Your questions on children's health as they return to school have been answered by Livi's expert, Dr Rhianna McClymont

[JustineBMumsnet]

Please note, questions have been answered and the expert is no longer available to answer new questions.

With the much-anticipated return to school now a reality, many parents have concerns about their children’s health. Whether your concerns are typical of any year or related to the effect of coronavirus, Dr Rhianna McClymont - Livi’s Lead GP - is here to help answer your questions.

Here’s some more info about Dr Rhianna McClymont: “Dr McClymont achieved a First Class Honours in Medicine. She then hit the ground running, carrying out medical, surgical and paediatric training at a number of prestigious London teaching hospitals, before specialising in General Practice. She has worked in a GP surgery in North London, and taken roles in urgent care settings, health-assessment clinics, and a digital healthcare company. Today, she works for Livi as a Lead GP as well as giving her time to the NHS.”

Here’s what Livi has to say: “If you’re a busy parent, being able to get medical advice quickly when one of your family is ill can be a real lifeline. Livi lets you see a registered GP quickly by video, at a time and place that suits you. Appointments are available seven days a week – usually within minutes, or you can book up to a week in advance. Our friendly, professional GPs can give you medical advice and prescriptions for a wide range of symptoms. You can use Livi for your children aged between 2 and 16 years old. Just register your child through the app and get instant access to medical advice when they’re feeling unwell – all without leaving home.”

So whether you’re worried about your little one’s skin rash, allergies or possible exposure to COVID-19 back at school, ask Dr McClymont your questions about children’s health.

Dr McClymont will be back between 16th and 21st September to answer your questions.

All who share a question on the thread below will be entered into a prize draw where three lucky Mumsnet users will each win a £100 Amazon voucher.

Thanks and good luck!

MNHQ

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*Please note this thread does not constitute personal medical advice, and please do not disclose personal health information on this forum. You should always speak to a GP/healthcare professional in person for advice specific to your situation.

@NELALLAN08100

Should older teens have a flu jab this year?

This year, the flu vaccine will be available for all children aged 2 or 3 on 31 August 2020, all primary school children, all year 7 children, and all children aged 2-17yrs with long term health condition. Yes, I would advise that any child eligible on the above criteria receive the flu vaccine.

@SonjaMorgan

My DC has sore cracked skin from repeatedly using hand sanitiser in school. They are now using a barrier cream during in the day to help soothe the skin. Will this cream harbour bacteria and be more harmful than not using hand sanitiser at all?

Although it can irritate the skin, it is still best to use hand sanitiser to protect against spreading viruses through hand contact.

@eandoauntie

Hi , Ive heard thats its much rarer for toddlers to pass on covid - is there any back up for this please?We see my parents and although I am always very careful it frightens me to death.

Research is ongoing into this, so I cannot give you a definitive answer I am afraid. We know that children are far less likely to suffer a severe form of covid-19 than an elderly person. However, research is continuing into how likely young children are to spread it - particularly if they do not show symptoms.

@clauski

Earlier in the year there was much talk of "Covid toes" with a rash on the feet being a potential symptom, especially in children. This seems to have died down in terms of discussion - so does this exist or was it not proven correct?

Skin rashes have been known to appear in patients with covid-19 but do not appear in every case, can appear as the only symptom or as part of a multitude of symptoms, can appear anywhere (although appear more commonly on the feet), and in various different forms/as different types of rash. Basically, there is no ‘one-rash fits all’ when it comes to covid-19 which has led to difficulties in classifying a particular rash as a ‘covid-19 rash’.

@baconbap

can wearing a mask cause mouth ulcers?

Some people have theorised this (the theory being that a mask contributes to a warm, moist environment which could predispose to mouth ulcers). However, there are no studies or evidence that I am aware of that have directly linked masks with mouth ulcers, and so I cannot say that this is true.

@pixelwife

Given how long our children have all been off school, how do we stop them picking up every bug going now their immunity will naturally have lowered. I'm dreading the winter sick bugs!

I am afraid it is going to be very disruptive for families this winter, and we will have to accept this to a certain extent. It is likely that many households will have to quarantine as their children contract normal childhood coughs, colds and temperatures – and this will be particularly common over winter. General measures ensure good immunity include a varied diet filled with lots of fresh fruit and vegetables to boost their vitamin levels, plenty of water and a good night’s sleep every evening. Time spent playing/exercising outdoors is great for mental health, exercise benefits and vitamin D levels from the sunshine (just don’t forget to use sunscreen if it’s a very sunny day!)

@Ikea1234

Having little one's and working in a school means I am vigilant about coughs but am concerned about getting the common cold confused with Covid. Do you have any advice?

Apart from the covid-19 swab test, there is no definitive way to distinguish the two as they can have similar symptoms and children often get a very mild form of covid-19 which may mimic a cold. Any new temperature, new continuous cough or new loss of taste and smell in a child requires a covid test - even if you think it is only a cold. You can arrange this via www.gov.uk/get-coronavirus-test or via calling 119.

