FAQ

Fever:

Q. What is a child’s normal body temperature?

A. The normal child’s body temperature ranges between 36.5°C / 97.7°F and 37.5°C / 99.5°F.

Q. My child feels hot to touch, what should I do?

A. It is likely that your child has a fever, although they may just feel hot to touch if the weather is too warm. It is important that you measure and record your child’s temperature as your doctor will need to know how high it has been to decide how to treat your child. Iftemperature of your child’s is higher than 37.5°C / 99.5°F, It is important that you strip your child down to try and cool them down. You may also use tepid sponging if the fever persists or is higher than 38.5°C / 101.3°F. To bring the temperature down, you can give a simple medication such as Paracetamol or Crocin according to the manufacturer’s or your doctor’s or nurse’s advice. If the fever is higher than 38.5°C / 101.3°For lasts more than 2-3 days, it would be important you check with your doctor in case your child needs other treatments.

Q. What are the warning signs which tell me that I should see the doctor straight away with my febrile child?

A. The following are important warning signs which you need to keep an eye on and respond to by taking your child to be seen by the doctor or by the accident & Emergencies department: a fever in your young baby less than 3 months of age, change in color to pale or mottle or blue, unable to rouse your child or keep them awake, irritability, child making grunting noises or breathing fast or with difficulty, an unusual skin rash which does not blanch when you press on it, stiffness in the neck or bulging in the fontanelle (soft spot on your baby’s head), any abnormal movements or seizures.

Abdominal pain:

Q. My child has abdominal pain, what is the cause for this and when should I see the doctor?

A. Abdominal pain is one the most common complaints of childhood and may be a symptom of many common conditions such as gastroenteritis (tummy bug), tonsillitis (sore throat), Urinary tract infection (urine/ water infection), and constipation. Less commonly it is a symptom of a more serious condition such appendicitis or inflammatory bowel diseases. It is important to note any other accompanying symptoms such as: fever, diarrhoea, vomiting, skin rash, mouth ulcers, wetting, soiling, joint pain and swelling, symptoms of generally being unwell. In general, you should be able to give your child a simple pain killer such as Paracetamol, within the manufacturer’s or your doctor’s or pharmacist’s instructions, but you should take your child to see the doctor if they are ill/ unwell, have a fever, they are vomiting or have the other unusual symptoms.

Constipation:

Q. I was told that my child has constipation, what does this mean?

A. Constipation is the term used to describe when your child is having difficulties with opening their bowels. This can be when the stool (poo) is very hard, or when they are unable to empty their bowels regularly (less than every 2-3), or both.

Q. What can cause constipation?

A. the most common causes for constipation are: too little natural fibre in the diet (fruit and vegetables), and not enough fluid intake. Sometimes constipation can follow a severe diarrhoea’s illness or during travelling and being away from home. Excessive milk intake in an older child may also contribute to constipation.

Q. How can I treat my child’s constipation?

A. it is important that you ensure your child is receiving the correct amount of fresh fruit and vegetables every day and that they are drinking plenty of fluids such as water and juice. Toileting is also very important so that your child is training their bowels to empty regularly. Please ask your doctor for advice on this.

Q. What medications could be used to treat my child’s constipation?

A. it is best to consult with your doctor on which are the most suitable medications for your child’s constipation. It is very important to see the doctor if your child is a young baby with constipation also. The usual medications your doctor may advise on consist of a stool softening medication such as Lactulose (a sweet liquid which draws fluids into the stool to make it softer), and sometimes a stimulating medication such as Senna (which makes your child’s intestines contract more to push the stool out faster). It is important that you follow your doctor’s advice when using such medication and not to use them in excess or too long without regular follow up. Your doctor may choose to prescribe other medication depending on your child’s constipation history and how they have responded to the other measures. Please note that any medication relies on good fluid intake and fibre intake and toileting for it to work.

