Every parent is concerned about their child’s health, whether they are at home, in school or in daycare. That’s why, when it comes to childhood illnesses, it’s good to be aware of the common issues, symptoms and treatments.
Dr. Abdulla Ghori, a pediatrician in The MetroHealth System, works in an urgent care setting two half days a week. Based on his observations, the most common reasons children come to the clinic differ based on the seasons. Summer ailments are different from winter ones, and fall complaints differ from both.
Generally, the most common symptoms include a cold, runny nose, a cough, fever, diarrhea, vomiting, a rash on a child’s body, eczema, abdominal pain, ear pain, asthma flares, seasonal allergies, food allergies, bug bites, trauma or falls, he said. Then comes more chronic conditions like behavioral health — nail biting, fighting in school, hitting a sibling or talking back to a parent. Doctors are also seeing child obesity, kids who are unable to focus on their studies, as well as kids who are hyperactive, or too fidgety.
“These are some of the most common conditions, symptoms, concerns for which kids come to the doctor,” says Ghori, who has treated children for more than 39 years.
Any time a child is sick, he says, the doctor and parent always have to consider the age of a child who is not feeling well. The seriousness of a symptom also depends on the age of a child.
“A serious condition in a newborn — a newborn is defined as someone who is 28 days to a month of age — is different from the same symptom in an older child. So we always consider the age of a child when we’re considering symptoms,” Ghori says.
We spoke with several experts, including Ghori, about 10 of the most common conditions children face.
Ghori says children often get a sore throat, and parents often think their child needs to be tested for strep throat. But if children have a runny nose, they do not need to be evaluated for strep.
Strep is more common in school-aged children and less common in younger children. Doctors test for strep if a child has a sore throat, but not a runny nose or cough. If it is strep, doctors can treat the illness with antibiotics. Otherwise, a sore throat doesn’t require antibiotics.
There are certain self-limiting (or self-recovering) viral infections that do not require antibiotics, and certain situations where a doctor would recommend antibiotics, such as if the cough is persistent or has lasted for more than one month, or if a runny nose gets worse after two weeks, or if a child has an added cough that is worse at night, he says.
“Otherwise, just be patient, and let the disease run its course, and most of the time, it goes away,” Ghori adds.
“When we talk about allergies, there are different kinds of allergies: There are food allergies, there are allergies to environmental allergens that we do not see, like pollen and other things that are flying around in the air. And then, we also have allergies from things that we come in contact with, most commonly, nickel in costume jewelry, poison ivy, or certain other plants and bushes that you may be allergic to, or being allergic to pets and so on,” Ghori says.
With food allergies, a parent might give a child a certain food, and the child may develop a rash. That can be helpful to doctors when determining what is causing the allergy. Then there are environmental allergens, such as grass, pollen and weeds, which emerge based on the season.
Kids can also be allergic to something in the air around them. That is called a perennial allergy, and it is usually caused by indoor exposure to airborne substances, such as something that’s in the carpet. Kids can also be allergic to pets, like a cat, and that might run year-round. Contact allergies usually occur in spring, summer and fall, because children are running around outdoors, and in the woods. Sometimes children can also be allergic to a medicine a doctor prescribes.
“One really important thing that parents should remember about allergies is in the context of an allergic reaction: If the child develops lip swelling, any funny feeling or swelling of the tongue, or if it feels like they’re choking, or they make a high-pitched sound, like a croup, or any abnormal sound they make when they are breathing in, or if they have shortness of breath or wheezing, they should immediately call 911 and seek medical care,” Ghori says.
Dr. Michael Perisa, a pediatrician with University Hospitals Rainbow Babies & Children’s at Chardon Pediatrics, said the common cold is an illness that routinely gets a viral upper respiratory infection diagnosis.
“No medication necessarily helps the common cold get better any faster,” he says. “It’s just one of those illnesses where, unfortunately, we must wait for the patient’s body to fight it off.”
Symptoms of the common cold include a runny nose, cough, congestion and possibly a fever. Rashes can sometimes pop up, too, as well as belly symptoms, such as nausea, vomiting and diarrhea.
