Most Common Childhood Illnesses

Introduction

Childhood is a time of growth, exploration, and discovery, but it is also a period when children are more susceptible to various illnesses. As parents and caregivers, understanding the most common childhood illnesses is crucial for timely intervention and providing the best care for our little ones.

In this blog post, we’ll look further at some of these frequent childhood illnesses, their causes, symptoms, and what parents and caregivers can do to help a child recover swiftly.

The common cold

The common cold is a viral infection of the upper respiratory tract that frequently occurs in children, especially those younger, as their immune systems are still developing. According to NICE, children experience an average of 5–8 colds annually.

Rhinovirus is the most common cause of a cold and can enter the body via the mouth, nose or eyes. It can spread in the following ways:

• Direct contact – an infected individual touches another person, and then an uninfected person touches their nose, eyes or mouth.
• Sharing objects – an infected individual can transfer the virus onto shared items like towels and household items.
• The air – when an infected person sneezes, coughs or talks, droplets containing the virus can become airborne and inhaled by others.

According to the NHS, the virus can live on hands and surfaces for 24 hours.

In most cases, infected individuals are contagious for two to three days before their symptoms show and can infect others until their symptoms have gone.

Adopting good hygiene practices can prevent the cold virus from spreading, e.g.:

• Regular handwashing with soap and water by the whole family.
• Sneezing and coughing into tissues and putting them into the bin as soon as possible.
• Cleaning and disinfecting contact surfaces, such as door handles, regularly.
• Not sharing objects or household items.

Symptoms of the common cold come on gradually and can include:

Main symptoms

• Sore throat.
• Blocked or runny nose.
• Cough.
• Sneezing.
• A raised temperature.
• Generally feeling unwell.

Less common symptoms

• Aching muscles.
• Headache.
• Earache.
• Ear/face pressure.
• Loss of smell/taste.
• Reduced appetite.
• Mild tiredness and irritability.
• Difficulty sleeping.

Adults and children develop the same symptoms, but they may last longer in children.

If a child has a cold, the following can help to alleviate their symptoms:

• Rest.
• Drink plenty of fluids.
• Painkillers, e.g. child paracetamol or ibuprofen. Check with a pharmacist, GP or health visitor first, especially if a child has asthma, as ibuprofen may be unsuitable. Always read the instructions on the packet and the patient information leaflet.
• Saline nasal drops can help loosen mucus and relieve congestion in the nose.

Note: only use over-the-counter remedies if recommended by a GP or pharmacist.

According to the NHS, most colds get better in 5 to 7 days but can take up to 2 weeks in small children.

If parents or caregivers are concerned the child’s symptoms are not improving after three weeks or are worsening, they must always trust their instincts and contact their GP or phone the NHS helpline 111 for advice.

Influenza (flu)

Influenza (flu) is a highly contagious viral infection caused by one of three types of influenza virus (A, B and C) that infects the respiratory tract. It is more common in winter, especially between December and March.

The influenza virus is not the same as common cold viruses. However, it can be spread the same way, e.g. via direct contact, indirect contact or in the air when someone sneezes or coughs.

Flu is a serious illness, especially in younger children and those with asthma. It can cause complications such as ear infections, acute bronchitis and pneumonia. According to the UK Health Security Agency, flu hospitalisation rates are highest in the under 5s. In the winter of 2022/23, more than 10,000 children stayed in hospital with the illness.

A flu vaccination (via nasal spray or injection) is recommended for children, as they are particularly vulnerable to the flu. The UK Health Security Agency has five reasons why it is important to get children vaccinated here.

Flu symptoms are similar in adults and children. They can include some of the following:

• Sudden high temperature (fever).
• Severe body aches.
• Clear nose or stuffy nose in some cases.
• Extreme tiredness or exhaustion.
• Dry cough.
• Sneezing.
• Sore throat.
• Headache.
• Difficulty sleeping.
• Loss of appetite.
• Diarrhoea or tummy pain.
• Nausea and vomiting.
• Ear pain and less activity (seen in younger children).

It can often be difficult to differentiate between the flu and the common cold, especially if a child is not yet talking. Here are some ways to tell the difference:

• Flu symptoms come on quickly, e.g. within a few hours, whereas cold symptoms develop gradually.
• Children can usually carry on normally when they have a cold but will be too unwell and tired if they have the flu.
• A cold tends to affect just the nose and throat, but the flu affects more than this.

Flu symptoms typically worsen after 1-2 days; most fully recover after 2-7 days. Some symptoms may persist for a while after others have gone, e.g. persistent cough.

