Dr Ranj Singh, leading paediatrician on ITV’s This Morning and CBeebies’ Get Well Soon programme, talks to Kayley Loveridge about mental health issues in children, when to give over-the-counter medication to your little one and key advice for keeping children healthy and happy during the colder months
What exactly is a fever, and when should parents be worried?
RS: A fever is a raised temperature (normal is around 36.5-37.5C), is most often due to an infection and is usually no reason to be worried. Most infections in children are viral and self-limiting, however, sometimes they may be due to bacteria and therefore may require antibiotics. Fever itself is seldom harmful (even when it is quite high) and is a sign that your child’s immune system is fighting something. There is also some evidence that it might actually be useful, so currently we only advise that you treat a fever (with medicines) if it is making your child feel unwell or distressed. Most fevers can be managed at home using medicines, ensuring your child stays hydrated and is not over-dressed or too wrapped up. However, there are some instances when parents should seek further help: a fever over 38C in a baby under three months’ age, a fever over 39C in a baby between three to six months, a fever that lasts for longer than five days, if your child is showing any other signs of serious illness (e.g. difficulty breathing, a rash that doesn’t fade when you press it, a fit/convulsion), if your child isn’t getting better or is getting worse.
In your view, is it safe to give young children over-the-counter painkillers like ibuprofen or paracetamol?
RS: Medicines such as paracetamol and ibuprofen are used for the treatment of pain and fever, and are safe and effective for the vast majority of children provided they are used appropriately. That means only using them for the right reason and following the dosage instructions. We currently don’t recommend routinely treating a raised temperature or fever unless it is making your child uncomfortable or distressed (or you have been advised to by a healthcare professional). There are a couple of instances where we would usually advise not to use ibuprofen because it may cause problems including if your child has severe asthma, if they have kidney problems, if they have stomach problems such as bleeding or an ulcer, or if they have chicken pox. If you have any concerns about using these medications, you should talk to your doctor to get advice.
Almost one in four children are starting school already overweight or obese. What key things do parents need to know to help them tackle the problem effectively?
RS: Firstly, the best way to manage obesity is to prevent it developing in the first place. That means educating children about healthy eating and exercise—something that both parents and schools should be responsible for. If a child is already overweight or obese, then dealing with it needs to be a team approach between families, healthcare professionals and school. Mealtimes need to be structured and meals need to be balanced with appropriate portion sizes for your child. Snacking needs to be kept to a minimum and the intake of fizzy or sugary drinks also reduced. It is a good idea to think about swapping sugar-heavy foods for healthier alternatives. At the same time, it’s a good idea to try to get your child involved in more physical activity. Doing things together as a family really helps motivate children and keep the whole family fit!
Could you explain what sepsis is, what can happen as a result and how parents can spot the symptoms?
RS: Sepsis is a potentially life-threatening condition that can arise from any infection. It’s relatively rare in children, but parents should be aware of possible signs and what to do. It happens when the immune system goes into overdrive and starts to attack the body itself, and is more likely with certain infections (e.g. infections in small babies, people with weak immune systems, infections that cause meningitis, urine infections in elderly people). Most infections will not develop into sepsis, but if they do they should be treated as soon as possible in hospital. If proper treatment is not given, then it could result in disability and possibly even death.
Spotting sepsis in children can be tricky as there are no simple signs or tests. Parents should be on the lookout for signs that might indicate sepsis and feel empowered to speak to a health professional and ask: could it be sepsis? Signs of potential sepsis in children include fever or very low temperature, breathing very fast, a fit/convulsion, a rash that doesn’t fade when you press it, excessive lethargy or drowsiness and feeling abnormally cold to the touch. Additional signs in small children/babies include: poor feeding, repeated vomiting and not passing urine.
If a parent is worried that their child has an infection and signs of possible sepsis, then they should speak to a medical professional and seek advice immediately.
Finally, what five pieces of advice do you have for parents to keep their children healthy and happy during the winter months?
The winter months can bring a whole host of illnesses and injuries that affect children. My five tips for staying well would be:
- Ensure your child keeps their immune system in top condition through a healthy, varied diet, exercise and adequate sleep.
- If they do become unwell with a cough or cold, then practising good hand hygiene is important to prevent the spread of germs.
- Whether at home or outside, preventing accidents is always important so be wary of hazards around the house and be careful in cold or icy weather outdoors.
- Immunisation is one extremely important way to reduce illness, so make sure your child is up to date, especially when it comes to the annual flu vaccine (if they are eligible).
- Mental health is just as important as physical health, so being aware of your child’s emotional and psychological needs is also important. Fostering a loving relationship with your child where they are able to open up to you and seek help is vital, and listening to their concerns and offering support and guidance is key to a happy and healthy childhood.