Family health


General information about children’s health including helpful resources to support you and your family. It’s a real worry when your child becomes ill. Understandably, we don’t want to take any risks.

Here you will find useful information about registering with a GP, the importance of having a basic first aid kit, minor ailments and head lice and nits plus some other advice that will help keep your family healthy. You can find more information about child health on NHS UK and there are a number of apps available that offer further advice and support.

Sleep

Getting into good sleeping habits is important for all of us. This can seem difficult at times when you have children, however, good sleep is important for your child’s physical and mental wellbeing as well as your own. The following links provide some excellent advice that you can follow for yourself with your family. If for any reason problems still persist, please contact your 0 to 19 team for further advice.

Find out more about the following sleep related concerns.

  • How much sleep does my child need?
  • Why is sleep so important?
  • Healthy sleep habits
  • Sleep and autism
  • Nightmares and night terrors
  • Emotional health and sleep
  • Teenagers
  • Information & who else can help

Teeth and toothbrushing

Poor dental hygiene affects not only your child’s teeth but also their health and wellbeing.

Taking your child to the dentist from a young age (usually when their first milk teeth appear) is the best way to avoid problems such as tooth decay. Tooth decay can be avoidable yet it remains an issue in many young children.

Your child may experience pain or infections in the mouth which may cause other childhood difficulties such as poor eating habits, sleep disturbance and general behavioural issues. Registering with a Dentist and attending recommended reviews may help parents recognize if their children are at a particular risk of dental decay.

‘Brushing for Life’ is a government scheme to promote oral hygiene in young children. The ‘brushing for life’ pack contains a fluoride toothpaste and toothbrush offered to children under the age of 3. The pack also contains further information about dental care and keeping teeth healthy – these are provided from your health visitor at your child’s 9 to 12 month review.

Keeping your children’s teeth healthy will help them to maintain clean and healthy teeth and gums and develop good oral hygiene habits they will need throughout the rest of their lives. Remember the most important thing is brushing at least twice a day with fluoride toothpaste and to have regular dental check-ups. Although children enjoy eating and drinking sugary food and drinks it’s best to keep these to a minimum and for children to only have them at mealtimes.

Teething

Baby’s first teeth usually appear at around six months of age.

Some children have a tough time as the teeth break through the gums, it can be miserable and painful for them. Some babies do not seem troubled by this at all.

There is no set list of symptoms that means your baby is teething, but some parents say they notice their baby;

  • Dribbles a lot
  • Has red cheeks
  • Is miserable
  • Is difficult to settle
  • Wants to chew on everything
  • Is hot – with a slightly raised temperature (more than 37.2 but less than 38 degrees).

If your child seems poorly keep a close eye on them – it may not be teething and it is important you seek medical advice if you are unsure.

It is very important to be sure that your baby is not unwell with an illness that needs treating by a health professional.

Baby Teething Problems

When it comes to teething, all babies are different. But your baby will probably get their first tooth some time during their first year.

Keep reading to find out how to spot when your baby is teething and what order your baby’s teeth are likely to appear in. 

When do babies start teething?

Some babies are born with their first teeth. Others start teething before they are 4 months old, and some after 12 months. But most babies start teething at around 6 months. 

Teething symptoms

Baby teeth sometimes emerge with no pain or discomfort at all. At other times, you may notice that:

  • Your baby’s gum is sore and red where the tooth is coming through
  • One cheek is flushed
  • Your baby is dribbling more than usual
  • They are gnawing and chewing on things a lot
  • They are more fretful than usual 

Read NHS UK’s  tips on how to help your teething baby.

Some people think that teething causes other symptoms, such as diarrhoea and fever, but there’s no evidence to support this.

You know your baby best. If they have any symptoms that are causing you concern, then seek medical advice. You can call NHS 111 or contact your GP.

Read more about spotting the signs of serious illness.

When should I start brushing my baby’s teeth?

Spotting your child’s first tooth is such an exciting milestone. It can happen at any time in their first year, but they often start to come through when they’re around 6 months old.

From the moment you spot a tooth, it’s important that you start looking after them. Use a baby toothbrush with a tiny smear of fluoride toothpaste.

Don’t worry if you don’t manage to brush much at first. The important thing is to get your baby used to brushing their teeth as part of their daily routine. You can help by setting a good example and letting them see you brushing your own teeth.

For further information about how to look after your baby’s teeth, visit the NHS website.

What order do baby teeth arrive?

Here’s a rough guide to how babies’ teeth usually emerge:

  • Bottom incisors (bottom front teeth) – these are usually the first to come through, usually at around 5 to 7 months
  • Top incisors (top front teeth) – these tend to come through at about 6 to 8 months
  • Top lateral incisors (either side of the top front teeth) – these come through at around 9 to 11 months
  • Bottom lateral incisors (either side of the bottom front teeth) – these come through at around 10 to 12 months
  • First molars (back teeth) – these come through at around 12 to 16 months
  • Canines (towards the back of the mouth) – these come through at around 16 to 20 months
  • Second molars – these come through at around 20 to 30 months

Most children will have all of their milk teeth by the time they are two and a half years old. 