There is no cure for the flu. However, parents and caregivers can help children feel comfortable by:

• Keeping them home in the warmth to rest and sleep.
• Ensuring they drink plenty of fluids to avoid dehydration. Their urine should be clear or light yellow.
• Trying to get them to eat some small meals, such as soups.
• Giving them child paracetamol or ibuprofen if a GP, pharmacist or health visitor says it’s ok. The treatments will depend on a child’s age, symptoms and general health. It is important to note that antibiotics will not work for the flu, as it is a viral infection. Antibiotics are for bacterial infections.

If a child’s symptoms worsen, they do not improve after a week, or there are any other concerns, the advice is to use the NHS 111 online service initially or phone 111 if they are under five or help is unavailable online.

Call 999 or go to A& E if the child has any signs of breathing difficulties, chest pain or coughing up blood.

Ear infections

Ear infections are very common in children, especially those younger, between six months and two years. Their eustachian tubes, which allow for drainage, are narrower than adults and do not function optimally, which can cause fluid to build up behind the eardrum, increasing the risk of infections.

Bacteria, viruses or fungi can cause ear infections in children and affect their middle ear (acute otitis media) or outer ear (otitis externa). In some cases, ear infections can occur after a cold, as germs can travel from the throat to the middle ear.

According to Patient Info, most children will have two or more episodes of otitis media before they are five years old, and 9 out of 10 children will have had an ear infection before they start school.

Symptoms of ear infections in children come on quickly and can include:

• Inner ear pain.
• High temperature.
• Nausea and vomiting.
• Cough.
• Ear discharge.
• A lack of energy.
• Hearing difficulties.
• Fullness and pressure inside the ear.
• Irritation and itching around and in the ear.
• Scaly skin around and in the ear.

Parents and caregivers may be able to identify a child has an ear infection from the following signs:

• Pulling, tugging or rubbing of their ear.
• Crying.
• Fussiness.
• Unresponsive to certain sounds.
• Irritability.
• Restlessness, especially at night.
• A lack of appetite or feeding difficulties.
• Losing balance.

Most ear infections in children will clear up within three days, but some may experience symptoms for up to a week and even hearing loss for a while. It is best if the child stays at home and avoids contact with others until they are better, especially if they have a high temperature.

There are several treatment options to alleviate a child’s symptoms, for example:

• Putting a cold or warm flannel on their ear.
• Wiping their ear with cotton wool to remove any discharge.
• Giving them child paracetamol or ibuprofen (not both together, unless advised by a GP or other healthcare professional). Never give aspirin to children under 16 years old.

Doctors will not usually prescribe antibiotics unless the infection has not cleared in three days, fluid is coming out of the ear, or there is a risk of complications.

Parents and caregivers may need to see their GP if the child is:

• Not better after three days.
• In a lot of pain.
• Getting pus or fluid coming from their ear.
• Getting regular ear infections.
• Having hearing issues that are not improving within a few weeks.
• Suffering from underlying health conditions, e.g. cystic fibrosis or congenital heart disease.

Stomach viruses (gastroenteritis)

Another common illness in children is gastroenteritis, an intestines (gut) infection. According to Patient Info, many children have more than one episode of gastroenteritis in a year.

Bacteria, viruses and other germs can cause gastroenteritis. However, viruses (rotavirus and adenovirus in particular) are the most common causes in children in the UK. It is also known as viral gastroenteritis or stomach flu.

Stomach viruses can easily spread in the following ways:

• Directly touching.
• Through food, i.e. if an infected person prepares or handles it.
• Touching surfaces and objects that an infected individual has touched.
• Not washing hands after going to the toilet.
• Sharing towels, flannels, etc.
• Swimming pools.

The main symptoms of gastroenteritis are:

• Sudden, watery or loose diarrhoea (may contain blood or mucus).
• Nausea.
• Vomiting.
• Mild fever.

Children may also experience:

• A high temperature (fever).
• Tummy pains and cramps.
• Headache.
• Body aches, especially their limbs.

Symptoms usually occur a day after infection and last less than a week (5-7 days for diarrhoea and 3-4 days for vomiting). In some cases, they can last longer.

In most cases, you can treat children with gastroenteritis at home, and medicines are not typically required, as it will clear by itself. If a child has severe gastroenteritis, they are at risk of dehydration. The signs to look out for are as follows:

• Urinating less.
• Sunken eyes.
• Dry mouth, tongue or lips.
• Unusually tired or irritable.
• Mottled skin.
• Cold hands and feet.

If a child has signs of dehydration or is becoming dehydrated, contact a GP or NHS 111 urgently for advice. If they become unresponsive, dial 999 or go to A&E.

