Given we’re in the midst of a pandemic, it’s natural to be worried when your children display COVID-related symptoms. We’ve chatted to Dr. David Cremonesini, who is a Consultant Paediatrician with a special interest in Allergies at Mediclinic Parkview Hospital to find out a little more about general coughs and colds, allergies, COVID, and when we, as parents, should be worried.

It’s important to remember that in a child’s life, it is normal to get a new cold every month, sometimes even twice a month. This is because there are hundreds of different cold viruses and young children only start to build up immunity to them when they start spending time with other children, so we naturally see this as they start nursery or school for the first time. Overtime they build up their immunity and so get colds less often. We see this in families too, the first-born child is well and never sick until they start nursery. However, younger siblings get unwell when they’re babies as they have older brothers and sisters at home to catch bugs from, meaning they build up their immunity sooner.

When to be worried?

Almost always, children with a cold develop a cough and this is something parents worry a lot about. Its normal for that cough to last a few weeks, even up to 4 weeks. In fact, the coughing, although distressing for the child and parent, is doing an important job. Young children are very bad at blowing their nose so the mucus can fall backwards into the throat, especially at night when they are lying down. A big cough is the best way for the child to clear the phlegm from the throat and so prevent it going into the lungs and causing more severe problems like pneumonia. The cough is the body’s way to fight the infection and protect itself. When to be worried therefore, is when the child has problems otherthen coughing. Ask yourself these questions:

1. Is my child drinking ok and staying hydrated?
2. Is my child breathing ok and not distressed or wheezy?
3. Is my child having periods of normal playing and activity?
4. Is the fever improving after a few days and not getting worse?

If the answer to all of these is yes then good news! Give it a few weeks and during that time the cough should slowly improve. Seek advice if the child is deteriorating or the answer to some of the questions changes to no.

Snot can be different colours but again, it’s all about how the child is as a whole. If the child has pneumonia, we would expect tiredness, persistent fever and breathlessness. If the child has asthma, we expect to see breathlessness, decreased activity and expect to hear a wheezing sound.

When is it allergy?

If the cough lasts a long period of time (a few months) then it’s worth considering if this is allergy-related. If the child gets an itchy nose a lot, and what’s running from the nose is clear, watery liquid, this can be a sign of an allergy. If there is associated wheezing, then this makes it even more likely. However, it can be hard to be sure as children can get one cold after another and so they might be coughing for several months.

An allergy is more likely if the child has other allergic problems, like eczema or a food allergy. Some important questions to ask yourself to help identify if the cough is allergy-related are:

Has something new happened at home, like a pet arriving?
Does the cough go away when the child is on holiday or away from the home?
Is the cough seasonal and only there in the summer?

Allergy coughs are normally worse at night when exposed to dust mites from the mattress and pillows in the bedroom. In Dubai, often doctors label a cough as an allergy there’s some allergy tests that can confirm this, rather than staying on allergy medication long term.

Is it coronavirus?

Children do get coronavirus but it seems to be generally a mild illness, much like other cold viruses. There are some very rare complications leading to more serious illness (egPIMS – Pediatric Inflammatory Multi-System Syndrome) but the risk is very low, roughly 1 in 5000. With COVID symptoms, we do need to test children in nursery or school to reduce the risk of spreading it. The best and most accurate test is still the nasal PCR test. It is important to talk to your child and support them when having the test.

What medicines can I give?

Coughing is a good thing and is the best way to clear the mucus. Keep your child hydrated with plenty of fluids to keep the mucus less thick and easier to clear. Saline drops in the nose for babies is important so they can still drink from the bottle and breathe through their nose. Cough medicines should be avoided, especially those that make the child drowsy as they have serious risks if accidentally overdosed. Treat a fever with paracetamol or ibuprofen and consult your doctor if worried.

If you have a nebulizer at home, try a salty water (saline) as and when needed and continue if it helps the child. However, please only use Ventolin if the child has wheezing and breathlessness as it won’t help a cough or sore throat, but instead just make the child agitated and restless.

In summary, do not be worried about coughs and colds if the child is otherwise ok. Lots of cuddles and fluids but do check with your doctor if worried. For appointments with Dr. David, simply call 8001999 or visit mediclinic.ae.