From the pages of the Baby & Child Care Encyclopedia: Chapter 7, When Your Child is Sick
It’s tricky to know what might be ailing your child, so we’ve rounded up some of the most common illnesses, their symptoms, how to treat and when to head to the doctor.
Abdominal pain, acute
Abdominal pain may be the symptom of a great number of ailments from childhood diseases, internal disorders or simply the result of overeating or eating the wrong foods. Other causes would include a twisted digestive organ, stomach ulcer, twisted testicle, viral or bacterial diarrhea or food poisoning, pneumonia, hepatitis, chronic constipation and even pain associated with emotions, such as high levels of worry.
Diagnosis: Diagnosis will vary according to the location of the pain, when it began, how long it has lasted, the age and sex of the child and whether there are other symptoms such as changes in bowel movements or urination, fever, nausea or vomiting.
Home Treatment: If you suspect constipation, avoid routine use of laxatives. Give plenty of fluids, fresh fruits and vegetables. Encourage your child to sit on the toilet regularly following meals, to increase opportunities for bowel movements to occur.
Emergency Treatment: A physician should see your child if there is severe pain—especially if there is vomiting. If a physician is unavailable, go directly to a hospital emergency room.
Allergies
An allergy is present when your child’s body overreacts to one or many things, including things that are eaten, breathed, touched or injected (such as medications). The most common childhood reactions are to foods, house dust, certain pollens, poison ivy, oak and sumac, stinging insects and some medications, such as antibiotics. Asthma often has an allergic component.
Symptoms: Swelling of the lips and mouth, hives, wheezing and even shock are some of the more severe symptoms. The shock reaction (called anaphylaxis) may be fatal. A reaction to stinging insects includes swelling and itching at the site of the sting, but if the reaction is severe it can cause anaphylaxis. Whatever symptoms are evident in a small child may change as the child grows older.
Medical Treatment: The symptoms of most allergic reactions can be reduced or eliminated with proper treatment—your doctor may prescribe an antihistamine or other medication, or a desensitization program. It is a medical emergency if a child has an associated breathing difficulty.
ALLERGY, FOOD
Food allergies aren’t as common in children as you’d think. Still, the most allergenic food is the peanut, and in infants, it’s eggs and milk products. Symptoms can involve swelling of the mouth, hives, a stuffy nose and difficulty breathing or swallowing.
Symptoms: Usually appear within a few minutes to an hour after eating. Some food allergies may result in vomiting, diarrhea, abdominal pain and bloating.
Home Treatment: If you know what caused the allergic reaction, remove the food from your child’s diet. Give plenty of clear liquids if he or she has lost fluids through vomiting or diarrhea. If the reaction includes itching from hives, try antihistamines, calamine lotion, decongestants and cool compresses.
Medical Treatment: If asthma results, a physician can prescribe medication to help breathing difficulties. Children often outgrow food allergies by age two or three.
If the child shows signs of shock (rapid pulse, fast shallow breaths, dizziness or fainting, clammy skin, thirst or anaphylaxis) get medical attention immediately. Epinephrine may be administered to control a severe allergic reaction. A kit may also be prescribed for home use.
Appendicitis
Appendicitis is uncommon in children younger than five. However, diagnosing appendicitis is difficult, so doctors take prompt action.
Symptoms/Action: Consult your healthcare provider or take your child to an emergency room if he or she complains of pain, tenderness or cramps in the stomach around the navel or lower right side of the abdomen for three hours or more.
Medical Treatment: If it’s appendicitis, an appendectomy may be required following the diagnosis.
Asthma
Wheezing and difficulty in breathing in children is usually an indicator of asthma, but a doctor will check for alternate reasons. A viral infection, such as a cold, may precipitate an attack. The good news is that many children outgrow asthma.
Medical Treatment: Mild asthma attacks may be treated with a prescription medication that relaxes smooth muscles in the breathing tubes. Medication usually continues for two to seven days after the wheezing has stopped. A child with severe asthma usually requires hospitalization.
