Worms in Children: Maybe they’re not being naughty! How to Treat and Avoid them today

Thread worms are thriving everyday in the bottoms of little children and affecting their daily activities and causing sleepless nights for many families. It's not a nice experience but easily identified and treated. I am frequently finding worms a problem for our little pre-school aged non-sleepers and mum and dad are horrified. Worms are spread very easily in the community across all social backgrounds and generations. They are spread most commonly in pre-schoolers’ because in my experience the only things toddlers share are germs (and love) and this age group are not always efficient at hand washing, particularly before eating.

How do we identify a child with worms?

An infected child has an itchy bottom!! They will naturally be very irritable during the day, frustrated, uncooperative, fidgety, not be able to sit still, cannot concentrate, argumentative and angry. This is the most common reason for climbing out of the cot.
You might suspect someone performed a personality transplant on your little angel!
They want to scratch their bottom and will commonly be seen taking their clothes or nappy off
They will walk strangely like they are trying to keep a coin safely between their buttocks and having trouble (imagine)
They will frequently urinate and or bed wet at night
They will not be able to go to sleep and not be able to explain why to you, but will be crying and uncomfortable, not naughty

What to look for

If you suspect worms, look for a pinky/red rash about 2cm wide completely around the outside of the genital area
If you wish to look for worms, keep the room dark, ask for your partners help, comfort the child and 'spring' a torch light onto the exposed bottom. The worms come out at night to lay eggs. This process creates the uncomfortableness and irritability. So in the night time only you will see 1.5cm long wriggling pieces of white sewing cotton, moving fast away from the light, around the anal passage. In girls the worms can crawl into the vagina and be even more irritable

How to get rid of them

Firstly, collect as many worms as you can see immediately and dispose of them. Your child will feel calmer after the worms have disappeared from the skin.
If you have a daughter and you suspect they are in the vaginal area, you can very gently slightly spread open the outer labia (flaps of skin) and if you see any worms, gently roll them onto a cotton bud (q tip). Tissues and cotton balls are too large and you won't be able to see what you are doing. (personal experience) This will provide immediate relief from the irritation of the worms trying to lay eggs in this sensitive area
Apply a thick layer of Vaseline to the anal area to provide temporary relief to the skin and catch any worms that come out again in the night.
Wash in hot water/use the dryer/hot sun on all linen, towels and clothing worn by the child. Repeat for the whole family. The worms can live outside the body long enough to infect everyone.
There are a variety of medications to offer your family. There are one dose liquids, orange chewable tablets and chocolate squares, please do the whole family the day you find the worms and then again 7 days later in case of re-infestation See your pharmacist for the appropriate dose and the minimum age.
It's a good idea to keep the medication in your medicine cupboard (personal experience), it will be late at night that you discover them, the shops will be closed and no-one can sleep if anyone else has worms crawling out of their bottom!
Please inform your pre-school/daycare centre if your child has them (even anonymously if embarrassed) so that other families can be on the look out for them and the centre's can be more proactive with hygiene and symptoms in other children. Always think about whether you would appreciate the warning if another child had worms and played with your child.

How do children get worms?

Through their mouth
The worms come out at night to lay their eggs in the tissue around the anal passage, this causes the skin irritation.
The child scratches their bottom because it's itchy
The eggs get under the finger nails and are spread onto everything the child touches: toys, toilets, taps, towels, pencils, chairs, etc...
The next child/person touches the same objects and then....doesn't wash their hands before eating/ touching the face and they swallow them.

Tip: The simplest form of infection control used in hospitals everyday that prevents doctors and nurses from catching all of the bugs in the hospitals is HAND WASHING. Make it a family routine that no-one eats before they have washed and thoroughly dried their hands. Encourage this at pre-school and day care as well. If we start young enough the children will think it as normal as cleaning their teeth before bed or kissing you good bye. It is up to us as parents to start and lead by example with these sensible habits.

RN, Child and Family Health Nurse. Mother of three.
I want to give you your life back! Would you appreciate being empowered with an understanding of your baby's needs and a gentle strategy that you apply to your baby/toddler's personality? Do you feel like you've read everything and nothing is working?

Visit http://www.sleepandsettle.com.au for my free report “Sleeping Baby Secrets”

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There are many reasons for your baby 9 months or older waking early in the morning around 5-6am and not wanting to go back to sleep. If the early waking is not working for your family and you would like to try and extend the morning wake time, we need to identify the possible causes of the early waking and deal with each issue.

Common issues to address are:

Too much light coming in the bedroom in the morning
Household/environmental noises
Baby not dressed warmly enough for the early morning temperatures
The reward of an early breakfast
Waking for a milk feed
Habits and routine already established as a younger baby, of an early start to the day
The timing of the first day sleep
Your baby's bedtime in the evening
Genetics! Your baby is made up of two parents

So once you decide what the possible causes are you can begin to play with some solutions.

Always give each try at least a week to have an effect on your baby's body clock and be patient.

It is easy to adjust the amount of light coming into the bedroom with appropriate window coverings of any sought. Whatever is handy will work, it doesn't have to be professional or expensive to be effective, just block out the light. Think an old quilt cover, dark sheet, large towels, a picnic blanket, coated block out fabric.

Sometimes we can train the family to be quiet around the house early in the morning, but sometimes outside factors affect your baby's waking. Try playing soft sleep time music such as 'Music for Dreaming' on repeat all night to cover some of the noises and wean baby off the music in a few months

Over 9 months Babies are very mobile in the cot and should be dressed for the night assuming they are rolling around in the cot and will not be under the warm covers all night. Think how you would feel, sleeping in what you have dressed your baby in, if you were sleeping on top of your blankets without a partner. Excess blankets become a SIDS (Sudden Infant Death Syndrome) risk if your baby is mobile and crawling or rolling around the cot.

If your baby over 9 months of age is currently enjoying early morning milk feeds or gets breakfast as soon as they wake, this is a nice reward for waking. If you are happy to offer these feeds, early mornings are a consequence unless you resettle back to sleep after the feed. If you don't think baby needs these feeds for nutrition and they are simply waking for them as a habit, you can drop them if baby is over 9 months and eating solids well during the day. This is a personal decision.

Sometimes mum and dad need baby to get up early for the working schedule during the week but want to encourage a sleep in on the weekends. Unfortunately baby doesn't understand the difference between a workday and a weekend, so I recommend that you treat every day like a Sunday and encourage a sleep in until the last minute and arrange breakfast for baby at the place of babysitting or childcare.

If you reward your baby waking early in the morning with a sleep shortly after breakfast, you are encouraging early waking.

If you put your baby to bed too early in the evening, they will meet their sleep quota earlier in the night and not be able to sleep in to your reasonable wake time in the morning.

The last and obvious reason is that if you or your partner is an early riser, it is possible that the baby takes after the early riser and will always grace you with their presence when they wake! After all the baby is genetically related!

Tip: If your baby's routine is working for your baby and your family, don't change anything! If the routine needs fine tuning, first look for the possible contributing factors, then put a consistent plan in place confidently and monitor your results to see what works.

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