Category: Child Health

  • 5 Back to School Illnesses You Should Know About (That Aren’t COVID-19)

    5 Back to School Illnesses You Should Know About (That Aren’t COVID-19)

    The dog days of summer. The leaves are turning golden. The days are getting shorter. And children everywhere are returning from their summer holidays and bringing with them millions of bugs from around the world to spread to their classmates. Here’s our guide to the top 5 back to school illnesses and how to avoid them. 

    Hand, foot and mouth

    Caused by a group of viruses known as enteroviruses. Very common in the Autumn months. Causes raised red lesions to develop in and around the mouth, on the palms and soles. The spots can also affect the buttocks and genitalia and extend up the arms and legs.  The lesions, which can be uncomfortable are typically accompanied by a fever above 38 and lethargy. Children may often complain of a sore mouth or throat. Although children under 5 are most commonly affected, it can affect people of any age. A further bit of bad news: because hand, foot and mouth can be caused by several viruses children can get it more than once. 

    How to prevent Hand Foot and Mouth:

    The virus is spread through coughs and sneezes but also through faeces. So if a child has the virus and does not wash their hands thoroughly after going to the toilet they can spread the virus. 

    • Washing hands thoroughly after going to the toilet
    • Carefully disposing of nappies
    • Not sharing cups, beakers, cutlery and towels. 
    • Encouraging children to cough or sneeze into the crook of their elbow. 
    • Promptly disposing of used tissues. 

    The virus can be passed out in the stool for several weeks afterwards so it’s important to maintain good hand hygiene several weeks after having the illness. 

    Chickenpox

    Like hand, foot and mouth, chickenpox is another viral illness that is characterised by blisters. It also spreads by coughs and sneezes and well as by direct contact with the fluid from the blisters. It is extremely contagious. Unlike Hand, Foot and Mouth, the spots of chickenpox are itchy. The blisters come out in crops and are usually preceded by a high fever. Headache and tummy pain are also common. Generally, the illness is mild but it can be much more severe in older children and adults as well as those people who do not have strong immune systems. Occasionally, children can suffer from serious complications such as bacterial skin infections and pneumonia can occur. Chickenpox is also potentially dangerous for pregnant women who have not previously had chickenpox. 

    How to prevent Chickenpox:

    • The best way to prevent chickenpox is through immunisation. The two-dose schedule gives 99% immunity. 
    • If your child does have chickenpox the best way to prevent spread is to ensure they stay off school or nursery for 5 days from the onset of the rash. 

    Acute Conjunctivitis

    Infectious conjunctivitis causes pink eyes often with yellow discharge. It can be caused by bacteria or viruses, which occur in almost equal numbers. Most of the time conjunctivitis will resolve by itself. However, depending on the cause and situation conjunctivitis can sometimes progress rapidly so it is always worthwhile having it checked by a doctor. Tears contain enzymes that help get rid of the bacteria or virus that has caused the problem. However, topical antibiotics can help speed the resolution and prevent transmission.

    How to prevent Conjunctivitis:

    • Not sharing towels and pillows. 
    • Washing hands, particularly after touching the eyes. 
    • Cleaning away any discharge from the eyes regularly. 

    Cold and Flu

    Runny nose, cough, sneezing and sore throat characterise a cold. Flu is more severe with fever, muscle aches and pain and lethargy. Young children in nursery get on average 5-6 colds a year but children in nursery can get 12 colds per year.  The peak time to get colds and flu is during the colder months of the year. 

    How to Prevent Colds and Flu: 

    • The annual flu vaccination can help prevent getting flu
    • Encouraging good hand washing
    • Coughing in the crook of the elbow. 
    • Maintaining a physical distance from infected individuals.
    • A daily probiotic has been shown to reduce the number of upper respiratory tract infections children get in a year. 
    • Ensuring children have adequate sleep can help maintain a robust immune system. 

    Croup

    Croup is a very common infection that mainly affects children of nursery and pre-school age. It is most common in the Autumn and early winter months. It is caused by a variety of viruses but the most common cause is the Parainfluenza virus. The name is thought to derive from an old Scottish word, roup, meaning to cry out in a hoarse voice. The symptoms typically start like a standard cold before the characteristic barking seal-like cough and horse voice appear. Croup is generally mild and self-limiting but occasionally can be severe so it is important if you are concerned about your child to see your doctor for an assessment. 