Diarrhoea:

Q. My child has just developed Diarrhoea, what should I do?

A. Diarrhoea in children is common, and on the whole is as a result of a viral infection. The most common virus is called Rota virus which is highly contagious, and occurs in particular times of the year. You may have already heard that your child had been in contact with another child who has diarrhoea which is very likely to be of the same cause. Occasionally, diarrhoea is caused by a bacterial infection, especially if you have recently returned from travel abroad. On the whole, treatment is supportive with plenty of fluids to be given so that your child does not get dehydrated. The best fluids are the oral rehydration solutions called WHO-ORS, which you can get from your chemist or your doctor. Do not worry too much if your child does not feel like eating, as long as you are able to get them to drink. It is important to check with your doctor if the diarrhoea is severe or lasts more than 3 days, or if your child appears listless with dry mouth and less urine produced. It is also very important to consult your doctor if you see blood or mucous in your child’s stool.

Q. My child has had diarrhoea for some time, what could be the cause?

A. Longstanding diarrhoea needs to be checked out by your doctor as it is important to find our why this is the case and if your child is affected by it in any way. Some of the causes for longer duration diarrheas are: Lactose intolerance (cow’s milk sugar intolerance), Cow’s milk allergy, wheat intolerance, Coeliac disease (a type of genetic wheat intolerance leading to malabsorption), Cystic fibrosis, inflammatory bowel disease (such as Crohn’s disease or ulcerative colitis), irritable bowel syndrome

Vomiting:

Q. My baby has been vomiting frequently, what should I do?

A. Vomiting in a young baby can be seen in a condition called Gastro-esophageal reflux (stomach reflux), which means that milk flows back up from your child’s stomach to their mouth after feeding (sometimes immediately after feeding and other times much later). It is important that you spend enough time trying to bring up your baby’s wind during and after feeding before you put them back to bed, as swallowed wind can make reflux worse. If you are concerned about your baby’s vomiting, you should consult with your doctor or nurse to find out if anything else needs to be done for them.

Q. What are the warning sign about my baby’s vomiting?

A. Most babies vomit sometimes without any underlying problems to worry about. However, it is important that you recognize some of the warning signs of other conditions which need medical attention when your baby is vomiting, and those are: excessive vomiting, projectile forceful vomiting, unusual color to the vomit (greenish, brown, blood), distended abdomen, no stools or wind passed, abdominal pain, your child looks unwell/ill. If any of these symptoms occur or you are worries about your child’s vomiting, it is important that you seek immediate medical help.

Asthma:

Q. I was told that my child has Asthma, what is this condition?

A. Asthma is a condition of the large airways in the lungs (wind pipes) which is characterized by narrowing of these airways, with extra production of secretions (sputum). The most common symptoms are: cough, wheezing, difficulty in breathing, tightness of the chest, shortness of breath. Some children have symptoms only once in a while which can be severe at times, and others may have frequent mild symptoms such as cough at night and cough on exercise only. Asthma can run in the family and you may find that other family members have one or more of the other “atopic” conditions that asthma belongs to, such as eczema and hay fever.

Q. How can I treat my child’s asthma?

A. it is very important that you follow your doctor’s or asthma nurse’s advice, as good asthma control is essential. You child may have been prescribed some inhalers which come in various colors and have different roles to play in your child’s treatment. Please ask your doctor for clarification on how to use each one of them and for how long. It is important that you have your child reviewed by your doctor regularly to ensure that the treatment is working well.

Sore throat:

Q. My child is complaining of a sore throat, what should I do?

A. Your child is most likely suffering from a viral throat infection, and you can simply treat them with Paracetamol for pain relief and with lots of liquids to drink.

Q. Does my child need antibiotics for their sore throat?

A. Antibiotics can be prescribed for a throat infection if your doctor finds evidence of a bacterial infection such as severely infected throat with pus on the tonsils (tonsillitis), or they find evidence of bacteria on a throat swab (a test to check if there are bacteria on the throat by taking a swab from the throat). Your doctor will be the best person to advise you on this.

