Quick facts
- 40% of children test positive for strep bacteria in their throats
- Children catch up to 10 colds a year
- Most infections pass quickly and can be treated at home
Colds, sickness bugs and other infections are more common in winter — especially in children. But contrary to popular belief, it’s not actually the cold weather that causes them.
‘It’s because we spend more time indoors,’ says Dr Tommy Södergren, Livi paediatric consultant. ‘The air is drier, which encourages viruses, and we have more close contact with friends and family — which helps infections spread.’
Children are particularly vulnerable, even when social distancing and other national restrictions put a limit on social contact. This is largely because, however hard you try, their hygiene habits may not always be ideal and they’re probably exposed to lots of other children at school.
Dr Södergren has advice on how to spot 7 of the most common winter illnesses, and what to do.
1. Colds, coughs and sniffles
Children catch up to 10 colds a year, so it’s likely your child will experience at least 1 this winter.
While it takes a couple of days for cold symptoms to appear, they’re usually worse in the first 2-3 days. This is also the time when your child will be most likely to pass on the virus, though they will be infectious for around 2 weeks.
How to spot colds in children
Symptoms like coughing, runny nose, congestion and sneezing are caused by swelling of the mucosa (the moist, inner lining of the mouth, nose and lungs) as well as build-up of fluid in these areas. This is an immune response designed to make life uncomfortable for the virus and, ultimately, clear it.
What to do
Infants don’t have the capacity to cough and clear mucus from their airways, so keep their heads and shoulders elevated, Dr Södergren says. Saline nasal sprays and drops can be used to ease congestion.
Give paracetamol for symptom relief, and plenty of fluids. Colds are caused by viruses, so antibiotics have no effect.
2. Flu
Flu is most infectious when symptoms first start, and remains infectious for up to a week.
How to spot flu in children
It’s difficult to tell the difference between a severe cold and a mild case of flu, says Dr Södergren. But you tend to get more fever with flu, and it often starts with a dry cough. This can persist for 2 weeks, or more. Other symptoms include headache, muscle and joint pain, generally feeling unwell, sore throat and a runny nose. To relieve symptoms, use the same relief as for colds.
Is it flu or Covid-19?
Children with Covid-19 tend to have mild symptoms, and a third have none. Apart from cough, fever and losing their sense of smell and taste, the most common clues in children are diarrhoea, vomiting and abdominal cramps.
Although children are more likely to catch the new variant of Covid-19 which first emerged in the UK, the good news is that most continue to show mild or no symptoms. And, there is no evidence that it causes more serious illness.
Speak to a GP if you suspect your child has Covid-19, or has any of the red-flag symptoms below.
3. Respiratory syncytial virus (RSV)
RSV is a common virus which infects the lower respiratory tract. Almost all children will be infected with RSV before they are aged 2 and, in most cases, it causes only mild cold symptoms.
Dr Södergren says in adults and older children, it’s difficult to tell the difference between RSV and a mild cold.
What to do
For most people, this is simply a matter of treating symptoms, says Dr Södergren (see Colds, coughs and sniffles, above). However, for some children the RSV virus will turn into bronchiolitis (see below).
4. Bronchiolitis
Bronchiolitis is a more serious inflammation in the smallest airways in the lungs. In babies and young children, where the lower respiratory tract is still developing, the RSV virus can lead to bronchiolitis.
How to spot bronchiolitis in children
Symptoms of bronchiolitis include a rasping dry cough, rapid or wheezy breathing, being irritable, not wanting to feed and vomiting after feeding. Symptoms are at their worst from days 3-5 and can last for up to 3 weeks.
What to do
Keeping your child upright will make it easier for them to breathe. Try giving smaller, more frequent feeds. Infants over the age of 2 months can be given paracetamol for fever. Steam will also help to loosen mucus.
Speak to a doctor if your child has taken less than half their usual feed for 2 or 3 feeds, is breathing rapidly, has not had a wet nappy for 12 hours or more, or has a persistent temperature of 38C or higher.
5. Ear infection
Ear infections can be painful for children, especially at night. Almost all ear infections that occur in children are secondary bacterial infections in the middle ear, which can follow a viral infection such as a cold or flu.
