Kids' health Q&A with Dr Pixie McKenna

Thanks to Nurofen for Children, Mumsnetters had a rare opportunity to ask Dr Pixie McKenna for advice on children's health - everything from colds and fever to teething and earache

Nurofen for Children understands that being a parent is a wonderful and rewarding experience but can be worrying, and you can't be expected to know all the answers - especially when it comes to health. To help you feel more confident, it's teamed up with Dr Pixie McKenna to answer your burning health questions. 

As a mum of one to daughter Darcey, Pixie is more than a medical expert - she's a parent who's had first-hand experience looking after her own child and is here to share her top tips and advice (without endorsing any brands). We've selected 18 of your brilliant questions - read exactly what she had to say about them below.

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Growing pains

Mumsnet: Is there such a thing as growing pains, or is this a myth? (anonooo)

Dr Pixie: According to the NHS1, growing pains commonly occur in children between the ages of three and 12. They aren't actually due to growth but because these crampy pains occur in growing children, they were given the title. In truth, we don't really know what causes these pains. Typically they come on in the late evening or night time and feel like intense aches in the calves, thighs, shins and ankles. The pain is generally gone by the next day. Children's medicine such as ibuprofen or paracetamol can be given to ease the discomfort, and they may also find it soothing if you rub or massage the sore area.

Treating earache

Mumsnet: Apart from medication is there anything to help prevent/treat earache? (glennamy)

Dr Pixie: Earache is one of the most common reasons a parent resorts to calling a GP out of hours. Prevention and treatment very much depend on the underlying cause. If your child is distressed you can hold a cold flannel to the ear for 15-20 minutes to help ease symptoms. In terms of prevention, avoid germs and you are off to a good start. Bacteria and viruses that cause ear infections are picked up via air droplets from coughs and sneezes, so good hand hygiene is the key to curbing infection. Immunisations are also vitally important because they can prevent certain viruses which can lead to ear infections, so make sure your little one is up to date with their jabs. If you smoke, now is a good time to stop as NHS research2 tells us that household smoking can increase your child's risk of ear infections by around 35%. Also, ban the bud! Earbuds should not be used in children as a method of cleaning out their ears, as there is an increased risk of both trauma and infection. Finally, if your child uses a dummy, try and ditch it once they hit the 12-month mark as there is some evidence to suggest this will reduce the chances of them getting ear infections.

Caring for poorly children

Mumsnet: How do you get a two-year-old to take liquid medication or are there any alternatives? (WannaBeAMummy16)

Dr Pixie: Many children's liquid medicines come with a syringe, which makes them easier to administer. However, if for some reason your child fears the syringe, then swap to a spoon - ideally their favourite spoon. If they don't mind the syringe then allow them to play with it before you put the medicine in. My own daughter likes to squirt water out of it - usually at me! 

I'm not a fan of bribes but they can come in handy where medicine is concerned, for example star charts with a reward at the end can encourage enthusiasm. Stay positive, if you are stressed rather than smiley when it comes to medicine time your child will pick up on this negative vibe and will be less likely to engage. Enlist the help of their favourite toy or TV show - this helps to distract them - and be matter of fact about administering medicine. If your two-year-old really kicks off then have someone else play 'nurse' and give your child the medicine...there might be less of a battle!

Dealing with children's bugs

Mumsnet: When my three-year-old starts nursery, is there anything we can do to limit the apparent onslaught of bugs that I have been told are coming our way? (Kraggle)

Dr Pixie: There's no 'wonder drug' out there to arm you against the onslaught of nursery bugs, but there is one secret weapon; hand hygiene. We all teach our kids to high-five so we can just as easily teach them to wash their hands. Aim to have them washing their hands for the length of time it takes them to sing happy birthday twice. Make them feel grown up by giving them tissues, and teach them how to avoid putting their hands in their mouth - although it's easier said than done. Strict hand hygiene is essential for all the family otherwise it won't just be the little one that falls foul of the nursery bugs . Finally, if your child is unwell with an illness that is going to impact or infect others, they should remain home from nursery. They don't need to be at home for simple coughs and sniffles as those are the norm for toddlers.  

Mumsnet: What is the best way to avoid a child getting nits? (PiperIsTerrysChocolateOrange)

Dr Pixie: Head lice are an incredibly common problem in primary school children. Regular detection combing can help as it enables you to find new lice early on in the life cycle and interrupt it so no further eggs are laid. There are also conditioners available, which contain special products to help prevent head lice, which are normally advised for use twice a week. There is some evidence to suggest that keeping long hair tied up will also reduce the chances of catching head lice, so it's worth a shot! My advice would also be to notify the school so that they can tell all the parents to look.