Parents and caregivers should encourage children to drink plenty of fluids frequently and in small amounts, e.g. milk, diluted juice or squash (not with sweeteners). Avoid fizzy drinks, high-energy drinks and undiluted fruit juices. Keeping a record of drinks and urination times is also advised.

Streptococcal pharyngitis (strep throat)

Streptococcal pharyngitis (strep throat) is an infection of the throat and tonsils with a bacteria known as Group A Streptococcus (GAP) or Strep A. Infections with this bacteria are more common in children than adults, and it can cause other conditions, such as:

• Scarlet fever.
• Impetigo.
• Cellulitis.
• Tonsillitis.

Strep A is very contagious and is transmitted by:

• Touching an infected person, especially their skin sores or fluid from them.
• Sharing items or touching surfaces an infected person has touched and touching your mouth or nose.
• Respiratory droplets from an infected person when they cough or sneeze.

If a child has strep throat, they may have the following symptoms:

• High temperature (fever).
• Swollen tonsils with white patches or streaks.
• Tiny, red spots in the mouth.
• Sore red throat.
• Chills.
• Swollen lymph nodes in the neck.
• Aching body.
• Headache.
• Pain when swallowing.
• Difficulty swallowing food and water.
• Appetite loss.
• Nausea and vomiting, especially in younger children.

Most strep A infections are mild and are easily treatable. However, there are instances where it can be serious and cause complications, e.g. pneumonia or a bloodstream infection (sepsis). It can also result in a life-threatening condition, invasive group A strep (iGAS).

If a child has any of the above symptoms, parents or caregivers should contact their GP or NHS 111 as soon as possible, as prompt diagnosis and treatment with antibiotics is key in reducing the risk of complications.

Hand, foot, and mouth disease (HFMD)

Another common illness in children is hand, foot and mouth disease (HFMD), a viral infection caused by the Coxsackie virus that spreads like the other viruses we have covered here. It should not be confused with the virus that causes foot and mouth disease in cattle, sheep and pigs.

Younger children are more likely to get HFMD, especially those under ten years old, and symptoms are usually worse in children under five.

Symptoms are typically seen between 3-5 days after infection.

Initial symptoms can include:

• High temperature (fever).
• Sore throat and mouth.
• Generally feeling unwell.
• Loss of appetite.
• Cough.
• Abdominal (tummy) pain.

Symptoms after a few days may include:

• Painful mouth blisters and ulcers.
• Spots or blisters on the hands and feet, and occasionally on the bottom and thighs.

While HFMD is unpleasant, the infection is typically mild and will clear within 7-10 days. Antibiotics and other medicines will not cure HFMD. However, there are some actions parents and caregivers can take to help children manage their symptoms and discomfort, such as:

• Ensuring they drink plenty of fluids to prevent dehydration, but not acidic drinks, e.g. fruit juices.
• Encouraging them to eat, but avoid anything hot and spicy. Give them soft foods, such as soups, yoghurts and ice creams.
• Giving them children’s paracetamol, ibuprofen or mouth ulcer gels, sprays and mouthwashes to help alleviate their temperature and pain. Always read the patient leaflet or check with a pharmacist.

If parents or caregivers suspect HFMD, they should check with their GP before visiting the surgery, as it can spread to other people, especially within the first five days. It can spread through coughing, sneezing, poo and fluid within the blisters.

Prevent HFMD from spreading by ensuring:

• The whole household regularly washes their hands with soap and water.
• The child sneezes and coughs into tissues. The tissues should be disposed of as soon as possible.
• You wash any soiled clothing and bedding on a hot wash.
• Towels, flannels and eating/drinking utensils and dishes are not shared.
• The child stays at home and off school and nursery while they feel unwell. The blisters do not have to be fully healed, so they can return to school or nursery when they feel better.

Allergies

When a child has an allergy, their body reacts to a typically harmless substance, such as food, pollen, house dust mites, animal fur and certain medicines. According to Allergy UK, 40% of children in the UK have been diagnosed with an allergy, and four common ones are:

• Food allergies – according to NICE, food is a common trigger in children, especially if food allergies run in the family or a child has eczema. There are 14 food allergens that are more likely to cause an allergic reaction, e.g. nuts and cow’s milk.
• Eczema – also known as atopic eczema or atopic dermatitis occurs in children with allergies and causes skin dryness, itchiness, and redness.
• Asthma – children can have different types of asthma. In allergic (atopic) asthma, symptoms are caused by exposure to allergens, such as pollen, animal fur, dust mites, etc.
• Hay fever – children can develop allergies to grass, tree or weed pollen. It affects 10 –15% of children in the UK (Allergy UK).

