What To Do If Your Child Has Worms
What To Do If Your Child Has Worms
Dr. Antony Zardis
A few weeks ago, when I was resident at the Out of Hours Centre, I saw a mother with her children, who had gotten herself so worked up over worms, that she just had to come in for advice on what to do. One could argue that her visit was inappropriate for the service we provide, however worms can spread very quickly and cause much panic and alarm.
She was anxious as they were about to embark on a holiday to Spain, but she was convinced that her 3 year old had worms as he had been complaining of an itchy bottom. She had already given him medication to kill the worms, but he was still itching and she wondered what else she could do.
What are worms?
They are known as threadworms and they are terribly small and thin, in fact as thin as a thread, hence the name.
They can live for up to 6 weeks inside the intestine, but the female worm may lay it's eggs in the back passage. These eggs are microscopic, but they produce mucus, which can cause irritation. This will ultimately cause itching around the anus. Inevitably this will induce scratching and thus the eggs can end up on your child's nails and fingertips, which in turn can end up swallowed through their mouth.
Another point worth making is that these eggs can survive outside the body for 2 weeks. This means that any eggs that fall off the skin around the anus may end up in your child's bed sheets or clothes. As you change your child's clothes or bedding, these eggs may end up thrown up into the air and mixed in with dust, food, drink and even the surfaces of tooth brushes. These eggs may well be ingested and in turn hatch in your child's intestine to form more worms... and so the vicious cycle continues.
How do I know if my child has worms?
You can sometimes see them mixed in with faeces in the toilet bowl.
Another option is to inspect your child's anus with a torch, late at night, while they are sleeping (as this is when the eggs are laid). Part your child's buttocks and look at the opening of the anus and you should see one or two coming out of the back passage.
If still in doubt, you may wish to conduct the sticky tape test, where you press some see-through sticky tape to the skin around the anus, first thing in the morning, before any wiping or bathing. Pop this tape into a specimen container and take it into your GP, in order to send it to the laboratory to check for the presence of eggs.
But are they dangerous?
Not really, however the itching and scratching may make your child's anus sore and this could wake them at night. If a large amount of worms builds up in the abdomen, then your child may complain of tummy pains, lack of appetite and weight loss, but this is rare. Young girls may also present with problems passing urine, in particular bed wetting.
There are two very important parts to the treatment of worms:
This is called Mebendazole and should only be used in children aged over 6 months.
It should be taken by ALL household members, including adults and those who do not have any symptoms. They should all take a single dose at the same time. This one dose is enough to kill all the worms.
A second dose must be taken by everybody 2 weeks later, incase any left over eggs have hatched and produced more worms.
You can buy this treatment over the counter at any pharmacy.
Do NOT take this medication if you are in the first trimester of pregnancy.
Instead, use hygiene measures alone, which should prevent you from swallowing any more eggs. This means that any worms that you DO still have inside you, should die of their own accord within 6 weeks, thus breaking the infection cycle.
2) Hygiene measures:
These measures aim to deal with any eggs that have been laid in the anus and could have broken loose and travelled around the home:
- Wash all pyjamas, bed linen, towels and cuddly toys at normal temperatures.
- Vacuum and damp-dust your home, throwing away the cloth you have used. Pay particular close attention to the mattresses and your child's play area.
- Clean the bathroom thoroughly.
Once this has been done, the following measures should be followed for 2 weeks:
- Do not bite your nails and discourage your children from sucking their fingers.
- Keep your toothbrushes in a closed cupboard.
- Do not share towels.
- Meticulously wash hands (including under the nails).
- Close fitted underwear should be worn to bed and changed every morning.
- Cotton gloves can be worn to prevent scratching.
- Wash around the anus every morning to get rid of any eggs laid at night.
- Change and wash nightwear daily.
Note - your child may continue to go to school if the above measures have been taken.
There is only one subject that is more unmentionable then ones unmentionables, at a play date and that is the subject of worms. It is a subject that many parents avoid having with other mums and dads because of the social stigma attached to it. As a result, they panic and don't know what to do.
What many parents don't know is that they can get the medication and advice from their local pharmacy, without a prescription. In fact there is little need, if any, to contact your GP, let alone your Out of Hours service for such a thing.
Last but not least, it is important to only use the OOHS when absolutely necessary. It is not the place for repeat prescriptions, head lice, worms or verrucas. Having said this, if your child were to develop tummy pains or problems urinating as result of worms, it is important to seek the advice of your GP as it may indicate that the worm infection is more extensive.