Helping to keep kids healthy over winter: Q&A with Dr Pixie McKenna

Sniffles and sneezes tend to become more common at this time of year, and looking after poorly little ones can take its toll on the whole family

Courtesy of Nurofen for Children, Mumsnetters had the chance to ask Dr Pixie McKenna their burning questions on children's health in winter - topics ranged from helping your kids sleep through the night when suffering with a cold, to seasonal nasties such as chilblains and conjunctivitis.

Pixie is more than a medical expert - as a mum of one to daughter Darcey, she's also got first-hand parenting experience. 

To help keep your children healthy this season, Pixie shares her top tips and advice below.

This Q&A is sponsored by Nurofen for Children. Answers to Mumsnetters' questions are expert opinions from Dr Pixie McKenna and not from Nurofen for Children. Dr Pixie does not endorse Nurofen for Children or any other medicines.


Want answers on a specific topic? Take a look at the following:

- What to do about those inevitable school germs

- Preventions and myths

- Helping poorly kids sleep through the night…

- and survive a car journey without being sick

- Coughs and colds that won’t budge

- How to treat dry skin in colder months

- Vitamins, flu jabs and medicine – what you need to know

- Asthma advice for little ones

- Are growing pains real?


WIN! One lucky Mumsnetter will have the chance to win a £250 John Lewis voucher.



What to do about those inevitable school germs

What's the best way to prevent kids bringing home germs from school? (Rosehips)

Pixie: Unfortunately, we have to accept that our kids are going to fall ill; their immune systems just aren't as good as ours.

The Royal Pharmaceutical Society advises that kids can catch up to 12 colds a year - arm yourself against this by practising good hand hygienei. If you can teach your little ones to do a high-five you can teach them to wash their hands. Make sure they do it thoroughly with soap and warm water and for 20-30 seconds (that's two verses of Happy Birthday).

We touch our faces several times a day, so that's lots of opportunities to make us ill if our hands are not clean. Advise them not to share drinks and eating utensils with others. Make them feel grown up by teaching them how to use tissues. This isn't just about the kids; you must also become a handwashing hero.

Hand sanitiser can be used if you are on the go and a great time to do a quick disinfect is when you pick them up from school, leaving the bugs at the school gate.

Finally, a healthy lifestyle primes the immune system so *all* the family need to eat, sleep and exercise well. Those who are vulnerable and eligible for the flu vaccine on the NHS should take it up.


Preventions and myths

My children refuse to wear coats. Is there really any association between being underdressed and getting ill? (Anononoo)

Pixie: Getting a cold has nothing to do with being cold. It's a myth! However newborns, infants and young children should always be wrapped up well in the winter to maintain their body temperature. This is to protect them from hypothermia. The only way kids catch colds is from coming in contact with a virus - in most cases they don't even have to go outdoors to do that. Coats will keep you cosy and warm but they won't fend off germs.


Any tips to avoid/prevent conjunctivitis? It seems to be a winter treat my gang come down with after a heavy cold. (IncaAztec)

Pixie: Most things kids pick up tend to be down to viruses. A virus can enter the body through the nose, mouth or eyes so it is not uncommon for kids to come down with conjunctivitis. The best way of preventing it is to be strict with hand washing as a contaminated hand rubbing an eye can result in infection. In addition, ensure they use tissues to rub away any of the debris from the cold and ensure the used tissues go in the bin, not the school bag. If they are prone to conjunctivitis, extra care needs to be taken with pillows, flannels, and towels – make sure these are clean and not shared. Kids should avoid touching their eyes and should not go swimming if they have a cold.


My children often get croup if they get a bad cold and cough in the winter. Is there anything I can do to help prevent croup developing? It's so scary and usually ends up with us ringing for an ambulance in the middle of the night. (RACHELSMITH45)

Pixie: Croup is a common virus caught by kids in the winter resulting in a classic barking cough. This kicks in a couple of days after cold type symptoms. You are right it can be really scary. The way to prevent croup is to try to prevent kids catching the virus in the first place. So it's back to the basics of hand washing to prevent catching and spreading infection.


