Medical symptoms your child may have that you should NOT ignore during MCO in Malaysia
The Movement Control Order (MCO, and now CMCO) has changed the way we behave towards many things. This includes the way we respond to illness.
Malaysians have done well in respecting the MCO and help Malaysia battle the first wave of Covid 19 successfully. To this regard, we are careful not to travel out of homes, especially with our kids, as parents are naturally careful and protective over their kid’s health.
For this very reason, it is equally important for parents to be aware of some medical conditions in their kids which would require more urgent attention and to take your child to seek appropriate medical help despite the CMCO.
Common conditions like the flu or cold still do occur and Dengue is still causing issues to Malaysians during this MCO period.
I work at Pantai hospital Kuala Lumpur, Gleneagles Kuala Lumpur, Prince Court Medical Centre and Tung Shin hospitals, all of which are extremely safe if you need to take your child to visit a doctor.
So here is a summary of symptoms, that if your child exhibits, you should go see your general practitioner or paediatrician without delay
Fever – especially one that’s persistent for more than 2 days or not responding to paracetamol.
Earache – sudden pain in one or both ears, and may be associated with fever.
Poor appetite – especially if your child is not taking enough fluids.
Lethargy – it can be an early sign of a serious illness.
Many children are now exploring their homes for more exciting things (and dangerous) to do. Hence we have been seeing a number of unusual mishaps at home, over this MCO period due to little inquisitive minds.
Trauma: If your child falls, brushes herself/himself off and carries on playing, it’s unlikely there is any significant injury. If they are not able to move or if they are not using the affected arm or leg, its best you take your child to the emergency department. The likelihood of significant injury is dependent on the speed of movement/ height of fall and the object they had an impact onto eg: concrete floor.
Head injuries onto a hard floor or object need to be taken seriously. A child who has lost consciousness, one who is disorientated, lethargic, vomiting or with persistent headache need to be taken to the Emergency department or you need to call for an ambulance.
Cuts: If they are superficial and not gaping, washing with clean water, a little antiseptic cream and a plaster is sufficient, unless it’s on sensitive or cosmetically unsightly areas like the face, or important areas like the palms of the hands or genital areas, these should be brought to the attention of a doctor.
Liquid: Ingestion (swallowing) of caustic/ poisonous or corrosive liquid is dangerous and potentially life threatening. Firstly, keep any harmful chemicals like caustic soda, bleach, air con refrigerants etc. locked away from your kids. Never transfer or store these liquid into drinking bottles, that your child might mistake for a drink. The first thing to do if they swallow corrosive liquid is to give your child honey to drink and get them to the hospital immediately.
Solid: If your child swallowed a solid object and have no symptoms, then it’s likely the object has entered the stomach safely. It’s still good to be assessed by a doctor and if you have a similar object to the one swallowed, do take it along to your doctor. If the object is stuck in the oesophagus (food pipe- the tube from the back of mouth to stomach) they may have difficulties swallowing or may be drooling saliva. This is an emergency and do take your child to a hospital with a Paediatric Surgeon.
Button or disc batteries (flat-coin shaped) are special exceptions as they can still discharge electric current and cause damage to the inner lining of the oesophagus or stomach. Again, the first thing you do is to feed your child a few tablespoons of honey and take them to a hospital with a peadiatric surgeon, urgently.
Airway: If the solid object goes into the airway they may be coughing or have difficulties breathing. Perform back taps or if you know the Heimlich maneuver do perform that or call for an emergency ambulance. Its best to avoid any such mishaps, so keep an eye on things that your kids are getting their hands onto. Do keep away any beads or circular (spherical) objects which can get lodged into their airways if inhaled and this shape is often difficult to dislodge with the above maneuvers. Any circular (spherical) fruits or food, such as grapes and blueberries should be cut in half for your kids for this reason.
Other subtle symptoms
There are some symptoms in a child that does not include acute pain or the child being acutely unwell, however needs to be seen to and investigated by a paediatrician.
These could be: generalized malaise, persistent limping with no history of injuries, unexplained lumps or bumps anywhere on the body, limbs or head, being easily bruised, bleeding gums, recurrent mild headache or vomiting or even a new squint.
Some of these symptoms may be very subtle and are most likely nothing too serious but some more serious conditions do presents with these symptoms too initially, hence its best a paediatrician assess your child if present.
Children over 5 years of age are more effected by changes in environment or their daily routine and this might affect them psychologically. Not being free and playing with their friends or even attending school is disruptive. This can manifest by a change in their temperament, being anxious or depressed, fear of being left alone, excessive crying or even critical of his or her own ability.
Parents are best judges of their child and if you are worried in any way, do take your child to see a paediatrician. Though these symptoms may not appear serious, an early intervention can nib the problem in the budding stage.
Tummy pain is a common symptom. For most children its due to “gas” or “indigestion” or constipation. Most of which will settle down. Children should take adequate fruits and vegetables and plenty of water, daily. This will allow them to open their bowels daily with soft faeces and pass colourless urine regularly, throughout the day.
Here are occasions when you should take your child to see a doctor for their tummy pain:
- Constant, persistent abdominal pain that lasts more than 2 hours, without relief.
- Diarrhoea lasting more than 24 hours, particularly with associated lower abdominal pain.
- Tummy pain with vomiting, especially when the vomitus is green or blood stained.
- Tummy pain with blood in your child’s faeces.
- A younger child who prefers to lie still, refuses to be cuddled, wants to be left untouched.
Vomiting is common especially with younger children. However, then its persistent and associated with the following, you should take your child to be assessed by your GP or paediatrician:
- Vomiting with diarrhea: Your child is not tolerating fluids orally for more 6 hours or has persistent diarrhoea for more than 24 hours.
- Cough and persistent vomiting: If your child has a cough and persistently vomiting mucus and has poor oral intake.
- High fever with vomiting (more than 38 degrees Celsius): Together with vomiting and with or without the following: headache, pain on passing urine, ear ache, sore throat or runny nose, pain over the chest, tummy pain.
A painful swelling in the groin which does not settle should be seen by a doctor.
The commonest cause in children are hernias. These often come and go. In children under one year of age, hernias are treated urgently to avoid complications. A child with a hernia with associated vomiting, suggests the possibility of their intestine being trapped, causing intestinal obstruction. The hernia lump should be “pushed back” to avoid more serious complications.
This would mean a visit to a hospital with a paediatric surgeon available.
Do look out for the testicle of your boy child too, as a twisted or torted testis can be found in the groin and not scrotum and is very painful and tender to touch.
Testicular torsion (twisted)
A torted testis is painful and if you find a painful swollen scrotum, its best to take your child straight to an emergency department with a Paediatric surgeon available.
A twisted testis has about 6 hours before the testis dies so time is essential in trying to save the testis.
A child with burning pain whilst passing urine may be experiencing a urinary tract infection (UTI), a visit to your GP or paediatrician and providing a urine sample to confirm a UTI is usually done, before antibiotics is commenced. A child with blood in the urine or is unable to pass urine will need to go to a hospital with a paediatric surgeon, to be assessed. This might be due to more serious issues, such as a stuck urinary stone.
Hospitals are open 24 hours and are dealing with emergencies all the time. We have been very fortunate in Malaysia with the discipline shown by everyone with this epidemic.
The hospitals I work in are all exceptionally vigilant and have strict protocols to avoid any potential carriers of Covid 19 entering the premises and all patients are checked thoroughly and tested (if entering the operation theatre).