Child Health

Flu (Influenza)

Influenza, commonly called ‘the flu’, is an infection caused by the influenza virus. It affects the nose, throat, lungs and other parts of the body. The flu can be a serious and sometimes life-threatening infection. It infects many people every year, mostly during the winter months in New Zealand. The flu is not the same as having a bad cold. Sometimes people confuse a cold with the flu. But with the flu, people are generally more unwell and flu symptoms may last longer. Yearly flu immunisation offers the best protection.

Flu in children usually causes at least 2 or 3 of the following symptoms: a fever that starts suddenly, body aches or pains, headache, dry cough which may become moist, sore throat, low energy or fatigue, chills or shivering, runny or stuffy nose, upset tummy, vomiting or diarrhoea.

How can I care for my child with the flu at home?

• If your child is miserable because of fever or aches and pains, you can give paracetamol to make them more comfortable. You must follow the dosage instructions on the bottle.
• Give your child regular fluids.
• Use saltwater drops (saline) to treat a stuffy nose – ask your pharmacist or family doctor for instructions.
• Keep your child at home and resting until they are well.
• Most children fight off the infection by themselves.
• Antibiotics are not helpful for the flu and your doctor won’t prescribe them unless your child also has a bacterial infection.

For more information on how to look after your child with flu at home and when to visit a doctor, click here.

Bronchiolitis

Bronchiolitis is a chest condition that causes breathing problems in babies. It’s caused by a virus – often respiratory syncytial virus (RSV) or rhinovirus. Bronchiolitis is very easy to catch so wash your hands before and after handling your baby.

Bronchiolitis often starts as a cold, with a runny nose. Babies with bronchiolitis: may have a fever, start to cough, breathe fast, put a lot of extra effort into breathing, have noisy breathing (wheeze). The second or third day of the chesty part of the illness is usually the worst. Bronchiolitis can last for several days. The cough often lasts for 10 to 14 days but it may last as long as a month.

Breastfeeding and a smoke-free environment give the best protection against bronchiolitis.

Please click here for more information on how to look after your baby/babies at home and when to visit a doctor.

Cough

Coughing is an important reflex that helps to clear mucus from your airways. It is a common symptom in children, especially when they are under 5 years of age. A cough can sound awful, but it is rarely a sign of serious illness. Cough in children can be commonly caused by colds, chest infection, asthma, secondhand smoking, whooping cough, or croup.

Tips to look after a child with a cough

• Making your child more comfortable is the main focus. There are no medicines to treat the commonest viral causes of cough.
• Encourage rest and give lots of water to drink.
• For children older than 12 months, honey can help soothe their cough.
• Vapour rubs can be applied to their chest and back. However, there is little scientific evidence as to how well they work and they are not recommended for babies under 3 months. Avoid putting the rub near the nostril area.
• Simple pain relievers such as paracetamol (commonly known as Pamol or Panadol) can be used to reduce pain or fever and make your child more comfortable.
• Keeping your home smokefree, warm, clean and dry is best for your children’s health.

Please click here for more information on how to look after your child at home and when to visit a doctor.

Asthma

Asthma is a condition that leads to narrowing of the airways of the lungs. Symptoms include wheeze, cough and difficulty breathing. Common asthma triggers are colds (viruses), exercise, dust, pollens and cigarette smoke.

Asthma affects the small and medium-sized airways (bronchi) in the lungs. In asthma, your child’s airways are inflamed and there is:

• swelling of the airway wall
• an increase in mucus or phlegm
• tightening of the muscle in the airway wall (see the image below).

These changes cause narrowing of your child’s airways. This leads to wheezing, cough and difficulty with breathing.

Wheezing is a musical, whistling sound that children make, usually when breathing out. It can also happen when they breathe in. The sound comes from the chest, not from the nose or throat.

Some tips to manage your child’s asthma:

• Asthma symptoms and triggers may differ from child to child and from time to time. It is useful to know your child’s triggers. Keep a symptom diary and keep a record of possible triggers.
• Make sure your child’s environment is smoke-free, wherever they happen to be. Asthma increases in children whose parents smoke. Tobacco smoke also triggers asthma attacks and makes a child’s asthma more severe than it would otherwise be. Many environmental factors contribute to asthma; cigarette smoke is one that you can avoid.
• Aim to keep your house warm, dry and well-insulated.
• Every child with asthma needs an action plan. If your child has asthma, ask your family doctor for an asthma action plan. The plan will tell you how to prevent asthma attacks and how to manage them when they happen.

Please click here for more information on how to look after your child at home and when to visit a doctor.

Sore Throat

Sore throats (mate korokoro) can be painful and cause discomfort when you swallow.

Around 90% of sore throats are caused by viral infections such as the common cold or flu. Viral sore throats usually get better by themselves within a week. Antibiotics do not fix viral sore throats. Some sore throats are caused by bacteria, most commonly Streptococcus (often known as ‘strep throat’). Children and young people at risk of rheumatic fever require treatment with antibiotics for 10 days to prevent rheumatic fever.