Bits and stings (See First Aid chapter)
Bleeding (See First Aid chapter)
Blisters
These are raised, red bumps filled with an almost-clear fluid that forms when skin is damaged by being rubbed or injured. A blister can also result from an allergic reaction to plants or insects. The blister won’t disappear until the skin underneath the blister has healed.
Home Treatment: Protect the area with a bandage or gauze to prevent infections. Don’t break a blister, but if the blister should be accidentally broken, wash with soap and water, apply a mild antibiotic ointment (a prescription medication isn’t required) and cover.
Infection may result if a blister breaks. Red streaks that spread or redness at the base of the blister indicate infection and a physician should be seen.
Blood (in stool or vomit)
Symptoms: Vomiting a large amount of blood usually suggests that the bleeding originates in the esophagus or stomach. Blood in the stool is a sign that bleeding originates in the intestines. A black stool may also indicate internal bleeding. Significant blood loss can lead to shock. (Notice if the child is cool, clammy, weak, pale, thirsty, nauseous, dizzy, faint or has a rapid pulse.)
Medical Treatment: If there is a large amount of blood in vomit or rectal bleeding, get medical attention immediately. For massive bleeding, intravenous fluids and salts may be given to combat dehydration and shock. A blood transfusion may be started. Specific treatment depends on the cause. Comfort and reassure the child, who will be frightened. Fear and anxiety can complicate the problem.
Blood (in urine)
Blood in the urine may be due to bladder infections, inflammation or kidney disease. It can indicate serious conditions, so get an immediate medical evaluation. Sometimes coloured foods, such as beets or red dyes, can cause red urine. All children with blood in the urine should be seen by a physician.
Breathing (Rescue breathing, choking, hyperventilation) (See First Aid chapter)
Broken bones (See First Aid chapter)
Burns (See First Aid chapter)
Chest pain
Chest pain in children isn’t usually a cause for alarm.
Home Treatment: This depends on the cause. A warm heating pad helps relax sore or tense muscles.
Medical Treatment: If a child has serious chest pain accompanied by difficulty breathing or fever, get medical attention immediately—it might be an injury or infection to the lungs. Don’t bind the chest in any way because it may interfere with breathing. A physician should be consulted if chest pain is cause by injury.
Chicken pox
Chicken pox (varicella) is a viral infection. It is common in childhood in children who haven’t been vaccinated against it, and the infection is usually mild. Chicken pox usually begins with a fever, followed by a rash after one or two days. The rash usually starts as red spots, and then turns into blisters filled with fluid. Within a few days, crusts form over the blisters. New spots may also appear over the following days. The rash may be very itchy. If your child gets chicken pox, they should develop immunity and will likely not get the infection again.
Treatment: You can try to control your child’s fever by giving him acetaminophen. Do not give your child aspirin or any products that contain aspirin. Aspirin increases the risk of getting Reye’s Syndrome, a severe illness that can damage the liver and the brain. Treat the itchy rash with calamine lotion and/or baking soda baths.
Transmission/Prevention: The virus that causes chicken pox spreads through the air, or spreads through direct contact with the blister(s) of an infected person. Chicken pox is infectious five days after the rash first appears, or until a crust has formed over the last blister. If your child isn’t vaccinated and has been around another child who has chicken pox, watch them for signs of the infection over the following two weeks.
If your child gets chicken pox and attends a daycare centre or school, it is important to tell the centre staff or teacher.
Common cold and flu-like illnesses
Symptoms of a common cold or head cold are usually a stuffed-up nose, lessened appetite, headache and mild fatigue. A sore throat or mild cough are somewhat common. Sometimes there is a mild fever. With a flu, symptoms are more severe, and may include fever, cough, fatigue and achiness. There may also be a sore throat, hoarseness and the swollen glands in the neck. Loss of appetite, vomiting and diarrhea are also common with flu-like illnesses.
