Toddler health Q&As answered by our health visitor

Threadworms, asthma and eczema – our health visitor covers every topic as she solves your toddler health problems

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Q. My son has eczema – how can I protect his skin when he goes swimming?

A. It’s important that your toddler gains water confidence and starts swimming, but eczema can sometimes be aggravated by chlorine, so if possible wait until his skin is in a relatively good phase.

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Before he goes into the pool, protect him with lots of emollient cream, applying it using downward strokes to avoid blocking hair follicles. Choose his swimwear carefully, as a suit with arms and legs may help by keeping your hands, toys or other potential irritants away from his skin. Watch out for armbands, though, as they can aggravate skin in the elbow creases where eczema is more common. A better option is a swimming suit with a built-in float, which will give him added water confidence, too.

After swimming, give him a nice long shower and then pat him dry gently, this will allow some moisture to remain on his skin. Then re-apply his emollient cream generously.

Q. I think my little one has threadworms. How do I get rid of them?

A. Threadworms cause intense itching around the bottom, that’s often worse at night when eggs are laid. You may also see tiny white worms, that look like 1cm-long cotton threads in your child’s poo. Eggs get onto little fingers, are swallowed, and grow in the intestine. Then eggs are laid again, so the cycle is repeated. They’re harmless, and although getting rid of them is time-consuming, it does work. All the family need to be treated to prevent cross-infection, so get the suitable medicine from your GP. Strict hand washing by the whole family before eating, teeth brushing and after going to the loo breaks the cycle of re-infection. Eggs can lurk in underwear, pyjamas, bedding and towels too, so wash these every day until the worms have gone, and shower your tot each morning.

Q: My 22 month old always seems to have a cold. Is this normal?

A: In the first few years, it’s not unusual for little ones to get between 8 and 11 colds and viruses in a year. Each can last 10 to 14 days, so it’s not surprising you feel as if he’s constantly ill. It can be a miserable time, but take comfort in the fact that at least his immune system is building up.

Colds and viruses are spread when someone coughs or sneezes, or by direct contact, so always wash hands and use disposable tissues.

To relieve symptoms, humidify the air in his room and raise the head of his cot by popping something under the mattress. Apply a thin layer of protective barrier cream under his nose. Don’t worry is your tot eats less – fluids are much more important, so keep him well hydrated. To relieve fever, give him infant paracetamol, as directed.

Q: Are there any rules for getting a toddler’s eyes tested? My daughter’s 4 so does she need one?

A: Newborn babies get their eyes tested at birth and again during their first developmental check-up at 8 weeks. It’s really important that children have regular eye tests, as early detection of problems can prevent long-term damage. So from the age of 2 or 3, all toddlers should have an eye test and this should be repeated every 2 years, whether you think your little one’s having visual problems or not.

Kids don’t need to be able to read or know letters to have their eyes tested. The government recommends all children have an eye test during their first year at school, which is completed by the school nurse team. Eye tests are free until the age of 16, so speak to your child’s school to ensure your little one receives one.

Q: My 2 year old has diarrhoea. Do you have any advice on managing it?

A: It’s always best to take your little one to the GP to exclude food allergies or other problems, but some dietary changes may help. Cut out sugary drinks, especially apple juice which can ferment in the bowel, making it worse. Stick to water and milk instead. A toddler needs five to eight drinks a day, let him satisfy his thirst and he won’t get dehydrated from all the fluids he’s losing. Some little ones find high-fibre diets trigger loose poos, so see how his bowel is with fewer high-fibre foods. He also needs some fat in his diet as higher fat foods slow down everything passing through the gut. Try finishing his meals with a full-fat yoghurt, a smoothie, or a cube of cheese. By 4 or 5, these symptoms will settle and you can slowly change his diet back to high fibre and lower fat.

Q: My toddler’s been diagnosed with asthma. What can I do to reduce the likelihood of an attack?

A: Asthma is a condition that affects the airways of the lungs. The airways become extra sensitive to certain triggers, like infections, dust and cigarette smoke, and become narrowed, making it difficult for the sufferer to breathe freely.

Your doctor will prescribe medication to help prevent attacks, and relieve symptoms should an attack occur. It’s very important that your toddler has these available at all times, so make sure you always carry them and leave them with his nursery and other carers.

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Minimising triggers can help so keep house dust to a minimum; keep your tot’s bed clear of toys, and wash bedding regularly to get rid of dust mites. Most importantly, enforce a strict no smoking policy. 

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