Q. What other conditions than tonsillitis can give my child a sore throat?

A. Most viruses that cause cold/flu-like symptoms can cause a sore throat and a cough. There is another condition called glandular fever, which is also caused by a virus, which and can give your child a sore throat and enlarged glands in the neck. Your doctor can decide if this is the case or if your child needs any tests to confirm this diagnosis.

Ear infection:

Q. I think my child has an ear infection, what should I do?

A. You may notice that your child is in pain and pulling on their ear, or you may notice that there is a discharge from their ear. As you will not be able to tell yourself if your child needs any specific treatment for this, it is best to check with your doctor. The doctor will be able to have a look inside your child’s ear and decide if they need any treatment such as antibiotics or ear drops.

Chest infection:

Q. I heard about chest infections, how can I tell if my child has one?

A. A “chest infection” is a broad term used by doctors to describe various chest conditions, the majority of which are caused by a virus. The symptoms are of a fever, cough, chest pain, and crackles heard when your child is breathing. They may also complain of difficulty in breathing. This infection may also be caused by bacteria and if so will need antibiotics to treat it. Your doctor will know if your child has this type of infection by listening to their chest and advising on what the best treatment is. If you think your child might have a chest infection, it is important that you check this out with your doctor.

Q. My doctor said that my child has “pneumonia”, what does this mean?

A.  Pneumonia is a type of chest infection where it is most likely caused by bacteria. Nowadays, this can be treated very successfully with the modern antibiotics available. Many children can even be treated at home with oral (medicine) antibiotics, but some may need to be admitted to hospital for the antibiotics to be given through a drip in the child’s vein. Your doctor will decide which is the best treatment for your child, and will advise for how long to give the antibiotics for. It is very important that you follow your doctor’s advice and give the full treatment course to make sure that your child gets better from their pneumonia.

Urine infection, Cystitis, Kidney infection:

Q. What is a urine infection?

A. This is an infection that can affect any part of your child’s urinary tract (waterworks). Its symptoms depend on which part of the urinary tract is affected but the most common are: burning sensation when passing urine (dysuria), blood in the urine (Haematuria), smelly or cloudy urine, abdominal pain, back or loin pain, fever, wetting. Some young children can get very unwell with a urine infection and may develop a febrile convulsion with it.

Q. What are the types of a urine infection?

A. The types of a urine infection depend on which part of the urinary tract they occur. Cystitis is an infection of the bladder, a pyelonephritis is an infection of the kidney, a balanitis is an infection of the foreskin, and a vulvovaginitis is an infection of the female genital area.

Q. How can the urine infection be confirmed/ diagnosed?

A. You will be asked by your doctor or nurse to collect a urine sample from your child. This needs to be done in a very clean way and the urine collected in a special sterile urine pot. Once the urine is collected in such a way, this will be tested straight away by a urine dipstick test and will also be sent to the lab for further analysis to confirm the diagnosis. Your doctor will be able to tell you if the initial test suggest an infection and advise you on what to do. The lab analysis usually takes up to 2 days for the results to come back.

Q. How can my child’s urine infection be treated?

A. The usual treatment method is with the appropriate antibiotics which your doctor will advise you on. In addition it is very important that you make sure your child is drinking plenty of fluids, and passing urine regularly to clear the infection. If your child has constipation it is also very important to treat this as well.

Q. Will my child need any further tests now that they had a urine infection?

A. Your doctor is the best person to advise you if your child needs any further tests such as a kidney scan. Usually if your child’s infection was simple and happened only once, then no further investigations are necessary. However, if your child was unwell with the infection or took a long time to get better or they have had several infections that your doctor is likely to advise on some further tests to check out why your child has had this problem.

Q. What other tests will my doctor request to investigate my child’s urine infection?

A. The most common test to request would be an ultrasound scan (jelly on the belly scan), which is a simple and non-invasive test that can show if your child has any anatomical problems with the kidneys or bladder associated with the infection. Your doctor can then decide if further tests are needed to investigate the urine infection further.