A sore throat that is caused by a viral infection is usually treated by self-care measures such as:

• pain relief medicines, like paracetamol or ibuprofen
• drinking more fluids
• eat cool, soft food or warm soups
• trying ice blocks
• honey and lemon juice
• older children and adults may be able to gargle with warm salt water
• avoid smoking or smoky places
• rest as much as you can
• suck medicated throat lozenges (not for children)

Please click here for more information on how to look after your child at home and when to visit a doctor.

Fever

Fevers are common in children. Fever by itself does not tell you whether your child is seriously sick. Even an ordinary cold can cause a high fever. Fever is a normal way for a child to fight an infection. Being hot may make your child feel unhappy or uncomfortable, but slight fever is very unlikely to cause any long-term problems. Your child’s normal body temperature is around 37 degrees Celsius. Your child has a mild fever if their temperature is higher than 38 degrees Celsius. A high fever usually means more than 39 degrees Celsius.

How do I treat a fever in my child?

• Undress your child so that they are just wearing a single layer (maybe a singlet and pants).
• Make sure the room is not too hot or too cold. These are the best and most comfortable ways to bring your child’s temperature down.
• You could use a cool face cloth.
• Your child may need extra rest or they may not want to play – this is OK.
• Encourage them to drink fluids and eat healthy small meals.
• If your child is miserable because of the fever, you can give paracetamol to make them more comfortable.

Please click here for more information on how to look after your child at home and when to visit a doctor.

Ear Infection

Ear pain and concerns about hearing are one of the most common reasons parents take their young children to the doctor. Older children will complain of significant ear pain and may have a fever. They may also feel unwell and complain of reduced hearing in the affected ear. They may complain of problems with balance. In babies and younger children, sometimes the only sign of an ear infection is a fever. Younger children may also: cry and become very upset, distressed, irritable and hard to settle, have very disturbed sleep at the beginning of the infection or become ‘clingy’ and ‘grizzly’.

Regular pain relief is important to help your child feel more comfortable. Paracetamol and/or ibuprofen can help reduce pain, and also lower fever which can make your child feel better. Antibiotics are often not needed. Your doctor may either: wait to see whether the infection will clear up by itself, or recommend treatment with antibiotics, if your child is unwell, feverish and a bacterial infection is suspected.

Please click here for more information on how to look after your child at home and when to visit a doctor.

Gastroenteritis (diarrhoae and vomiting)

Gastroenteritis (gastro) is a bowel infection, usually caused by a virus. It causes runny, watery poo and sometimes vomiting. Children with gastroenteritis need to drink plenty of fluids.

A virus usually causes gastro. Common viruses are rotavirus and adenovirus but there are many others. Because there are many viruses that cause it, your child can get gastro more than once. Infants younger than 15 weeks of age can have rotavirus immunisation free of charge. This protects against one of the most common causes of gastro.

How can I care for my child with gastroenteritis at home?

If your child is over 6 months old and has mild gastro and is not dehydrated, you can care for them at home. The main treatment is to keep giving your child fluids. Whichever fluids your child is having, the important thing is to:

• offer small amounts of fluid often rather than giving large amounts – aim for a quarter of a cup every 15 minutes or 1 teaspoon or 5 mls in a syringe every minute
• keep offering your child fluids even if they are vomiting
• if you are breastfeeding, continue to feed on demand – you may need to feed more frequently and take extra fluid
• if your child is on formula, continue to give them formula feeds

Your doctor or pharmacist may recommend electrolyte solutions such as Gastrolyte or Pedialyte if your child is dehydrated. You can buy these from your pharmacist – follow the instructions on the packet.

Please click here for more information on how to look after your child at home and when to visit a doctor.

Conjunctivitis

Conjunctivitis, or pink eye, is a very common condition in children. It causes red, irritated and sticky eyes. A viral or bacterial infection or allergic reaction are the most common causes of conjunctivitis.

You can help relieve the symptoms of conjunctivitis.

Clear away the discharge:

Gently clear away the discharge from the eye with a cotton ball soaked in warm water. Clean in one direction only, moving the cotton ball from the inside to the outside of the eye. Use a separate cotton ball for each eye and throw them away after each use.

Good hygiene can help prevent the spread of conjunctivitis:

• wash hands very carefully after contact with infected eyes
• try to discourage your child from rubbing their eyes
• wash pillowcases, face cloths and towels frequently and don’t share them

Please click here for more information on how to look after your child at home and when to visit a doctor.

Hand, Foot and Mouth Disease

Hand, foot and mouth disease is a common viral infection that mostly affects children under 10 years of age. Symptoms include blisters in the mouth or on hands and feet. Keep your child at home if they are unwell or have blisters. Make sure your child doesn’t go to childcare or school until all the blisters have dried.

Mild fever is usually the first sign of hand, foot and mouth disease. This starts about 3–5 days after your child has been exposed to the disease. After the fever starts, your child may develop other symptoms, including:

• painful red blisters in their mouth
• red or fluid-filled blisters that are not itchy or painful, usually on the arms and legs (particularly on the palms of  hands, or soles of feet), but they can appear elsewhere on your child’s body
• loss of appetite
• a sore throat and mouth
• a general feeling of weakness or tiredness.

