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Parents and Guardians

Febrile Seizures: A Guide for Parents

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Febrile seizures are seizures that occur in children in the context of a fever. They are relatively common in children between the ages of 6 months and 5 years and can sometimes run in families. While febrile convulsions can be frightening, they are usually brief and do not cause any long-term harm to the child. Very rarely, seizures that are prolonged or atypical require further investigations or monitoring.

What symptoms do you get?

During a seizure, your child may go stiff, jerky, shaky, twitchy or go floppy. Their eyes may roll or flicker. They may change colour going red, pale or blue. They may wet themselves. When someone has a seizure they may be unconscious and unaware of what is happening. After the seizure, your child may be drowsy or confused but will usually recover fully without any lasting effects.

How is it diagnosed?

Febrile convulsions are usually diagnosed based on the child’s symptoms and a description of the seizure provided by the parent or caregiver. Your healthcare provider may also conduct a physical examination to rule out other possible causes of the seizure. In some cases, additional tests such as blood tests may be done to investigate the underlying cause of the fever. It’s important to seek medical advice if your child has a febrile convulsion, especially if it is their first seizure or if they have other concerning symptoms.

What is the treatment?

In most cases, febrile convulsions do not require specific treatment beyond managing the fever and ensuring the child’s safety during the seizure.

If your child experiences a further febrile convulsion at home:

  1. Gently lay them on their side to prevent choking and remove any nearby objects that could cause injury.
  2. If you can, note the time at which the seizure started.
  3. Don’t restrict your child’s movements.
  4. Stay with your child and comfort them until the seizure ends.
  5. If the seizure is still ongoing at 5 minutes, phone an ambulance, unless you have been given different instructions.

Remember, while febrile convulsions can be frightening to witness, they usually do not indicate a serious underlying medical condition. However, it’s essential to seek medical advice if your child experiences a febrile convulsion, especially if it is their first seizure or if they have other concerning symptoms.

Henoch-Schönlein Purpura (HSP), or IgA Vasculitis, in Children: A Guide for Parents

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Henoch-Schönlein Purpura (HSP), now known as IgA vasculitis, is a type of inflammatory condition known as vasculitis, that affects the small blood vessels in the skin, joints, intestines, and kidneys. It is one of the most common types of vasculitis in children and typically occurs between the ages of 2 and 11 years old. While the exact cause of HSP is unknown, it is believed to be related to an abnormal immune system response, often triggered by a preceding infection.

What symptoms do you get?

Symptoms of HSP can vary but often include:

  • Purpura: Small, raised purple or red spots on the skin, typically on the legs and buttocks, which may be painful or itchy.
  • Joint pain and swelling, particularly in the knees and ankles.
  • Abdominal pain or cramping.
  • Nausea, vomiting, or bloody stools.
  • Kidney involvement, which may lead to blood or protein in the urine, decreased urine output, or high blood pressure.

It’s essential to seek medical advice if your child develops any of these symptoms, especially if they occur suddenly or worsen over time.

How is it diagnosed?

Diagnosing HSP in children usually involves a combination of a physical examination, medical history, and blood and urine tests. Blood tests are done to check for signs of inflammation and to assess kidney function, while urine is tested for blood and protein. Your child’s blood pressure will also be taken.

What is the treatment?

In most cases, HSP resolves on its own within a few weeks to months without specific treatment. However, symptomatic relief may be provided with over-the-counter pain relievers such as paracetamol to alleviate joint pain and discomfort. It’s essential to follow your healthcare provider’s advice closely and attend regular follow-up appointments to monitor your child’s progress as about half of children with HSP will have a further episode. Typically, your child will be followed up at regular intervals for one year.

Rarely, in more severe cases your child may require additional treatments such as medicines to reduce inflammation and protect organ function.

Most cases of HSP will be monitored and resolve without long-term complications. If you have any concerns about your child’s health or if their symptoms are severe or worsening, seek medical advice promptly.

Urinary Tract Infections in Children: A Guide for Parents

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A urinary tract infection (UTI) occurs when bacteria enter the urinary tract and cause infection. UTIs are common in children and can occur at any age, although they are more common in girls than boys.

What symptoms do you get?

Symptoms of a UTI in children may vary depending on the age and severity of the infection but often include:

  • Pain or burning sensation during urination.
  • Frequent urination or urgency to urinate.
  • Foul-smelling or cloudy urine.
  • Blood in the urine.
  • Abdominal pain or back pain.
  • Fever.
  • Irritability, fussiness or vomiting in infants.
  • Bedwetting or accidents in toilet-trained children.

It’s essential to pay attention to any changes in your child’s urinary habits or behaviour and seek medical advice if you suspect a UTI.

How is it diagnosed?

Diagnosing a UTI in children usually involves a combination of a physical examination and testing the urine. Your child’s healthcare provider may ask about their symptoms, medical history, and any recent illnesses. In some cases, imaging scans may be done to assess the urinary tract for structural abnormalities or other underlying conditions.

What is the treatment?

Treatment for UTIs in children typically involves antibiotics to eradicate the infection and relieve symptoms. The type of antibiotic prescribed will depend on the child’s age, the severity of the infection, and any underlying health conditions. It’s essential to complete the full course of antibiotics, even if your child’s symptoms improve before the medication is finished. In addition to antibiotics, your child may also be encouraged to drink plenty of fluids to help flush out the bacteria and relieve discomfort.

Remember, prompt diagnosis and treatment of UTIs in children are crucial to prevent complications and promote recovery. Some children will be referred to the RHCYP Urinary Tract Infection clinic for follow up and further scans after a urinary tract infection.

How can I prevent urinary tract infections?

There are some simple things you can do to prevent UTIs in infants and children at home.

  • Make sure your child has a good fluid intake, spread evenly through the day.
  • Make sure your child is not constipated -this is one of the commonest causes of UTI. If your child poos less often than every 2 days, or poos are hard, painful or large, discuss with your doctor to consider constipation and treatment for this.
  • Encourage your child to pass urine regularly throughout the day, every few hours, or if in nappies, change nappies regularly.
  • Make sure girls are wiping after passing urine or stool from ‘front to back’.
  • Have regular baths or showers, using plain soap to wash, avoiding bubble baths.

Preschool Viral Wheeze: A Guide for Parents

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Preschool viral wheeze is common. A virus causes swelling, and mucus clogs the airways. It causes difficulty breathing and cough. It looks like asthma, however only happens once or twice in most children before they reach school age. About 1 in every 3 children with preschool wheeze will develop asthma later in life.

What symptoms do you get?

Wheeze is a high-pitched whistling sound that occurs when your child breathes out. Other symptoms may include coughing, chest tightness, and difficulty breathing.

How is it diagnosed?

Preschool viral wheeze is typically diagnosed based on your child’s symptoms and a physical examination by a healthcare professional. Sometimes other tests are done if the wheeze is very severe.

What is the treatment?

The main treatment is inhaled Salbutamol. This medicine is breathed in through an inhaler regularly until the symptoms get better. Salbutamol works quickly, for a short time. Often another medicine is given by mouth which is a steroid called Prednisolone. Prednisolone works slowly, but lasts a long time. If your child is very unwell other treatments are given and your child may be kept in hospital until things improve. When it’s time to go home, you will be given a wheeze plan to follow at home.

Video on how to use an aerochamber spacer with mask video

Click on the image above to watch how to use an aerochamber spacer with a mask.

Remember, preschool viral wheeze should get better after a few days. If you are worried about your child you should get help quickly.

Contact NHS Lothian