Chapter 8 – When the Child Is Sick

Sooner or later, every child gets sick—especially if there’s an older sibling at home who can bring infections, or when the baby starts daycare. Vaccines protect against the most serious illnesses. For the rest, the body learns to defend itself by gradually building immunity. Here’s an overview of the most common illnesses and symptoms at this age.

• Fever: is a common symptom during infections. It is a natural defense mechanism that helps the body fight viruses and bacteria sensitive to heat, and does not always need to be treated. Experts recommend using paracetamol or ibuprofen only when: The fever is high (over 38°C / 100.4°F), It causes general discomfort, muscle pain, or headache. Measure temperature when the child is calm, in a cool environment. The most accurate thermometers are digital ones used on the skin (in the armpit or groin fold). Rectal thermometers are not recommended due to trauma risk. Contactless infrared thermometers are hygienic and fast but less reliable.
  During a fever, keep the child hydrated with breast milk, water, or herbal teas. Cool compresses can be comforting but are not effective in lowering temperature. The child may refuse food—don’t force them, and let them be active if they want, without tiring them. For persistent fever, especially in newborns, always contact the pediatrician.
• Cough: Is a natural defense used to expel mucus, irritants, microorganisms, or foreign bodies. It is divided into: Productive (wet) cough – with mucus, and Dry cough – without mucus (less common in children). Cough can disrupt sleep or even trigger vomiting. While protective, it may also signal respiratory infections such as: Colds, Flu, Tonsillitis, Bronchitis, Laryngitis. Persistent cough requires medical attention. Parents should note whether it is dry or wet and describe night coughing. Wheezing or stridor is often underreported by parents. Remedies include: Fluids to thin mucus, Humidifying the air, Avoiding irritants (e.g., smoke, dust). If medication is needed: Expectorants and mucolytics help treat wet cough, Cough suppressants are used for dry cough.

• EaracheVery common in the first 2–3 years. It may result from: External otitis:, infection of the ear canal, often preceded by itching and accompanied by pus. Caused by water retention in swimmers. Treatment: antibiotic, antifungal, or anesthetic ear drops prescribed by a pediatrician. Middle ear infection (otitis media) more common, linked to viral respiratory infections. It often resolves on its own, but bacterial forms require antibiotics. Risk factor: exposure to secondhand smoke.
  Protective factor: pneumococcal vaccine, as Streptococcus pneumoniae is a main cause.

• Cold is a viral upper respiratory infection, very common especially in daycare children (6–10 colds per year). Symptoms include: Nasal congestion, Fever, Fatigue, Cough, Poor appetite or nausea. Antibiotics are useless (cold is viral). It clears up in 5–7 days. Treat symptoms with: Paracetamol or ibuprofen for fever and discomfort, Saline irrigation for nasal congestion, Avoid nasal decongestant sprays in young children. Keep the child home to rest and prevent spread or superinfections. Ensure frequent hydration.

• Flu is aseasonal viral infection, more severe than a cold. Symptoms: High fever, Sudden onset, Lasts over a week, Weakness, Joint pain, Nasal congestion and cough. New flu strains appear yearly, so previous infection doesn’t protect. Annual flu vaccines are available each fall, protecting against 3–4 likely strains. Recommended for: High-risk children (chronic illnesses), Pregnant women, Adults 65+, Public-facing workers. Pediatricians advise vaccination for all children aged 6 months to 6 years. No antiviral drugs are available. Treatment is symptomatic, and a pediatrician should always be consulted. Keep babies away from sick people and crowded places during flu season.

• Gastroenteritis: Usually viral, this infection is very common in young children, spread through: Direct contact, Sharing toys or objects mouthed by others, Symptoms: Nausea, Vomiting, Diarrhea, Abdominal pain, Fever. It is usually mild and self-limiting, but can lead to dehydration, especially in babies.
  Rotavirus vaccination is recommended in the first year. Reinfections are possible, but symptoms are milder after the first time.
  Call the pediatrician and follow their advice. Ensure the child drinks: Breast milk (for infants), Water, herbal teas, juices, or oral rehydration solutions (for older babies), Probiotics may help shorten illness duration.
• Cystitis: An inflammation of the lower urinary tract, often due to normal intestinal bacteria (not contagious). More common in girls, due to the shorter distance between anus and urethra. Symptoms: Burning while urinating, Abdominal pain, Chills, Fever, Blood in urine. Young children may not localize the pain, making diagnosis difficult.
  Diagnosis is made by: Urine test and culture. Treatment: antibiotics based on bacterial identification.