HealthInfo Canterbury

Caring for your child at home with COVID-19

Most tamariki (children) with COVID-19 only get mild symptoms or none at all. A small number become more unwell and need extra care from their doctor or need to go to hospital.

If you're worried about your tamaiti (child), you can still get help for them even though you're isolating at home.

Use these three steps:

• Recognise – know what to look out for to tell if your tamaiti is becoming unwell.
• Record – keep track of your child’s symptoms using a COVID-19 health and symptom diary. Some tamariki will also get a pulse oximeter. This is for checking oxygen levels.
• Respond – know when to ask for help and how to get it. See the advice below about how to manage symptoms at home and what to do if your tamaiti becomes unwell.

Call your healthcare team urgently if your tamaiti:

• is under 3 months old and, after checking the section on young pēpi (babies) below, you're worried about them
• looks unwell and you're concerned
• is very pale or feels cold to touch
• is floppy, sleepy or drowsy
• is becoming less responsive
• has an unusual, high-pitched cry
• has trouble breathing, noisy breathing or is breathing fast
• complains of a stiff neck or light hurting their eyes
• has a severe headache
• refuses to drink - even small sips
• isn't doing any wee
• vomits a lot – and can't keep sips of replacement drinks down
• vomits green fluid (bile)
• vomits blood – this may be red or brown or look like coffee grounds if it isn't fresh
• has black tar-like poo or blood in their poo
• is in severe pain
• isn't interested in their surroundings
• has an oxygen level between 92 and 94% (if you've been given a pulse oximeter).

Your healthcare team will discuss with you when and how to check your tamaiti. This may involve seeing them by video or in person.

Monitoring your child's symptoms

Keeping track of your child's symptoms and how they're feeling helps you and the healthcare team looking after them know if your tamaiti becomes more unwell. Record the following things three times a day in your child's COVID-19 health and symptom diary:

• cough
• breathing effort
• vomiting
• diarrhoea
• temperature (see how to use thermometers for children)
• How fast they're breathing
• how they are overall.

If you've been given a pulse oximeter for your tamaiti, also record the following things:

• pulse rate
• oxygen level.

It's important you get an accurate measurement so check how to use a pulse oximeter.

Symptoms of COVID-19

Most tamariki children will have mild COVID-19 symptoms for up to two weeks. Symptoms tend to appear around two to five days after they're infected but can take up to 14 days to show.

Days one to three

Early symptoms of COVID-19 vary widely.

It can start with a tickle in your child's throat, a cough, a fever or a headache. Your tamaiti may also have difficulty breathing. Sometimes it begins with a bout of diarrhoea (runny poo).

Some tamariki may feel tired and may lose their sense of taste and smell.

Your tamaiti may have some or none of these symptoms.

Days four to six

These are important days to be more aware of your child's symptoms. This is when their breathing may start to get worse.

Your tamaiti may generally start to feel worse and may have aches, chills and cough and may be unsettled or irritable.

Some tamariki may develop rashes, including itchy red patches, swelling or blistering on their toes or fingers.

Days seven to eight

For tamariki with mild symptoms, the worst is usually over after a week.

Some tamariki may get worse at this point or start to feel better briefly then take a turn for the worse.

For how to tell if your tamaiti needs help, and how to get it, see Getting help for your child with COVID-19 if they become unwell below.

Days eight to 12 (week two)

Keep monitoring your child's symptoms and record them in your child's COVID-19 health and symptom diary.

Days 13 to 14

Most tamariki will feel better by now. Some tamariki feel more tired than usual. It's best for your tamaiti to return to activity slowly.

If your tamaiti has ongoing symptoms, your healthcare team will advise you what to do.

From two to six weeks

A very small number of tamariki develop a serious condition after having COVID-19 called PIMS-TS (Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2). tamariki with this condition can have the following problems:

• fever lasting for five or more days
• breathing difficulty
• tummy pain, vomiting or runny poo (diarrhoea)
• red lips or tongue
• red eyes
• a skin rash
• cold or swollen hands or feet.

For how to tell if your tamaiti needs help, and how to get it, see Getting help for your child with COVID-19 if they become unwell below.

Helping my child with COVID-19 at home

You can look after your tamaiti with a fever at home if they:

• are drinking and feeding well
• are still interacting with you
• don't look sick.

See Helping your child with COVID-19 symptoms for details of how to help your tamaiti with COVID-19 symptoms.

Helping my young baby with COVID-19 at home

Young pēpi babies (less than 3 months old) need a more cautious approach. If your tamaiti is under 3 months old and you're worried about them, call your healthcare team. Trust your instinct.

• Pēpi get fevers for the same reasons as older children, but they aren't as good at fighting off infections.
• If they have a fever, always call your healthcare team.
• If you're worried about your pēpi, call your healthcare team even if your pēpi doesn't have a fever.
• Some pēpi may have an unstable temperature with an infection. This means they may be colder than normal. This is a worrying sign in a sick pēpi. If this happens, call your healthcare team urgently.
• When you call your healthcare team, they'll discuss with you when and how to check your pēpi.

Getting help for your child with COVID-19 if they become unwell

If you're worried about your tamaiti child , ask for help. You could:

• call your healthcare team using the number they've given you
• call the after-hours healthcare team using the number given to you
• call Healthline on 0800-358-5453 if you aren't sure what to do
• dial 111 for urgent medical help.

Stay calm, explain why you're worried about your tamaiti, and tell them that your tamaiti is being looked after at home with COVID-19.

If you're waiting to hear back from your doctor and think your tamaiti is getting sicker, call back and calmly explain why you're worried.

If you've already seen or talked to a doctor but your tamaiti is getting worse, call your doctor back and tell them what's happening.

Call your healthcare team if your tamaiti has any of the following (you could choose to wait until your next health check phone call if it's due in the next 12 hours):

• is under 3 months old and, after checking the section on young pēpi babies above, you're worried about them
• has a sore throat or joint pains
• is drinking less than half their normal breast milk or other fluid
• is having fewer than four wet nappies in 24 hours
• is doing wee that's very dark or has blood in it
• has vomited half or more of their feed for the last three feeds
• has frequent and watery poo (diarrhoea)
• complains or cries when doing wee
• is in pain
• is getting sicker
• has a fever and isn't improving after two days
• has had a fever for more than five days.

  HealthInfo recommends the following pages

• KidsHealth – COVID-19

  Extensive information about COVID-19 and tamariki, including caring for a tamaiti with COVID-19, isolating at home, wearing face masks, COVID-19 testing in tamariki, and parenting.

On the next page: Helping your child with COVID-19 symptoms

Content shared between HealthInfo Canterbury, KidsHealth and Health Navigator NZ as part of a National Health Content Hub collaborative. Last reviewed February 2022.

COVID-19 symptoms image adapted from COVID-19 Coronavirus Symptoms infographic: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO.

Page reference: 937749

Review key: HICOV-710714