The common cold is actually caused by a virus that can infect the nose and throat. Flu-like illnesses are also often caused by a virus and usually infects the head and chest.
Treatment: Give your child plenty of fluids and urge him to rest. You can give your child acetaminophen for pain, aches or a fever higher than 38.5. Do not give your child Aspirin or products containing Aspirin because of the risk of Reye’s Syndrome. If your child has a dry, hacking cough and is older than age six, you can give your child a cough syrup that contains dextromethorphan (DM). Do not use stronger cough medicines for a cough that brings up mucus from the chest.
Contact your physician if your child shows any of the following signs: earache, fever higher than 39C (102F), excessive sleepiness, excessive crankiness or fussiness, skin rash, rapid breathing or difficulty in breathing. Common colds usually get better after five to seven days. Bad colds or flu-like illnesses may take a few days longer. A cough can linger for a few weeks. If your baby has breathing trouble, fever, poor appetite, or vomiting, make sure they are checked by their doctor. Sometimes a cold can lead to complications such as a middle ear infection, in which case your child needs to see a doctor. Signs of an ear infection are a high fever, earache, vomiting, irritability and especially pus draining from the ear. Your child should also see a doctor if they get an eye infection with a cold, a symptom of which is dried yellow pus in and around the eye.
Transmission/Prevention: The virus is carried in the saliva and nasal secretions and spreads through the air when people cough, sneeze or blow their noses. Teach your child to cover their mouth and nose when sneezing or coughing.
Cold cores (oral herpes, fever blisters)
These are clusters of painful bumps or blisters on one side of the outer lip. Kids usually get infected by coming in contact with the open lesions or saliva of someone who’s infected. (If adults around your child are prone to cold sores, they should avoid close contact when experiencing a flare up.) With the first infection these blisters also appear inside the mouth (stomatitis) and are confused with canker sores. However, they are very painful and are associated with fever. The infections usually start before age four. Cold sores (oral herpes) are associated with the herpes simplex virus, type 1.
Symptoms/Treatment: The blisters on the lip rupture, scab over and dry up in 10 to 14 days. They do not cause scars. After the blister heals, the virus is dormant and then, at a later time, can become active again. Cold sores heal by themselves and although they are a nuisance, they are not serious. Young children with herpes stomatitis may refuse to eat or drink, so are at risk of becoming dehydrated.
Home treatment: Warn your child not to touch the blisters or pick at the resulting scabs. Phenol and camphor may give some relief if the blisters are sore, and may also prevent bleeding of the scabs. Apply at the first sign of a cold sore.
Choking (See First Aid chapter)
Croup
Croup often begins like a common cold. Later, there is fever, cough and difficulty breathing. The lining of the throat and larynx gets red and swollen, and a barking cough develops. The voice gets hoarse and breathing can get rapid and noisy. Croup usually sounds worse than it is.
Cause: Croup is a viral infection of the throat and vocal cords (larynx). In an older child or adult, it is called laryngitis.
Treatment: Croup is a viral infection so antibiotics, which are used to treat bacterial infections, do not help. Call your child’s doctor right away if he gets a fever higher than 39C (102F), has rapid or difficult breathing, has a severe sore throat, starts to drool or has more drool or if he refuses to swallow or is uncomfortable when lying down.
Transmission/Prevention: As with a cold, the virus is carried in the saliva and nasal secretions and spreads through the air when people cough, sneeze or blow their noses.
Dehydration
This is an excessive loss of body fluids, and it can develop very rapidly among newborns and infants who are vomiting or have diarrhea. Notice if your child: has not urinated in more than eight hours; if there are no tears when crying; if the mouth is dry; if there is decreased quantity or frequency in urinating if the pulse is rapid; if the eyes seem to be sunken; and if your child is lethargic.
Home Treatment: Encourage him or her to drink water, fruit juices or soft drinks such as ginger ale. Don’t offer salty liquids such as broth. If the child is nauseous and can’t tolerate drinks, try offering chips of ice or frozen juice.