The disease is usually mild and lasts about 3–7 days.

Treatment

Please click here for more information on how to look after your child at home and when to visit a doctor.

Chickenpox

Chickenpox is a common childhood illness caused by a virus. Children with chickenpox need to stay home from school and daycare. Children at 15 months of age can now have free chickenpox immunisation.

Chickenpox can often start with the following symptoms:

• a fever
• a headache
• a runny nose
• a cough
• loss of appetite
• feeling tired

Chickenpox rash 

A red rash follows 1 to 2 days later. It usually starts on the face and scalp, spreads to the chest, back and tummy and then to the arms and legs. It can also appear inside the ears, on the eyelids, inside the nose and mouth, and even around the genital area. The rash continues to spread for 3 or 4 days. It usually becomes very itchy. Within a few hours after each spot appears, a blister forms. It may be full of yellow fluid. After a day or so, the fluid turns cloudy. The blisters release liquid containing the virus, then form crusts or scabs that fall off after 1 to 2 weeks. The spots heal at different stages, some faster than others, so your child may have the rash in several different stages at once. Some children have mild chickenpox with under 50 spots. Others have a miserable time with hundreds of spots.

How do I care for my child with chickenpox at home?

• Make sure your child drinks plenty of water.
• When blisters in the mouth and throat affect drinking and eating, offer clear cool drinks and soft bland foods – avoid acidic drinks such as fruit juices. 
• Trim your child’s nails short and use mittens or clean socks on their hands to decrease the risk of infection from scratching, especially overnight.
• Dress your child in loose-fitting clothing and change the bed linen daily.
• You could try giving your child a cool or lukewarm bath but do not use soap as it can dry out your child’s skin. Try adding oatmeal, baking soda or moisturising bath lotion to the water. Pat skin dry, do not rub, after bathing.
• For many years, people have used calamine lotion to help with the itch from chickenpox and found it may relieve itching. There’s really no clear evidence around its use. Calamine is generally considered to be safe although some suggest it may dry the skin too much.
• If your child with chickenpox also has eczema, and the above steps are not controlling the itching, talk to your doctor.

Please click here for more information on how to look after your child at home and when to visit a doctor.

Eczema

Eczema is a dry skin condition. You can usually control your child’s eczema by using lots of moisturiser, a bath once a day and using steroids when your child’s skin has active eczema.

The skin of people with eczema has cracks in the barrier so is more sensitive to irritants (such as soap) and more at risk of infection. A child is more likely to develop eczema if there is a family history of eczema, asthma or hayfever. Food allergies do not cause eczema although children with eczema have a higher risk of developing food allergy.

You can easily manage most eczema at home but it needs care every day. There is no cure for eczema – just good management.

• You can print out this Eczema care plan (PDF, 254 KB) and take it with you when you see your child’s doctor. Ask the doctor to mark on the diagram where you should put moisturiser and topical steroids on your child’s skin.
• Antiseptic baths 2 times a week can help prevent infection and improve eczema. Find out how to use bleach baths. Click here to see When & How To Use Bleach Baths For Your Child With Eczema.
• Getting too hot from clothing or heating can make eczema worse – stay cool.
• Soap and fragrances are the most common triggers of eczema. Only use skin care products designed for eczema. Many are available on prescription from your doctor or nurse prescriber.
• Prevent skin infections. Eczema is made worse by infection such as from: school sores (impetigo) or the cold sore virus which can cause severe painful infection of eczema.
• Removing foods from your child’s diet does not usually help eczema. If food allergy is suspected, please talk with your doctor about this.

Please click here for more information on how to look after your child at home and when to visit a doctor.

Constipation

Constipation is when your child has hard, infrequent poo – it’s a common problem in childhood.

Your child may be constipated if they have some of the following:

• large and hard poo
• hard ‘pebble-like’ poo
• no poo for 3 or more days
• pain or crying when having a poo
• bright blood around the poo due to tears in the skin around the anus (anal fissures)
• tummy pain
• urinary tract infections, wetting pants (urine incontinence), bedwetting – constipation can increase the risk of these
• liquid poo that may leak out at times in between harder poo
• soiling accidents (encopresis)

What simple measures can I try first for my child’s constipation?

• increase the water your child drinks daily – give them water at each meal time and extra water when it is hot
• increase the fibre in your child’s diet
• increase fruit and vegetables in your child’s diet
• try giving your child 1 glass of undiluted apple juice or KiwiCrush (a kiwi fruit drink) daily – do not give juice to infants under 12 months of age
• encourage your child to sit on the toilet regularly
• for bottlefed infants, consider experimenting with various infant formulas to see if there is one that makes the poos softer and easier to do
• encourage exercise

Fruit juice (and in particular KiwiCrush), and some of the medicines used to treat constipation, are high in sugar. Make sure you or your child brushes their teeth after the juice or medicine.

Please click here for more information on how to look after your child at home and when to visit a doctor.