Q. What are the associated conditions with a urinary infection in a young child?

A. The most common associated condition with a urine infection in a child is vesico-ureteral reflux (kidney reflux), where the urine flows up from the bladder into the kidney during bladder filling and/or emptying. Other conditions known to be associated with a urine infection are: pelvi-ureteric junction obstruction (PUJO), Vesico-ureteric junction obstruction, ectopic ureter and aureterocele. You will be informed by your doctor if any of these diagnoses apply to your child and if any further treatments are needed.

Wetting, incontinence:

Q. My child is 7 years old and still wetting the bed, what can I do?

A. You need to discuss this problem with your doctor. Most commonly bedwetting (nocturnal enuresis) is a simple and self-limiting condition which can respond to simple measures such as:

  1. Improving fluid intake during the early part of the day and at school while reducing the fluid intake in the afternoon and evening.

  2. Avoiding diuretic drinks such as coffee, tea, and cola and avoiding fizzy drinks.

  3. Regular daytime toileting and bladder emptying, treatment of constipation.

  4. Remove your child’s nappy or pull-ups.

Q. What are the signs that my child’s wetting needs a doctor’s attention?

A. it is important to seek medical help if your child is wetting with any of the following features:

  1. Your child started to wet again after having been dry for a while (secondary incontinence)

  2. If your child has had a urine infection

  3. If your child has blood in the urine

  4. If your child has daytime wetting (incontinence) as well

  5. If your child has to use the toilet very urgently (urgency, urge incontinence) and many times a day (frequency)

  6. If your child has soiling (stool in the pants)

  7. If your child has excessive drinking and is passing a lot of urine by day and night

Q. What are the types of childhood daytime wetting problems?

A. Children can have daytime wetting (incontinence) due to a variety of conditions such as:

  1. Detrusor over activity: an overactive bladder where the child feels the need to use the toilet many times (more than 6 times a day) and urgently and may have daytime with or without night-time wetting.

  2. Lazy bladder: where the child empties their bladder infrequently (less than 4 times a day), and they may not empty their bladder fully each time.

  3. Giggle incontinence: where your child only wets when they are giggling.

Q. How will my doctor know which type of wetting my child is suffering from? 

 A. your doctor will ask you many questions about your child’s wetting and urine habits as well as their general health, growth and development. It is also important for her to know if there is any family history of kidney conditions or other illnesses such as high blood pressure (hypertension) or diabetes. It is also likely that you may not remember accurately how often your child empties their bladder and how severe the wetting is, or if they are passing small or large amounts of urine, so your doctor will ask you to keep a diary of your child’s urine habits (how often they empty their bladder and how much urine they pass each time, and if they are wet before or after passing urine).

Q. How can I help my child stop wetting by day?

A. The management of your child’s wetting (incontinence) should always consist of the following simple measures:

  1. Improving fluid intake during the early part of the day and at school while reducing the fluid intake in the afternoon and evening.

  2. Avoiding diuretic drinks such as coffee, tea, and cola and avoiding fizzy drinks.

  3. Regular daytime toileting and bladder emptying (bladder re-training). You can use positive feedback to achieve this (positive praise, star charts, and reminders).

  4. Treatment of constipation.

Q. Will my child need any further treatments to manage their wetting?

A. Your doctor will decide if your child’s wetting could benefit from any further medications or treatments. The types of treatments that are available for the various wetting problems are:

  1. Desmopressin (Desmotabs® or Desmomelts®), which is used to treat night-time wetting (nocturnal enuresis) where your child’s urine production at night is large. Your doctor will advise you if this is suitable for your child and at what dose to give it.

  2. Anticholinergic medications: (Oxybutinin, Oxybutinin XL, Tolterodine), which are used to treat detrusor overactivity (daytime wetting). Your doctor will advise you which is the most suitable for your child and at what dose to use it.

  3. Enuresis Alarm: Your child may also benefit from using a special alarm at night to treat their night-time wetting (nocturnal enuresis), and this is called the enuresis alarm.

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