Swine flu (H1N1) - Babies and Children - Precautions, Symptoms, What to do...

Aug 4, 2009 2:11 PM

Babies and children under the age of five are particularly susceptible to swine flu.

Is it dangerous?

It is not clear as to whether swine flu is more dangerous in babies and children than any other flu.

Are children and babies more susceptible to it?

Yes. It is known though that babies and children especially under the age of five, are more likely to catch this flu (or any other infection) as their immune systems are still maturing.

What precautions should we take with children and babies, to avoid swine flu?

Children should wash their hands regularly as these germs can be anywhere. They can also use cleaning gels that are alcohol based.
Teach them not to touch their face and mouth, as germs on their hand may find their way into their body
Avoid contact with anyone who is sick, especially with flu-like symptoms
Try to avoid areas that are too crowded where people are breathing very close to your babies and children - crowded beaches, packed temples etc., Be sensible about this. Don't avoid going out, just try to avoid packed crowds.
If someone has returned from abroad, go see them or have them visit you after they have spent a week or so in India. This will give time for them to manifest any flu symptoms.
If one child has flu like symptoms, while another does not, try to keep them isolated from each other. Of course, do this gently in a way that is fair to both children so that the one with the flu like symptoms does not feel that they are at fault.
If they have a cough or a cold, make sure they use a tissue when they cough or sneeze and then throw it away. Ensure they wash their hands after this also.
Follow other good general health practices with children also
- Drink enough fluids
- Eat nutritious healthy foods
- Physical activity

If I have swine flu and or on swine flu medicines, should I stop breastfeeding my baby

Talk to your doctor about this but the general advice is not to stop feeding your baby your breastmilk. Your breastmilk contains antibodies that are important for your baby's immunity. These can help your baby ward off illnesses like swine flu. You can express it and have someone else feed your baby.

Maintain the general precautions above like washing your hand etc., before coming in contact with your baby or child.

Symptoms of swine flu

Symptoms of swine flu are like any other flu:

Fever
Cough
Sore throat
Aches and pains
Headaches
Tiredness
Loss of appetite
Sometimes diarrhoea and vomiting

In children emergency warning signs that need urgent medical attention include:

Fast breathing or trouble breathing
Bluish skin colour
Not drinking enough fluids/eating food (loss of appetite)
Not waking up or not interacting (tiredness, fatigue)
Being so irritable that the child does not want to be held (irritability)
Flu-like symptoms improve but then return with fever and worse cough
Fever with a rash

What should I do if I see these symptoms in my baby or child?

Don't panic. Do not avoid going to the doctor because people scare you about quarantine etc., It is better to have a professional treat your baby or child than stay at home and hope for the best.

As soon as you see the symptoms above, call your baby or child's paediatrician and inform them that your baby or child has flu like symptoms, before you drop into their clinic. They may want to take precautions to ensure that you do not spread it to other people there.

Do not wait till things become worse. And please do not send your child to school or preschool, especially if they have these symptoms. The Government of India has also issued an order that schools cannot ask for Medical Certificate for this type of absence. If possible, stay at home yourself, till they get better.

Many of us have an inherent fear of government hospitals (GH). We also hear stories that the government will immediately put people in isolation wards if they have flu-like symptoms. This is not accurate. Many people just have ordinary flu. Everyone with flu cannot be put in isolation in the GH. It is not practical.

The Government of India (GOI) has issued clininical management protocols that doctors should use to determine if the patient should go to the GH or not. Not everyone with flu-like symptoms will be forced to go to the GH. The baby or child will be examined by your paediatrician, to see if they match any of the symptoms that could indicate swine flu and if they are identified as such, only then will the baby or child be put in isolation.

Updated: On Aug 6 2009, the Government of India has issued new isolation guidelines. They say

"Any person with flu like symptoms such as fever, cough, sore throat, cold, running nose etc. should go to a designated Government facility for giving his/her sample for testing for the H1N1 virus. After clinical assessment, the designated medical officer would decide on the need for testing. Except for cases that are severe, the patient would be allowed to go home (This was not allowed under the existing guidelines).

The sample of the suspect case would be collected and sent to the notified laboratory for testing. If tested as positive for H1N1 and in case the symptoms are mild, the patient would be informed and given the option of admission into the hospital or isolation and treatment at his own home.

In case the patient opts for home isolation and treatment, he/she would be provided with detailed guidelines / safety measures to be strictly adhered to by the entire household of the patient. He/ she would have to provide full contact details of his entire household. The house hold and social contacts would be provided with the preventive treatment.

Notwithstanding the above guidelines, the decision of the doctor of the notified hospital about admitting the patient would be final."

Even if swine flu is suspected based on symptoms, unless a test is done at a lab, it cannot be confirmed. Since the identification of this virus is done by government labs like the NICD etc., the government hospitals can confirm faster if you have the H1N1 virus or not.

The Government of India is also assuring everyone that they have well trained doctors at their facilities and adequate stocks of the right medicines. The government has also passed strictures forbidding the sales of medicines used in swine flu in the open market and have taken control of stock. They have also gotten ready the mechanisms to test to check if the virus causing flu like symptoms is swine flu (H1N1) or not.

How will it be treated?

The doctor will decide the course of treatment. Oseltamvir and Tamiflu seem to be the popularly used medicines for this though children under 3 months of age may not be administered any medicines. The doctor will prescribe rest and also ask you to ensure that your baby or child is getting enough liquids especially if they have diarrhoea or vomiting. Doctors may also prescribe other medicines like painkillers, antibiotics for protection against other infections etc.,