My child has tested positive for COVID-19! What should I do?

Here are some helpful tips on navigating managing a child with COVID-19 symptoms.

The good news is that in the majority of cases COVID-19 causes mild symptoms in healthy children and young people. The key points to managing a child who has tested covid positive involve giving lots of supportive care, such as:

Adding moisture and humidity to the bedroom. I usually recommend taking off the air conditioning if possible because it generates cool dry air and tends to worsen nasal mucus production. It's better to have fresh air circulating or, if that isn’t possible, to turn up the temperature of the room. It would be ideal to run a vaporizer or humidifier in the room at night time because this will help with nasal mucous clearance.

Using saline nose drops or nasal sprays. Saline is a great nasal decongestant. I recommend one squirt or drop to each nostril up to every 2 hours as needed.

Using Menthol and Eucalyptus oils. This can be done as a single drop of Menthol and Eucalyptus oil in the vaporizer, bathtub or bath water. An alternative is a menthol-containing chest rub, applied to the chest and upper back at night time, to help clear nasal passages and help attain a restful night’s sleep. Just remember if you're using essential oils to store them safely out of the reach of children because they can be toxic if ingested.

Paracetamol as needed for fever, body aches and pains or sore throats. This can be administered as recommended on the packaging based on weight and age. Paracetamol can be given every 4 to 6 hours if needed, with a maximum of 4 times in a 24-hour period. You can also add in Ibuprofen if needed (if there’s no contraindications like a history of ibuprofen allergy) , up to every 6 to 8 hours if needed up to a maximum of 3 times in 24 hours, given with something to eat or drink.

Encouraging lots of fluids. It's not unusual to find the young person doesn't have much appetite for food but hydration is really key. Encourage lots of fluids including water, juice, oral rehydration liquids, coconut water and soups. Aim for wholesome nourishing foods, fresh fruits and juices if you can.

Getting lots of rest.

Daily Zinc and Vit C supplements. This could be in the form of a daily children's multivitamin or for older kids a Vitamin C effervescent tablet once daily – many of these also have added Zinc. Both Zinc and Vitamin C are essential for a healthy immune system response.

Vitamin D is important too. Vitamin D is also important for a healthy immune response. It is usually one of the components of most daily children’s multivitamins or it can alternatively be given as a daily Vitamin D3 supplement (always check the label for recommended dose for age). Vitamin D is known as the sunshine vitamin since it’s made in our skin on exposure to sunlight, so it’s important to either open up the windows or go out into the garden if possible and get at least five minutes of sun exposure on exposed skin daily.

Typical COVID-19 symptoms are tiredness, fever, body aches, sore throat, nasal congestion, headaches, cough, sweating and sometimes diarrhoea or vomiting. These symptoms last an average of 5 days in most healthy children. However, it is important to follow your local Public Health guidelines, and keep children away from family gatherings, pods, school, vulnerable family members and social events during the recommended period of quarantine. Ideally they should have their own separate eating utensils, bedroom and bathroom facilities (or if that’s not possible, the bathroom and any high touch surfaces should be disinfected after their use). Older children (over the age of 5 years) should wear a mask when in communal spaces in the home during the quarantine period if they can. During this time, do keep an eye on them and look out for any red flags or symptoms of concern.

Typical symptoms are tiredness, fever, body aches, sore throat, nasal congestion, headache, cough, sweating and sometimes diarrhoea or vomiting.

So what red flags do I look out for?

- Being unable to keep fluids down. In this case we're looking for signs of dehydration such as less than half normal urine output (for example less than half the normal wet pampers in a 24-hr period). Other signs of dehydration could be sunken eyes or dry lips and tongue.

- Spiking fevers (above 38 degrees Celsius or 100.4 degrees Fahrenheit) that are not settling with or responding to paracetamol.

- Signs of increased work of breathing such as using the additional breathing muscles in the chest, the nose flaring in and out or noticing sinking in between the muscles of the rib cage.

- If the young person's lips or tongue appear blue. Alternatively, if you have an oxygen saturation monitor at home, recording readings of below 95% in room air (first check that there’s good skin contact, your child’s hand is kept flat, they are not wearing nail polish and the device is picking up a good signal).

- Any seizures (convulsions).

In the event of any of these red flags or if you have any concerns then you should contact your child’s paediatrician or arrange to take the young person to the ER. It is important to let the medical team there know that there's been a positive COVID-19 contact or that the young person has tested positive for COVID-19 recently so they can take any necessary isolation procedures.

Be well,

Paula

Dr Paula Robertson is a mom and a paediatrician with over twenty years’ experience working with children, young people and their families. www.paulathedoctormom.com