Children aged 7 and over

Children aged 7 and over should be able to brush their own teeth, but it’s still a good idea to watch them to make sure they brush properly and for about 2 minutes:

  • Brush at least twice daily for about 2 minutes with fluoride toothpaste.
  • Brush last thing at night before bed and at least on 1 other occasion.
  • Use fluoride toothpaste containing between 1,350ppm and 1,500ppm of fluoride (check label).
  • Spit out after brushing and don’t rinse – if you rinse, the fluoride won’t work as well.

Sugar

Quite simply, too much sugar is the main culprit of tooth decay. Some foods naturally have a high amount of sugar in them. The sugars that are in unsweetened fruit juices, honey and syrups and the sugars that are added to food and drinks are sometimes called ‘free sugars’. Children aged 4-6 should not have more than 19g per day.

  • Don’t give your child drinks sweetened with sugar such as squash, fizzy drinks and juice drinks
  • Limit unsweetened fruit juice or smoothies to only one glass (150mls) a day as even unsweetened fruit juice/smoothies are sugary
  • Always serve sweet drinks and any sweet foods, such as dried fruit, with a meal as this can help to reduce the risk of tooth decay
  • Avoid adding sugar or honey to any drinks or food
  • If your child is unwell and needs medicine, you can ask to have this sugar free
  • Never give sugary drinks or food just before bedtime
  • Sugar is also hidden in lots of shop-bought foods, including savoury foods, to make them taste nicer. Check food labels as items such as pasta sauces, ready meals and ketchup can have a lot of sugar and salt added to them
  • Regardless of whether sugar is brown, white, unrefined or in the form of honey, sugar is sugar and no one type is ‘healthy’

Find out more

Visit Better Health food swaps to see what healthy foods you could swap sugary foods for.

Download the ‘Change4Life Food Scanner’ app and find out how much sugar shop-bought foods contain. You’ll find it at the bottom of the Better Health Food Facts webpage.

Reduce the risk of tooth decay

There are a few easy things you can do to help protect your child’s teeth and gums and reduce the risk of tooth decay.

Reduce the amount of sugar in your child’s food and drink. Every time we have something sugary, the bacteria in the dental plaque in the mouth will produce acid that will attack the teeth. The more often we have sugary foods and drinks, the more ‘acid attacks’ we will have and this causes teeth to decay.

As soon as you see that first little tooth appear, brush twice a day:

  • Use a fluoride toothpaste containing 1350-1500ppm fluoride (you can find this on the side of the tube)
  • If your child is under 3 years, just use a smear of toothpaste, but if they are 3-6 years use a pea sized amount of toothpaste
  • Brush their teeth or supervise them brushing their own until they are at least 7 years old to make sure that they’re doing it well
  • All the surfaces need to be cleaned, making sure that the gum line is cleaned as this is where a lot of the plaque forms
  • Choose a toothbrush with a small head and medium texture bristles
  • Brush for at least 2 minutes
  • When you’ve finished brushing, encourage them to spit out the toothpaste, but don’t rinse with water, as this will rinse away the fluoride
  • Always brush your child’s teeth at bedtime as this will protect their teeth while they’re sleeping

Start taking your little one to the dentist as early as possible! Take them along with you for your check-ups to get them used to the experience and environment so that it’s familiar to them. Once their first tooth has appeared, take them to see the dentist and then take them every 6 months. When your child is 3, you can ask your dentist about a fluoride varnish, which is a coating that can be applied to protect their teeth. Remember, dental treatment is free for children (and mothers from the start of pregnancy until your child is one year old).

Information and advice

From brushing their first tooth to their first trip to the dentist, here’s how to take care of your children’s teeth.

NHS children’s teeth

How do I brush my child’s teeth? (6 months to 7 years)

The NHS website – How to find an NHS dentist

Teeth grinding in children

Teeth grinding (also called bruxism) is often related to stress or anxiety. There are things you can do to help and treatments available from a dentist or GP.

Find out more from this NHS website

Healthy eating and teeth

It is important that children are helped to make tooth friendly choices;

  • As a family try and eat ‘lower sugar’ foods. Visit NHS Healthier Families for information on healthy eating.
  • Drink tap water or milk – using an open cup not a bottle or a beaker with a valve.
  • Always brushing teeth before bed and one other time every day.

Tooth brushes and toothpaste

Choosing the right toothbrush and toothpaste to clean teeth and gums is important.

Why not get your child to choose their own toothbrush, this will help encourage them to brush their teeth.

