Most young children get sick. Common Health Problems of Toddlers are
1. Common Cold (Upper Respiratory Infection, or URI)
Symptoms: Runny nose (discharge is watery at first, then thickens and becomes opaque and sometimes yellowish or even greenish); nasal congestion, or stuffiness; sneezing; often fever, especially in toddlers; sometimes, sore or scratchy throat, dry cough (which may worsen at night), fatigue, loss of appetite. Most of these, incidentally, are not true ‘symptoms’. They are part of the immune response, the body’s way of defending against illness – in this case, the cold virus.
Season: A cold can strike anytime, but occurs most from autumn to spring.
Cause: Almost always a virus. More than two hundred viruses are known to cause colds (including the rhinovirus, the parainfluenza virus, and the respiratory syncytial virus) and it’s suspected that there are may be as many as 1,500 cold viruses through previous infections, they are extremely susceptible to colds. Contrary to popular belief, going bare-headed in the winter, getting the feet wet, exposure to cold draughts, and so on, do not cause colds.
Method of transmission: Most commonly, it is believed, via hand-to-hand contact (the child with a cold wipes her nose with her hand then holds hands with a playmate at play group; the playmate runs his eye with his hand and the infection is passed on.) Also via droplet transmission from sneezes or coughs, and via contact with an object (such as a toy) contaminated by an infected person-but only as long as the moisture surrounding these droplets remains. Incubation period is usually 1 to 4 days. Cold are often passed along a day or two before symptoms appear; once the runny nose dries up, a cold is less contagious.
Duration: usually 7 to 10 days (with day 3 the worst for most sufferers); a residual nighttime cough may linger longer, however.
Treatment: No known cure, but symptoms can be treated, as necessary, with:
- Time off. It’s a good idea to keep a child home for the first day or two of a cold, when possible. It’s not necessary, however, to restrict activity; in fact, exercise stimulates production of adrenalin, which is natural decongestant.
- Saline nose drops to soften dried mucus (use those sold over-the-counter in chemists rather than making your own solution, but avoid drops containing alcohol, which can burn tender mucous membranes). You can also give warm (not hot) tap-water nose drops (3 drops in each nostril two or three times, until the nose seems clear). Drops may be most useful before your child eats or sleeps. Warm commercial saline drops to body temperature before administering them by tucking them into your pocket or inside your shirt for 15 minutes.
- Humidification to help clear nasal passages.
- Petroleum jelly (Vaseline) or a similar ointment, spread lightly on the rims of the nostrils and under the nose to help prevent chapping and soreness. But be careful not to get the ointment inside the nostrils, where it could block breathing.
- Elevation of the head of the cot or bed (by placing pillows or books under the head of the mattress) to make breathing easier.
- Warm slippers or slipper socks; when the feet are cold, the redistribution of blood flow can lead to a stuffy nose.
- Decongestants, but only if prescribed by the doctor; they tend to be ineffective in young children.
- Non-aspirin fever reducer, but only if fever is high. Check with your doctor for guidelines.
- Commercial decongestants nose drops or sprays, but only under medical supervision; used for more than 3 days, they can cause ‘rebound’, making stuffiness worse than before. Some may be toxic.
- Antibiotics, only if a secondary bacterial infection (such as middle ear infection or pneumonia) develops. Antibiotics are not effective against cold viruses.
2. Croup (Laryngo-tracheobronchitis, or LTB)
Symptoms: Spasmodic croup. sudden onset in the middle of the night, of gasping for breath, hoarseness, bark-like cough; usually no fever. There may be repeated episodes or the same night or the next 2 or 3 nights. Laryngotracheitis: cold symptoms that gradually develop into hoarseness and bark-like cough; noisy, laboured breathing; retractions (the skin between the ribs can be seen to be sucked in with each breath) as airways swell and secretions increase and thicken. There may or may not be a fever. Laryngo-tracheobronchitis: symptoms are similar to laryngotracheitis, but onset is more variable as 40 degree C/104 degree F. The child usually looks sick.
Season. Most often, autumn and early winter.
Cause. Narrowing of the airways below the vocal cords due to inflammation of the larynx and trachea, usually triggered in spasmodic croup by a combination of allergy and viral infection (though the mechanism isn’t clear); in laryngotracheitis by a viral infection (most often with a parainfluenza virus); and in larynotracheobronchitis.
Method of transmission. Depends on the cause. Parainfluenza viruses are believed to be transmitted by direct contact and by contaminated secretions.
Duration. Several days to a week. Spasmodic croup may recur.
Treatment. Steam inhalation. Or cool night air (take the child out into the fresh air for 15 minutes). Humidifying your toddler’s sleeping space may help, too. Also crucial: comfort and support to minimize crying, which could worsen the problem. In severe cases, inhaled steroids or other medical treatment to open the airways. Occasionally, hospitalization (usually brief) is necessary.
3. Diarrhoea, With or Without Vomiting
Symptom. Two or three (your child’s doctor’s guidelines may differ) or more liquidy stools in a 24-hour period; colour and/or odour may vary from unusual. Sometimes, an increase in frequency and volume of stool, mucus in the stool, vomiting and/or redness and irritation around the rectum. Weight loss, when diarrhoea continues for several days to a week. Many doctors consider diarrhoea that continues for 2 to 3 weeks top be chronic; when it persist for 6 weeks or more, it’s termed ‘intractable’.
Season. Any, but may be more common in warm weather, when more fruit is consumed and food spoils more quickly. Rotavirus – caused gastrointestinal infections, however, are more common in winter, in temperate climates.
Causes. Many causes, including microorganisms (viruses, bacteria, parasites) picked up from contaminated food or another person (directly or indirectly); excessive amounts of ‘laxative’ foods (such as fresh fruit, prunes and other dried fruit, or fruit juices, especially pear or apple, prune and grape).
Method of transmission. Diarrhoea caused by microorganisms can be transmitted via the faeces-to-hand-to-mouth route or by contaminated foods. Incubation periods vary according to the causative organism.
Duration. Acute episodes usually last anywhere from a few hours to several days; some intractable cases can last indefinitely, unless the underlying cause is found and corrected. Chronic nonspecific diarrhoea is usually outgrown by age three or four.
Treatment. Varies with cause. The most common treatment for diarrhoea with no underlying medical problem is dietary. Diarrhoea due to an underlying medical problem is treated by dealing with the problems appropriately. Antibiotics may be prescribed for bacterial and parasitic infections, but medications is not routinely given for simple acute diarrhoea.