First, it was a fever and watery stool—not a good sign. Then, comes the fussing and crying because of uneasiness. You start to get worried because out of all the possibilities, COVID-19 is one of them.
Since the nation transitioned from the pandemic to the endemic phase, there is less fear of the virus as most people are vaccinated, and the virus seems to have reduced its rage.
However, the possibility of your child contracting COVID-19 is still there. When they start showing symptoms, fear can rise, and some parents are stricken with the fact that they don’t really know what to do!
What would you do if your child contracted COVID-19? Do you try to sponge the fever away? Give them paracetamol? Or feed them with coconut water? What are the should-dos and the should-not-dos?
If this is you, stop—take a deep breath and calm down because we’ve got you covered.
Keep Calm and Don’t Panic
We spoke to Dr Hieu Yu Jin, a paediatrician from Mini Child Specialist Clinic and Dr Yeoh Tze-Hau, a paediatrician based at Tung Shin Hospital and My Babysteps Child Specialist Clinic, regarding what you can do if your child below five years contracts COVID-19. They were gracious enough to answer some of the most asked questions.
Q1. What are the symptoms of a child that may have contracted COVID-19?
Dr Yeoh: COVID-19 symptoms in kids and babies are milder compared to adults. Common symptoms include fever, cough, runny nose, sore throat, headache, diarrhoea or tummy ache, nausea or vomiting and body aches.
The most common symptoms are fever and cough. Shortness of breath is more likely to happen in adults, though some children may develop pneumonia. COVID-19 shares similar symptoms with the common flu, and it may be difficult to determine which virus might be present unless tests are conducted.
Children with flu-like symptoms should be tested for COVID-19 and influenza. It is important to test for influenza as anti-viral treatment (Tamiflu) can be prescribed to reduce the severity and duration of symptoms if given within the first 48 hours of the illness developing.
Respiratory Syncytial Virus (RSV) can be serious among certain groups of children. Amongst those vulnerable are premature babies, babies under six months old, or children with chronic heart/lung disease.
Although there is no specific medication to treat RSV infection, early detection is crucial.
Q2. What are immediate steps to take if my child tests positive for COVID-19?
Dr Hieu: The first thing to do is to remain calm and not panic. Identify the symptoms first. Once you are certain of them, prepare the medications needed for your child.
Q3. How should parents treat those symptoms at home?
Dr Yeoh: When treating mild COVID-19 infection in children, focus on relieving the symptoms. Typically, symptoms are worse in the first few days and will slowly subside over the next few days. By then, the body’s immune system starts to clear off the virus. At the peak of the illness, supportive care is necessary to ease the symptoms and prevent them from developing complications such as dehydration.
These remedies will help your children feel better:
Stay hydrated
Drink water, juices, milk, clear broth or any fluid to prevent dehydration and loosen congestion. Children may not have a good appetite and refuse to drink, especially if given large amounts. Therefore, encourage them to drink small amounts frequently. You can spoon-feed them or have them sip slowly from a cup with a straw.
For babies below six months old, continue breastfeeding them or give them formula milk in small amounts frequently. Monitor their nappy to see if urine has reduced.
Provide adequate nutrition
When ill, our body needs extra energy and nutrients to combat infection. Prepare semi-solid food for easy consumption. Semi-solid food is easier to swallow, ensuring they receive the nutrients needed.
Giving them vitamin C and zinc supplements may help to shorten the duration of symptoms, but there is no strong scientific evidence to support its use. Do note that overdosing on them may cause harmful side effects, even if it is just vitamin C.
Control fever
Only give paracetamol to your children. It will bring down the temperature and help relieve body aches. While paracetamol can easily be obtained over-the-counter (OTC), always consult your doctor or pharmacist for the correct dose according to your children’s age and weight. Avoid giving aspirin to your children as it has been linked to health complications at that age.
Relieve stuffiness
A runny nose and nose block are the most distressing symptoms for children and parents. Children will be uneasy and may throw tantrums as they struggle to breathe. It may cause parents to be anxious.
Over-the-counter saline drops and sprays can help loosen mucus secretion. One can clear it using a bulb syringe or nasal aspirator. It provides children temporarily relief, allowing them to rest and sleep.
Rest
Our body works very hard trying to fight off infections. Getting adequate rest will allow the body to heal.
The above-mentioned remedies aid children’s sleep and rest.
