Paediatrics (Child Health)

Paediatric Services
at Gleneagles Hospitals

Paediatricians specialise in the care of infants, children, and early adolescents.

Paediatricians are often the primary care physicians from the birth of a child to caring for their health as well as general growth and well-being, including administering inoculations and vaccinations as and when necessary.

Common Childhood Illnesses Symptoms

To learn more about common childhood illnesses and symptoms, select the portion of the body where your child is experiencing symptoms on the diagram below.

A-Z List of Common Childhood Illnesses

To view the list of symptoms, select from the A–Z listing tab below.

Asthma

As a common and long-term health condition, the severity of asthmatic symptoms may change depending on the child. It affects their airways with a sudden and severe onset of symptoms such as the difficulty to breathe, wheezing and shortness of breath.

A sudden, severe onset of symptoms is known as an asthma attack.

Bronchiolitis

Bronchiolitis is a lower respiratory tract infection that affects babies and children under two years old. Bronchiolitis affects bronchioles (smaller airways). It is caused by a virus called RSV (respiratory syncytial virus).

Symptoms of bronchiolitis include:

Runny nose
Dry persistent cough
Fever
Difficulty breathing

Chickenpox

A mild disease and a rite of passage for many, chickenpox is a disease that most children will catch at some point. Caused by the varicella-zoster virus, chickenpox is highly contagious and can be passed onto others about 2 days before any symptoms have shown.

It is best to keep your child away from public areas within 10-21 days after being near someone who has chickenpox.

Symptoms of chickenpox include:

Fever
Rash (small, itchy, red spots like pimples) develops on the chest and back, and spreads to the face, mouth, scalp, arms, and legs.
Rash develops into thin-walled water blisters which then burst, dry up and become dry brown crusts.

Getting the chickenpox (varicella) vaccine can reduce the risk of your child contracting the highly contagious chickenpox infection.

Older children and adults are at higher risk the later they catch the virus.

Seek help when:

The victim of chickenpox is a pregnant woman.
The victim of chickenpox is an infant.
The victim of chickenpox has a weakened immune system.

Clubfoot

Clubfoot is a condition where the forefront, the section where foot is joined to the lower leg bone is abnormally twisted associated to the lower leg bone that is pointing inward and downward. This can develop in either one or both feet. This condition is also known as Congenital Talipes Equino Varus.

There are two types of Clubfoot:

Postural Clubfoot that includes muscle imbalance and/or tightness, however there is essentially no bone or joint involvement.
Structural Clubfoot that includes the bone and joints of the foot, where the child's foot is unable to go through the full spectrum of movements.

Symptoms of clubfoot include:

One or both feet may be turned inwards and can be seen soon after birth.
The calf muscle and the affected foot may be slightly smaller than normal.
Difficulties in movement.

Coughs & Colds

Though mild to us, even the smallest viral infection of the upper respiratory tract such as the common cold should be cautioned in children. From nasal stuffiness to running noses, sneezes as well as sore throats, coughs and fevers, your child may be irritable and face difficulty with feeding.

Seek help from a paediatrician when:

Symptoms last more than ten days.
Your child has a rash with fever.
Your child is not waking or interacting.
Your child faces difficulty in breathing.

Conjunctivitis

Conjunctivitis is a common eye infection where the conjunctiva (thin, clear membrane that protects the eyes) become inflamed as the result of a bacterial or viral infection.

Symptoms of conjunctivitis include:

Inflammation (swelling) of the conjunctiva
Red, itchy eyes, and sticky eyelids
Watering the eyes more than usual
May have a discharge
Eyes may feel sore
Vision is blurred

Constipation

Constipation is a very common condition among children of all ages. When they are constipated, they find it hard to pass motion and the stools they pass may be hard. Another symptom of constipation may include persistent abdominal pain.

Croup

Croup is a common respiratory tract infection in children between the age of six months and 12 years old. It is an infection that affects the child’s upper airway (larynx, trachea, bronchus).

Croup is caused by respiratory viruses. Viral croup usually resolves within one week.

Symptoms of croup include:

Fever
Watery nose
Hoarseness of voice
“Croupy” or barking cough
Difficulty in breathing
Stridor (noisy breathing)
Poor feeding

Diarrhoea and Upset Stomach

Though loose stools in children can happen on occasion, diarrhoea, however, is when your child passes unformed and watery stools on a frequent basis. They may have food allergies but most of the time this is caused by an infection or a stomach bug.