Medical Treatment: If hospitalization is necessary, the child may be given fluids and nutrients intravenously.
Diarrhea/dehydration
Diarrhea is most often caused by a virus. Sometimes it is caused by bacteria. Your child has diarrhea if he is having more bowel movements than usual and his stools are loose and watery. Your child may also have a fever, nausea, vomiting, pains in the stomach, cramps, blood and/or mucus in the stool and may not want to eat. Diarrhea can be dangerous if it causes dehydration. Signs of dehydration are less urination, lack of tears, dry skin, mouth and tongue, sunken eyes and a sunken fontanelle in babies. Dehydration can be very dangerous, especially for babies and young children.
Treatment: At the start of diarrhea in your baby, continue breastfeeding on demand. If you do not breastfeed, continue to offer your baby food and drink. Whether you breastfeed or not, offer oral rehydration solution (ORS) following this schedule.
For the first six hours:
- For a child less than six months old, give 30 to 90 ml of ORS every hour.
- For a child six to 24 months old, give 90 to 125 ml of ORS every hour.
- For a child over two years old, give 125 to 250 ml ORS every hour.
If your child vomits in addition to having diarrhea, you may need to stop food and drink. Continue to give ORS, however, using a spoon. Give your child 15 ml (1 tbsp) every 10 to 15 minutes until the vomiting stops. Then go back to the schedule above. If vomiting doesn’t stop after four to six hours, take your child to the hospital.
- From six to 24 hours, keep giving ORS until the diarrhea happens less often. When the vomiting happens less often, have your child drink small amounts of milk or formula often.
- After 24 to 48 hours, most children can eat and drink normally. It can take seven to 10 days for stools to return to the normal form.
Transmission/Prevention: The germs that cause diarrhea are spread easily from person to person, especially among children who haven’t learned to use the toilet. Wash your hands and your child’s hands well after changing a diaper and going to the toilet and before preparing food and eating.
Call your child’s doctor if he has diarrhea and is younger than six months, if he has bloody or black stools, if he is still vomiting after four to six hours, if he has a temperature greater than 38.5C (101.5 F) or if he has signs of dehydration.
Dizziness (vertigo)
This involves a feeling of the world spinning—a sensation that indicates the balancing mechanism of the inner ear is disturbed. The feeling can be momentary, but if it persists, nausea and vomiting are likely. A few children experience dizziness during their early years (one to four), but it usually isn’t a cause for concern. Some children experience dizziness when they ride in a car.
Home Treatment: Most dizziness will pass quickly, especially if the child has been spinning during play. If it persists for more than a few minutes, ask your child about other symptoms.
Medical Treatment: See a doctor if there is earache, buzzing in the ears, headache, fever or if the child is unable to stand or walk.
EAR INFECTION
The peak ages for earaches are six months to two years, but they continue to be a problem until children are eight or 10 and usually cause both pain and fever. An ear infection can be in the external ear, the middle ear or the inner ear. Young children are most affected by middle ear infections—it’s the most common early childhood problem next to colds. An external ear infection (often called swimmer’s ear) can ache, be tender and red, swell and have a discharge of pus that has an unpleasant odour. Itching and discomfort can last for a few days, even after treatment has started.
Home Treatment: Don’t use folk remedies, such as warmed oil dropped in the ear, and don’t plug the ear canal with cotton. To relieve pain, put an ice bag or ice in a washcloth over the ear for 15 minutes. Cold provides better relief than warmth. Don’t allow water near the ear. If the pain is from water in the ears, get the child to lie with the affected ear downward so the water can drain.
Medical Treatment (External Ear): The physician will clean the ear canal and prescribe ear drops with antibiotics and cortisone.
Medical treatment (Middle Ear Infection): Antibiotics are generally indicated to combat infection. Sometimes a small incision is made in the eardrum to admit a tube that allows fluid to drain from the middle ear. This is generally done if a child has multiple ear infections.