Kids can also sometimes have ear pain, which can be frustrating because it can look and feel a lot like an ear infection. But if a doctor looks in a child’s ears and doesn’t see any signs of an ear infection, and listens to a child’s lungs and doesn’t hear any signs of pneumonia, they will recommend symptomatic care.
“Symptoms tend to peak in the first couple days, and they slowly resolve after that,” Perisa says. “Fevers can be as high as 103 degrees sometimes, and that can still be a viral illness, but if symptoms are persistent, more than five to seven days, or if a child has a fever for more than five days, it’s worthwhile to check in with a child’s doctor. Even if it is the same viral illness at that time, you just want to make sure that nothing else may have popped up, because a child can get ear infections and pneumonia shortly after getting viral colds.”
Hand, Foot, and Mouth Disease
Doctors are also seeing a lot of hand, foot, and mouth disease, which is common with kids in mid-to-late summer. This common childhood illness has the name “hand, foot, and mouth,” but the rash can pop up anywhere on the skin. Parents will see it on arms, legs, or in their diaper area or underwear area, and it is very uncomfortable.
“I can speak about this common kid’s health issue firsthand,” Perisa says. “My son gave it to me a couple of months ago, so it’s important to note that adults can get this, too. When we tend to get it, we tend to get a little bit different flavor called herpangina. It’s the same or similar viral illness, but for whatever reason, it just causes the blisters in the back of the throat, and we typically don’t get the skin blisters that we see in kids with hand, foot, and mouth.”
Hand, foot, and mouth often starts with a fever. Kids might have some belly pain, feel a little bit sick, and have a little bit of a runny nose and congestion, he said. Often when the fever breaks or goes away, that’s when they start to get rashes that pop up all over their skin, most characteristically on their hands, feet, or obviously on their mouth, hence the name of the disease, and those blisters can be very painful.
“There’s nothing really to treat it,” he says. “Since it’s viral, no antibiotics will help it. It’s Tylenol, Motrin (Motrin only if your child is older than six months old), and making sure they are staying hydrated. If they have belly discomfort, there are some anti-nausea medications we will sometimes suggest, but it’s the same viral treatment that we talk about for other viral issues like the common cold, such as keeping them as comfortable as possible.”
Don’t expect kids to eat normally until the blisters are gone. Once the blisters pop up, the symptoms will go away in five to seven days. If children have skin blisters that are visible, they can transmit hand, foot, and mouth disease that way. If they have mouth blisters, it can be transmitted through saliva as well. So, it’s important to let your child’s daycare or school know, and follow their recommendations.
Asthma is a condition where a child’s airways become inflamed, narrow, and swell, and produce extra mucus that makes it difficult for them to breathe.
Asthma is one of the conditions that causes wheezing. Your doctor can examine your child and tell you if your child is wheezing.
Sometimes doctors will use the term “reactive airway disease” before they diagnose asthma, and sometimes the doctor will tell you your child has asthma, Ghori says.
Most of the time for asthma, a doctor will tell you what kind of medication your child has to be on. There are two broad groups of medications doctors will recommend. One is called controller medication, or medications used to prevent an asthma attack. The most common medications include inhaled steroids.
“A controller medication that the doctor prescribes and says, ‘Take daily’ must be taken daily. Regardless of whether your child has an asthma attack or does not have an asthma attack, they should be taking it regularly,” Ghori says.
“Whereas the second category of medications are called rescue medications. That’s like calling the fire guard when you have a fire. So those are used only when you have a fire, which means when your asthma is triggered, or is exacerbated. The most common medication that’s prescribed for that is called Albuterol, and the doctor would prescribe that in an inhaler form or in a nebulizer form, and patients can feel free to start using that medication as the doctor recommends.”
Dr. Sara Bohac, a pediatrician at Cleveland Clinic Children’s, says pink eye or conjunctivitis is very common in the pediatric population.
It’s also very contagious. Most often, it’s caused by viruses, but it can be caused by bacteria. Pink eye, or eye discharge, can be caused by allergies as well. Kids can get pink eye in one or both eyes.
