Ear, nose and throat ailments are a common cause of illness in children, giving a great deal of distress to both parent and child.

Coughs, Colds and Fever

We have all had a viral infection at one point or another. On average a child will get six colds per year and is therefore more prone to secondary illnesses. This is due to their mixing closely with other children at playgroup and nursery, and thus being continuously exposed to new viruses.

Most coughs and colds can be treated at home and usually disappear within a few days. You should try and make the child as comfortable as possible, by making sure that they drink plenty of fluids. If they have a temperature, giving them Paracetamol can help bring this down. Antibiotics are sometimes prescribed, but do not always work.

Measles

This is a highly infectious disease that affects about a third of those who have not been immunized. It is spread through the air in droplets of saliva via coughs and sneezes. The most infectious time is just before the first symptoms appear, with the incubation period being about ten days.

Symptoms

These are very similar to a cold with cough, fever and bloodshot eyes. Red spots develop a few days later, which spread to the face and behind the ears. Most children are immunized against this disease at around 15 months, and are also given the vaccine for mumps and German Measles. As a consequence, cases are rare these days.

Meningitis

This is probably one of the most serious diseases that a child can have, and it is on the increase. Its seriousness is reflected in the speed with which it spreads, and its fatality in not being treated quickly.

Symptoms

Severe headache

Development of a rash of purple/blue/red spots

Stiff neck with difficulty in bending the head forward onto the chest

Vomiting

If your child has any of these symptoms and seems unduly ill or drowsy, your doctor should be contacted immediately.

Coughs

An upper respiratory tract infection, whooping cough or asthma can cause this. Most coughs are self-limiting and will clear up by themselves. But if you think that your child has a persistent cough, then you should take them to the GP.

Whooping cough is caused by a bacterium that progressively gets worse, making it hard to breathe. The sound consists of a high-pitched noise in the throat, resulting in a cough followed by a distinctive whooping from which the name is derived. A vaccine is available against whooping cough that is safe and effective. If you think that your child needs a vaccine, you should speak to your GP.

Catarrh

This is a nasally discharge which is very common in small children, and is caused by a viral infection or an allergy. Most parents find that catarrh improves greatly when children are of school age.

Sinusitis

As a rule, most children do not suffer from sinusitis but from viral infections involving the nasal passages. If a child is suffering from sinusitis, common symptoms will include fever, tender sinuses and a general feeling of being unwell. If your child has this problem, you should refer them to the GP.

Thrush

Many babies get this condition, where they develop white spots or patches on the inside of the palate, tongue and cheeks. This can easily pass down through the mouth, and affect the baby's skin in the nappy region causing nappy rash, though thrush is not a major cause of nappy rash. The best way to prevent thrush in the mouth is to sterilize bottles and teats thoroughly, and if your child is taking any medication for asthma, to make sure the mouth is rinsed after use.

Dribbling

All young children will dribble at some point, some more than others. A sore throat or other infection can sometimes be the cause. Most children grow out of it by the time they are 4 years of age. In severe cases, an operation on the glands that carry the saliva from the gland to the mouth may be necessary. However, this is very rare.

Chemical Burns

If your child swallows something by accident such as an acid or alkaline substance which can burn the mouth or throat, they should not be given anything to drink such as milk or water. Instead, they should be taken straight to the nearest hospital, for a doctor's decision on appropriate therapy.

Sore throats

Most are caused by a simple viral infection. The only treatment that is needed is a pain relieving liquid such as Paracetamol and drinking plenty of fluids. Antibiotics are not normally needed unless a specific bacterium is identified.

Tonsillitis

In tonsillitis it is mainly the tonsils that become inflamed. The child normally finds it hard to swallow becoming feverish and unwell. It is more likely to be caused by a bacterial infection than a viral one, and a short course of antibiotics may be given to treat the problem.

Stridor

This is a shrill, high-pitched noise that is usually heard when the child is sleeping. It is due to a narrowing of the airways in the larynx. It can be common in newborn babies who have not yet developed their cords, but most grow out of it as they develop. In severe cases, the baby may need an operation to open up the windpipe.

Nose Bleeds

The medical name for this condition is epistaxis. It is common in children, and is usually caused by damage to blood vessels in the nose by fingers, infections, allergies or foreign objects. If your child has a nosebleed, sit them upright with their head tilted forwards. This prevents the blood from running down the back of the throat. Press firmly on the nose but not so that it hurts. In most cases the bleeding will stop fairly soon, but you should see a doctor if not.

Allergy

A sudden allergic reaction may be caused by something that your child may have eaten. Some of the common foods that can cause this problem are peanuts, milk, fish and shellfish.

Symptoms may include wheezing, blotchy rash, swelling in the throat, and in severe cases, a shock that can lead to collapse. If this has happened to you in the past, you should try and identify the cause of the allergy and avoid it in future.

Hayfever

Hayfever is easy to recognize by a nasal discharge, frequent sneezing, watery eyes and runny nose. Most children can be treated with medication in the form of antihistamines. Most of these are now non-drowsy, so the child does not have to miss school.

Otitis Media (Infection of the middle ear)

This is an infection of the middle ear, which commonly becomes inflamed when a child has a viral infection. Examining the eardrum is all it takes for a doctor to make a diagnosis. Most children recover in a few days without antibiotics, though will perhaps need a pain relieving liquid such as Paracetamol.

Glue Ear

This is a common condition in children where the middle ear becomes infected with pus and prevents them from hearing properly. Decongestants and nose drops can be given to reduce any swelling in the lining, or alternatively, a small incision may be made by a surgeon to allow the fluid to escape.

Immunization

This is very important and can prevent a lot of serious problems later on in life. The vaccines that are a must for babies and children are: by 6 months: 3 doses each of diphtheria/tetanus/pertussis, Hib and polio - by 15 months: measles/mumps/rubella (MMR).

At school age: diphtheria and tetanus and polio. Between 10 and 14 years: BCG for TB.

If you would like to know any more about any of these conditions, you should contact any of the organisations below:

Royal College of Paediatrics and Child Health, 50 Hallam Street, London W1N 6DE, Tel: 0207 307 5600

The National Children's Bureau, 8 Wakeley Street, London EC1V 7QE, Tel: 0207 843 6000 Website: www.ncb.org.uk

Dr. A. Bose
Mr.Jai Cheema
© allcures.com September 2009

Ref:BNF, CPD Lit.,MIMS, Clinical , Internet,WebMD,Clinical Medicine edited by Kumar and Clark, NHS