Is It Normal for Toddlers to Get Sick Often?

Some parents may grow concerned that they spend all their time at their pediatrician's office or the pharmacy this time of the year. Unfortunately, many young children seem to constantly battle colds, respiratory infections and every "bug" that goes around. Although any loving parents would worry, chances are there is little reason to be concerned. If you're a parent fighting this battle, here are a few answers to the questions you have to ease your mind. 

No one likes seeing their child ill. Whether it's a simple cold or something more serious, it can be a worrying and stressful experience, especially if you can do nothing to make them feel better. Thankfully, this doesn't happen too often for most of us, and with all the resilience that children have, they tend to bounce back pretty quickly. But what about the children that don't? The children who seem to get ill a little too often and seem to struggle to get better? How do you deal with a child who seems to get sick frequently?

How Often Do Children Get ill?

The single most common illness among children is colds. Some children seem to always have the sniffles – as soon as they get over one, they come down with another. After a while, you might start to worry that something is wrong with your immune system. The truth is, though, children begin to get colds from around six months old when the immunity they receive from their mother fades, and they have to build up their immune system to defend themselves.

The average baby, toddler and child can get around 7 to 8 colds every year, at any time of year, not just in winter. By the time they reach school age, that should reduce to around 5 to 6 times a year, and when they become teenagers, they reach the adult level of about 4 colds a year. As well as colds, children get many diarrhoea-type illnesses (with and without vomiting) and tummy bugs, which they tend to get around 2 to 3 times a year. Some children will be more susceptible to high fevers when they get a cold, or others might have a particularly sensitive tummy and develop diarrhoea symptoms easily.

In the short run, though, you'd probably like to minimise your child's suffering — and those sleepless nights. Following these simple steps can help prevent your baby from catching more than her share of colds:

• Wash your child's hands regularly with warm, soapy water. Hands down, hand-washing is the best way to prevent the spread of any infection. Wash your baby's hands often, especially after coming in from outside and before eating. Once she's a toddler, teach her hand-washing basics, especially after she's potty trained. Can't get to a sink? Hand-sanitising gels and wipes will also help prevent colds in children.
• Stay away from other kids and grown-ups with colds if possible. And if you have a cold, wash your hands frequently to avoid passing it on.
• Try to keep your child's hands out of her mouth, nose and eyes. Easier said than done, of course — babies and toddlers gum or chew whatever they can get their hands on, especially if they're teething. But to avoid giving germs a free pass into your baby's body, especially when someone else in the house is sick, swipe her hands with a wipe regularly. That way, the hands she's sucking on are clean — or at least, clean enough.
• Introduce her to yogurt. Look for yogurt brands with "live, active cultures" — they contain probiotics, which can help prevent colds in children. Or ask your pediatrician to recommend a probiotic supplement (make sure it's one designed for kids). Studies show that kids who take probiotics may have fewer cold and flu symptoms than those who don't.
• Don't share germs. Kids may be bad at sharing toys, but they're pros when it comes to swapping germs. Don't let your baby use anyone else's utensils, plates, cups, bottles or pacifiers — and don't let anyone commandeer hers.
• Toss tissues into the trash right after you've used them. And when your baby is a toddler, teach her to do the same. This way, you can prevent colds and other viruses from lingering and spreading.
• Keep your house and your child's toys as clean as possible. You can't avoid all germs — remember, some germs do your baby's body good. But you can help prevent colds in children by regularly disinfecting the playroom, bathroom and changing the table and kitchen. Use disinfectant wipes and sprays for surfaces, toys and hard-to-reach nooks. Wash towels and bedsheets once a week, and give those plush toys an occasional spin in the washing machine, too.

How do infections spread? 