Mumsnet: Is slap cheek contagious? And if so for how long? (JoJoY)

Dr Pixie: Slapped cheek syndrome is a viral infection common in children. The symptoms tend to occur a couple of weeks after you have come into contact with the virus, so you are at your most contagious before your symptoms actually appear. Once the rash has developed, your child is no longer contagious, so if they feel well they are fine to go to school or nursery. It is important to let the school or nursery know that they have had a case of slapped cheek, as pregnant women are particularly vulnerable to this infection.

Mumsnet: I would love to know how I could prevent my son from getting threadworms again... (cheryl100)

Dr Pixie: Preventing reinfection involves a bit of housework. The lifecycle of a threadworm is six weeks, so this regime needs to be followed for that period of time. Threadworm medication only kills the worms not the eggs, which is why you have to stick to this domestic boot camp for a month and a half otherwise the threadworms may make a reappearance. All bed linen, pyjamas, towels and soft toys need to go in the washing machine as soon as your child is diagnosed, and the entire house needs to be hoovered and dusted from top to toe. The bathroom and kitchen surfaces need special attention where cleaning is concerned. Have everyone in the house cut their fingernails short and ban nail-biting to help prevent ingesting eggs. Make hand washing a family affair and get them scrubbing under their nails to get rid of the infection. Ensure each family member has his or her own towel and face cloth. Finally the entire household must be treated, not just your child, if you want to break the infection cycle!

Mumsnet: Do you recommend having all vaccinations? (castleton)

Dr Pixie: Yes, I strongly recommend all vaccinations on the NHS childhood vaccination schedule. Each vaccine has undergone a rigorous research, development and testing process before it comes to market. Not only that, vaccines are continually monitored once they go to market and all side effects and safety concerns are logged. Vaccination has reduced death and disability from countless diseases (eg measles) and even eliminated some diseases entirely (eg smallpox). Vaccination not only protects your child, it also protects those around them.

Dental worries

Mumsnet: My four-year-old daughter is  grinding her teeth at night whilst sleeping. Should I be concerned about it? (MummyDuckAndDuckling)

Dr Pixie: The medical term for this is bruxism, and amazingly a lot of kids do it - around 1 in 5 according to the NHS3. If you are a grinder, then your daughter is much more likely to be one. The habit tends to start around the age of three-and-a-half and stop around six. We don't really know why they do it but some theories include stress, teeth not lining up correctly, discarding the dummy - though nothing for definite. Sometimes it's simply a bad habit. The good news is it sounds worse than it is, and usually they grow out of it. If she hasn't been to see a dentist then now is a good time, but rest assured she isn't likely to have done any dental damage. Like many things in the field of child development, this too will pass without incident! 

Mumsnet: Is there anything I should do or worry about teething, or will it just take its own course? (smit23)

Dr Pixie: Teething is yet another milestone you have to pass as a parent, and you can't avoid it. Some kids sail through it, whilst others struggle. So it's a case of hope for the best but expect the worst if teething time is on the horizon for you. As your baby is cutting teeth they'll like having something to chew so invest in a teething ring and have fresh fruit and veg at hand for them to munch...a busy mouth is a happy mouth.  If the gums seem sore you can ask your pharmacist about teething gel, beware though it doesn't always taste great.  If your child is in distress then you can opt to give them a liquid painkilling medicine such as paracetamol and ibuprofen. Ibuprofen also helps with the inflammation.

Dry skin

Mumsnet: What is the best way to treat dry skin on my baby's face caused by teething? (stewaris)

Dr Pixie: A rash often crops up thanks to the constant flow of saliva from the corner of their mouths. Try to wipe their chin gently whenever possible, and invest in a selection of dribble bibs. Wash the skin with some lukewarm water and then apply a baby friendly moisturiser. If possible avoid the temptation to continuously wipe with wet wipes - cotton wool and water is the preferred option.

The inevitable cold/flu

Mumsnet: What advice would you give for a cold-filled, bunged-up baby? Any tips to help her recover quickly? (WannaBurger2016)

Dr Pixie: Because a cold is a virus, a visit to the doctor is unlikely to yield anything more than advice. However that doesn't mean you can't do anything to ease her symptoms. 

If she is distressed and has a fever consider giving her a liquid children's medicine like ibuprofen or paracetamol. Make sure she is getting enough sleep and enough fluids. She is likely to need extra milk feeds. If her nose is clogged, help clear it with a tissue. You can also use saline nasal drops to ease congestion, and also help with feeding. Steam also unblocks snot so if you sit near a warm bath this may ease her breathing. Just take care, as steam can burn just like a flame, so don't get too close.

Mumsnet: My three-month-old suffers with a blocked nose at night, is there anything I can do to help her? (emmav6)

Dr Pixie: Noses get blocked, it's a fact of life. Early in their lives babies tend to be more congested as their nasal passages mature. A cold can be at fault as can an allergy or an irritation. As your baby is used to breathing through her nose and feeding through her mouth, she might get distressed when the nasal passages are clogged. Saline nasal drops can help irrigate the nasal passages and make your child breath more easily.

