Will the child be sick often? Check its appearance.

The spring equinox and the autumn-winter period are difficult times for young children and their parents due to infections. Some children are sick almost constantly from November to April. Others catch infections every few weeks. The "one week at kindergarten, two weeks at home" mode is the nightmare of working parents. Can we avoid this state of affairs? What should parents of frequently ill children take special care of? Pediatrician Marek Pleskot, M.D., author of the information website pediatraodpowiedz.pl , talked about this in an interview for nikaMag.

Should preschool children be sick often? Is this the norm?

Marek Pleskot, MD: Children of this age actually get sick often because their immune system is still immature. When they go to school, they will be more resistant to colds. However, before this happens, the little ones will catch infections. You could even say that mild respiratory illnesses are mandatory . This cannot be avoided. Moreover, such infections stimulate the immune system much better than synthetic "immune" drugs. There may be about 10 such episodes a year , but if they do not lead to complications and the cold is not constant, it can be considered a variant of the norm. Any uncomplicated respiratory infection will benefit, as will an athlete's fatigue during training.

However, some children get sick much more often than others. Why is it like that?

In rare situations, it happens that children have "supergenes" that prevent them from getting sick in kindergartens and nurseries. Sometimes older siblings also help in the sense that a younger brother or sister catches infections from them while still infancy. And by the time they come to kindergarten, they already have developed immunity to the most common infections at this age. But there are also children who have a specific phenotype , i.e. a set of certain features, e.g. body structure, skin color, eye color, hair color, which is associated with more frequent disease than among their peers.

Does this mean that a child's appearance can tell if he or she will be sick?

Over the course of over 30 years of working as a pediatrician, I have noticed a certain pattern. Nasal infections, bronchitis, conjunctivitis and ear infections are more common in children who have long eyelashes, dry skin, dark circles under the eyes, flushed cheeks, a lot of ear wax, and calloused or lumpy skin on the arms or thighs . I called it the atopic phenotype. Such children are also more likely to develop allergies , even later in life. They don't always have atopic dermatitis, so please don't confuse the two. It is true that their skin is indeed delicate, dry and prone to inflammation. Interestingly, such skin also reacts unusually to scratches - it turns pale instead of red. In recent years, he has observed more and more such children. We don't need any research for this. Any parent can look at their child and determine whether they fit this description. If so, you need to be particularly vigilant.

A specific type of beauty is a signal that the child's body is more vulnerable to infections. But our appearance depends on our genes, or do they ultimately determine our immunity?

The phenotype, i.e. the set of our external features, is shaped by genes, but not only that. The environment plays a huge role . Our phenotype is shaped by various stimuli, both during fetal life and later in life. Our surroundings change our external features and personality. Diet, climate, living conditions, nurseries, kindergartens and schools, company - all this affects our phenotype. Genes are the basis, but under different conditions they will create different phenotypes. Likewise, unrelated people with different genotypes may look alike and have similar phenotypes. So, to answer the question - genes are important, but the environment and lifestyle are equally important .

Can parents of frequently ill children do anything to reduce the frequency of infections? Does the fact of having the described phenotype mean that they simply have to accept that the child will be sick all the time until he grows out of it?

The atopic phenotype indicates that the child is at higher risk and we should reduce the risk . You should be aware that such children get sick more often than others when they are sent to nursery rather than when they begin their intensive contact with microbes in kindergarten. In other words, the later we expose such a child to mass contact with germs, the better. If it does go to nursery and kindergarten, parents should be vigilant. If we see any first signs of a cold, it is not worth sending your child to kindergarten or nursery that day . He will come back even sicker, and in the process he will also infect other children. This also applies to a runny nose . It is not worth underestimating it, small children suffer from a cold much more seriously than adults. According to research, approximately 90% of patients with infectious rhinitis also have sinus symptoms . A runny nose is a symptom of inflammation that can develop in many ways. If a child goes to kindergarten in such a weakened condition, he or she may catch another infection or bacteria. This leads to even longer illness and complications such as sinusitis, ear inflammation and bronchitis. Untreated inflammation may lead to damage to the nasal mucosa. All this promotes the development of chronic inflammation . A weakened child begins to catch further infections more easily. If your parents or other household members are sick at home, it is best to try to follow the rules of isolation (as much as possible) and hygiene - sneezing into a tissue or the bend of your elbow, carefully washing your hands, cutlery and dishes, and avoiding kissing. With face-to-face contact, the risk of infection is approximately 70%.

Do children who get sick often need stronger drugs to fight the disease?

A sick child should be treated in accordance with current medical knowledge . The drugs used should provide more benefits than side effects. Unnecessarily used nebulized steroids are known to increase the risk of pneumonia . In the case of viral respiratory infections, antibiotics are also harmful . In children with an atopic phenotype after 3 years of age, allergic rhinitis and/or adenoid hypertrophy coexist much more often . In both cases, chronic nasal blockages occur, which increase the risk of new infections and the vicious circle of infections continues faster.

For the good of the child, each underlying and coexisting disease (such as allergies or adenoid hypertrophy) must be properly treated. Only then will the child get sick less often and recover from recurrent infections faster.

And if there are several children in the family and one of them is sick - is it better for the siblings to go to kindergarten or nursery to have less contact with the sick brother or sister?

As I mentioned, even partial isolation is advisable. Longer exposure to germs will contribute to disease. So sending healthy siblings to healthy friends is a safer solution . Of course, they will have to stay at home if the first symptoms of the disease appear.

What about infection prevention? What are the best ways?