Germs usually spread in one of the following ways:

• Direct contact with a person who has germs in the nose, mouth, eyes, stool, or skin. Direct contact can include kissing, touching or holding hands with a person who has an illness.
• Indirect contact with an infected person may spread germs by touching or mouthing an object such as a toy, a doorknob, or a used tissue that another person later touches. The germs can cause infection when people who now have germs on their hands touch their eyes, nose, or mouth. Some germs can stay on countertops or toys for many hours.
• Droplets transmission is very common. Germs in the nose and throat can spread through droplets when the infected person coughs or sneezes without a tissue to cover the mouth and nose. Droplets travel through the air and can reach another person close by (less than a metre away). These germs don't stay in the air and don't travel over long distances.
• Airborne spread is much less common. This happens when germs stay in the air and are carried around on air currents. These germs can infect people who are not close to the infected person and may even be in a different room. Chickenpox and measles viruses spread this way. These germs are hard to control. The best way to protect your child is with vaccines against these infections.

An adult can also spread germs from one child to another by indirect contact without realising it. For example, if you're changing a diaper, helping your child use the toilet, or wiping your child's nose, you may contact germs. If you don't wash your hands well afterwards, you can pass these germs to another child.

Why Do Children Get Ill So Often?

7 to 8 colds a year seems high. So why do children get ill so often?

The main reason children pick up infections and viruses so easily is because they are being exposed to new viruses all the time. Every new person they meet, where they go, and things they touch will expose them to new viruses, no matter how much you clean. There are over 200 different recorded cold viruses alone, and they mutate all the time, so it's tricky to avoid them!

On top of that, your child's body hasn't built up the same immune defences that your adult body has. They retain some of their mothers' immunity for the first 6 months of life, but after that, their immune system needs to develop – part of which is coming into contact with viruses and learning how to fight them off. As they are exposed to more viruses, they will build up their immunity, but it takes time. As they enter nursery or school, they will start picking up more bugs, germs and viruses, so it can sometimes feel they are ill all the time with one thing or another, from colds to infections or tummy bugs.

How Often Is Too Often?

That's a difficult one to answer because it depends on the child. Some children will always seem to be sick, while others will very rarely catch anything.

Most children will stop getting ill as frequently as they get older and their immune system develops. So a completely healthy child but catches a lot of colds isn't anything to worry about. Neither are children who seem to 'keep a cold' (you know the ones – they linger, the runny nose never seems to dry up). That can sometimes be caused by allergies, small sinuses or even their ear anatomy, making it difficult for the mucus to clear out completely. This will often turn into respiratory infections unless you're aggressive about clearing mucus, but it is fairly easy to handle. Look out for the types of illnesses your child is getting, as this can be a sign of something else.

Children who are genuinely unwell – who aren't growing well and suffer from many other issues beyond the common childhood illnesses. Things like chronic diarrhoea, thrush, respiratory infections or unusual, hard-to-treat infections. If your child has these kinds of problems and tends to catch many different, uncommon or hard to treat illnesses, you may need to see a doctor and be assessed for immune deficiency.

Ultimately, you know your child best. There is no substitute for a parent's intuition. If you ever have concerns about how often your child is getting ill, it's worth taking them for a check-up.

Although it is par for the course for children to get ill occasionally, it can be exhausting for parents, especially if children wake up in the night with fever or because they are in pain. In addition, they were trying to remember when the last dose of medicine was given and if it is safe to give another dose can be difficult when parents are exhausted and half asleep.

How can I protect my child? 

• Washing your hands and your child's hands is the best thing that you can do to stop the spread of germs. Wash your hands after:
  • Coughing or sneezing into your hands or wiping your nose.
  • Using the toilet or helping your child to use the toilet
  • Caring for someone with any infection.
  • Cleaning up vomit or diarrhea. 
  • Wiping your child's nose.
  • Changing a diaper.
  • Handling raw meat.
  • Handling pets or animals.
• When your child is old enough, teach them to wash their hands after wiping their nose or using the toilet. 
• Wash your hands before preparing or serving food and before eating, and teach your child to do the same.
• If your child has a cough or cold, cover their mouth and nose with tissues when they cough or sneeze. When they are old enough, teach them to protect their nose and mouth with a tissue. When they sneeze, or cough put the used tissue in a wastebasket right away and wash their hands afterwards. Teach them to cough or sneeze into the curve of their elbow if they don't have a tissue.
• If your child attends child care, tell the caregiver about any symptoms and ask if your child should stay home that day. When both parents work outside the home, plan by making other arrangements for someone to care for your child when they are sick. 
• Make sure your child has received all of the recommended vaccines.

