Should children be dewormed? Here is the truth

As a pharmacist at a children's hospital and a mother of a 3-year-old baby, I have been struggling with whether to deworm my child. The main reason is because of a sentence from his grandmother: "My dear, why doesn't Andy gain weight even though he eats so much? Does he need to take some deworming medicine?" I originally thought that children nowadays have better hygiene conditions, so there would be no parasites! But after such doubts, I, as a mother, was not calm and was determined to find out the truth.

Originally, when we said that children have worms in their stomachs, we generally meant roundworms and pinworms. Now that we don't drink groundwater and sanitary conditions are better, the infection rate of roundworms is very low. However, there is still a certain proportion of pinworm infection. From 2014 to 2016, the pinworm infection rate of children aged 3-6 in my country was 3.43%, and the proportion in some rural areas is even higher. So should we deworm or not? Answers to questions we often encounter.

Question 1: My child has white spots on his face. Are they roundworm spots? Does he need to take anthelmintics?

Some parents think that the small white spots on their children's faces are worm spots. In fact, what you think of as worm spots are just a common skin disease in children - pityriasis alba. It mainly occurs in children aged 3 to 16 years old, characterized by patchy hypopigmentation, usually distributed on the face, neck, upper trunk and proximal limbs. Therefore, white spots are not worm spots and have nothing to do with whether there are roundworms in the body. Don't give your child deworming medicine just because he has white spots on his face.

Question 2: My child keeps grinding his teeth at night. Should he give him deworming medicine?

A mother must be very anxious when she hears her child grinding his teeth in the middle of the night. How can she stop grinding her teeth? Some people say that teeth grinding is caused by roundworms in the stomach, so get rid of the worms as soon as possible! In fact, teeth grinding is an unconscious, involuntary rhythmic activity caused by the contraction of the masticatory muscles, which causes the upper and lower teeth to clench or grind against each other. It can happen to both adults and children. Some people do believe that the activities and metabolic products of parasites entering the body can stimulate the corresponding parts of the brain and cause teeth grinding, but there is currently no definite evidence to confirm this. You cannot simply judge that a child has parasites in his stomach based on teeth grinding and take deworming medicine. We need to do further examination and send the child's stool for examination to see if there are worm eggs.

Question 3: My child has been complaining of stomachaches recently. Should he take deworming medicine?

If a child has roundworms in his stomach, he may have stomach pain. However, there are many reasons for stomach pain, such as chronic gastroenteritis, constipation, swollen abdominal lymph nodes, etc., which can all cause stomach pain. Just because a child has had stomach pain from time to time recently, it cannot be judged that there must be roundworms in the stomach, and the child should not be given deworming medicine based on one's own guess. We still need to do further examination and send the child's stool for examination to see if there are worm eggs.

Question 4: My child always complains that his butt is itchy and he scratches it all the time. Should he give him deworming medicine?

If a child has unexplained anal itching, we must check for pinworm infection. How to check? Parents can pull open the skin folds around the anus 1-2 hours after the child falls asleep at night to check if there are any worms, because this is when the worms will come out to ovulate. You can also use transparent tape to stick the skin around the anus folds after getting up in the morning and send it to the hospital for examination. It is generally recommended to send it for examination for 3 consecutive days or until the worm eggs are found.

Whether to deworm or not cannot be determined by blind guessing based on white spots, teeth grinding, stomach pain, itchy buttocks, etc. You must have evidence, see that there are indeed worms, and stool examination shows eggs before taking deworming medicine. Medicine is three-point poison, so be careful when deworming!

(Author: An Xiaoxia, Henan Provincial Children's Hospital; Reviewer: Zhang Shengnan)