How to Deworm and How Often to Deworm Your Child

When a child complains of frequent stomach aches – almost every adult around the child’s parent is likely to say – “You know – I think your child has worms” or “You should deworm your child”

Suspecting or wondering if your child has worms is really not a pleasant thought because it brings up horrifying images of creepy crawly creatures moving around inside your child’s body, but there is no need to panic. In this article  – with the help of Dr. Chinka Gupta MBBS,DNB (Pathology) – I explain in detail – when to suspect that your child has worms, when to reach out to a doctor for the treatment of worms, how to de-worm a kid and how to prevent the child from getting worms again.

What is worm infestation?

Worm infestation means that there is presence of worms in kids intestine. The child could have caught it from someone else, when walking around barefoot on infected soil, playing in the contaminated water and eating unclean food.

Types of common intestinal worms found in the tummy?

Major worm infections of public health importance include Ascariasis, Trichuriasis, Hookworm, and Enterobiasis, which are transmitted through contaminated soil.

What is deworming?

Deworming means administration of prophylactic drugs to prevent children from having worms. WHO recommends periodic treatment with antihelminthics (drugs which treat worm infestation) to all children who are at risk and living in an endemic region. WHO recommends that in developing countries like India, preschool children(2 – 5 years of age), school-age children and pregnant women(second and third trimester) are at risk and should be given medicine for deworming.

What are the signs of stomach worms?

The most important thing a parent needs to know is – How to suspect if a child has worms.

That is the first step towards getting the kid de-wormed because it prompts the parent to take the child to the doctor.

Before looking for signs to satisfy yourself of the presence of worms in your child’s stomach however, it is important to understand that in the initial stages – when the worms are few in number – the child may not show any signs of worms at all

When the number of worms increases – the following signs may appear.

Symptoms of worms in kids

The first signs of a worm infestation that may be seen are the following –

1. Stomachache – Stomach ache is the most common sign of worms. If your child complains of stomach ache frequently – you must definitely suspect that he/she has worms
2. Crankiness and irritability – Worms cause distension of the stomach and this makes the child feel bloated and uncomfortable and this makes the child irritable
3. Vomiting and loose motions
4. Not feeling hungry
5. Skin rash
6. Itching around the anus

At a later stage after several days of infestation – when the number of worms increases – children may show these signs

1. Poor growth and weight loss
2. Nutritional deficiencies
3. Cough fever breathlessness and coughing out worms
4. Headache and seizures

Also read Iron Deficiency Anemia ; what parents should know

How do children get worms?

Children are more commonly infected by worms because they have weaker immune systems

1. Eating with dirty unwashed hands is the commonest cause of infection
2. Biting the nails is another common cause of worm infestation. Especially in children who have perianal itching – the worm eggs get under the nails while itching the anus. And enter the mouth when the child bites his/her nails or sucks the thumb.
3. Handling contaminated toys in common play areas and more especially putting these toys into the mouth are responsible for worm infestations
4. Worms can also live in bed sheets and clothing. And children can get infected when they share these things with other children or adults.
5. Uncooked or not well cooked food like meat and fish can also be a source of worms and it is better to avoid eating these.
6. Playing, bathing and swimming in water infected with worms is also responsible for children getting worms
7. Pica, – a condition in which a child eats non-food substances such as plaster, charcoal, paints and earth may also lead to children getting worms

Can a child who lives in hygienic conditions have worms?

Worms are very common in India. Studies have shown that 1 in 5 persons living in India are infected with at least one kind of worm. According to WHO estimates 241 million children in the age group 1 to 14 years have worms in their intestines.

Going by the above estimates – there is a high chance that your child may have worms even if you live in very hygienic conditions. He/she may have got infected by using articles of personal use like bed sheets and clothes of other children. Or by playing with infected toys in a common play area

Can my child have worms

What should you do if you think your child has worms?

If you see any of the signs mentioned above – there is a possibility that your child has worms. And if you suspect worms – you must reach out to your doctor for a consultation immediately.

It is important to consult a doctor in the early stages of worm infection because at that point treatment is easier and the chances of complications like malnutrition, seizures and lung infestation are lower.

How to de-worm a kid?