@cathryn1

since going back to school my daughter is hardly drinking, she is only 6 but says they only go to the toilet on "new" break times in their bubbles. She has red sores down below now, now sure if they are connected, we have put cream on and it seems to getting better with calpol but just a bit worried

If she has new red sores in her genital region then it is definitely best you have a chat with your GP to look into this further and provide a diagnosis. I'm sorry that I can't help further, but I think it is best she have a more detailed consultation with an examination.

@WhatILoved

Yes! How long should we live with molluscum contagiosum before getting the blighters frozen off (can that be done??) DS2 had them for 3 years now DS1 had some but only took a year to go. I know advice is to leave them but DS2's get itchy often.

Most molluscum lesions resolve on their own given enough time. You might also like to consider Molludab, which can be bought over the counter and can speed resolution of molluscum lesions particularly if they are large and bothersome!

@grannybiker

How do we distinguish between the usual "Back to school" virus and something more sinister?

By 'sinister', do you mean covid-19? Apart from the covid-19 swab test, there is no definitive way to distinguish the two as they can have similar symptoms and children often get a very mild form of covid-19 which may mimic a cold. Any new temperature, new continuous cough or new loss of taste and smell in a child requires a covid test - even if you think it is only a cold. You can arrange this via www.gov.uk/get-coronavirus-test or via calling 119. If you are concerned your child is more unwell with something sinister, then of course please contact your child's GP.

@hwg3141

What measures will be taken to help children not catch Coronavirus in schools?

I cannot answer this I am afraid. You must discuss this with your child's individual school as each school has come up with their own protocols.

@Bellaboo1234

We thought my DD had Asthma before lock down and GP was going to testing but she has been fine throughout lock down and am now not sure if she has or not, what test would be best to show this?

If a GP suspects asthma from the clinical history and presentation, then usually either a peak flow diary or spirometry tests would be conducted. A peak flow diary is when your child measures how hard they can blow air out of their lungs and into a handheld device. You would have this meter at home and typically measure the peak flow mornings and evenings. Spirometry (often called 'lung function tests') may be conducted by your practice nurse and is similar to a peak flow assessment except that an inhaler is used and a before/after picture can be conducted as to whether inhalers improve your child's breathing (which would indicate asthma).

@Decentsalnotime

I’d love some more info about livi app

Is it private? If so, what’s the cost please? Are prescriptions also extra?

Livi is free on the NHS in some areas of England. You can check in the app or on the Livi website to see if the service is free in your area. If it's not, anyone living in England can use the Livi pay-as-you-go service. An appointment costs £29, and this includes prescriptions, fit notes and referrals.

@ButterflyOfFreedom

What is the best non-prescription mosituriser/ cream for dry skin for children please? My DS is prone to dry patches on his legs & back plus his hands (exacerbated by more hand washing) are flaring up. I've tried my hand creams but wasn't sure if they are really suitable for a child's delicate skin Thank you

There are various good emollient skin creams available over-the-counter and a pharmacist would be able to talk you through the options in detail. Creams that have worked very well for my patients in the past include cetraben, diprobase and aveeno.

@IaltagDhubh

My DD is functionally asplenic. What is the current guidance for people with no spleen in regards to Covid? She never received a shielding letter, but it seems perhaps she should have. I can’t find any information more recent than April.

Thank you!

I have taken this guidance from the British Society of Haematology, published in May 2020; 'Based on knowledge of the immunological functions of the spleen, there is no evidence that the lack of a spleen or part of a spleen or a non-functioning spleen on its own renders patients at higher risk of Covid-19. Recommendations for shielding will therefore depend in the underlying cause for splenectomy or asplenia and any associated comorbidities and treatments'. Therefore, I cannot answer your question specifically as shielding guidance will depend on the reason that your daughter is asplenic. I suggest you chat to your GP further as they will be able to give you a clear answer based on your daughter’s medical history.

@user1493805144

My 16 year old daughter keeps getting issues with her tonsils every Winter requiring antibiotics each year.

I've heard they need something like 8 recorded attacks before considering removing them, is this true and/or do you have any advice?

You are correct that a tonsillectomy is generally a restricted procedure on the NHS and a child has to meet certain criteria in order to be referred for this. Guidelines currently say that a tonsillectomy is recommended if a child has 7+ reported episodes of tonsillitis in the past year, 5+ episodes of tonsillitis in each of the past two years, or 3+ episodes of tonsillitis in each of the past three years

@06cw01

How best to tell the difference between my child having a 'normal' cold and covid? Should I keep them off school regardless?

Apart from the covid-19 swab test, there is no definitive way to distinguish the two as they can have similar symptoms and children often get a very mild form of covid-19 which may mimic a cold. Any new temperature, new continuous cough or new loss of taste and smell in a child requires a covid test and self-isolation at home- even if you think it is only a cold. You can arrange this via www.gov.uk/get-coronavirus-test or via calling 119.

@nanoobaku

My DS has autism and is non-verbal like many parents on the thread how do we get him to have a covid test?