Mumsnet: Is there anything that can help keep the endless loop of colds at bay? It seems as soon as our little chap gets over one cold it is a matter of weeks before he has another. (compy99) 

Dr Pixie: I would love to say there is solution to the endless stream of snot that is a toddler, but there isn't. However, if you want to reduce the number of coughs and colds he - and by default, you - get, here's my top tip. Hand washing is the key. Make it part of his daily ritual, even challenge him to see how clean he can be. Teach him how to wash his hands and the importance of not putting his hands in his mouth. He is still likely to get 6-10 bugs a year but the more hand washing he does the less likely he is to fall ill. Make sure he is up to date with all of his jabs so he can be protected against infections over and above the common cold.

Mumsnet: What's the most effective way of getting a temperature down? (barbsbarbs) 

Dr Pixie: A fever in a child is defined as a temperature over 37.5 degrees. You can help reduce their fever by keeping them cool (eg have them sleep with just a sheet over them rather than a duvet). Make sure their room is cool - ideally around 18 degrees. It is only necessary to give medicine to reduce the fever if the child is distressed or in pain, and remember fever is the body's defence against infection. You can help reduce fever with specialist children's medicine containing ibuprofen or paracetamol, both of which help reduce pain and fever. Whilst they cannot be given together you can alternate them, ensuring you stick to the dosage instructions. You should take your child to a doctor if they are under three months of age and have a temperature of 38+ degrees. For children aged three-six months, seek medical attention for a fever of 39+ degrees. If at any point you are concerned about your child's fever speak to a healthcare professional.

How to get a restful night's sleep

Mumsnet: My three-year-old has been experiencing nightmares around the same time every night which is approximately 45 minutes after he goes to bed. Is there anything we can do to prevent the nightmare from occurring? He doesn't wake up but it's horrible to hear him calling out in his sleep. (bridge16)

Dr Pixie: Night terrors and nightmares are relatively common in kids. Whilst it upsets you, rest assured they are neither aware at the time nor have they any memory of it afterwards. If a child is having a night terror, they generally wake up and scream, move about and seem panicked for a few minutes. It  can be triggered by extreme tiredness or anything that wakes them in the night eg noise. You might find if the pattern is repetitive you could wake your child before the anticipated time and break the sleep cycle. Thankfully children grow out of this in time.

Helping children with confidence issues

Mumsnet: Do you have any tips for making life a little easier for an incredibly anxious six-year-old? (purplepandas)

Dr Pixie: I'm so sorry to hear this. It isn't unusual for children to be anxious or to develop minor phobias, but it becomes a concern if it encroaches on normal life. I think you need to slowly tease out of her why she is anxious - what outcome does she fear (eg is it retribution by a teacher, bullying from a school friend  or does she worry about being separated from her parents?) What makes her happy? Focus on this and making sure she spends time doing what she enjoys - the stress-free things in life for her. How is her health? Find out how she is at school- how does she interact with her peers? If she is very anxious then finding something that she is really good at could be a massive confidence boost. She may need some talking therapy if the anxiety is holding her back, or indeed you may need to engage in therapy instead to learn how to support her.

Mumsnet: How is it best to deal with potential school avoidance tactics? And how can you tell the difference between real and 'dramatic' symptoms? (tishist)

Dr Pixie: Generally the symptoms associated with school refusal tend to be those associated with worry and stress (eg headache, tummy ache, fatigue, dizziness, general aches and pains, feeling sick or having diarrhoea). The differentiator is that the child is adamant they are not going to school first, and then presenting as sick second. Generally when they are truly ill their prime concern is that they don't feel well. School avoiders also seem more agitated rather than overtly ill. You will also find symptoms most severe after the weekends or holidays. Engage with your child. Is there anything bothering them about school or home life? Be supportive of them going to school rather than staying at home. Log their symptoms and their school attendance. Explain the situation to the school and enlist their help. Try to encourage them into school by rewarding attendance and focusing on positive steps. Emphasise the positive aspects of going to school, for example meeting friends. Help your child gain confidence by finding a hobby or activity they enjoy - this is also relaxing for them and could help reduce their stress levels.

Mumsnet: How can I stop my son chewing his nails? We've tried him with the stuff you paint on them but he totally refuses to have it on his nails. (andywedge)

Dr Pixie: Half of all children are nail-biters - I was and still am one! What triggers it? Get your son to do a bite-sized diary. Make him aware when he bites - don't say stop biting just use a code word eg Battleship. Nominate one nail that you are going to preserve and allow him free range on biting all the rest. Next week nominate another. Give him something to keep his hands busy (eg a stress ball or blue tack to play with whilst he is watching TV or sitting on the bus). When he gets the desire to bite, ask him to pinch the nail instead until the desire goes away - this will serve to replace an old habit with a new one. If your own home-grown treatment doesn't work you could engage a psychologist to work with him on a habit reversal programme.

For more advice and tips from Dr Pixie watch her videos on teething, cold and flu, fever and earache.


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