Most babies and young children contract recurrent minor illness within the first 2-3 years of life when their immune systems are immature and all the bugs they encounter are “new” to their systems. Babies in crèche/daycare and babies with older siblings are exposed to more bugs and tend to get sick more frequently. Do not be surprised if the child has 5-10 minor infections (eg common colds) per year in the first 2-3 years of life. In addition, every cold may last 1-3 weeks so it can feel as if your baby is “always sick.”
However, it is no longer considered normal if infections are too great in number, last for too long, fail to resolve with standard treatment, or have severe or unusual complications. Examples of such cases are:
- The need for intravenous antibiotics to clear an infection when oral antibiotics have failed
- More than 2 serious sinus infections or pneumonia episodes in 1 year
- More than 4 ear infections in 1 year
- Use of more than 2 months of antibiotics in one year
- Two or more episodes of sepsis or meningitis in a lifetime
- Unusual organisms causing the infections
- Chronic diarrhea
- Extensive, recurring skin lesions or abscesses.
The above may indicate a problem with the immune system or with the anatomy of the child and should be investigated further. For example, recurrent ear infections may be because of an unusually angled ear canal or Eustachian tubes, and may require grommets to help ventilate the middle ear canal. Recurrent “bronchitis” may actually be due to underlying asthma which can be treated. Recurrent pneumonias may be due to a real problem with the immune system, which needs to be investigated and managed in expert hands.
Remember again- recurrent minor infections are common and normal in children, but if infections are serious, unusual, greater in frequency than expected for age or don’t resolve with standard treatment, rather have them looked into further.