Try to get your child used to mint flavoured toothpaste early. It can be difficult to swap from sweet flavoured toothpastes as they get older.

Toothpaste

The most important thing to think about when choosing toothpaste is that it contains fluoride. This is written on the back of the tube or box.

Fluoride is a mineral that plays an important role in preventing tooth decay. When children use toothpaste from an early age it is harder for plaque to stick to the tooth enamel and decay is reduced.

Toothpaste should contain a fluoride level of 1350ppm (parts per million). Family or adult toothpaste is completely safe for children of all ages. Children’s toothpastes have become more popular but you do not need to use them. 

If using children’s toothpaste makes brushing easier and it contains no less that 1000ppm fluoride, then it is fine to use. Just ensure you switch to family toothpaste as soon as possible.

Dentists can apply a ’fluoride varnish’ to your child’s teeth which protect them even more.

Choosing a Toothbrush

Baby Toothbrushes

  • Choose a small headed baby toothbrush with soft bristles.
  • Use a piece of clean gauze or muslin cloth wrapped around your finger to clean those very first teeth.
  • Do not leave your baby alone with a toothbrush.

Toddlers

  • Continue to use a small headed, soft bristled toothbrush.
  • Allowing your child to choose their own toothbrush may encourage them to be involved in regular brushing.

Older Children

  • Children will still need help and supervision with tooth brushing until they are at least 7 years old.
  • Avoid using an electric toothbrush until a good brushing technique has been learnt. 

Toothbrushes should be replaced about every 2 to 3 months – or before, if they begin to look worn.

Habits for healthy teeth

Ideally little ones should visit the dentist by aged one – then visit every six months or as advised by your dentist. If your child hasn’t visited the dentist yet, then make an appointment as soon as you can. If you do not have an NHS dentist you can find out how to register here.

Regular Brushing

Your child should be brushing their teeth twice a day. Try using star charts to remind and encourage them. You will need to supervise and give your child a hand to brush until they are around seven.

Help your child to;

  • Use a pea sized blob of fluoride toothpaste once they are 3 years old (just a smear is needed before this).
  • Use the ‘spit don’t rinse’ rule. This keeps the fluoride on the teeth as long as possible.
  • Brush for two minutes – you can use timers or play songs to help keep to time. Have a look at the BrushDJ app.

Make sure your child sees their carers taking care of their teeth too. Being a good role model makes a big difference.

Information leaflets from your 0 to 19 Torbay team to download.

Headlice

Head lice infestation is a condition caused by a parasitic insect. Live lice can be found anywhere on the scalp; the eggs are most commonly found behind the ears and at the back of the neck. The severity of infestation varies from a few lice to thousands of lice, but a typical infestation might have about 30 lice per head. Head lice infestation is most common in children 4–11 years of age.

Confirming active infestation of head lice includes systematic combing of wet or dry hair with a head lice detection comb. A live louse must be found in order to confirm active head lice infestation. An itching scalp is not sufficient to diagnose active infestation.

The presence of louse eggs alone, whether hatched (nits) or unhatched, does not indicate active infestation as it is hard to distinguish between dead and live eggs with the naked eye, and eggs may maintain a viable appearance for weeks after death.

All members of the household and close contacts should also be checked for head lice as untreated family members and close contacts may cause re-infestation in the people, who have been treated.

Treatment of head lice
First line treatment is Dimeticone 4% lotion (Hedrin) which is a physical insecticide. This can be purchased over the counter or be given as a prescription. It is rubbed into dry hair and scalp, allowed to dry naturally, shampoo is applied and rinsed off after at least 8 hours (or overnight). A repeat application is needed after 7 days. This prescription can be given by a Health Visitor or a GP.

For further information:

British Association of Dermatologists
The NHS website – Head lice and nits

Helpful videos

Torbay health and care videos – finding and treating headlice

Toileting

Daytime wetting

If your child has not been fully successful with toilet training and continues to have accidents once they start school your 0 to 19 service can offer continued support.

Daytime wetting affects 1 in 75 children aged 5 years and above. It is usual for younger children to have wetting accidents as part of the toilet training process but as children get older, daytime wetting can be more difficult to manage at school or in social situations.

The following are ways in which you as a parent can support your child:

  • Encourage your child to drink regularly through the day, 6-8 water based drinks each day. For more information on recommended fluid intake for children, see: Water UK.
  • Continue to give younger children prompts.
  • Constipation can be the cause of wetting, provide a balanced diet which includes fibre, cereals, fruit and vegetables. See: The NHS website – Good foods to help your digestion.
  • Check that your child’s school allows easy access to drinking water and to the toilets.
  • Encourage your child to wait before getting off the toilet to make sure that they have fully emptied their bladder.
  • Above all stay calm and relaxed.