Seek help from a paediatrician when:

Your child has passed six or more diarrhoeal stools.
Your child has vomited three times or more within 24 hours.
Your child has not been able to hold down fluids for at least eight hours.
Your child is floppy, irritable, and has no appetite.
Your child is experiencing stomach pain.
Your child has a headache and/or a stiff neck.

Ear infections

Common in infants and toddlers, ear infections tend to be caused by viruses after a cold. It can be painful, may cause a fever and cause your child to try and rub or pull at their ears. Young babies cannot always describe where the pain is coming from and react by being irritable or crying.

Seek help from a paediatrician when:

Symptoms last longer than four days.
Pain becomes more severe.
Your child develops a high temperature.
Your child experiences breathing difficulties.

Eczema

Eczema is also known as atopic dermatitis. The onset of eczema is most common when the infant is between 1 to 3 months old.

Symptoms of eczema include:

Patches of itchy, dry skin on hands, neck, face, and feet.
Redness, scaly skin, and skin discolouration.

Eczema is usually recurrent. The rash gets better, then reappear soon after.

Eczema rash is often itchy, so treatment is usually needed for this condition. Moisturisers are often used to treat mild eczema. For severe eczema, a topical steroid cream or ointment may be needed.

Fever

Fever is usually a symptom of other conditions such as infections (e.g., common cold, influenza, gastroenteritis, tonsillitis).

It is a fever when your child's temperature is at or above one of these levels:

Measured orally (in the mouth): 37.8°C / 100°F
Measured rectally (in the bottom): 38°C / 100.4°F
Measured in an axillary position (under the arm): 37.2°C / 99°F

Seek help from a paediatrician when:

Your infant younger than 3 months old has a rectal temperature of 38°C / 100.4°F or higher
Your child has a temperature higher than 38.9°C / 102.2°F
Your child has a temperature lower than 39°C / 102.2°F who:

Shows signs of dehydration (peeing less than usual, not having tears when crying, less active than usual).
Has lasting diarrhoea or repeated vomiting.
Has a specific complaint such as a sore throat or an earache.

Learn more about fever in children, the causes of prolonged fevers, when it is just a symptom, and when it may indicate something more serious.

Gastroenteritis (upset stomach)

Called gastroenteritis, the most common causes are usually viruses like the rotavirus. In younger children, diarrhoea and vomiting may be more serious, especially babies as they can easily lose too much fluid from their bodies and become severely dehydrated.

Seek help from a paediatrician when:

Your child has passed six or more diarrhoeal stools.
Your child has vomited three times or more in the past 24 hours.
Your child has not been able to hold down fluids for the last eight hours.
Your child is floppy, irritable, not eating.
Your child is having severe stomach pain.
Your child has a headache and stiff neck.

Hand-Foot-and-Mouth Disease (HFMD)

Hand-foot-and-mouth (HFMD) is a common infectious disease that is seen in children and infants. The disease is usually mild and self-limiting.

HFMD is contagious. The virus spreads from person to person through faecal-oral route and the infected person's nose and throat secretions, fluid from scabs or blisters.

Symptoms of HFMD include:

Fever
Sore throat
Mouth sores
Skin rash with blisters on arms, legs, and buttocks

Seek help from a paediatrician when:

Your child is not drinking enough water.
Your child’s condition is not improving after 10 days.
Your child has a weakened immune system.
Your child has severe symptoms such as high fever with chills.
Your child is younger than 6 months.

Heat rash

A heat rash appears after exposure to heat or sweat. However, it usually disappears after a cool environment is provided to the affected child, such as wearing loose clothing or switching on air-conditioning.

A heat rash typically does not necessitate treatment. If symptoms worsen, they are usually attributed to other illnesses. Bring your child to a paediatrician if you have concerns about your child’s condition.

Influenza

Influenza or more commonly known as the flu is caused by a virus and spreads through the air when infected people cough/sneeze.

Symptoms of influenza include:

High-grade fever above 38°C
Chills
Cough
Sore throat
Headache
Nasal congestion
Muscle aches
Fatigue

If you notice these symptoms, seek your doctor’s help for medication. Most influenza cases can be well managed at home with medication, rest, and proper fluid intake by the child.

Getting flu vaccines every year can reduce the risk of contracting influenza for various common strains.

Pertussis (Whooping Cough)

Pertussis or whooping cough is an acute bacterial infection caused by the bacteria Bordetella pertussis. This infection affects the respiratory tract and is highly contagious. It spreads through respiratory droplets and by direct contact with fluids from the nose or mouth of infected person.

Serious cases and fatalities are often observed in early infancy stage.