    How to prevent Croup:

    • Try to minimise contact with other children who have been diagnosed with croup. 
    • Ensure that your child is in an environment that is free from respiratory irritants such as smoke that can irritate the respiratory tract and impair the natural defences against infection. 
    • Making sure that your child’s vaccinations are up to date can prevent some of the causes of croup. 

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

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  • Paediatric Multisystem Inflammatory Syndrome

    Paediatric Multisystem Inflammatory Syndrome

    PIMS is a rare condition that seems to affect children who have or who have had COVID-19. As the name suggests, it causes inflammation of many organ systems of the body. Less than 0.5% of children who contract COVID-19 will go on to have this condition. MOST children are not seriously affected, but in a small number of cases, it can be serious.

    What can happen in these serious cases?

    The inflammatory process can affect the blood vessels, particularly the ones around the heart. This process is otherwise known as vasculitis and can lead to tissue damage and poor organ function. Inflammation is usually a normal response to infection but in PIMS this process seems to go into overdrive causing damage to the body. PIMS seems to affect older children and teenagers and happens about 2-4 weeks after infection with COVID-19.

    How can I tell if my child might be developing PIMS?

    Typically, children with PIMS have a high fever over several days and can also have symptoms of:

    • Tummy pain
    • Diarrhoea
    • Vomiting
    • Rash
    • Cold hands and feet
    • Red eyes

    If your child has these symptoms or has a fever >38C, cold hands and feet and is sleepy – do discuss this with a GP so further action can be taken.

    What can be done if doctors think that my child has PIMS?

    There is no single test to diagnose PIMS. Further tests will be carried out and along with the medical history, it can be determined whether your child might have PIMS. If this is the case, then treatments can be started to suppress the inflammatory process. 

    Despite the increased numbers of children having contracted COVID-19 during the Autumn of 2020, it is rare for children to become unwell with COVID. It is even less likely for them to be admitted to hospital (1-5 children per 100, 000). Most children would be expected to make a full recovery following PIMS with the right treatment and will be followed up to ensure they remain well.

    It is difficult to confirm whether there has been any death related to PIMS. There have been 2 suspected cases of PIMS where children have sadly died. But, doctors cannot be certain if there were other reasons for this. It is important to remember that there are more deaths in children related to illnesses like influenza or even chickenpox.

    In short, it is worth being aware that PIMS exists and to be aware of how it might present. As it is so rare, it is not something that you should be overly concerned about. But, if you do have concerns you should get in touch with your GP to discuss things further. 

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Child Health Guides
  • Breastfeeding newborns – the simple yet essential questions

    Breastfeeding newborns – the simple yet essential questions

    Breastfeeding is supposed be a very natural thing. You would think that some sort of instinct would kick in, and that it really would be something everyone would be able to do. For whatever reason, this is not always the case and it definitely was not something that I found particularly easy. Perhaps because our lives have changed so much, it is not something we are exposed to or really have much knowledge about until you are expected to feed a crying infant. Despite the fact that there has been such a big push to promote breastfeeding, babies are hidden away under muslins and feeding bibs because that is just what is socially acceptable. So, how can we ask the questions we need to? That’s why this blog is intended as a tool for newcomers that have the simply yet important questions.

    Q: How do I prepare?

    It is definitely a good idea to try to talk about breastfeeding and look at pictures or videos, before baby arrives. This can be at an antenatal class, at an NCT meeting or simply with friends or family. Don’t be afraid to ask, most people are happy to share their tips and distastes stories. Despite being prepared, don’t worry if it takes a little time to get the hang of it. The midwives are great at explaining and showing you what to do and if you can get access to a specific breastfeeding consultant, this goes a long way to helping you get things going. If things are going a little slowly or you need to express, this does not mean that you will not be able to breastfeed. Simply go with what baby needs at the time and don’t give up.

    The first fluid that you will produce following the birth is colostrum, which does not look like milk at all, but is usually a yellow coloured fluid. Colostrum has more protein and less fat and carbohydrates than mature breast milk. It is rich in secretory immunoglobulin A, which helps to protect baby from infections and also helps to establish a normal gut microbiome. As it is low volume and highly nutritious, it helps your newborn as they learn to regulate the suck, swallow, and breathe cycle during feeds. I remember having to hand express tiny quantities of colostrum and painstakingly collect tiny drops in a syringe, which did seem a bit ridiculous but given the benefits, felt worth all the effort. The main thing to remember is that you just do the best that you can and try to get some of the benefits of this precious fluid.