Helping poorly kids sleep through the night…

Have you got any tips to help children sleep through the night if they are struggling with a chesty cough? (Quills)

Pixie: Make sure they are propped up a bit and humidify the air in the room by leaving a bowl of water on the radiator. Don't have the room too warm or too cold as that might encourage coughing.

If they have a fever that is distressing them, then treat their temperature by giving them children's medicine such as liquid ibuprofen or paracetamol. If their nose is blocked, a saline nasal spray can help clear this. Antibiotics will rarely make an impact as the majority of these winter bugs caused by viruses.

Finally, anticipate that your little one might be tired if they are not sleeping well and give them a bit more leeway on the naughtiness scale.


My 10–year-old is a worrier and sometimes has problems falling off to sleep. What can we do to help? (PinkSwimGoggles)

Pixie: Firstly, establish why your child is worrying. Is it an underlying level of anxiety, school bullying or worries about home life? Engage with them about how you can reduce their worries together as a family. Sometimes something very simple can prove a huge burden to a 10-year-old. If they won't talk to you, see whether they will talk to another family member in confidence. If it is really impacting their sleep and day-to-day wellbeing, take the time to talk it through with your GP. In the first instance, go without your child and then on the next occasion bring them with you.

Make sure they avoid things that interfere with sleep like caffeine, watching scary or controversial films before bed, or playing on a digital device before bedtime. Also ensure they burn off a bit of anxiety though the distraction of exercise and socialisation.


My one-year-old is a belly sleeper and has been since she could roll over. This causes huge sleep disturbances when she has a cold and the usual tricks of raising the mattress etc don’t help. She will not stay on her back no matter what we try. Do you have any tips to make it easier for her to breathe/sleep with a blocked nose? (FranksBobot)

Pixie: It might help to buy a humidifier and try to moisten the air in the room. In addition, you could try saline nasal drops to clear her air passages. These are drug-free, have few side effects and are available without prescription. Most kids are bothered when they are bunged up so I don't think the sleeping position makes a huge difference and by the sounds of things, she is set in her way so there’s no going back.


What is the best way to help clear a baby aged 14 months of congestion, particularly when she goes to bed at night? (Babanew)

Pixie: Babies like to breathe through their noses, so when they are blocked it can cause distress. A bath pre-bed will loosen some of the mucous. So too will saline nasal spray, which can be used in a baby of this age.

Children with longstanding problems of congestion may need a review by their GP to ensure there is no problem with the adenoids. These are little glands at the back of the nose that grow until you are five-years-old and then shrink. Allergy or infection can make them grow and they can then interfere with sleep and breathing or cause ear or sinus problems.


…and survive a car journey without being sick

What can be done about horrendous motion sickness in a 16-month-old? By horrendous I mean full on projectile vomiting literally less than five minutes in the car or three stops on a London bus. (EstelleRoberts)

Pixie: I would suggest you see your GP about this as they can prescribe you something such as domperidone syrup to help ease the symptoms. Keeping your child focussed and looking ahead also helps.


Coughs and colds that won't budge

My almost-four–year-old has had a cough for three weeks. She coughs at night time mostly but a bit during the day too. She has no other symptoms except she looks pale. She is generally in good form during the day. When should I get worried if the cough continues? (TulipsInAJug)

Pixie: As a rule of thumb, kids who are well in themselves are exactly that - well in themselves. In the absence of any other symptoms, this could just simply be a lingering cough long after a viral infection has gone. A night time cough can also be the first sign of asthma, so I would suggest you take her to your doctor and get them to take a listen to her chest, just in case. If nothing else this will reassure you that, as is often the case, the best medicine is time. Her pallor may be because she isn't sleeping, so mention this to the doctor and anything else you have noticed to help with the assessment.


