improvement. By delaying this for a few days we reduce the unnecessary use of antibiotics, as they often improve in the meantime without needing them. Ultimately this gives the child’s immune system more of a chance to do what it is designed to do, and makes it stronger and more efficient at its job in the long run.
Gradually she got better after a few days, but then a few weeks later, it all happened again. Unfortunately, she’s now at the age where this can happen every few weeks (children on average get 8 – 12 coughs or colds a year) so we’re getting a bit more used to it. Suffice to say, the whole experience has given me much more sympathy and time for exhausted parents now!
