Worm Infections in Children: Signs, Deworming and Prevention

6 min read · Conditions · By the Asthra Health Care team

What are worm infections?

Intestinal worms are parasites that live in the gut and feed on the child's nutrition. The most common ones in India are soil-transmitted worms: roundworm, hookworm and whipworm. Their eggs pass out in stools and contaminate soil and water where there is open defecation or poor sanitation. Pinworm (threadworm) is another very common worm that spreads easily within families and schools.

Children are infected when they swallow eggs from dirty hands, soil, unwashed fruits and vegetables or unsafe water. Hookworm larvae can also enter through the skin of bare feet walking on contaminated soil. Pinworm eggs stick to fingers and fingernails after scratching and are easily passed to food, toys and other family members.

Signs and symptoms

Many children with a mild worm infection have no obvious symptoms. Heavier infections can cause a range of problems that develop slowly, and parents may simply notice that the child is tired, pale or not growing as expected. Hookworm feeds on blood and is a known cause of anaemia in children and adolescents.

• Stomach pain, bloating, nausea or loose motions
• Poor appetite and poor weight gain
• Tiredness, paleness and anaemia
• Itching around the bottom, especially at night (pinworm)
• Worms seen in stools
• Difficulty concentrating at school

Why they matter

Worms take away nutrients the child needs to grow. Over time, this can lead to undernutrition, iron deficiency anaemia, stunted growth and reduced energy for play and studies. A very heavy roundworm load can rarely block the intestine or the bile duct, causing severe stomach pain and vomiting, which needs urgent care.

Pinworms rarely cause serious harm, but the night-time itching disturbs sleep, and in girls the worms can sometimes cause irritation or infection around the genital area. Tired, sleepy children may find it harder to concentrate in class, and constant scratching can break the skin.

How worms are diagnosed

A stool examination under a microscope can show worm eggs or parasites. Because eggs are not passed all the time, the doctor may ask for more than one sample on different days. For pinworm, the doctor may suggest a simple sticky-tape test, pressed around the anus first thing in the morning, before bathing, to pick up eggs.

A complete blood count may show anaemia or a raised eosinophil count, which can hint at a worm infection. Often, doctors treat based on symptoms and the fact that worms are common in the area. A negative stool test does not always rule out worms, so the doctor may still advise treatment if the signs suggest them.

Deworming treatment

Deworming medicines such as albendazole or mebendazole are safe and effective. Under India's National Deworming Day programme, children and adolescents are given deworming tablets at schools and anganwadis at regular intervals. Outside this programme, use deworming medicine as advised by a doctor or pharmacist, who will guide you based on the child's age.

For pinworm, doctors often suggest treating the whole family at the same time, because the infection spreads easily at home. Pregnant women, especially in the first three months, and very young babies should take deworming medicine only on a doctor's advice. If the child is anaemic, the doctor may also advise iron supplements.

Hygiene that prevents worms

Teach children to wash hands with soap and water after using the toilet, before eating, and after playing outside. Keep fingernails short and clean, and discourage nail-biting. Make sure children wear footwear outdoors, especially in fields, gardens and near drains. Always use a toilet, and keep toilets clean.

Wash fruits and vegetables well with clean water, cook food thoroughly and drink boiled or purified water. For pinworm, change and wash underwear, bedsheets and towels often in hot water, and bathe the child each morning. Clean toys and surfaces the child touches, and avoid shaking bedsheets, which can scatter eggs around the room.

When to see a doctor for worm infections in children

See a doctor if your child has ongoing stomach pain, poor weight gain, paleness or tiredness, or if worms keep coming back despite deworming. Seek urgent care for any warning sign below. A doctor or pharmacist can advise on the right deworming schedule for your child and the whole family.

This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.