The "COVID in Kids" One

My child has COVID - now what?!

This post is about COVID-19 in kids. It is not intended to replace medical advice or government guidelines, but to provide information on:

  • Overview on kids illness (severity and symptoms)

  • Monitoring kids at home

  • Practical tips to manage symptoms at home

  • When to worry 

  • Services to help parents at home

Overview

In most children, COVID-19 infection will be ‘mild’ – that is, you’ll be able to manage it at home. 

Common symptoms in children 

  • Cough

  • Fever

  • Runny nose

  • Sore throat

  • Diarrhoea and vomiting 

  • Headaches

  • Irritability 

  • Rash (a red, blistered and itchy rash on toes and fingers)

  • Abdominal pain


Monitoring kids at home

Your job is to know when something isn’t quite right, and to seek the appropriate level of help. You don’t have to diagnose your child if symptoms change, nor do you have to turn into a Doctor and provide all of the treatment from home without any help. Simply focus on the basics, monitor for any changes and seek help if in doubt. 


At this point, it’s very difficult to predict whether a child will have mild, moderate or severe symptoms. So we need to approach this illness the same as any other illness: by understanding what symptoms of sickness are abnormal in kids, and knowing when to get help.



Practical tips to manage kids at home

  • Prioritise rest.  Let them sleep more if they wish, but monitor their behaviour when they are awake. If you are concerned they are “too sleepy” aka they are lethargic, please seek medical attention.

  • Encourage fluids as much as possible. Small frequent sips, or shorter, more frequent bottles and/or breastfeeds is key here. If your child is eating solid food, don’t be discouraged if they aren’t eating as much as they normally do. It’s ok for them to temporarily go”off” their food. However, you must prioritise fluids.

  • Saline drops or sprays to the nose can help ease congestion, and help them be able to breathe more comfortably. Saline won’t stop the secretions, rather it will help loosen them up to help our little ones sneeze the snot out, blow their nose or wipe it up with a tissue.

  • Pain relief. Paracetamol and Ibuprofen are great over-the-counter options. Both of these medications can be used to make our kids more comfortable, and it can also ease sore throats in order to maximise drinking fluids. When giving medications like Paracetamol and Ibuprofen, it’s critical to keep track of how much you gave, to which child, and what time. My Medicine Tracker Magnets are designed for this exact purpose.

  • Fever management. Your goal of fever management in kids is NOT to lower the “number,” rather, it’s to provide comfort, prioritise fluids and assess for red flag symptoms (as outlined below). It is important to note that any child aged three months of age or younger with a fever (38ºC or higher) must seek medical attention immediately, regardless of any other symptoms.



When to worry

These are the primary red flag symptoms to watch out for (for any respiratory illness in children)

  1. Difficulties breathing

  2. Dehydration

  3. Reduced level of consciousness


Difficulties breathing — Are they breathing faster, harder or noisier than usual? Do they look like they are working hard to breathe? Are they sucking-in in between their ribs bones or at the front of their neck? Are they nodding their head along with each breath? Are they making funny noises like grunting or whistling when they are breathing? 


Dehydration — Are they drinking their usual amounts of fluid*? Are they having a normal amount of wet nappies / toilet trips? Is their wee dark in colour or smellier than usual? Is their mouth dry? Are they crying tears? Are they vomiting/have diarrhoea?


*Fluid can be anything from breastmilk, formula, water or other liquids. It’s not abnormal for children to temporarily go off their solid foods when they are sick. However, it is critical that they continue to drink fluids.


Reduced level of consciousness — Are they far sleepier than usual? Are they difficult to wake up? Are they sleeping so much that they are not drinking? Are they acting “strangely” aka more “spaced out” than usual? Are they floppy? What’s their behaviour like? 


Other reasons to seek help:

  • Your child is under 3 months of age

  • Fever continues for 5 days or more

  • You are worried about your child


Services to help parents at home

Obviously we do not want to use our already overloaded healthcare system inappropriately, BUT do not hesitate to call an ambulance or head to your closest emergency department if your child’s symptoms are severe.


If you are unsure, call one of our fabulous 24/7 helplines to help you troubleshoot through your decision making process. They will ask you questions about your child’s health and symptoms, and how you have been managing at home. Sometimes it’s nice to talk to someone, get that reassurance that you are doing everything wonderfully, or that it’s time to seek medical attention.


Here are some services available to parents in Australia:

HealthDirect – Health information & advice 1800 022 222 (24hrs)

Pregnancy, Birth & Baby – Maternal Child Health Nurse Support 1800 882 436 (24hrs)

Medicine Helpline – Medication information & advice 1300 633 424 (9am-5pm week days)

Tresillian parents helpline – General parenting support 1300 272 736 (7am - 11pm every day)

Australian Breastfeeding Association – 1800 686 268 (24hrs)

Beyond Blue – Mental Health Support 1300 224 636 (24 hrs)



References and other useful information

https://dontforgetthebubbles.com/evidence-summary-paediatric-covid-19-literature/

https://dontforgetthebubbles.com/covid19-children-europe/

https://www.rch.org.au/kidsinfo/fact_sheets/Coronavirus_COVID-19/

https://www.rch.org.au/wallaby/COVID-19_resources/

https://www.health.nsw.gov.au/Infectious/covid-19/communities-of-practice/Pages/Caring-children-COVID19-community.aspx

https://www.schn.health.nsw.gov.au/fact-sheets/covid-19-in-children

https://www.health.gov.au/health-alerts/covid-19/case-numbers-and-statistics

https://www.health.nsw.gov.au/Infectious/factsheets/Pages/advice-for-confirmed.aspx

https://www.mcri.edu.au/sites/default/files/media/documents/covid-19-and-child-and-adolescent-health-140921.pdf 


Collaboration blog by myself (Penny Blunden) and Dr Jessica Stokes-Parish

Penny Blunden RN, MN (Adv. Prac.)

Dr Stokes-Parish RN, GCC (ICU), MN (Adv. Prac.), PhD

Jessica is an Intensive Care Nurse and researcher. She is an experienced educator and communicator, and is working on the frontline during this pandemic. She is part of the planning teams to protect and prepare staff and will be deployed to work with patients once the demand is there.

Penny Blunden