CHILDHOOD ILLNESSES


Ear, noSE and throat condItIonS In YoUng chILdrEn – In addItIon to common coLdS and fLU – can bE dIStrESSIng for both chILd and ParEnt. hErE, PharmacISt KUrtIS moffatt LooKS at thE moSt frEQUEntLY occUrrIng chILdhood ILLnESSES and conSIdErS thE roLE of thE PharmacISt In SUPPortIng ParEntS...


mInor aILmEntS: maJor dIStrESS


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child’s immune system is typically underdeveloped, therefore presentation of


infection and illness can be expected and, in most cases, is generally self-limiting.


however, development of symptoms or a change in their child’s behaviour can be very stressful for parents, especially for cases in which the children are very young and are not capable of articulating exactly what they are feeling.


In these cases, distressed parents typically turn to others for help, with more now turning to their community pharmacist before looking to their gP for advice and treatment.


Sometimes symptoms may appear more alarming than their underlying cause. however, in some cases, they are unfortunately not. children are not strangers to the community pharmacy environment and therefore, as pharmacists, we need to be prepared to differentiate between conditions which may be treated over the counter in practice, and those which require further investigation.


children tend to become ill more often than adults, and may take longer to recover, particularly when a large number of common illnesses are in circulation. many symptoms overlap and can be easily misinterpreted.


by looking in more detail at the most frequently-encountered conditions, it


34 - PharmacY In focUS


may improve the advice and treatment we provide, resulting in better outcomes for the child and their parents. the most prevalent infectious illnesses encountered in children are:


• conjunctivitis • otitis media and externa • tonsillitis • Whooping cough • respiratory syncytial virus • croup • cold and flu • fifth disease • chicken pox • hand, foot and mouth disease • Scarlet fever • Impetigo • gastroenteritis • Urinary tract infections


one of the most common conditions encountered in both children and adults is conjunctivitis (commonly referred to as pinkeye): an inflammation of the conjunctiva, the clear membrane that covers the white part of the eye.


the symptomatic appearance of this condition causes particular concern to parents, as the eye appears red, inflamed and spreads quickly. however, it is fairly common and in most cases no long-term eye or visual damage results.


conjunctivitis can be classed based on the causative agent, which may usually be distinguished by the


symptomatic presentation of the child’s eye. one of the most common symptoms is discomfort in the eye, described as ‘sand-like’.


many children have redness of the eye and inner eyelid, but conjunctivitis can also cause discharge from the eyes (bacteria causes purulent discharge, whereas viral is watery). Some cases have swollen eyelids or sensitivity to bright light.


many cases are caused by bacteria and viruses that are responsible for colds and other infections, or, in some more severe cases, by chlamydia and gonorrhoea. neonates are at particular risk of developing complications if the underlying cause is a sexually-transmitted infection (transferred via an infected mother to child during childbirth), therefore urgent referral may be common practice if suspected; usually five to twelve days after birth.


however, in children it is usually caused by allergies, with itchiness and tearing common symptoms of allergic conjunctivitis. these cases tend to happen more often in those who are prone to other allergic conditions, such as hay fever. triggers of allergic conjunctivitis include grass, ragweed pollen, animal dander, and dust mites.


Sometimes a substance in the environment can irritate the eyes, such as chemicals (chlorine, soaps,


etc), or air pollutants (smoke and fumes). therefore, first-line therapy in these cases is avoidance of the allergen or irritant.


conjunctivitis will most likely either resolve alone or with the use of otc drops or ointment. however, some instances do require referral, as other serious eye conditions can have similar presentation, so a child who complains of severe pain, changes in eyesight, swelling around the eyes or sensitivity to light should be examined further. additionally, if there is no improvement after two to three days of treatment, or after a week when left untreated, referral is also deemed necessary.


If the child starts to develop increased swelling, redness, and tenderness in the eyelids and around the eye, along with a fever, further investigation is required, as these symptoms may mean the infection has started to spread beyond the conjunctiva.


aside from conditions affecting the eye, young children are also prone to ear infections because of their small auditory canals and tubes. these tubes connect the ears to the throat, and they may get blocked when a cold causes inflammation, thus trapping fluid inside the middle ear and allowing germs to breed.


the symptoms include fever, fussiness, reduced hearing, tinnitus and earache resulting in ear pulling. >


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