What To Do About Recurring Illnesses in Children

If you're a parent, you might notice that your child gets sick over and over again. It might feel like your child gets sick every two weeks. That's because kids are exposed to a lot of viruses and bacteria—often for the very first time—which makes them vulnerable to catching everything that crosses their path.

It's normal for young kids to have quite a few colds, ear infections, or gastrointestinal upsets in a single year. "Children have an immature immune system," says David W. Kimberlin, MD, a pediatric infectious disease specialist at the University of Alabama at Birmingham. "The number of normal sicknesses a child can have is astonishing."

Even so, it may still seem like your child gets sick more often than their peers. Here's what we found out about seven common childhood illnesses and why some kids seemingly always get sick while others don't.

Common Colds

The common cold can be a near-constant companion for young children, with some studies indicating that kids can catch as many as eight colds per year. It's no wonder then that it can feel like little ones have a never-ending runny nose during the cool-weather months.

Although a cold isn't considered a serious illness, the symptoms can be pretty miserable:

• Cough
• Congestion
• Runny nose
• Sneezing

Colds are spread easily in school and daycare settings, and it's possible to catch one through direct or indirect contact with infected individuals.

Why your child might be vulnerable to colds

There are more than 100 viruses that cause the common cold, so many young kids fall prey to continual rounds of sniffles, sneezes, and coughs, says Preeti Jaggi, MD, an infectious disease specialist at Children's Memorial Hospital in Chicago. Plus, if your child is in daycare, they'll be exposed to more of these nasty cold bugs at an earlier age, but there are a few reasons why they may be more likely to catch one, including:

• They have a genetically active immune system that reacts more strongly to viruses.
• They live in a home that's too clean. "That's the hygiene hypothesis," says Dr. Kimberlin. "Children's immune systems are designed to learn from exposure to all sorts of things. But researchers increasingly believe that our modern environment may be too clean. As a result, kids aren't building the immunity needed to resist certain illnesses."
• They have upper respiratory allergies, which can cause inflammation of the upper respiratory system that can make a child more susceptible to cold germs or make cold symptoms more pronounced.

Tips for combatting the common cold

Here are a few tips for parents when it comes to helping prevent current colds:

• Make sure your kids get lots of sleep.
• Include plenty of fruits and veggies in your child's diet.
  
• Don't smoke in the house.

It's important for parents to keep in mind that COVID-19 can be a cause of cold symptoms, especially in young children. If your child is presenting with cold symptoms, it's a good idea to perform an at-home COVID test before sending them to school or daycare.

Croup

Croup is a viral infection that leads to swollen airways and a scary-sounding "barking" cough. The characteristic cough is a result of constriction of the airways in the upper respiratory system. Researchers estimate that up to half of all kids who've had one episode of croup will go through it again.

Why? Reasons range from physical anatomy to genetics to prematurity. While croup sounds quite scary, it's typically a mild virus.

Why your child might be vulnerable to croup

Croup is more likely to strike in the fall and early winter. One risk is being born with a narrower-than-usual voice box (larynx) and windpipe (trachea). The tiniest portion of the windpipe, the subglottic trachea, swells during croup. Pediatricians are also realizing that the breathing tubes that premature infants often require may scar the delicate lining of the trachea, leading to more croup as they grow.

Asthma and a family history of allergies also heighten a child's risk.

Tips for combatting croup

Skip the cough syrup since it won't reach the larynx or trachea and never try to open your child's airways with your finger. The best home treatment? Time in a steamy bathroom (turn on the shower). Or if that doesn't work, try moist, cold air. Call a health care provider or 911 if your child's breathing worries you.

Ear Infections

Some kids are prone to repeated ear infections which affect the part of the ear that's behind the eardrum. Ear infections are caused by bacteria or viruses, but don't spread from one person to another, says Madathupalayam Madhankumar, MBBS, a gastroenterologist and surgeon. Often times, ear infections are triggered by other illnesses like a cold, flu, or allergies.

Why your child might be vulnerable to ear infections

Little kids are more prone to ear infections than are older kids and adults because their eustachian tubes (which drain the ears) are shorter, thinner, and more horizontal. During a cold, these tubes swell, trapping fluid in the middle ear, which becomes a perfect breeding ground for bacteria and viruses.

Children who have extra-short or extra-slim tubes are at even greater risk of getting acute otitis media (AOM), an often painful middle ear infection, says Margaret Fisher, MD, chair of Monmouth Medical Center's pediatric department in Long Branch, New Jersey. Kids with a certain type of bone structure may have problems as well. "The flatter the middle of a child's face, the less the eustachian tube will be angled," says Dr. Fisher.

Living with a smoker and inhaling secondhand smoke raises a child's risk of ear infection. Lying flat while drinking a bottle or inheriting low levels of maternal antibodies to pneumococcal bacteria also increase the odds.

"One of the most worrisome trends of the past few decades has been the emergence of antibiotic resistance among the 'big three' bacteria that cause most cases of AOM," says Ali Andalibi, PhD, a researcher in the department of cell and molecular biology at the House Ear Institute in Los Angeles. Researchers have found that many germs are currently resistant to penicillin, and some are resistant to other antibiotics as well.

Tips for combatting ear infections

If your health care provider suggests watchful waiting (i.e., using a pain-and-fever reliever but no antibiotics for 48 to 72 hours), consider this approach. "Most kids get better with or without antibiotics," says Dr. Kimberlin. "Some kids need them, but antibiotic overuse is leading to serious problems."