    Q: How long will I have to do this?

    Initially baby may want to feed very often, so it is not unusual to have to feed every hour. Then once your breasts produce more milk and baby gets better at feeding you will notice baby feeding for longer. The more you feed the more this will stimulate your milk production. The other thing that you will notice is that the sucking will release your milk – otherwise know as the let-down reflex. Some women will feel this as a tingling or burning sensation, which can be quite strange. Baby will initially do quick sucks at the start of the feed, then sometimes pause waiting for the release of milk and change to a deep rhythmic suck when the flow begins. It can be quite fast and may cause your baby to cough or splutter when the milk does start to flow. This is not usually a persistent problem as baby will adapt to this, but you may need to change your position.

    Q: How do I know how long baby needs to feed for?

    The general rule about how much to breastfeed a baby is – on demand, which means as often as they want and for as long as they want. This will change over the days and weeks to settle into a more reasonable pattern. A rough guide is at least 8 times in 24 hours in the first few weeks. It is not possible to overfeed a breastfed baby – you will hear this many times. It is worth trying to look out for the hunger cues and start feeding then, because once they are really crying it is difficult to calm them down and just makes everything more stressful for you. If you notice baby sucking their fist, getting restless or rooting (turning their head an opening their mouth), try to get yourself in a place and position to be feeding.

    I felt that the most important thing, was being taught about how to get baby to latch. It is a bit counter intuitive and there are a couple of tips that may help, although it really is something that is easier to demonstrate and get somebody to help you with. The first thing is to ensure you are comfortable and relaxed, make sure your arms are relaxed and not straining, you may be there a while! Your baby’s head and body should be in a straight line and baby’s face should be close to your breast. Support their neck, shoulders and back, but don’t hold the back of their head. They will tilt their head back a bit which allows them to swallow more easily. Bring your baby towards your breast, with their nose at the level of your nipple. Wait for them to open their mouth wide and allow them to get a big mouthful of breast, with their chin coming into contact with your breast first.

    Q: Should I express?

    This is a personal choice and everyone will find their own happy balance. It is very useful to have some milk stored and to be able to get baby to take a bottle, to give you some rest. I would recommend that everyone has a pump though. Even if you are not planning to express for feeds, you may need to use the pump to help prevent or ease the symptoms of mastitis. This is something that breastfeeding mothers fear as it makes you feel so awful. Usually you will be feverish, and there will be an area on the breast that will be red, hot, firm and very tender. If this is the case seek medical attention immediately as you may need a course of antibiotics. This can come on when there is a mismatch in your supply and how much baby is feeding. If you feel that after a feed instead of being soft and pain free, they are still firm and sore it can be useful to express until the pain eases and are less firm. Don’t be tempted to express too much as this can increase your supply. Baby will usually then catch up or your body will regulate your milk supply.

    Q: How can I tell if I have thrush?

    You may notice burning or stinging around the nipple or areola. The nipple may look different – going white during feeds and bright red after feeds or cracks that don’t seem to heal. You may also notice severe pain on latching, which worsens with re-latching or a deep pain in the breast. Baby can also get thrush, which can be white patches or a coating on the tongue or appearing uncomfortable during feeds. If you notice any of these symptoms please seek medical attention for you and baby to be checked over and to get appropriate treatment.

    Q: How long should I breastfeed for?

    This is also a very personal thing, every mother and baby is different. Do not feel bad if you have to or want to top up with formula. You may be advised to do this if baby is not gaining weight, and the main thing is having a healthy, happy baby (and Mummy). The World Health Organisation (WHO) recommend breastfeeding for at least 6 months, at which point most babies start weaning. There are so many factors that determine how long women breastfeed for and it is different with each child. Ironically, after having struggled through and becoming successful breastfeeders, some mothers find the next battle is how to stop. The WHO also recommend that breastfeeding should continue for up to 2 years or beyond. It really it something that you will decide for yourself and when the time is right, you will find the strength to overcome this hurdle. I wish you all the very best of luck!

    Some additional great resources for further information on these topics can be found online at Mom Loves Best, a fantastic place for all your questions.

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Child Health Guides