Should you worry about these children’s health issues?

It’s only natural for parents to worry about their children’s health and fear the worst when they get a fever or a cough or other common childhood complaints.

All too often, they will search the internet for initial advice about how to deal with children’s health issues – but this can open up a world of misinformation, warns GP Dr Nighat Arif.

In a bid to help people get the right advice about a myriad of both children’s and adult’s health problems, Arif has written The Complete Guide to Family Health, and explains: “This is a perfect antidote to Dr Google or ChatGPT, and it came about because there was so much misinformation online.

“So this is my underpinning of more than 15 years’ worth of GP practice knowledge put into a book; a how-to health guide for your whole family – things to have in the emergency medicine cupboard, when to call 111, what red flags to look out for.

“I’ve tried to make it as simple as possible, so if you do worry about a headache, you’re not googling something that comes up with a brain tumour.”

Arif says the most common query from parents is ‘Is my child normal or not?’, often relating to their behaviour or eating patterns.

“Or it could be a simple rash, or a cough and cold – is this normal or do I need to be worried and escalate this? Could this turn into a pneumonia? Those are some of the huge concerns, and they vary so much.”

Here are some of the most common children’s health problems parents may worry about, and Arif’s advice…

Head injury

Children bang their heads with alarming frequency, but it can be hard for parents to know when it’s just a bump, or something more serious that needs checking out.

Arif says head injuries aren’t usually serious, but stresses: “Caution should be exercised with young children who can’t communicate well how they feel. Bear in mind that there may be minimal visible damage, but there could be bleeding or swelling in the brain that you can’t see.

“Head injuries in children can mean all different things – it’s looking out for what’s unusual for your child.”

She says most children with head injuries will just have bumps and bruises and recover quickly within 24 to 48 hours, but stresses that parents should monitor them and not leave them alone. “Keep an eye on them because you’re looking for concussion symptoms – that could be dizziness, loss of consciousness, vomiting, confusion, and severe headaches,” she says.

They may also have trouble walking and “feel jittery on their feet”, she says, adding: “I would say to parents, you know your child best, so keep an eye on them, and look for irritability, because young children who’ve had a head injury, especially ones that aren’t speaking yet, can’t express pain, so they might cry, and be more irritable than usual.

“With young children, look out for behavioural signs like being off their food, disinterest in toys or crying more than usual – go to A&E if you have any concerns. It’s much better to get it checked out.”

Fever

Arif points out that fevers are the body’s response to infection, and while a temperature accompanied by other symptoms may indicate something more serious, she says in many cases a fever is simply a healthy immune system reacting to an infection as it should. “It’s usually nothing to worry about,” she says.

In the book she stresses that if a baby under three months has a temperature above 38°C (100°F) or below 36°C (97°F) it’s a red flag situation where urgent medical attention is needed.

Generally, fever treatment depends on the age of the baby/child and the temperature, with a table in the book outlining what to do in various scenarios.

But Arif warns: “Fevers are more serious in babies. If you are worried, trust your instincts and go to your nearest hospital – this also applies to children over five years old and adults.”

Eczema

“I see a lot of eczema, it’s so common and it’s a bane on parents’ lives,” she says, pointing out that the main treatment is moisturising emollient creams. “Emollients, emollients, please put on repeatedly throughout the day with your child,” she stresses.

She says emollients with paraffin in are particularly good, and it’s also important to look at a child’s diet to see if that could be causing the eczema. “Could there be something you’re giving them that’s allergic?” she asks, “because the skin is the largest organ we have, but the problem can be elsewhere.

“So have a look at their milk intolerance or gluten intolerance etc, and then please go and see the doctor if the emollients need changing or we need to investigate.

“Don’t just sit on eczema, because it can be investigated further.”

Coughs

Arif says most of the patients with coughs that come to her practice have a virus. “But it can still make parents feel absolutely worried about the cough, and children can be really poorly,” she says.

Red flags to look out for in children with a cough, she says, are: have they had a temperature that isn’t coming down, even when they’ve had paracetamol, and are they drinking enough fluids? So if they’re still in nappies, monitor how often they’re wet and whether it’s a normal amount.

She stresses that viral coughs don’t need antibiotics, and warns that some coughs can last two to three weeks. If a cough lasts longer than three weeks for children or adults, it’s worth seeing a doctor, she says, as a chest x-ray may be needed to work out if the cough may be caused by something else, like undiagnosed asthma, for example.

“It’s all about TLC,” she says, “and parents are so good with their gut feeling – it’s trying to reassure them to go with their gut. If they feel their child is really struggling with breathing, come in and let a doctor have a look.”

And the doctor, who has three boys herself, stresses that parents should never be worried about overreacting to their children’s symptoms. “It’s easily done where you can miss the signs in your children – and I say that as a mother and a doctor.

“I say to parents you’re just being vigilant – you’re doing the role you’re assigned to do, assessing what’s normal and what’s not normal. Nobody knows your child better than you do.”

The Complete Guide to Family Health by Dr Nighat Arif is published in hardback by Hamlyn, priced £22. Available now.