It is normal for a child to be tired if he or she has slept badly the night before or had a particularly long or energetic day. It is also common for children to need more sleep than normal during growth spurts and at puberty. If your child seems tired most of time or tiredness is preventing him or her from taking part in social activities or keeping up at school, there may be an underlying medical problem. In many cases, such tiredness is short-lived and may be the result of a recent infection. However, you should consult your doctor to rule out a more serious problem.
1Has your child always seemed less active than other children of a similar age?
Possible cause A quiet child may appear to be tired if he or she is not very active. However, it is normal for some children to prefer sitting quietly rather than running around.
Action Make sure your child gets enough exercise. Try exercising together by going swimming or playing games. If you are still concerned about your child's level of activity, consult your doctor.
15See your doctor within 24 hours
Possible cause Diabetes mellitus is a possibility. This condition is caused by insufficient production of the hormone insulin, which is needed by the body to get energy from sugar and carbohydrates.
Action Your doctor will take a blood sample to check your child's blood sugar level. If the diagnosis is confirmed, your child will probably need insulin injections for life. He or she will be taught how to inject the insulin and monitor his or her blood sugar level. Your doctor will also advise you on your child's diet and lifestyle (seeDiabetes mellitus).
16See your doctor within 24 hours
Possible cause Your child may have anaemia, in which there is too little of the oxygen-carrying pigment haemoglobin in the blood. In children, anaemia is often due to a lack of iron in the diet.
Action Your doctor will arrange for a blood test to confirm the diagnosis. In some cases, further tests will be necessary to determine why anaemia has developed. If your child has iron-deficiency anaemia, your doctor will probably prescribe an iron supplement and advise you on your child's diet (seeIron-deficiency anaemia).
Possible cause Your child may have chronic fatigue syndrome, a collection of symptoms including severe fatigue, that in some cases, but not all, may be preceded by a viral illness. Consult your doctor.
Action Your doctor will examine your child and may arrange for tests to rule out other illnesses. Your child may be referred to a specialist, who will suggest a programme to encourage your child to gradually increase his or her level of activity. You should discuss the situation with your child's teachers. Your child should continue to go to school if at all possible so that his or her schoolwork and friendships are not disrupted.
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Possible cause and action It is normal for a child to feel "washed out" for a week or two after a severe infectious illness. Make sure that he or she is getting enough rest. If there is still no improvement after 1 month, consult your doctor.
20
Possible cause and action Certain drugs, such as antihistamines and anticonvulsants, can cause tiredness as a side effect. Consult your doctor. Meanwhile, make sure your child does not stop taking his or her prescribed drugs.
21
Possible causes Children often snore if they have a cold, and this is nothing to worry about. However, if your child snores all the time, he or she may have enlarged tonsils or adenoids, which may be blocking the airway during sleep. Consult your doctor.
Action Your doctor will examine your child's throat. In some cases, your doctor may refer your child to a specialist. Surgical removal of the tonsils and adenoids may improve the situation.
22
Possible cause Symptoms of conditions such as asthma or eczema that do not bother a child during the day can disturb his or her sleep. Consult your doctor.
Action The doctor will examine your child and prescribe appropriate treatment. If your child is already receiving treatment for a condition such as asthma or eczema, it may need to be adjusted. Once the symptoms have been treated, your child should sleep better.
Possible cause A lack of sleep is one of the most common causes of tiredness. Difficulty in getting your child to sleep is usually temporary and caused by lack of a fixed bedtime routine or anxiety. However, persistent problems may be the result of a behavioural problem.
Action Impose a regular bedtime routine, and be firm with your child (seeGetting your child to sleep). If he or she is old enough, talk about any worries he or she may have. If your child is still not sleeping properly within a few weeks, consult your doctor.
25
Possible cause Tiredness may be one sign of anxiety or depression as the result of a temporary upset.
Action Try to discover and deal with any underlying worries that your child has. Mild anxiety or depression can often be cleared up with extra reassurance and support. However, if your child's tiredness persists or becomes severe, consult your doctor.
26
Possible cause It is likely that your child is overdoing things due to long days or pressure to take part in various activities.
Action Talk to your child about dropping or rotating any optional activities. Encourage him or her to spend more time at home, playing quietly. Most children adjust to increased levels of activity at school within a term.
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Consult your doctor if you are unable to make a diagnosis from this chart and your child's tiredness is persistent or severe.
Iron-deficiency anaemia
Providing an iron-rich diet Offer your child plenty of iron-rich foods. Try to make green vegetables look attractive to encourage your child to eat them.
In children, iron-deficiency anaemia is usually caused by a lack of iron in the diet. Try to get your child to eat green vegetables and red meat, although this may be difficult. Certain foods, such as some breakfast cereals, are fortified with iron and are useful if your child will not eat other iron-rich foods. A child that is not eating solids by 6 months of age may need a formula milk with additional iron. Ask your doctor for advice.
Family Doctor Health Advisor is for information purposes only, and is designed as a general reference and catalyst to seeking further information.
The RACGP is not engaged in providing medical or other advice or services, and is not responsible for the results of any actions taken by any person on the basis of any information in this publication, or for any error in, or omission from, this publication.
Publication Date: 31 March 2009 Authorised By: RACGP