What can I do if my child is sick? 

Do not give OTC medications to babies and children under 6 years old without first talking to your doctor.

When your child is sick, you want them to feel better. Many parents turn to over-the-counter (OTC) cough and cold medicines for help. Unfortunately, there is no proof that these medications work. Some of the side effects can make your child feel even worse. The only exceptions are drugs used to treat fever (such as ibuprofen and acetaminophen). 

However, medication is not always needed to reduce a child's temperature. Talk to your doctor if your baby (under 6 months) has a fever. 

There is also a risk of giving your child too much medication. For example, giving acetaminophen for a fever on top of a cough syrup that already contains acetaminophen may result in an overdose of acetaminophen. Never use more than one product at the same time unless advised by your doctor.

What is a sign I should be concerned about frequent child illnesses?

First, consider your child's overall health. If he is gaining weight and robust, you shouldn't worry. Your child is no sicker than the average child of their age. Children get over colds by themselves. Although you can reduce the symptoms, you can't shorten the course of each cold.

Many parents worry that their child has an underlying disease because they get a lot of colds. A child with health concerns does not look well between illnesses, will experience hospitalisations and not gain weight.

A child with an immune system disease doesn't get more colds than the average child. They will, however, experience numerous serious infections every year, such as pneumonia, before they are even a year old. In addition, a child with a serious disease does not gain weight very well or look well between infections.

When can my child return to school after an illness?

The first five days of a virus are the hardest. Cold symptoms can often linger for two to three weeks. As long as your child is fever free for 24 hours, there is no reason she cannot attend the majority of her normal activities. Sports and gym activities may need to wait for a few additional days until he feels up to it. 

When should I call my doctor? 

If your child shows any of the following signs:

• Fever and is less than 6 months old.
• Fever for more than 72 hours.
• Coughing that won't go away (lasts more than a week) or is severe and causes choking or vomiting.
• Earache.
• Excessive sleepiness.
• Won't stop crying or is very irritable all the time.
• Rapid or difficulty breathing.
• Diarrhea and is younger than 6 months old.
• Bloody or black stools.
• Vomiting for more than 4-6 hours.
• Dehydration (dry sticky mouth, no tears, no urine or fewer than 4 wet diapers in 24 hours in infants and fewer than 3 wet diapers in 24 hours in older children).

Managing colds and flu in babies and young children

Young babies with upper respiratory tract infections sniffle a lot and may cough a little. Even if your baby seems to be breathing comfortably, they may have trouble feeding if their noses are blocked. Proper feeding is important to avoid dehydration and loss of weight.

Babies with colds and flu need:

• cuddles and reassurance
• smaller, more frequent feeds — paediatric (but never adult) nasal drops may help with breathing while your child feeds, but drops should never be used for more than a couple of days without consulting your doctor
• extra sleep

Babies can be given paracetamol or ibuprofen in liquid form to relieve uncomfortable symptoms such as pain. Make sure to read the label for the recommended dose.

Young children

Like babies, young children with infections also need rest, warmth, nourishing food and plenty of fluids.

You can give older children paracetamol as tablets. Be sure to use them only as recommended and to store them out of the child's reach.

Do not give aspirin to babies or young children as aspirin may have serious side effects.

Cough and cold medicines and over-the-counter products such as nasal sprays should not be given to children except on the advice of a doctor, pharmacist or nurse. Learn more about colds and flu.

Things to remember

• Colds and flu should get better in a week to 10 days.
• Watch for breathing problems and other infections if your child has a cold or flu.
• Medication can ease some symptoms but must be used carefully. Talk to your doctor, pharmacist or nurse about all medicines for children.

Preventing colds and flu

If your child attends a child care centre, it is good to let the director know. Centres have guidelines on when and how long sick children should stay away to minimise the risk of the disease spreading to other children.

If your baby or child has asthma, be extra careful and watchful during bouts of colds or flu and protect them from passive smoking. In addition, consider immunising them and yourselves against influenza. Children are more likely to get infections of the airways if someone in the family smokes at home.