My seven-month-old gets a runny nose, streaming eyes and a cough when he is cutting teeth. His sleep (and mine) is disturbed and he just looks unwell. Is it just a coincidence or do colds and teething go hand in hand? (lozengeoflove)

Pixie: There is a big debate as to what symptoms teething actually causes. Each baby is of course different but it would be difficult to blame teething exclusively for the respiratory symptoms you describe. I suggest you try an ibuprofen or paracetamol-based children's medicine to ease your baby’s pain and discomfort.


My 10-year-old hates blowing his nose and is constantly bunged up. Any tips? (MrsOllyMurs)

Pixie: He won't have a permanent cold so it is worth considering the possibility of allergy. House dust is a common theme where this problem is concerned with mattresses, cuddly toys, couches and curtains teeming with allergy-provoking house dust mites. The other culprit could be the family pet. I would suggest he completes a symptom diary and then sees his GP. In the meantime he could try saline nasal spray to help clear things out.


My mum advises me to give the children lots of fluids when they have colds to flush it out. Is this correct? And is there any truth in the saying 'feed a cold and starve a fever'? (ILostItInTheEarlyNineties)

Pixie: Drinking lots of fluid is essential to prevent dehydration - it has nothing to do with flushing things out! The phrase feed a cold and starve a fever is just that, a phrase. Most of us don't feel like eating if we have a high fever, but if we did want to eat there is no reason why we shouldn't. Infection burns calories so although you may not have moved from the bed, there will still be an energy demand.

Your child can eat if they have the appetite to do so, whether they are feverish or not. If they are distressed by their fever, consider giving them some children's medicine like paracetamol or ibuprofen. This should help lift the fever and may result in them 'finding' their appetite. The overriding issue is fluid above food; this should be prioritised to prevent dehydration.


How to treat dry skin in colder months

What's the best way to look after kids' skin in winter to avoid it getting dry and sore? My seven-year-old daughter in particular suffers on her hands and around her mouth. When she has a cold and runny nose it gets much worse too. (WuTangFlan)

Pixie: Invest in what doctors refer to as an emollient - this is a medical moisturiser available via your pharmacy. If you know SLS (Sodium Lauryl Sulphate) dries your daughter's skin further, choose a product which is SLS-free. Use it regularly - don't wait for the skin to become dry. Apply it thinly and frequently and always after handwashing.

Ensure the tissues she uses are soft and non-abrasive and encourage her to blow her nose rather than wipe the secretions away with her hand. Skin also becomes dry if it is exposed to cold weather so ensure she is protected when she is outdoors; cover her hands and mouth with a scarf and gloves.

At home, make sure your environment is not too drying - avoid the temptation to crank up the heating.

Finally, protect her lips with lip salve when she is outdoors and wipe away any saliva or drool as soon as possible at this irritates the skin. Petroleum jelly around the mouth can help with this.


Vitamins, flu jabs and medicine – what you need to know

Is it advisable to give children vitamin supplements during winter months? (jrobbs)

Pixie: The Department of Health (DOH) advises all children aged six months to five years are given vitamin supplements containing vitamins A, C and D every day - not just in winteri. Outside of this, it is completely up to you. Children with poor diets or those who spend a lot of time indoors may benefit from additional vitamin supplements. However, outside of the DOH age guidelines, most children who eat a healthy diet and spend time outdoors in the daylight probably don't need additional nutritional support. If in doubt or you are concerned about specific deficiencies then your doctor can advise you.


Should my nine and four-year-olds get the flu vaccine? (VilootShesCute)

Pixie: At the moment the NHS is only vaccinating two, three and four-year-olds or children in school years one, two and three. In some areas all primary school children will be offered the jab as a pilot scheme.

The NHS' aim is ultimately to vaccinate all primary school children on an annual basis. This protects them, and it also helps to protect adults who are susceptible to flu - as children are often the source of the infection.

