My 18-month-old daughter started attending a creche this year. She seems to be sick all the time and I have had to attend the doctor regularly. Her nose is running and she coughs a lot. My GP tells me most of these infections are viruses and hasn't prescribed anything to help. I really feel antibiotics would be a good idea and I've asked to have a prescription at home just in case but my doctor said this isn't a good idea. What should I do to keep my daughter healthy?
THE first year in creche can be a tough one for most parents, especially if it is your first child. Years ago, children used to pick up infections in their first year in school but now, as many have attended some form of childcare prior to this, we are seeing infections in the younger age group.
A certain amount of this is to be expected with children, especially babies and toddlers, who are in close contact in a creche setting.
I see parents regularly who think there is some serious underlying problem with their child's immune system due to frequent respiratory infections. Most children will be found to be perfectly healthy.
There are a few things you can do to help your child. Firstly, and most importantly, ensure their childhood vaccines are up to date and given on time.
Observe the creche environment: is it clean? Are cots assigned to each child so that sheets etc aren't being shared? Is there good hand-washing practice? What is their policy on admitting sick children?
Ideally children should be fever free for 24 hours before coming back, or 48 hours free of diarrhoea or vomiting. A good creche will inform you about any illness.
The home environment is equally important. All smoking and smoke exposure should be banned. Wash hands well at all nappy changes and if anyone at home has a cold or flu they should avoid really close contact (ie cuddling) with the baby or toddler. Rest assured though that a runny nose or cough is actually a sign of your child's immune system fighting back.
I agree with your doctor about the use of antibiotics. Most coughs, colds and sore throats occur due to viruses and antibiotics will not help in this case. There is a serious overuse of antibiotics worldwide.
Antibiotics are a group of medicines that kill bacteria. When used correctly they can be life-saving. The problem is that as we use more and more antibiotics, bacteria are becoming more and more clever and developing ways to become resistant to what have been lifesaving drugs.
Neither are antibiotics universally safe. Side-effects from the use of these can be a common cause of attendance to A&E departments. Severe allergic reaction to antibiotics can be life threatening.
Diarrhoea from antibiotics can cause dehydration and destroy healthy gut bacteria that aid with digestion and well-being. Antibiotics can interact with other medication making them less effective.
It is very important to only take antibiotics that have been prescribed.
Having a just-in-case antibiotic may result in using the wrong drug, which may cause more problems than it solves.
On the flip side, if you have been prescribed an antibiotic it is really important that you take it as directed. Partially treating an infection may give the bacteria just enough exposure to the antibiotic to become resistant whereas completing the course is likely to kill it.
So, it sounds like your child is a generally healthy toddler whose immune system is growing and gaining strength.
I don't think you need prescriptions at home. For now I would advise giving over-the-counter remedies such as paracetamol or ibuprofen for fever, and using nasal rinses and sprays to clear her nose.
Do stay in touch with your doctor. Ultimately he or she has your and your baby's best interests at heart.