Medical Treatment (Inner Ear): Your healthcare provider will drain the accumulated fluid from the inner ear and start antibiotic therapy. Surgery is sometimes necessary.
Eczema
Eczema is a skin eruption that, in infants, usually starts on the cheeks and is red and oozing. Thickening of the skin will occur in older children if the eczema is long-term. It is not contagious. Infantile eczema tends to run in families. Usually a close relation to the child is susceptible to eczema or some other allergic complaint, such as hay fever or asthma.
Eczema usually starts in infants two to three months old and often clears when a child is between three to five years old. It may be associated with other allergic conditions such as hay fever. You will notice it first on your infant’s cheeks, but it will probably spread to the rest of the face, the neck, the wrists and the hands. Because it is so itchy, the child will rub against blankets and try to scratch. Then there will be oozing, followed by crusting and scaling. It may become infected.
Home Treatment: If a child scratches, eczema is very difficult to control. Apply cool, moist compresses to calm the itch. Keep your child’s fingernails as short as possible, but don’t insist they wear mittens—it will be very difficult on your child if they can’t even rub the area to get some relief. Avoid harsh soaps and detergents. Let the child soak in warm water to relieve the dryness, but after bathing coat the skin in oil to seal in moisture. Avoid rough or scratchy clothes. If the cause is food related, it can be treated by eliminating specific foods. These triggers may include milk products, eggs, tropical fruits, fish, shellfish, wheat flour products and chocolate. After the eczema has cleared up introduced these foods one at a time, a week apart, so that the problem food can be identified. If you’re having trouble get a handle on your child’s eczema, make an appointment with their doctor.
Medical Treatment: A hydrocortisone ointment may be prescribed to help reduce inflammation. (A mild hydrocortisone would be used for infantile eczema.)
Eye injuries
Eye injuries can be caused by a piece of matter in the eye or under the eyelid; a sharp object puncturing the eye or eyelid; a blow to the eye; burns sustained from being exposed to chemical substances (cleaning agents, firecrackers); or overexposure to the sun.
Home Treatment: Blinking can usually force dust out of the eye. If you can see the culprit, moisten a cotton swab and gently flick it out, or flush the eye thoroughly with running water for at least 15 minutes. If the injury is from an explosive substance, if the eye has been penetrated or if it has come into contact with a chemical substance, do not wash out the eye. Call your healthcare provider for actions to take.
Emergency Treatment: If the foreign matter is embedded, don’t try to remove it. Go to an emergency room. After the object is removed, the physician may prescribe antibiotic ointment and pain relievers if the cornea is scratched. If the cornea has been burned by ultraviolet light, both eyes should be kept closed until healing occurs (one or two days). A cut in the eyeball may require surgery. Teach your child to wear protective eye goggles when working with tools or chemistry sets. It should become an automatic habit.
VACCINATION SCHEDULE
Vaccinations are scheduled differently in every province but there is a general consensus that the standard vaccines are spread out at intervals from two months of age to age 11. Booster shots to update vaccines may occur throughout adolescence and adulthood. Keep an eye on the calendar to ensure your child’s vaccinations are up to date (especially when kids go to school—you may be asked to show proof of vaccination depending on your region). Vaccinations are a contentious topic for some families; any concerns can be discussed with your child’s doctor.
For more information, and to view and print your own copy of the Provincial and Territorial Routine and Catch-up Vaccination Schedule for Infants and Children in Canada, visit canada.ca. (You can also search “Canadian vaccination schedule” for easier access.)
Read more from the Baby & Child Care Encyclopedia.
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- Prenatal 101
- Breastfeeding and the First Three Months
- Starting Solids and the Toddler Years
- An Age-by-Age Guide to Sleep
- Family Nutrition
- Kids and Mental Health
- When Your Child is Sick
- Safety and First Aid
- Milestones, Checklists and Charts
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