Causes

If a baby walks around barefoot on infected soil, plays in contaminated water, or eats unclean food the worms enter through. Once these eggs hatch, the worms will grow and lay more eggs in your baby’s body.

• Infected water areas - Some types of worms breed in water bodies. They can be found in lakes, dams and puddles. Playing, bathing and swimming in these areas, or drinking and eating food contaminated by the water, can cause a worm infection.
• Infected soil - This is the most common way children get worms such as hookworms, roundworms, tapeworms and whipworms. If an infected person goes to the toilet in the soil, they deposit worm eggs, which then grow into larvae (immature worms). The larvae then mature. Children can get infected with hookworm from walking barefoot or crawling on infected soil, as these larvae can penetrate the skin of the feet. Other worms get into the body when someone gets soil in their hands or under the nails and then puts their dirty hands in their mouth. Children tend to be affected the most as their immune systems are weaker than those of adults.
• Undercooked or infected food - Hookworm, whipworm and roundworm eggs stay on plants and vegetables that have been grown in soil that is contaminated with faeces and have not been thoroughly washed. We can get infected by eating these vegetables. Animals that live along water areas, such as fish, cattle, sheep and goats can also be sick with worm infections such as tapeworms. So meat and fish that are raw, or not well cooked, can carry worms.
• Contact with an infected person - If someone your baby is in contact with has worms, they can pass the infection on to your baby if they do not have proper hygiene. Pinworms pass in this way. Worm eggs can remain under fingernails or on unwashed or improperly washed hands and can pass on from there to your baby's toys or directly into her mouth. Threadworms can live for up to three weeks in bed sheets or clothing.

Symptoms

• Most often a worm infestation does not show symptoms, or the symptoms may be so slight and gradual that they are overlooked.
• PICA (eating inedible, non-nutritive things such as soil, chalk, paper and so on) is another symptom of worm infestation.
• A sore or painful tummy.
• Weight loss.
• Irritability.
• Nausea.
• Blood in the stool.
• Vomiting or coughing, as it is possible to cough up or vomit a worm.
• Itching or pain around the anus, where the worms entered. This is true particularly for pinworms.
• Trouble sleeping, because of the itchiness.
• Painful and frequent urination due to urinary tract infection (UTI). This is more common in girls.
• Internal bleeding that can lead to loss of iron and anaemia, malabsorption of nutrients, diarrhoea and loss of appetite.
• Very rarely if there are very many worms, there can be a blockage of the intestines. Some children might vomit out worms (usually round worms that look like earthworms).Severe tapeworm infections can cause seizures.
• Some doctors say that teeth grinding can be a sign of worms, but the research is conflicting on this subject.
• If your baby has a mild infection of threadworms, she may not show any symptoms, apart from complaining of an itchy bottom, particularly at night.
• Check your baby’s bottom at night, after she has gone to bed. Gently part her buttocks and shine a torch around the opening of her bottom. If she has threadworms, you may be able to see one or more worms crawling out or around her night suit and bed sheets. You may also see threadworms in your baby’s stool.

Diagnostic tests and investigation

• Stool examination - The doctor will ask for a sample of your baby’s stool. The sample will be sent to a lab to check for worms or worm eggs.
• The sticky tape test -This test is done for threadworms and involves sticking a piece of tape around your baby’s bottom to collect possible worm eggs. The tape is then sent to a lab for testing.
• Checking under fingernails - Your doctor may check for worm eggs under your baby’s fingernails.
• A cotton-bud swab - The doctor or nurse may run a cotton swab around your baby’s bottom to check for worm eggs.
• An ultrasound test - This usually works when there is a severe infestation of worms. With the ultrasound, your doctor will find out the exact location of the worms.

Prevention

• Always ensure that your child plays in a clean, dry area.
• Don’t let your child play in or around water bodies such as puddles, potholes, lakes or dams.
• As much as possible, make sure your child only relieves herself in a clean toilet, and not outside.
• Make sure your family washes their hands with soap before meals and after using the toilet.
• Keep your child’s nails short and clean. Worm eggs can get caught under long fingernails and spread around the house.
• Once your child can walk, get her some closed shoes. Make sure she wears them when she plays outside. Wash her hands and feet when you get home.
• Change your baby’s nappies regularly and wash your hands thoroughly afterwards.
• Clean your house often and well, with a good disinfectant.
• Keep your child away from slushy play areas, moist sand pits and soil. Take special care during the monsoon when there is waterlogging. Contaminated water can flow in from anywhere.
• Always drink clean water. You can boil or filter your drinking water.
• Wash fruit and vegetables thoroughly in clean water. Take special care when washing leafy greens as they can harbour soil and grit.
• Check that meat and fish are fresh before cooking. Cook meat and fish thoroughly, till there are no raw bits. Read more about food hygiene.
• If you have a maid or ayah looking after your baby, make sure she keeps clean. It's best for her and for other household help to get dewormed along with your family members.
• Keep your toilet clean. Wash your baby’s bottom every time she pees and poops. Wash your hands thoroughly afterwards. If your child is old enough, teach her to wash her hands after going to the toilet every time.
• Probiotic foods, such as curd (dahi), lassi, chhach (buttermilk), raita or yoghurt are said to support the growth of good bacteria that is important for your child's immunity.

Treatment

Fortunately, almost all worm infections can be treated with oral medication. Your doctor will prescribe medicines for deworming treatments based on the type of worm infection your baby has. Your child may also need iron supplements if she has anaemia.