Worms in children: signs, deworming, and stopping reinfection

The signs

The commonest is itching around the anus, worse at night, from threadworms (pinworms) — a child who wriggles, sleeps badly and scratches. You may see thin white threads in the stool or around the bottom at night.

Other signs: poor appetite or excessive hunger, weight not gaining, tiredness, pallor from iron loss, abdominal pain, nausea, irritability, disturbed sleep, and sometimes teeth grinding.

Larger worms — roundworm, hookworm, whipworm — are spread through soil contaminated with faeces, which is why they are commoner in children who play barefoot outdoors and in areas with poor sanitation. Hookworm in particular causes anaemia by feeding on blood.

Many infestations cause no obvious symptoms at all, which is exactly why routine deworming exists.

Treatment and the national programme

India runs National Deworming Day, with albendazole given free to children and adolescents through schools and Anganwadi centres twice a year. Take it — it is safe, it takes one dose, and it is one of the highest-value free health services available.

For a child with symptoms, a doctor will prescribe albendazole or mebendazole. For threadworms, the whole household is usually treated at the same time, because reinfection between family members is otherwise guaranteed, and a repeat dose after two weeks is often advised.

Deworming is generally given from one year of age, and your doctor will advise for younger babies. Mild tummy ache or nausea after a dose is common and passes.

Treat the anaemia alongside: worms are a leading cause of iron deficiency in Indian children, so a haemoglobin check and iron supplementation often go with the deworming tablet.

Stopping reinfection

Threadworm eggs survive on hands, under nails, on bedding and on surfaces for around two weeks. Breaking that cycle is the whole job.

Cut nails short, stop nail-biting and thumb-sucking where you can, wash hands with soap after the toilet and before eating, and bath in the morning to wash off eggs laid overnight.

Wash bedding, nightclothes and towels in hot water on the day of treatment, and do not shake them out (that scatters eggs). Vacuum or mop the bedroom.

For soil-transmitted worms: footwear outdoors, no defecating in the open, washing vegetables well, drinking safe water, and keeping children's play areas clean.

When to see a doctor

Same-day: severe abdominal pain, persistent vomiting, a swollen tender abdomen, blood in the stool, or a child who is pale and breathless — heavy hookworm infestation causes serious anaemia, and a large roundworm burden can obstruct the bowel.

Book an appointment for: visible worms, persistent night-time itching that does not settle after treatment, poor weight gain, ongoing tummy pain, or anaemia. And ask for haemoglobin to be checked at the same time.

This article is general information, not medical advice, and is no substitute for personal medical advice. For any decision about your or your child's health, please consult your doctor.

Frequently asked questions

Q: How often should children be dewormed? — Twice a year is the national recommendation for children in India, and that is what the school programme provides. Ask your paediatrician for your child's schedule.

Q: Does eating sweets cause worms? — No. That is folklore. Worms come from contaminated soil, water, food and hands.

Q: Do I need to deworm the whole family? — For threadworms, usually yes, at the same time. For soil-transmitted worms, the doctor will advise based on who is affected.

Q: Are home remedies useful — garlic, neem, papaya seeds? — They are not reliable treatment. One inexpensive tablet clears the infestation; use it and keep the kitchen remedies for flavour.