Nightime wetting

Bedwetting (known as Nocturnal Enuresis) is a common childhood condition affecting an estimated 500,000 children and young people in the United Kingdom (UK). Bedwetting usually stops happening as your child gets older without the need for any treatment. Please be aware that bedwetting is not the child’s fault, it happens during sleep and there is no conscious awareness that it is happening.

The following are ways in which you as a parent can support your child:

  • Drinking a good amount of fluid is crucial in training the bladder to fill and empty – encourage your child to visit the toilet to empty their bladder regularly throughout the day.
  • Encourage your child to drink water based drinks as some fizzy drinks, tea, coffee and dark squashes such as blackcurrant can have a diuretic effect on the bladder causing the need to go to the toilet more often.
  • Constipation can be the cause of bedwetting, provide a balanced diet which includes fibre, cereals, fruit and vegetables.
  • A bedtime routine of going to the toilet as part of getting ready for bed and again just before settling down to sleep – should ensure that the bladder is empty before going to sleep.
  • Ensure that your child has easy access to the toilet during the night. Perhaps a night light or a light switch near the bed, or leaving the bathroom light on can be useful.
  • Try to avoid ‘waking’ or ‘lifting’ your child overnight to go to the toilet – whilst this may result in a dry bed it does not help them recognise and wake to the sensation of a full bladder on their own.
  • Remain calm and positive and supportive of your child – remember it is not their fault.

Please note that much of the above information has been resourced from the ERIC website. The ERIC website is an excellent resource for further information, advice and support around this topic.

Soiling

Soiling is when a child regularly poos their pants. If they are already potty-trained, the soiling is often because they are badly constipated.

You may feel angry or frustrated when your child keeps pooing themselves. But they aren’t likely to be doing it on purpose and may not even realise its happening. Causes of soiling, advice about when to seek medical help and treatment from a GP and things to try at home can be found on the NHS website.

The NHS website – Soiling (child pooing their pants)
There is also a lot of useful information about young children and school aged children soiling, and a ‘poo guide’ on the ERIC website.

ERIC – Guides to children’s bowel & bladder problems

Constipation

Constipation is a problem for 1 in 3 children. It commonly starts around the potty training stage and can also affect babies.

It is a medical problem that needs treating properly to stop it getting worse. Constipation won’t go away by itself.

Go to the ERIC website to find out the common causes, the signs to look out for and how to relieve constipation in your child.

Additional help

Seek professional support from your 0 to19 public health nurse team if problems persist and can complete a professional assessment to identify why the issue is happening and offer support to resolve or manage it.

ERIC – Children’s Bladder & Bowel Charity – Free helpline: 0808 169 9949 (Monday to Thursday, 10am – 2pm)

The NHS website – Constipation in young children

The NHS website – Pelvic floor exercises

Hand washing

It’s really important for children to learn how and when to keep their hands clean as it stops germs from spreading and helps prevent your child and those around them from getting an infection.

How to wash hands

Use warm water and soap and make up a lather on both sides of the hands, wrists, between the fingers and around the nails. Hand washing should take about 10 to 15 seconds.

When to wash hands

  • Before eating or touching food
  • After using the toilet
  • After blowing your nose or coughing
  • After having contact with pets or other animals
  • After playing outside
  • Before and after visiting a sick friend or relative
  • When hands are dirty

Home hygiene

Keeping your home clean helps to avoid germs spreading and causing illnesses. A germ is a microbe that causes disease. Not all microbes are germs – there are many microbes in our environment that do not, or only rarely cause infection.

In any home there will be many millions of microbes including some germs. Good hygiene doesn’t mean getting rid of all the germs in the whole house; it means getting rid of as many germs as possible, where and when there is a risk of them spreading and causing infection.

A healthy place to live

Washing with hot, soapy water and using disinfectants to clean floors and surfaces, and washing laundry at the right temperature to kill germs can help make your home a healthy place to live.

Cleaning means removing visible dirt by vacuum cleaning, damp dusting, or washing with warm water and detergent. Cleaning removes dirt and some germs but does not necessarily reduce them to a ‘safe’ level.

Hygienic cleaning means removing dirt and getting rid of as many germs as possible, either by removing them or killing them by disinfecting.

  • Removing germs can be by thorough cleaning with hot water and detergent and then rinsing to remove the germs.
  • Disinfection can be achieved using heat or by using a product that states it ‘kills’ germs
  • Sometimes a combination of removal and killing is used.

After hygienic cleaning, surfaces should be dried. Drying can be by air drying, tumble drying, hanging to dry or by using clean towels, cloths or paper towels on surfaces.

Helpful information and advice

It’s also really important for you, your child and others in your household to keep your hands clean to help stop germs from spreading. Teach your child how to wash their hands. 

NHS How to stop germs spreading