How to spot ear infections in children
Excess liquid produced in the ear usually drains away through a tiny tube to the throat, but if this becomes swollen and blocked, fluid builds up. Viral infections cause inflammation in this tube and make it easier for bacteria to travel up and infect the fluid. The main symptom will be ear pain at night.
What to do
Dr Södergren advises using alternating doses of both paracetamol and ibuprofen if one alone doesn’t work. Anything that clears congestion will also help.
‘In the old days, we used to prescribe antibiotics, but we know now that most infections clear in around 3 days,’ he says.
Speak to a GP if there is any fluid coming from the ear, as this is a sign that the eardrum has been perforated, if there is no sign of improvement after 2 or 3 days or your child is in a lot of pain.
Antibiotics may be prescribed if your child is very unwell, has symptoms of a more serious illness or is at high risk of complications.
If ear infections recur, your doctor may recommend inserting tiny tubes, called grommets, into the eardrum to drain fluid and equalise pressure, but there is no evidence that antibiotics help with recurrent infections.
6. Strep throat
Streptococcus is a bacteria that causes a sore throat and is widespread in children.
How to spot it
Your child will have a sore, red throat and is also likely to have fever, headache and swollen glands in the neck and below the jaw.
‘If you went into any school and tested children for strep, almost 40% would be positive,’ says Dr Södergren. And even if they had a sore throat, that doesn’t mean you would treat them with antibiotics as most infections clear up by themselves, he asserts.
What to do
Treat symptoms with paracetamol and provide plenty of cool drinks. There is no evidence that medicated lozenges help, but sucking on hard sweets or an ice lolly will soothe symptoms.
Viruses are the most common cause of sore throats, and usually antibiotics won’t help these infections.
But speak to a doctor if symptoms persist, as occasionally strep infections do require antibiotics.
7. Norovirus (Winter vomiting bug)
Norovirus is a highly infectious stomach bug that peaks during winter. While anyone can catch it, children in particular can easily pick it up because they share toys, spend a lot of time in close contact with friends and carers, and often put their hands in their mouths.
How to spot norovirus in children
Symptoms start within a day or 2 of being infected and usually include nausea, diarrhoea and vomiting — which is more common in children than adults. It can also cause headache, a high temperature and aching arms and legs.
It usually only lasts a couple of days, but people can be contagious for up to 2 days after symptoms pass.
What to do
In the meantime, Dr Södergren advises encouraging children to keep drinking fluids, but don’t stress if they only take small amounts, and avoid milk.
Speak to a doctor if your child is weak, or tired and is not interested in play.
How to prevent winter infections
Ultimately the only way to prevent your child catching winter bugs is to keep them away from their friends and family. But you can reduce the risk by:
- Avoiding anyone with obvious symptoms
- Encouraging your child to wash their hands after using the toilet and before meals
- Discouraging them, if possible, from putting their hands in their mouth, chewing their nails, or rubbing their eyes
- Cleaning toys, chairs and work surfaces regularly
- Making sure they are eating healthily and getting plenty of exercise
- Encouraging the whole family to cover their nose and mouth with a tissue when they cough or sneeze — and to wash their hands after binning the tissue
- Following social distancing and hygiene regulations in your area
If occasional colds and coughs are inevitable for children, know that there are also several steps you can take to support your child’s immune system.
Red flag symptoms — when to see a doctor
Parents should seek immediate advice if their child:
- Is under 3 months old and has a temperature of 38C or higher
- Is 3 to 6 months old and has a temperature of 39C or higher
- Has had a high temperature for 5 days or more
- Has a high temperature which does not come down with paracetamol
- Has signs of dehydration
- Keeps vomiting and can’t keep fluids down
- Has diarrhoea for more than 7 days or vomiting for more than 2
- Breathing difficulties, shallow breathing or any other change in their breathing
- Has a rash that doesn’t fade when you press a glass against it
- Is bothered by light
- Is drowsy and difficult to wake
- Has unusually cold hands and feet
- Has pale, blotchy, blue or grey skin
- Has a weak, high-pitched cry that is not like their normal cry
With the Livi app, you can easily add a child to your account and see a GP by video if they’re feeling unwell.
This article has been medically approved by Dr Tommy Södergren, Livi paediatric consultant.