“When you come to see your doctor, they will get a good history, and physical, and see if it’s one eye or both eyes. Is it a clear discharge, or is it pus? We also check to see if there’s redness around the eye, or swelling of the eyelids,” she says. “We will check to see if there are hot-cold flu symptoms or ear pain, and we will go through all of that. Depending on what we think it is, will determine the treatment we give.”
Children can get pink eye a lot, and it can spread rapidly in schools and daycare centers. Symptoms of pink eye can include itchy eyes, eye redness, watery eyes or eye pain. Children should stay away from others for at least 24 hours after they start treatment.
Treatment can include a warm compress put on the eye for a few minutes, several times a day, or artificial tears. For those who wear contacts, doctors recommend kids stop wearing them until the eye feels better.
“All kids are active, and we want them to be active, but sometimes they try to do things they are not quite ready for yet, or when they are doing normal sports or activities, something goes wrong,” Bohac says. “They get hit by another player, or they slip, or they twist their ankle. There are lots of different kinds of injuries that pediatricians can take care of.”
She says pediatricians are trained to take care of injuries from sprains and overuse injuries to concussions and fractures. Sometimes a pediatrician will diagnose a fracture, and then refer a child to an orthopedic specialist. Certain injuries may result from different kinds of sports. For example, in the winter, sports injuries can result from kids playing basketball and volleyball, or falling on the ice. Pediatricians generally see more injuries in the summer, because kids are outside more.
According to the Center for Disease Control and Prevention’s latest Childhood Injury Report, an estimated 9.2 million children annually visit the emergency department for an unintentional injury.
Dr. Mary Carol Burkhardt, medical director of the Hopple Street Clinic for Cincinnati Children’s Hospital, says COVID-19 is still in the forefront of everyone’s mind.
Currently, the CDC recommends that everyone ages 5 and older get a COVID-19 vaccine and wear masks in schools and other indoor public spaces to help protect against COVID-19 infection. There’s no medication for routine cases of COVID, and most children recover at home with fluids and rest.
“I think with COVID, the challenge right now is COVID is still common in the community,” she says.
She says COVID is really tricky, because the signs and symptoms of COVID overlap with so many other common pediatric viruses, and there’s not a clear way to look at a child and know if they do or don’t have COVID. Because of that, a lot of families are struggling with children who are getting routine illnesses, but are asked to stay home from school, appropriately, to avoid infecting others. Doctors and parents are relying on COVID testing to determine if a child has COVID.
“That’s frustrating and hard for families, because there’s a lot of missed school and work due to those things,” she says.”But unfortunately, I think that’s what we have to do, and the way out of this pandemic is through vaccination. Parents have questions about the vaccine, because it’s new, and I think with anything new, people have questions about it. But what we know is that the side effects and long-term effects of COVID in children are certainly more concerning than the side effects of the vaccine, so even when families are weighing that out, I encourage them to consider the long-term effects of COVID in kids, which are not well known. But we do know that those, at least right now, are certainly more serious than some vaccines, so we are having a lot of conversations about that with families.”
Two things parents should monitor are the respiratory status of their child and their hydration status, and make sure they’re staying hydrated.
The mental health issues doctors are seeing right now are also high on the list.
“Mental health was a problem before the pandemic, but it has worsened over the course of the pandemic. Everybody’s world has been affected by COVID in different ways, and our kids have been affected in different ways than us as adults,” Burkhardt says. “We have seen a lot of depression and anxiety, because a lot has changed, and a lot is unknown, and that makes kids prone to both depression and anxiety.”
Kids know what’s going on in the adult world, and they see their parents struggling with layoffs, or stresses at work, and all the things that have changed. It’s affecting kids because they don’t always have the same resources and the same coping skills, because they are younger and haven’t developed those things yet.
“In the mental health world, we also have seen a lot of oppositional behaviors, which is kids that are acting out. They can be defiant towards adults, and I think the causes of these are very multifactorial, but I think if parents are seeing those symptoms in their children, then addressing them early on is really helpful, so that they don’t spiral and get worse,” she says.