Diarrhea

According to Dr. Madhankumar, the following are common causes of diarrhea:

• Bacteria
• Parasites
• Food poisoning
• Viruses like rotavirus
  
• Certain medications like laxatives or antibiotics
  

Less common causes can include irritable bowel disease (IBD), Crohn's disease, ulcerative colitis, food allergies, and celiac disease.

Why your child might be vulnerable to diarrhea

The loose bowels of babyhood and early toddlerhood can be impressive both in their number and explosive power. Most are caused by the highly contagious rotavirus, which is spread through the stool of an infected person. It's all too easy for rotavirus to be passed around in your own home, and far easier at daycare. (Fortunately, washing hands with soap deactivates the virus.)

But don't blame all loose bowels on viral invaders. "Some antibiotics, such as Augmentin, Biaxin, and Zithromax, can speed up transit time in the bowels," notes Dr. Fisher. "And for young toddlers, the most common cause of frequent diarrhea is diet. Too much fruit juice makes the bowels pull in extra water." Other dietary causes include lactose or soy intolerance.

Tips for combatting diarrhea

Limit fruit juice, since it has little nutritional value, says Dr. Fisher. Also, go easy on milk. If your child has had a bout of diarrhea, their gastrointestinal system may be hypersensitive for a while.

Vomiting

Getting frequently sick with vomiting could be caused by gastroesophageal reflux or something called cyclic vomiting, which is repeated vomiting with no known cause. Vomiting is no fun for anyone, but if there's any good news in this, it's that most bouts of vomiting aren't serious, and they'll self-resolve in short order.

Why your child might be vulnerable to vomiting

True vomiting—usually a reaction to infection, food poisoning, or stress—is different from a baby's everyday spit-up, says Dr. Fisher. The gastrointestinal system of some babies takes extra time to mature and they'll experience wet burps or gastroesophageal reflux. This is normal.

But if your baby or toddler vomits fiercely after each feeding, they may have a condition known as pyloric stenosis, a thickening of the valve between the tummy and intestines that keeps the stomach contents from emptying.

Some babies and preschoolers gag easily while eating or having their teeth brushed, causing them to vomit. Other preschoolers and elementary school kids who experience frequent vomiting may have cyclic vomiting syndrome. This condition involves intense vomiting for several hours or even days, followed by weeks or months of peace.

Tips for combatting vomiting

If your pediatrician can't diagnose the cause of your child's vomiting, consider consulting a pediatric gastroenterologist. In the meantime, make sure your child stays hydrated, eats bland foods, and rests. It's also important to wash hands and disinfect toys as much as possible.

Strep Throat

If your child keeps getting sick with strep throat, it's possible they never fully recovered the first time, or that they've been repeatedly exposed to the illness. Strep throat can affect people of all ages, but it's most common in children ages 5 to 15. Symptoms can include:

• Sudden high fever
• Sore throat with red or white patches
• Headache
• Chills
• Swollen lymph nodes in the neck

Strep throat can spread from one person to another by sneezing, coughing, sharing utensils, or close contact with someone who has the infection.

Why your child might be vulnerable to strep throat

Some kids with strep don't respond to the first course of antibiotics prescribed by a health care provider. So even though these kids have been treated, the infection never gets knocked out. Some children need longer treatment to get rid of the strep bacteria while others need a different antibiotic.

Sometimes kids come in close contact with a carrier who has no symptoms but can pass the infection along. And if your child gets their first infection during peak strep season (spring and fall), they're more likely to become reinfected, because bacteria thrive during those months.

Health care providers are swift to treat strep throat to prevent rare yet serious complications, but the most accurate test (a throat culture) takes two days to yield results. A rapid antigen test offers results in minutes but can fail to detect strep some of the time. For these reasons, providers may over-diagnose and overprescribe antibiotics to be on the safe side.

Tips for combatting strep throat

If your child is diagnosed with strep throat, ask for a 10-day course of antibiotics, and make sure they take all of it. "Studies have shown that a seven-day course of penicillin is much less likely to eradicate the strep germ than is a 10-day course," says Richard J. Schmidt, MD, a fellow in pediatric otolaryngology at the Nemours Hospital for Children in Wilmington, Delaware.

When strep keeps coming back with a vengeance, some health care providers suggest an old standby: tonsillectomy. Repeat infections can create pockets of hard-to-kill bacteria on the tonsils.

Pneumonia

Kids who get sick again and again with pneumonia often have an underlying condition prompting the illness, such as acid reflux or asthma. Pneumonia is the inflammation of the lung sacs caused by a bacterial or viral infection.

"In a pneumonia infection, the air sacs become filled with pus and may become solid," says Dr. Madhankumar. Pneumonia is spread by droplets of infected fluid, and it can be contagious before symptoms begin.

The most common symptoms of pneumonia include:

• Aches and pain in the chest when coughing or inhaling air
• Chills and fever
• Cough that produces phlegm

Why your child might be vulnerable to pneumonia

Recurring pneumonia could be a sign of an underlying illness such as asthma, gastroesophageal reflux, cystic fibrosis, neurological problems, or an immune deficiency, says Raj Padman, MD, chief of the division of pulmonology at the Nemours Hospital for Children. But some cases of repeat pneumonia have no known cause.

Tips for combatting pneumonia

Ask your health care provider for a referral to a pediatric pulmonologist. This specialist can perform lung-function tests and lung scans to help detect and solve your child's problem.