Paediatrics - Child Specialist Clinic (Children's Health)

Ear infections

Ear infections are common in babies and toddlers. Most ear infections are caused by virus and often after a bout of the common cold.

Ear infections can be painful and can sometimes cause fever. A child may rub or pull at their ears. Young babies cannot always tell where the pain is coming from and may just cry and seem irritable.

When should you seek help from a paediatrician:

• If symptoms last longer than four days.
• If the infection worsens with severe pain.
• If your child has a very high temperature.
• If your child is having breathing difficulties.

Eczema

Eczema is also known as atopic dermatitis. The onset of eczema is most common when the infant is between 1 to 3 months old.

Symptoms of eczema include:

• Patches of itchy, dry skin on hands, neck, face, and feet.
• Redness, scaly skin, and skin discolouration.

Eczema is usually recurrent. The rash gets better, then reappear soon after.

Eczema rash is often itchy, so treatment is usually needed for this condition. Moisturisers are often used to treat mild eczema. For severe eczema, a topical steroid cream or ointment may be needed.

Fever

Fever happens when the body's internal 'thermostat' raises the body temperature above its normal level. This thermostat is found in a part of the brain called the hypothalamus.

Fever by itself is not an illness; it is usually a symptom of other conditions such as infections (e.g., common cold, influenza, gastroenteritis, tonsillitis).

It is a fever when your child's temperature is at or above one of these levels:

• Measured orally (in the mouth): 37.8°C / 100°F
• Measured rectally (in the bottom): 38°C / 100.4°F
• Measured in an axillary position (under the arm): 37.2°C / 99°F

When should you seek help from a paediatrician:

• Your infant younger than 3 months old has a rectal temperature of 38°C / 100.4°F or higher
• Your child has a temperature higher than 38.9°C / 102.2°F
• Your child has a temperature lower than 39°C / 102.2°F who:
• Shows signs of dehydration (peeing less than usual, not having tears when crying, less active than usual).
• Has lasting diarrhoea or repeated vomiting.
• Has a specific complaint such as a sore throat or an earache.

Learn more about fever in children.

Hand-Foot-and-Mouth Disease (HFMD)

Hand-foot-and-mouth (HFMD) is a common infectious disease that is seen in children and infants. The disease is usually mild and self-limiting.

HFMD is contagious. The virus spreads from person to person through faecal-oral route and the infected person's nose and throat secretions, fluid from scabs or blisters.

Symptoms of HFMD include:

• Fever
• Sore throat
• Mouth sores
• Skin rash with blisters on arms, legs, and buttocks

When should you seek help from a paediatrician:

• Your child is not drinking enough water.
• Your child’s condition is not improving after 10 days.
• Your child has a weakened immune system.
• Your child has severe symptoms such as high fever with chills.
• Your child is younger than 6 months.

Heat rash

A heat rash appears after exposure to heat or sweat. However, it usually disappears after a cool environment is provided to the affected child, such as wearing loose clothing or switching on air-conditioning.

A heat rash typically does not necessitate treatment. If symptoms worsen, they are usually attributed to other illnesses. Bring your child to a paediatrician if you have concerns about your child’s condition.

Influenza

Commonly known as the flu, influenza is caused by a virus and spreads through the air when infected people cough/sneeze.

Symptoms of influenza include:

• High-grade fever above 38°C
• Chills
• Cough
• Sore throat
• Headache
• Nasal congestion
• Muscle aches
• Fatigue

If you notice these symptoms, seek your doctor’s help for medication. Most influenza cases can be well managed at home with medication, rest, and proper fluid intake by the child.

Getting flu vaccines every year can reduce the risk of contracting influenza for various common strains.

Pneumonia

Pneumonia is an infection that affects one or both lungs. It can usually be triggered by cold or flu bouts.

Pneumonia causes fluid or pus to fill the air sacs of the lungs. It obstructs the normal exchange of gas inside the lungs, which leads to low levels of the oxygen in the blood and impaired removal of carbon dioxide from the body.

Young children are considered most susceptible to pneumonia. 

Symptoms associated with pneumonia differ considerably depending on the cause and the health condition of the child. They may include:

• Cough with or without phlegm that is yellow, green, brown, or blood-stained
• Difficulty breathing
• Chest pain that worsens when you breathe or cough
• Fever and chills

Skin allergy

Skin allergy can be acknowledged if the onset of the rash is after exposure to an allergen, which causes the allergic reaction. The reaction may occur within minutes, or between 4 to 6 hours after the exposure.

Allergens are usually substances or foods that trigger an allergic reaction. Common culprits of an allergic reaction in children are certain foods such as eggs, seafood, and peanuts.

Symptoms of an allergic skin reaction include:

• Flaking of skin
• Redness
• Itchy rashes
• Bumps
• Swelling of the lips or the eyes
• Breathing difficulties

Sticky eyes

‘Sticky eyes’ is a common condition in newborn babies and young children while their tear ducts are developing. Symptom includes sticky stuff in the corner of their eyes or eyelashes.

Strep throat (throat infection)

Strep throat is an infection caused by the bacteria Streptococcus pyogenes.

Symptoms of strep throat include:

• Sore throat
• Swollen tonsils
• High fever
• Stomach pain

Take your child to a paediatrician for a strep test if he/she shows the symptoms above.

Tonsillitis

Located on each side of the back of the throat, tonsils are part of the immune system that produce antibodies to fight germs that attack the mouth.

Tonsillitis is a condition when the tonsils are infected and enlarged. Viral infection is the main cause of tonsillitis.

Symptoms of tonsillitis include:

• Difficulty and pain when swallowing
• Fever and chills
• Headache
• Loss of voice
• Sore throat
• Swollen lymph glands at the jaws and neck
• White spots of pus on the tonsils
• Abdominal pain

Torticollis (Wry Neck)

Torticollis (also called Wry Neck) is when the baby’s head is tilted. The chin points to one shoulder, while the head tilts toward the opposite shoulder.

Congenital Torticollis occurs when the neck muscle that runs up and toward the back of the baby’s neck is shortened. Torticollis may be present soon after birth due to scar tissue and tightness of the muscle on one side of the neck, or it may occur later in childhood.

Symptoms of torticollis include:

• The baby has difficulty turning the head to the opposite side.
• The baby may not be able to move his or her head as normal as other babies.
• There may be a lump in the baby’s neck muscle.
• The baby may have flattening of head and face due to his or her preference of head position.
• The neck muscle (sternocleidomastoid) may be tight.

Urinary Tract Infection (UTI)

Urinary tract infection (UTI) is a common bacterial infection of the bladder or kidneys. It is a common cause of fever in young children. UTI can be suspected especially when no other obvious sources of fever are identified.

Symptoms of UTI in children include:

• Fever
• Child starts to cry when passing urine
• Going to the toilet very frequently (feeling of “cannot wait”)
• Small amount of urine at a time
• Urine may be cloudy or strong smelling
• Blood may be present in the urine
• Stomach or back pain

Take your child to a paediatrician for if he/she shows the symptoms above. UTI in children must be treated because untreated UTI poses a risk of kidney damage.