In terms of your children, your younger one is likely to be eligible but the older won't be eligible for it on the NHS. You could however access the vaccine for him or her through a private clinic.


Should pain relief medication for children - such as ibuprofen and paracetamol products - only be given with food? (Sammyislost)

Pixie: Paracetamol for children can be given on an empty stomach. Ibuprofen for children can also be given with or without food, to babies and children from three months, weighing over 5kg, so both may be taken whenever they are needed. Always check the information on the pack before giving your child pain relief.


Asthma advice for little ones

Any tips for encouraging a baby or toddler to take an inhaler? (peaceloveandbiscuits)

Pixie: I'm a fan of the spacer device for ease of delivery. Get the pharmacist to show you how to use it and then plaster the outside with stickers of your baby's favourite TV character. Make it in to a game - a counting game works well - and then reward him or her with a star for each use.

Sometimes kids take things from a third party more readily than from mum so enlist the help of dad or gran. Role-playing can also really help - get them to show their favourite teddy how it's done and pretend they’re a doctor.

Finally, don't fight with them, as this will make it a really negative experience.


What's the best temperature to keep a bedroom when sleeping, as my son has asthma when the weather gets bad, and he has a chest infection or a cold? I have the heating on but he gets too hot and finds it hard to breathe. If I turn it off he gets too cold and also finds it hard to breathe. (Lisapaige24)

Pixie: Asthma can be triggered by both cold and very dry air. The temperature in his room should be comfortable and the same as the rest of the house – this shouldn't change when he has an infection. Abrupt changes in temperature - eg a very warm living room versus a very cold bathroom - can in themselves trigger asthma so it's best to keep all rooms the same.

Avoid blow heaters or anything that circulates air as they will also circulate dust, which is a definite asthma trigger. If he has an infection, it is best that he sleeps propped up a little so he can breathe more easily. Airways tighten up a bit as we head in to the night, so asthma sufferers can often feel a bit caught for breath around bedtime. Ensure he uses an inhaler that will keep his airways open overnight (a long-acting bronchodilator) and that you have access to a reliever so you can promptly alleviate symptoms if needed. When kids have coughs and colds their inhaler technique often goes out the window so it might be worth investing in a spacer device to help deliver the inhaler more easily. Your pharmacist can advise you about this.

Kids with asthma also panic a bit if their nose is blocked so something like saline nasal spray might help to release this. You can buy a humidifier to moisturise the air in his room or leave a bowl of water on the radiator, which will do a similar thing. This may also help his breathing.

Make sure his asthma regime is stepped up during a period of the infection. Your practice nurse can help to devise an action plan for this.

Finally, keep your house smoke-free and avoid contaminating his bedroom air with anything - aerosol deodorants and fragranced washing powder can be common culprits.


Are growing pains real?

My four-year-old wakes at night with pains in his legs. He usually settles back down quickly but is definitely in pain. He has no problems in the day. (MakeTeaNotWar)

Pixie: They sure are and generally start at the age of three and go on until the age of 12i, according to the NHS. Nobody really knows what they are or why they occur, but they are often triggered after a very active day. Thankfully they cause no long-term damage and can be easily treated by taking a children's painkiller like ibuprofen syrup or paracetamol syrup.

The interesting thing about growing pains is that they occur late in the evening or at night. By day, they cause no issue with the way your child walks or runs. Make sure your child has shoes that fit well and fasten securely as a matter of course. Pain occurring by day or associated with swelling or loss of function is not down to growing pains and should be urgently reviewed by a GP.


Nurofen for Children for fever and pain relief. Three months - nine years. Contains Ibuprofen. Always read the label.


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Royal Pharmaceutical Society, Developing treatments: the Common Cold [Last accessed December 2016]

ii NHS Choices, Vitamins for Children [Last accessed December 2016]

iii NHS Choices, Growing pains [Last accessed December 2016]


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