Symptoms of pertussis include:

Onset of runny nose, sneezing, low-grade fever, malaise, mild conjunctiva inflammation
Cough that gradually becomes more severe but non-productive
Paroxysmal cough with inspiratory whoop
Post-tussive gagging / vomiting / cyanosis

Ensure that your infant receives the pertussis vaccination at 2, 3 and 5 months of age according to the Malaysian National Immunisation Programme.

Pneumonia

Pneumonia is an infection that affects one or both lungs. It can usually be triggered by cold or flu bouts.

Pneumonia causes fluid or pus to fill the air sacs of the lungs. It obstructs the normal exchange of gas inside the lungs, which leads to low levels of the oxygen in the blood and impaired removal of carbon dioxide from the body.

Young children are considered most susceptible to pneumonia.

Symptoms associated with pneumonia differ considerably depending on the cause and the health condition of the child. They may include:

Cough with or without phlegm that is yellow, green, brown, or blood-stained
Difficulty breathing
Chest pain that worsens when you breathe or cough
Fever and chills

Sinusitis

The build-up of sinus fluids allows viruses and bacteria to grow which may cause a sinus infection.

Symptoms of sinusitis include:

Stuffy nose
Inability to breathe clearly
Headaches
Sore throat caused by postnasal drip
Cough
Pain near cheekbones

Skin allergy

Skin allergy can be acknowledged if the onset of the rash is after exposure to an allergen, which causes the allergic reaction. The reaction may occur within minutes, or between 4 to 6 hours after the exposure.

Allergens are usually substances or foods that trigger an allergic reaction. Common culprits of an allergic reaction in children are certain foods such as eggs, seafood, and peanuts.

Symptoms of an allergic skin reaction include:

Flaking of skin
Redness
Itchy rashes
Bumps
Swelling of the lips or the eyes
Breathing difficulties

Sticky eyes

‘Sticky eyes’ is a common condition in newborn babies and young children. This condition is due to their tear ducts still developing. Symptom includes sticky discharge in the corner of their eyes or eyelashes.

Strep throat (throat infection)

Strep throat is an infection caused by the bacteria Streptococcus pyogenes.

Symptoms of strep throat include:

Sore throat
Swollen tonsils
High fever
Stomach pain

Seek help from a paediatrician to run a strep test if your child shows the symptoms above.

Swollen gums

Swollen gums in children are often an indication of gum disease. They may appear red or purplish due to increased blood flow in the affected area and can also seem smooth or shiny. In many cases, swollen gums will bleed easily, especially when brushed.

If your child’s gum swelling does not subside after a few days or if it causes significant discomfort, consult a dentist or periodontist for further assessment and treatment.

Tonsillitis

The tonsils are two lymph nodes that are located on each side of the back of the throat that is associated with the immune system. When there is a threat to the immune system, it releases antibodies to fight bacteria that infects the mouth area. The infected tonsils can suffer from inflammation and become enlarged leading to tonsilitis. Viral infection is the main cause of tonsillitis.

Symptoms of tonsillitis include:

Difficulty and pain when swallowing
Fever and chills
Headache
Loss of voice
Sore throat
Swollen lymph glands at the jaws and neck
White spots of pus on the tonsils
Abdominal pain

Torticollis (Wry Neck)

Torticollis, also known as wry neck, occurs when the baby's head is tilted – it is where the chin points to one shoulder, while the head tilts towards the opposite shoulder.

Congenital torticollis occurs usually when the neck muscle at the back of the baby's neck (Sternocleidomastoid Muscle) gets shortened. After birth, this condition might appear due to scar tissues and tightness of the muscle only on one side of the neck. This condition may occur later in childhood.

Another factor might be caused by a bone problem in the neck portion of the spine (cervical spine). This is known as a congenital malformation of the cervical spine.

Symptoms of torticollis include:

The baby has difficulty turning the head to the opposite side.
There may also be signs that indicate his or her head will have mobility issues as compared to other babies.
Lumps can show in the baby's neck muscle.
Prolonged head position can lead to the flattening of head and face of the baby.
The neck muscle (sternocleidomastoid) might be tight.

Urinary Tract Infection (UTI)

Urinary tract infection (UTI) is a common bacterial infection of the bladder or kidneys. It is a common cause of fever in young children. UTI can be suspected especially when no other obvious sources of fever are identified.

Symptoms of UTI in children include:

Fever
Child starts to cry when passing urine
Going to the toilet very frequently (feeling of “cannot wait”)
Small amount of urine at a time
Urine may be cloudy or strong smelling
Blood may be present in the urine
Stomach or back pain

Take your child to a paediatrician for if he/she shows the symptoms above. UTI in children must be treated because untreated UTI poses a risk of kidney damage.