Children
Children's health
For fever, cough, rashes and other childhood illnesses
with a medical interpreter
24 hours a day, 365 days a year
OK to consult together
payment information
About
About Children's health
We treat all kinds of childhood illness, including fever, cough, runny nose, rashes and tummy trouble. The whole family can also be seen together.
Why it happens
Children's immune systems are still developing, and group settings such as nursery and school give many chances to catch infections, so they often get fevers, coughs and diarrhea again and again. Because their bodies are small and have little fluid in reserve, they become dehydrated from vomiting or diarrhea faster than adults. Most recover on their own, but the younger the child, the more closely they need to be watched.
What's happening in the body
Children's bodies are not the same as adults'. Water makes up a larger share of their body weight and their metabolism is more active, so dehydration from vomiting, diarrhea or fever develops quickly. Dehydration that would take several days in an adult can become a problem in half a day in babies and toddlers. Their temperature control is also immature, so they tend to run high fevers with infections, but the height of the fever doesn't necessarily match how serious the illness is. Their immunity, too, is built up by meeting many germs one after another after birth, so getting repeated infections after starting group care is a natural process. In the ears, the tube connecting the back of the nose to the middle ear is short and nearly horizontal, which makes middle ear infections more likely after a cold. We take these differences into account and assess children differently from adults.
Children's bodies are not the same as adults'
| Adults | Children | |
|---|---|---|
| Water as a share of body weight | Lower | Higher |
| Metabolism | Slower | Faster |
| How fast dehydration develops | Over several days | Can become a problem in half a day |
Main symptoms
- Fever (mood, appetite and fluid intake are important signs to watch)
- Cough, runny nose, sore throat
- Vomiting, diarrhea, stomach pain
- Rash (all over, inside the mouth, on the hands and feet, etc.)
- Complaining of ear pain or often touching the ear
- Poor appetite, low energy
- Fast breathing, or heaving shoulders when breathing
- Won't stop crying, or not their usual self
When you can wait and see
What you can do yourself
- Give small amounts of fluid often (oral rehydration solution may help)
- If your child has a fever but is in good spirits and drinking, stay calm and keep an eye on them
- Don't overdress or overcool your child, and change their clothes if they sweat
- Offer what they can eat, without forcing it
- Keep a record of symptoms, temperature, fluid intake and how often they pass urine
Please consult us
If any of the following apply
- Your child has a fever or is unwell
- You're not sure where to go at night or on a holiday
- You want siblings to be seen at the same time
Seek care right away
If any of the following apply
- Seems to be struggling to breathe (heaving shoulders, skin pulling in between the ribs, flaring nostrils)
- Slow to respond when called, not making eye contact, or very weak and floppy
- A seizure lasting 5 minutes or more, repeated seizures, or not regaining consciousness afterward
- Pale or purplish lips or face
- No pee for half a day or more, no tears, or a weak cry
Don't wait for a Cotovia consultation; call the emergency number in your country.
See the emergency guide for each countryIf you're not sure, ask us on LINE
Differential
Telling it apart from similar conditions
Symptoms that look the same may need different care depending on the cause. Use this as a guide to find what's closest to your situation.
Colds and viral infections
In reasonable spirits and drinking, with a runny nose or cough
Mainly monitoring at home
Dengue
High fever, pain behind the eyes and a rash, with likely mosquito bites
A blood test is needed. Seek care urgently if there is stomach pain or repeated vomiting
Gastroenteritis
Vomiting first, followed by diarrhea
Preventing dehydration comes first
Middle ear infection
After a cold, touching the ear, fussy and crying at night
We check the eardrum
Urinary tract infection
Ongoing fever with no other symptoms (especially in babies and toddlers)
It needs to be assessed with a urine test
Emergencies
Listless and slow to respond, seizures, fast breathing, or bluish-purple lips
Consider emergency services immediately
* This is not a complete list. If you're not sure, please consult us.
When it might be something else
Course
Typical course
This is the general course. Actual progress varies from person to person.
- Days 1–2 of the fever
The fever rises and your child becomes fussy
Rather than how high the fever is, watch whether your child is drinking and responds normally
- Day 3
With most viral infections, the fever starts to come down around now
Please consult us if the fever hasn't gone down after 3 days
- Days 4–5
A rash may appear after the fever goes down
If there's only a rash and your child is lively, you can usually just keep an eye on it
- If it lasts 5 days or more
Another cause needs to be considered
An assessment by a doctor is recommended
Local Insight
For people living in Southeast Asia
The climate, healthcare and access to medication differ from Japan. Here are points specific to this region.
In Southeast Asia, hand, foot and mouth disease occurs all year round, and severe cases have been reported with enterovirus 71, one of the viruses that cause it. Singapore and some other places have set rules for returning to nursery, which may differ from Japan's.
Children can also get dengue, and warning signs such as persistent vomiting, severe abdominal pain and bleeding may appear around the time the fever goes down. Unlike what people in Japan might expect, a fever going down doesn't necessarily mean all is well.
Routine vaccinations differ in type and timing between Japan and local countries (for example, how BCG and Japanese encephalitis are handled), and international and local schools may ask you to submit vaccination records. It's reassuring to have both your Maternal and Child Health Handbook and vaccination records in English.