However, parents should not do these:
Give cough and cold medications from OTC pharmacy
These medications include decongestants, antihistamines and cough remedies. While these are commonly given to older children and adults, they pose a safety risk to younger children (under two years old), such as allergic reactions, breathing and sleeping problems.
It also causes them to hallucinate. These medications are only prescribed by the doctor after careful evaluation and consideration.
Give children cough sweets or lozenges
These remedies may help soothe sore or itchy throats, but they are also a potential choking hazard.
Parents should look out for these red flags in their child:
i. breathing difficulties—fast or noisy breathing
ii. unable to drink
iii. drowsiness or a change in behaviour in a bigger child
iv. unusual irritability or persistent crying in a baby
v. persistent high fever (> 38°C) that does not come down with paracetamol or ibuprofen
vi. rashes
vii. intense headache, ear pain, ear discharge
viii. seizure
ix. any unexplainable symptoms
Q4. Should I rush my child to the hospital?
Dr Hieu: Severe illness is rare. However, parents should be alert if the symptoms escalate, severely affecting their child’s daily activity, appetite and sleep. That is when you need to consult a healthcare professional. Head over to the nearest hospital to get further treatment.
Q5. How often should I check my child’s temperature?
Dr Hieu: Check their temperature every six hours and monitor your child’s intake and output.
Q6. What kind of liquids should my child take?
Dr Hieu: Plain water or any juices without much sugar is good. The most crucial element is to ensure your child is hydrated and passing urine regularly. Appetite is generally lower, especially if sore throat is predominant. Hence, soft diets such as porridge or soups are encouraged.
*Note: According to the American Society for Parenteral and Enteral Nutrition, the body loses water rapidly when there is an onset of fever. Fluid continues to diminish with sweating, coughing, breathing, nausea, vomiting or diarrhoea.
Q7. What is long COVID, and how can parents identify if their child has it?
Dr Yeoh: Most children with a mild COVID-19 infection recover within one to two weeks of disease onset. However, some children can experience a longer duration of symptoms. Post-COVID-19 condition or long COVID is an umbrella term to describe a broad range of physical and mental health symptoms four weeks after a COVID-19 infection.
Commonly reported symptoms include tiredness, weakness, headache, sleep disturbance, muscle/joint pain, breathing problem, a sensation of a forced beating of the heart and changes in their sense of taste/smell.
Dr Hieu: If there is one thing that parents may be fearful of when it comes to COVID-19 among young children, it would be Multi-System Inflammatory Syndrome in Children (MIS-C). Though MIS-C is a life-threatening complication caused by COVID-19 infection in children, its occurrence is relatively rare, with a 1-in-100 000 risk in the population.
Hence, there is no need to panic. Recent data shows ages six to 12 are more at risk. This condition causes organs to become inflamed.
Q8. How would I know if my child has MIS-C?
Dr Yeoh: MIS-C’s symptoms include fever (lasting three to five days), abdominal pain, vomiting, diarrhoea, and breathing difficulty. Some experience headaches, extreme tiredness, confusion or irritability.
They may also develop a rash, red eyes, red or swollen lips, or strawberry tongue. You should seek treatment at a hospital immediately if your child develops such symptoms.
Dr Hieu: In severe cases, they may even faint. MIS-C requires urgent hospital care once identified. Its occurrence post-COVID is a special entity. Hence, for parents and for us as healthcare professionals, it’s important to be aware of it.
MIS-C tends to occur four to six weeks after a COVID-19 infection. Early identification and treatment of this condition will help prevent any long-term consequences to the child.
Q9. How can parents care for COVID-19 infants and toddlers?
Dr Hieu: Protection is two-fold. Firstly, the child must maintain strong immunity. Proper nutrition, rest and vaccinations are a must, as per schedule.
Secondly, good personal hygiene is a way to prevent contracting any viruses. Practice frequent handwashing, masking, avoiding crowded areas unless necessary, and isolation if unwell.
Dr Yeoh: There’s no specific anti-viral treatment for children. Most children with COVID-19 infection only need symptomatic relief and can be treated at home. You should focus on relieving their symptoms and monitor for any worsening signs (red flag symptoms).
The caregiver should practice necessary precautions to avoid spreading the virus to another household member. If you notice your child has any warning signs, seek medical attention immediately.
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Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner.
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