After a child comes into contact with a substance they are allergic to (a trigger), their immune system sees it as a threat, overreacts and releases chemicals, including histamine. It is these chemicals that cause symptoms, known as an allergic reaction.

Parents and caregivers can recognise allergic reactions in children by looking out for the following symptoms:

• An itchy, runny or blocked nose.
• A scratchy or itchy mouth or throat.
• A flushed face.
• Mild swelling of their face, lips or eyes.
• Sneezing.
• Coughing, wheezing or breathlessness.
• Cheek, eye or forehead pain or tenderness.
• Itchy skin or a red raised rash (hives).
• Nausea, vomiting, stomach cramps and diarrhoea.
• Red, itchy, watery eyes.
• Worsening of asthma or eczema symptoms.

The above symptoms tend to be mild/moderate and typically develop with a few minutes of allergen exposure, but some may come on gradually over a couple of hours.

A child may have a severe allergic reaction, known as anaphylaxis, which can be life-threatening. The symptoms come on quickly and can include:

• Other allergy symptoms, as above, but more severe. These tend to develop first.
• Swollen tongue and throat.
• Breathing difficulties, chest tightness, wheezing, noisy breathing and coughing.
• Difficulty swallowing or speaking.
• Bluish tinge to the lips and tongue.
• Increased heart rate and palpitations.
• Clammy skin.
• Dizziness or lightheadedness due to a sudden drop in blood pressure.
• Confusion, irritability and anxiety.
• A sense of impending doom.
• Collapsing and unconsciousness.
• Floppiness, limpness  and unresponsiveness

Always phone 999 or go to the nearest A&E if a child is showing symptoms of anaphylaxis, as they will need hospital treatment.

If a parent or caregiver suspects a child has an allergy, they should contact their GP, who may arrange for the following tests:

• Skin prick or patch – putting small amounts of allergen onto the skin.
• Blood tests – checking for specific antibodies in the blood that respond to allergens.
• Special diet – avoiding or eating less of certain foods to see if symptoms improve.

Managing a child’s allergy will depend on what they are allergic to and the severity of their symptoms. They will usually be given an allergy management plan that details how to manage their condition.

Allergy UK has further information on allergies in childhood on their webpage here.

Asthma

Asthma often starts in childhood but can affect individuals of all ages. It is a condition that affects the lungs and can result in breathing difficulties in sufferers. According to Allergy UK, approximately 1 in 11 children (1.1 million) in the UK are affected.

The exact causes are unknown, but there are many different types, such as:

• Allergic (atopic) – triggered by allergens like pollen, animal fur and dust mites.
• Non-allergic – not triggered by allergens. It usually affects people later in life, but some children can be affected.
• Exercise-induced – caused by exercise.
• Seasonal – having it at certain times, such as winter or during hay fever season.
• Childhood – occurs in childhood but disappears or improves with ageing.

The main symptoms can include:

• Breathlessness.
• Wheezing.
• Chest tightness.
• Coughing.

An asthma attack is when the above symptoms get worse and can also include the following if severe:

• Unable to eat, speak, walk or sleep due to breathlessness.
• Tummy ache.
• Faster breathing.
• Increased heart rate.
• Blue fingers or lips.
• Exhaustion.
• Confusion.
• Dizziness.
• Drowsiness.
• Fainting.

According to the NHS, asthma attacks are responsible for three deaths daily and are medical emergencies. Asthma + Lung UK has advice on what parents and caregivers can do if a child has an asthma attack.

If a parent or caregiver suspects a child has asthma, they should see a GP, as they must manage their condition to prevent asthma attacks. The management needed will depend on the asthma type, but most are managed by:

• Using a preventer inhaler daily.
• Using a reliever inhaler if they have asthma symptoms.
• Having a written asthma action plan specific to each child.
• Having regular asthma reviews with a GP or asthma nurse.

An asthma action plan is essential for any child diagnosed with asthma, as it helps parents and caregivers manage symptoms and has all the information in one place. It should include:

• Daily actions to ensure the child is well.
• Actions to take if the child’s asthma worsens.
• What to do in the event of an asthma attack.

Further information on managing asthma in children is on Asthma + Lung UK.

Conclusion

Understanding common childhood illnesses can help parents and caregivers look out for the symptoms to ensure children get the correct diagnoses and treatments. It also helps them better manage their children’s illnesses so they can recover more quickly and comfortably.

Most childhood illnesses are mild or moderate and are treatable at home. In more serious cases, understanding the symptoms and knowing what to do in an emergency can reduce the risk of complications and things taking a turn for the worse.

If parents and caregivers have concerns about their children’s illnesses, they should always trust their instincts and contact healthcare professionals for advice.