Dr Phil Kieran: I'm worried my child will pick up bugs at playschool 

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My three-year-old is starting playschool next month, and I'm worried about him picking up infections while there. He's close to his grandparents, whom we visit regularly, so I'm also concerned that he might pass on a bug to them. What steps can I take to minimise the risk?

I wish I had a straightforward answer to this question, as I get asked it regularly.  Children get about eight to 12 viral infections annually in their preschool years, which is normal. These infections usually feature a runny nose, cough, fever, and possibly rashes.

Symptoms of the initial illness typically last three to five days, but it is unusual for a fever to last past five days. The child's cough can sound chesty, and it can sound surprisingly chesty in little ones. Parents often describe it “like they smoke 20 a day.”

This cough doesn’t mean they have a chest infection - it just sounds bad. Unfortunately, the cough can last up to three weeks after the illness settles, and there isn’t much you can do to shorten it.

When my kids were over a year old, I used saline nasal rinses and honey to help with their coughs. I'm not sure whether it helped them or just made me feel that I was doing something.

One of the most important things to pay attention to is how the child is, not just how the cough sounds. If a child has a significant chest infection, they will have difficulty breathing and will often be lethargic with reduced appetite. If they have a severe cough but are still in decent form and feeding well, you can be pretty reassured the cough will eventually settle.

As most of these illnesses are viral,  antibiotics will not help. Antibiotics will not, as is commonly believed, help the immune system fight the virus, ensure they don’t catch anything else, or help them settle quicker.

Antibiotics target specific proteins in bacteria and do not impact viruses. However, they can harm the gut microbiome,  something you want to mess with unnecessarily. Antibiotics have many benefits and can be life-saving, but I would avoid them unless my GP thinks I need them.

While it's unavoidable that your child will pick up viruses at playschool, you can do a few things to protect your immediate and wider family. A healthy diet with fruit and veg will help build an efficient immune system and healthy gut. Teaching him good respiratory etiquette, which we all learned during the height of covid, will make it less likely that he will catch bugs and pass them on. Encourage him to wash his hands after using the toilet, after wiping his nose, and before meals. If acutely sick, keep him away from others so it doesn't spread. The phase of continuous illness will pass, and by the time he's in big school, it will be behind you.

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