Babies and children / winter ailments

Coughs, colds and flu in babies and children

Here in the southern hemisphere, Easter is more about autumn leaves, avocado-pears and oranges than daffodils, bunnies and chickens. While the northern hemisphere celebrates the coming of warmer days and longer nights, we’re taking out our winter woollies and putting the duvets back onto our beds.

Winter is also the season of flu, coughs and colds. It takes just one person infected with a virus to unwittingly spread it to family, friends, colleagues and just about everyone he comes into contact with. The elderly, pregnant women, people with poor resistance, children and babies are particularly vulnerable. This week’s blog is about vulnerable children and babies and respiratory tract infections.

The nose, mouth and throat are the first line of defence when it comes to fighting microbes. Microscopic tuberculosis spores, fungi, viruses, bacteria and parasites are everywhere – in the air we breathe, on surfaces we touch and the people we mix with. The fine hairs inside the nose filter the biggest of these. When they’re particularly irritating, they make us sneeze. The mucous lining of the mouth, nose and throat is our second line of defence. This moist, slippery surface contains a fluid that is able to protect the body from invading micro-organisms.

When a virus or bacteria manage to bypass these defences, babies and children can come down with an upper or lower respiratory tract infection.

An upper respiratory tract infection begins with rhinitis, or runny nose caused by a virus. This infection can spread up the nose into the sinuses causing sinusitis. A middle ear infection can be bacterial or viral and is mostly spread from the nose and through the eustachian tube (this connects the middle ear to the top of the nose called the nasopharynx) to the middle ear. Tonsillitis and pharyngitis are bacterial upper respiratory tract infections.

Lower respiratory tract infections spread downwards into the chest and are mostly viral. These begin with laryngotracheal-bronchitis and tracheobronchitis that can become bronchitis.

The greatest concern about these infections is that upper respiratory tract infections in very small babies and young children can spread to the brain and become meningitis or encephalitis. In severe cases this can cause life-long complications. Severe lower respiratory tract infections can become pneumonia.

What to look out for when your baby/child is sick:

• Before your baby/child shows typical symptoms, they will be just plain miserable and clingy, reluctant to play and eat.
• They may look flushed or very pale with a temperature of 38°C or more
• Your baby/child may be thirsty but not hungry. If they’re coughing and are very ‘mucousy’ they may vomit their feeds
• Because they’re drinking less, babies will wet fewer nappies. Children will use the toilet less often. This is a sign of dehydration.
• A baby’s cry will tell you that s/he is not well. It becomes a whimper rather than a loud lusty cry
• Lack of feeding and a fever will make your baby/child listless, limp and lethargic
• Coughing may get worse. If your baby/child has an ear infection, s/he will rub the infected ear
• Some infections cause a rash.

 These symptoms are good reason to take your baby/child to the doctor, especially if they are becoming dehydrated.

What should you do when your child is ill:

Take him/her to the doctor. An antibiotic will only be prescribed if the infection is bacterial. Viral infections cannot be cured with an antibiotic.

• Make sure you give your child the correct dose of medicine at the right time and at the intervals that they’ve been prescribed
• Treat the symptoms i.e. give your child medicine for a fever regularly. While the fever persists, give your baby/child a tepid (not cold) bath and keep him/her very lightly dressed. Give them rehydrate in small doses very often until they can tolerate liquids. Give them easy-to-swallow and digest food like jelly and soup.
• Leave them to sleep undisturbed while their body heals
• Nebulising and physiotherapy helps with lower respiratory tract infections

If the symptoms persist, or get worse, please take your baby/child back to the doctor.

Luckily, babies and small children are exceptionally resilient and recover remarkably quickly. Keep them healthy this winter with lots of vitamin C – found in just about every fruit available. Keep them warmly dressed (especially in the early morning and late evening when they are being fetched from crèche or nursery school), and if they’re picky-eaters, give them a good multivitamin (ask your pharmacist to recommend a brand with a combination of vitamins and minerals made specially for children).