When you've got young kids, it can seem like a constant cycle of back-to-back bugs. But why do kids get sick so much, and can you do anything to help?
We talked to Dr Jenna Macciochi (drjennamacciochi.com), an immunologist and university lecturer with 20 years' experience of immune system research, who's also mum to two young boys.
It's understandable to worry when your kids get poorly. "That's a normal anxious response of all parents," says Macciochi - but she reassures that it's normal for kids to get sick. "It's perfectly normal to get a few bugs a year, even as an adult - around four to six mild, self-limiting infections is very normal. For children it's a bit more. It's normal for your child to get maybe eight to 10 infections a year. Nothing serious, we're talking colds, flu or a sore throat, maybe a tummy bug," she says.
"(Children's) immune systems are still developing", she explains. "We're born with an immature immune system - it needs to kind of learn and develop as we age. For kids, particularly pre-school age kids, this process is really still actively happening."
Another thing is simply greater exposure to infectious bugs, as kids tend to spend a lot of time in close quarters together. This doesn't mean we need to panic or keep them cooped up at home, but it's helpful to accept that this is just part and parcel of parenting.
That said, there are things that can help. "No matter how many times I tell my kids about hygiene, they're never the best hand-washers!" says Macciochi - and this is another big reason why kids get sick so much.
Good hand-hygiene is one of the most important things we can do to reduce the spread of infections, so it's really worth encouraging kids to be thorough, consistent hand-washers, every time they use the bathroom and before preparing or eating food.
Should your child use antibacterial hand gel? "From my side, what we know is that good old hand-washing with soap and water, where you get a good lather - and it's actually the friction and motion of rubbing your hands together that gets rid of the germs - is more than sufficient," says Macciochi.
While we often talk about 'boosting' immune systems, we're better off understanding how we can help set kids up for long-term healthy immune function.
As Macciochi mentioned, children's immune systems are still developing - and there is a "window of opportunity" that occurs mainly in the first three years of life ("it tails off after age five") where our diets can make a big difference.
During this "window" our gut microbiome (the eco-system of trillions of micro-organisms, including bacteria, that lives in our guts) is also still developing, and as Macciochi explains, this "is really a big educator of our immune system".
Not always easy with kids - who Macciochi acknowledges can be "intrinsically fussy and stubborn eaters" - but a healthy, balanced diet can "feed" the microbiome and help make it as diverse and healthy as possible.
"(For kids) I don't think you need to think about probiotics and fermented foods so much, but try to give them a varied diet with as much fibre as possible," she says. "Often people think about fibre as being like All-Bran or just cereals, but actually fibre is mostly fruit and vegetables, beans, pulses and legumes. Think about diversity of plants as much as possible, as that's so important for the gut and will help them support immune development in a healthy way."
We can support immune development further, says Macciochi, by encouraging kids to roam in nature too. "The environment we live in does play a part in our microbiome," says Macciochi. "So I would recommend trying to get your kids out into green spaces. Let them play, get dirty, breathe in the fresh air - and then wash their hands before eating, of course. Get them into parks and green space as much as possible."
Macciochi suggests "avoiding antibiotics unless they are strongly suggested by the doctor. But I think most GPs nowadays are more on this, and know antibiotics should only be reserved for the bacterial infections that really need them."
Antibiotic overuse is a serious global health concern, as bugs can become resistant to them. They can be bad news for the gut microbiome too, damaging 'good' bacteria as well as targeting the nasties. Your pharmacist or GP will be able to advise on medicines for kids and soothing symptoms.
Some kids will naturally fare worse than others with the coughs and sniffles too (our immune systems are unique and respond differently), but it's always a good idea to get things checked out with the doctor if you're concerned.
"If you did have a child that was tending to really get sick a lot, it might be a red flag for a problem that hasn't been discovered yet," says Macciochi. "(This could be) vitamin deficiency, or an immune deficiency - sometimes people are born with one part of the immune system not working properly due to a genetic abnormality but it often doesn't get picked up for a while."