In light of the ongoing COVID-19 pandemic, and especially with the new Omicron variant spreading, a primary concern for parents has been what to do if your child is sick and you suspect it might be COVID-19. Dr. Smita Malhotra, consultant paediatric gastroenterologist and hepatologist, Indraprastha Apollo Hospital, New Delhi, answers all the relevant questions, from queries about symptoms of COVID-19 in babies and children to how you should handle milder illness in children.

Is Omicron a serious concern for children?

Omicron is a variant of concern of the SARS COVID virus due to its high transmissibility and shorter incubation period. Initially, when this variant emerged, there was panic amongst the parents as increased rates of hospitalisation were noted in children in the West. This has not been noted so far in our country, and the virus has behaved as in adults with mostly a mild upper respiratory tract illness of short duration with no major complications in the majority of the child population. But it should not be taken too lightly.

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What are the symptoms of COVID-19 in children?

The Omicron variant causes an upper respiratory flu-like illness. The most common symptoms are high-grade fever, throat pain or congestion, runny nose, wet cough, headache, malaise, and fatigue. Gastrointestinal symptoms such as pain in the abdomen, diarrhoea, nausea, vomiting and loss of appetite may develop. Loss of taste and smell observed commonly with the Delta variant is not a usual feature with Omicron. It does not cause lower respiratory infection, pneumonia and drop in oxygen levels typically seen with the Delta variant. A few smaller children may develop croup (inflammation of upper airway in children). Usually, the illness lasts for a shorter duration and symptoms begin to resolve within 3-4 days.

Should children wear masks?

Masks can be safely worn by children above 2 years of age under supervision. Masks are not recommended below 2 years of age due to the risk of suffocation. Older children with developmental anomalies and cognitive impairments too may not be able to handle mask use. Mask recommendations vary in different regions of the world. The World Health Organization does not recommend masks below 5 years. For 6 to 11 years, mask use is not mandatory but encouraged as per local transmission and other factors, and for children above 12 years, mask usage is as per guidelines as for adults. The Centre for Disease Control (CDC) recommends indoor mask use amongst all children above 2 years of age. Children with immunodeficiencies or chronic diseases should wear N95 masks.

How do you care for children showing symptoms of COVID-19?

Children with COVID need reassurance, love and care, along with symptomatic and supportive therapy. Inform and consult your child's doctor if you notice symptoms. They do not always need to be isolated within the family but should not venture outdoors. Antipyretics and sponging with lukewarm water for the fever, saline drops for nose blockage, and decongestants offer relief of symptoms. There is no role of antibiotics like Azithromycin, Ivermectin or Hydroxychloroquine. Blood oxygen saturation should be monitored using the thumb or great toe of the foot to get adequate readings, and care should be taken that there is no nail polish on the nails.

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