If kids are showing symptoms, they should be addressed as soon as they start affecting their daily activities. So if a child is sleeping more or not enough, if they are eating too much or too little, or if they are having trouble going to school and maintaining their daily routines in any way, Burkhardt recommends discussing these issues with your provider, along with any safety concerns a parent may have.
“With mental health, I would say it’s better to raise it as a concern sooner rather than later, because it’s an area where prevention and treatment early can often be more effective and shorter lived,” she says. “So we want to address the problems when they are small and more mild, as opposed to severe and we have a large problem on our hands.”
Also super high on the list for doctors is obesity, which was already a problem before COVID, but has been exacerbated by the pandemic.
“We have already seen in literature that the obesity epidemic in kids has worsened due to COVID,” Burkhardt says.
With the shutdown, kids stayed at home more and changed their typical routines, and some still may not be going to school in person. They also potentially may have more access to food on a regular basis.
“Unfortunately, we’ve seen high weight gain in many patients since the pandemic began, and we already knew there was a problem leading up to that,” Burkhardt explained. “I think it’s just raising awareness of it. A lot of families see their child every day, so it’s not so clear to them that their child is putting on weight.”
According to the CDC, childhood obesity is a serious health problem in the United States. One in five U.S. children and adolescents have obesity. Some children are more affected than others, but all children are at risk of gaining more weight than is considered healthy.
Obesity is complex. Many factors can contribute to excess weight gain, including behavior, genetics, stress, lack of exercise and certain medications. But societal and community factors can also contribute to the problem.
If you have any medical concerns about your child, please contact your pediatrician or other medical professionals for advice. Seek immediate assistance if your child is having an emergency by calling 911.
If you or someone in your family is having a mental crisis, reach out to the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
Other Kid-Friendly Tips
Expect Kids to Be Sick A Lot. It’s Normal
Dr. Michael Perisa, a pediatrician with University Hospitals’ Rainbow Babies & Children’s at Chardon Pediatrics, says when it comes to dealing with common childhood illnesses, an important thing for parents to remember is that it’s normal for kids to get sick quite often, especially when they are around other kids.
When kids are licking things, putting things in their mouths, playing with toys and interacting with other children, they are going to get sick all the time, and that’s normal.
“With kids that are in daycare or at school, and in daycare especially, we expect them to get sick about once a month, or 10 to 12 illnesses throughout the year, which seems like they’re sick all of the time,” he says.
Vaccinations and Kids
Dr. Sara Bohac, a pediatrician at Cleveland Clinic Children’s, says following the childhood immunization schedule is very important as the child grows up and progresses from infancy into young adulthood, with vaccinations that protect the child against a lot of infectious diseases.
“The schedule is tailored so the child is protected when they are most vulnerable,” she said.
Kids often start getting vaccinated against illnesses like whooping cough and rotavirus at about two months old, for example. Whooping cough can damage the lungs and be deadly to young children. A child’s first pneumonia shot also starts at two months, which protects against 13 strains of strep pneumonia.
Healthy nutrition makes it easier to maintain a normal height and weight.
“I would suggest when it comes to preventing illnesses, it would be physical activity and staying physically healthy,” said Dr. Abdulla Ghori, FAAP, a pediatrician with The MetroHealth System.
When in Doubt, Check with Your Provider
“Having a good relationship with a provider can really make a big difference,” says Dr. Mary Carol Burkhardt, medical director of the Hopple Street Clinic for Cincinnati Children’s Hospital. ”Parents shouldn’t be expected to always make those calls, if this is something common versus something more serious.
“But I would say in general, signs of something that would be more serious would be when children have prolonged fevers, when there’s respiratory distress or labored breathing, or when kids are not drinking well, have low urine output, or are excessively fatigued. In general, I would say those are good signs that something needs to be investigated, or a child should see a provider, but I think it’s really hard, even as pediatricians. That’s why we rely on physical exams and lab work, because you can’t always just tell by looking, between something serious and something very common.”