I have sympathy for you both as he may find the idea of a test more stressful and worrying than other children. I suggest you explain in advance what it will entail - it will be a swab test of the throat and nose - and let him know how this will be done. It may help to watch a video with him of what will happen so that he knows and is prepared. The department of Health and Social care has released an instructional video for parents which you may find useful. You can find this on youtube with the title 'How to test your child for coronavirus (Covid-19) in the UK'. Some charities, such as 'Ambitious about Autism' also have good instructional leaflets and video's for parents and children.

@LOU2ASH

If a confirmed COVID case is reported at a school what is the protocol.

Your school will have constructed their own protocol and so I cannot answer this question; please discuss this with your child's individual school

@ikkle87

My son has always had excessively large tonsils and sometimes he gags when drinking or eating because of them. He also has very waxy ears. I know the ENT system is linked so could these be linked and is it worth seeing my GP about having his tonsils removed?

His waxy ears is a separate problem to his tonsils and the two would not be connected. You can use olive oil drops into the ear to try and soften the wax. The ear should naturally push out this wax and there is no need to use cotton buds - these are counter-productive and end up pushing wax further down into the ear canal. A tonsillectomy is generally a restricted procedure on the NHS and a child has to meet certain criteria in order to be referred for this. Guidelines currently say that a tonsillectomy is recommended if a child has 7+ reported episodes of tonsillitis in the past year, 5+ episodes of tonsillitis in each of the past two years, or 3+ episodes of tonsillitis in each of the past three years. If he struggles to eat and drink because of the size of his tonsils, then an exception to this might be made but you would need to have a more in-depth chat with his own GP regarding this.

@BubblingBlancmange

My DS has curved big toenails - the sides of the toe nail curve inwards so they dig into the skin surrounding it. We are careful to cut them straight across and not too short, but they appear to be getting worse. It isn't causing him any pain yet, but should we see his GP now or wait until it causes issues? Is there anything else we can do to encourage normal growth?

A podiatrist is more likely to be helpful here. Seeing one early may help prevent the nails in-growing in the future and causing pain or infection. However, this would need to be arranged privately as an NHS podiatrist is unlikely to accept a referral unless there is an infection present or a child is in significant pain from the toenail. By cutting his toenails as you are, and performing good nail and foot care, you are doing everything you need to.

@jhocknull

What is the best way to treat mild eczema for a 7 year old child effecting parts of their hands through extra handwashing? (We use a 'free' soap at home when washing but this is not always easy to monitor when out and at school).

Frequent hand washing, particularly with soap, and frequent use of hand sanitizer can dry out the skin and make it more likely to become cracked and sore. With a child with pre-existing eczema the effects of hand washing and sanitizer will be even more pronounced. Unfortunately, there is no effective alternative as it is necessary to sanitize the hands to prevent the spread of the virus. It becomes even more important therefore to make sure that your child is using a good eczema moisturizer. I would recommend moisturizing at least 5-6 times a day plus after hand washing for a child with hand eczema. If the skin remains very inflamed despite good moisturizer use, then your child may require treatment with a steroid cream for a short duration to calm the eczema flare.

@babyowl

Dd aged 13 gets frequent nosebleeds (1-3 a day), particularly during hayfever season & warm weather.

I grew out of having frequent nosebleeds by age 14 or so without any medical intervention. Is it likely that she will as well?

When do I need to start worrying about her frequent nosebleeds?

Are there any strategies she could use to avoid nosebleeds? Other than trying to avoid getting too warm (e.g. no jumpers/cardigans) & trying not to rub her nose too much?

Many children get nosebleeds, and if these are mild and resolve quickly then are not a cause for concern. Make sure she isn’t picking her nose, which can traumatize it, or blowing her nose too hard. If a nosebleed occurs then pinch the soft part of the nose hard for at least 15minutes without breaking the pressure, lean forwards and (if possible) put ice over the forehead or back of the neck as this constricts the blood vessels. If the nosebleeds are happening regularly, or she suffers a particularly heavy nosebleed, then you should visit her GP as there are nasal creams that can help or she may need some treatment (such as cautery) to a particularly problematic blood vessel in the nose.

@chris20201

What advice can you give in terms of supporting the mental health of teenagers during the pandemic?

It is certainly a scary time for children and teenagers filled with lots of change, uncertainty and worry. Make sure you’re talking to your child regularly about any worries he/she has about the news, school, relatives or the general situation. Also ensure that your child knows who to talk to at school if he/she has a problem or concern. Let your child ask questions rather than giving too much information in one go, and try and be supportive and reassuring while still giving the facts. Remember that although it is very scary, children and teenagers are very unlikely to become seriously unwell from covid-19 so make sure your child knows this in case they are worried about their own health. If he/she is really struggling, then you may find Youth Access - youthaccess.org.uk - which offers counselling services helpful.

@Carlychoc55

My daughter is 5 and suffers with outbreaks of eczema, it is better at some times of the year but in the winter it gets worse and I cannot seem to find a decent cream that will keep her skin nice and soft rather than dry as this is when the ezcema starts. The Child's Farm range are good, can you recommend any other cream? Thanks

Many of my patients have had a good response to cetraben, diprobase, aveeno and oilatum, and so I suggest you chat to your pharmacist about these if you haven't tried them already.