If you think your child has worms – your first question may be “How do I de-worm my child?”

And the answer to that question is –

De-worming must be done in 3 steps

Step 1– Confirm that the child has worms

Step 2 – Take the medicines prescribed by the doctor for de-worming

Step 3 – Take preventive measures to ensure that the child does not get infected again

Deworming is safe with the least side-effects, ensure that your children are dewormed at least once in a year to prevent Helminthiasis. (worm infestation)

How to deworm babies 0-12 months?

The medicine most commonly used for deworming is Albendazole. Infants under 1 year should not be dewormed.

How to confirm that your child has worms?

The only way to confirm that a child has worms is – to go to the doctor. If the doctor examines the child and thinks that the child may have worms – he will request some diagnostic tests to confirm that the child has worms.

Worm infestations are typically diagnosed by examining the stool of the child. The stool is examined in the laboratory by a doctor and if the eggs of the worm are found in the stool. The diagnosis is established and it is confirmed that the child has worms.

In the case of some worms – a swab may need to be taken from around the anus

Sometimes an Ultrasound may be required to confirm the diagnosis

A Blood examination may also be done to find clues to confirm the diagnosis of worms.

How are worms treated?

 There are no home remedies that can cure worms. Worms are parasites that require a certain kind of drug to kill them.

There are 4 drugs that are primarily used to treat worms in kids.

Which of these 4 drugs is used – in what dose and for how many days – is determined by the doctor on the basis of the age of the child and the result of the laboratory test done.

Things to remember when you de-worm a kid

1. It is dangerous to try to treat worms on your own without the supervision of a doctor
2. Antibiotics that are commonly used for stomach upsets do not work kill worms and are not useful in worm infestations.
3. Also there are several different kinds of worms and it is important that the right anti –worm medicine is used in each case
4. Many of the drugs used to treat worms are not supposed to be given to younger children especially those under 2 years of age.
5. And some drugs must not be given to those who are underweight and who have other problems like liver or kidney diseases. It may be dangerous to use these drugs without adequate information.
6. The anti-worm drugs can have side effects that can be frightening and confusing unless they are taken under the supervision of a doctor.

The duration for which the drugs must be taken differ depending on the severity of infection or the number of worms in the body which can only be assessed by the doctor through a laboratory test. Inadequate dose and duration of treatment can lead to prolonging of the infection and increase in severity of the infection.

It is important to remember that treatment alone will not eradicate worms. The child is highly likely to get re-infected with the worm from his/her surroundings unless steps are taken to improve the personal hygiene of the child. And an attempt is made to educate the parents about preventive measures.

How to treat worms .

What can I do to prevent worms?

 Being informed about the right way to maintain personal hygiene is the most effective way of preventing worms

1. When toddlers are using potty seats it is important to dispose of the excreta hygienically
2. Water must be drunk only after filtration and chlorination
3. Fruits vegetables and green leafy vegetables must be washed thoroughly before cooking and eating – especially vegetables used in salads and consumed raw.

How to prevent worms in children

Personal hygiene measures that can prevent worms in kids

1. Children must be instructed to wash their hands with soap frequently.
2. Children should be discouraged from biting their nails and walking barefoot on soil.
3. Children’s play area must be kept clean and dry.
4. Baby’s nappies must be changed frequently
5. Household help and nannies must be given the means to maintain high standards of personal hygiene as well.
6. Personal use items like bed sheets etc. must not be shared with other

Also read All that you may not know about Hand Washing

How often should you deworm a kid in a year?

In India where worm infestations in children are very common – it is important to have children assessed by a doctor for worms once or twice in a year

In parts of the country where the occurrence of worm infestations is very high like Assam, West Bengal, Bihar, Orissa, Andhra Pradesh, Tamil Nadu, Kerela and Maharashtra.– doctors may give children anti worm medication twice a year

Mass treatment for worm infection can be undertaken from time to time as a community initiative by the government when the number of cases of worms are seen to be rising.

A child with worms cannot perform to the best of his/her ability and may also end up with various serious medical complications. It is important to be vigilant about the symptoms of worms in kids and de-worm as necessary

Read more about worms here

If you have any questions about worms and what to do about them – do post them in comments below. We will be delighted to help you out with answers.