In hot tropical environments, dehydration from fever or diarrhea can develop quickly. The gap between constant air conditioning indoors and the heat outside can also make children unwell.
Care
What Cotovia can do
- Assessing your symptoms through a consultation
- Prescribing medication for children (prescribing is at the doctor's discretion)
- Advice on when to see a doctor and how to care for your child at home
- Advice on how to get care in an emergency at night
Tests you may have
Not knowing what will happen can make people hesitate to seek care, so here's what actually takes place.
Consultation
Checking overall condition, throat, ears, tummy and skin
Rapid test
Identifying flu, strep throat and similar infections
Blood test
Assessing possible infections such as dengue, dehydration and inflammation
Urine test
Checking for urinary tract infection
Treatment options
Fluids and electrolytes
Prevents dehydration
This is the most important part of treating children. Give small amounts, many times
Fever reducers
Eases discomfort and makes it easier to drink
The aim isn't to bring the temperature down for its own sake. Stick to the dose for your child's age and weight
Symptom relief
Eases symptoms such as cough and runny nose
Which medications can be used depends on age
Antibiotics
Used when a bacterial infection is confirmed
They don't work on viral infections. The doctor decides whether they are needed
* Tests, procedures and prescriptions are decided by the doctor after a consultation. Services may vary by country and location.
Preparation
Before your visit
When seeing a doctor abroad, simply organizing what you need to say makes a big difference.
What to bring
- Passport or residence card
- Insurance card and your insurer's contact details
- Maternal and Child Health Handbook (vaccination records)
- Your medication record and the medication you take
- A record of your temperature
What to tell us
- When the fever started and how high it is
- Whether your child is drinking and passing urine
- Changes in mood, energy and sleep
- Possible mosquito bites and any outbreaks nearby
- Vaccination status and any allergies
Self Care
What you can do yourself
Along with seeing a doctor, here are things to keep in mind in daily life.
Prevention
- Plan vaccinations (be aware of differences between the local and Japanese schedules)
- Build the habit of handwashing
- Use insect repellent (to prevent mosquito-borne infections)
- Be careful about food and drinking water hygiene
How to Consult
How to be seen
Choose from 3 ways to be seen, depending on your symptoms and schedule. If you're not sure, we'll guide you on LINE.
Online consultations
See a doctor by video call from home or the office. Medication delivered or from a pharmacy.
Available for this symptom
In-person care
In-person consultations at our clinics and partner hospitals, including tests and procedures.
Available for this symptom
Cotovia Counter
Support with an interpreter for visits to general hospitals.
Available for this symptom
If an online consultation finds that tests or procedures are needed, we'll guide you to in-person care or Cotovia Counter.
From consultation to receiving medication
Add us on LINE and consult
Tell us your symptoms, and we'll recommend the right way to be seen.
Book and be seen
See a doctor online or at the nearest location, with an interpreter present.
Receive your medication
Have it delivered or pick it up at a pharmacy or the clinic (varies by country).
Follow-up
You can also consult us on LINE about how you're doing afterward.
Special Care
People who need extra care
Babies under 3 months old
If they have a fever, seeing a doctor early is recommended, even with no other symptoms
Children who can't keep fluids down
See a doctor urgently if they haven't passed urine for half a day or more, cry without tears or have dry lips
Children who have had a seizure
Seeing a doctor is recommended after a first seizure. If one lasts 5 minutes or more, consider calling emergency services
Children due for vaccinations
Schedules may differ between Japan and the local country. Please bring your Maternal and Child Health Handbook when you consult us
FAQ
FAQ
Common questions before a visit, and common assumptions that lead people to judge for themselves.
QCan siblings be seen together?
Yes. The family can consult together. We may ask you to register each person separately.
QWhen should I see a doctor if my child has a fever?
Besides the temperature itself, important signs are whether your child is drinking, what their mood is like and whether they are passing urine. For babies under 3 months old with a fever, seeing a doctor early is recommended.
QI'm worried because the local vaccination schedule is different from Japan's.
If you show us your Maternal and Child Health Handbook and local vaccination records, we can discuss how to proceed, including what to do after returning to Japan.
QMy child's fever has gone down, but they still seem unwell.
Some infections cause symptoms after the fever goes down. With dengue, extra care is needed after the fever breaks, so please consult us if your child doesn't seem like their usual self.
Common misconceptions
Myth The higher the fever, the more serious the illness
Fact How high a fever is doesn't match how serious the illness is. Whether your child is listless or drinking are more important signs
Myth You should bring a fever down right away
Fact Fever is also part of the body's defenses. Fever reducers are used to ease discomfort and make it easier to drink
Myth You can give a smaller dose of adult medicine
Fact Some ingredients can't be used at certain ages. Always use children's medicine at the dose for your child's weight
Myth No baths when your child has a fever
Fact If your child is lively, a short bath to keep clean is fine
Myth Children who often catch things at nursery have a weak constitution
Fact Getting repeated infections after starting group care is a natural part of building immunity
Feel free to ask us on LINE first
It's fine to contact us even if you're not sure you need to see a doctor. We're available in Japanese 24 hours a day, 365 days a year.
- Symptoms
- When it started
- Your country of residence
- How you'd like to be seen
Sending these 4 things helps us respond faster. It's fine if you don't have them all.
Ask us on LINE