Thursday 18 January 2018

Symptoms you should never ignore in children

Children get sick often but what symptoms should never be ignored and when should you take action and go see a doctor? Bernice Mulligan speaks to Professor Alf Nicholson


A temperature

If your child is under three months and has a temperature, don’t ignore it, says Prof Alf Nicholson, consultant paediatrician and RCSI professor of paediatrics at Children’s University Hospital, Temple Street. “Very young babies tend not to mount temperatures easily so this could indicate a serious viral or bacterial infection.” His advice is to bring your child to your GP.

A temperature and a rash

This could indicate meningococcal disease, says Nicholson. “If you do the tumbler test – ie press a glass against the rash – and it doesn’t disappear, then get your child to a doctor immediately.” He says that time is of the essence, and that the sooner the infection is caught and treated, the less likelihood there is of your child suffering serious consequences.

Grass-green vomit

Children vomit all the time; most often in young infants it relates to gastrooesophageal refl ux, says Nicholson and it’s usually nothing to be overly concerned about. However, if your child’s vomit is a grass-green colour this is a cause for concern. “It could indicate a blockage in the bowel,” he says, “so do have it checked out.”

Excess crying

How do you know when a child’s crying is ‘normal’ or when it is indicative of something more sinister? Excessive crying is usually due to colic, says Nicholson, although this usually tapers off by six months. “Crying to take note of is crying that is different to your baby’s normal cries, ie it might be higherpitched. If the child also has a temperature, it could indicate an infection such as a urinary infection, or meningitis.”

Toddlers and young children

Acute tummy pains If your/child develops acute tummy pains that are severe and last more than four hours, this could be a sign of appendicitis, says Nicholson. “This is not to be confused with recurrent abdominal pain – also known as abdominal migraine – which many children suffer from. That is where the child has recurrent pains in the stomach generally around the belly button area but it usually settles down after an hour.” In the case of appendicitis, the pain comes on suddenly, progressively worsens and may be associated with a fever. “If the child is clearly in a lot of pain lasting more that four hours take him to your GP,” Nicholson advises.

Headaches that get worse over a short period

Headaches are very common, says Nicholson, with most of them being tension headaches brought on by stress, or in more rarer cases, migraine. “Parents worry about brain tumours but actually these are very rare in children,” says Nicholson. “However, if you child is suffering severe headaches that are getting progressively worse or if vomiting appears to relieve the headaches within a six to eight-week period, then that is worrisome and you should contact your GP about it.”

Severe reactions to food

Food allergies have risen dramatically in recent years, says Nicholson. “If your child has an immediate reaction to something after eating it, for example he has trouble breathing, breaks out in a rash or his lips start to swell, then bring him to your GP immediately for diagnosis.” Foodstuffs likely to cause an allergic reaction include eggs, fish, nuts (particularly peanuts) and milk.

Older children/adolescents

Excessive dieting/exercising

“This age group is tricky”, says Nicholson. “A lot of their issues are tied up with self-esteem and their psychological health.” However, he says an illness such as anorexia, which has the highest mortality rate of any psychiatric disorder, needs to be addressed as early as possible if serious consequences are to be avoided. “Signs to watch out for include a sudden interest in exercise, losing a large amount of weight quickly, restricting food and becoming increasingly body conscious. Early intervention is key here.” See for more information.

Symptoms linked to anxiety

A lot of children exhibit symptoms that actually suggest an underlying anxiety, says Nicholson. “When children complain of tummy pains, headaches and even chest pains it can all point to them being anxious about something else. I’d see a lot of high-achieving children complaining of tension headaches, and it could be linked with issues at school or perceived pressure to perform well.” He advises that you should talk to your child to fi nd out the underlying reason for their anxiety.

For more information on symptoms not to ignore, see When Your Child is Sick – What you can do to help, by Professor Alf Nicholson and Gráinne O’Malley. Published by Gill & Macmillan

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