By Dr. Patty Avila, Pediatrician
It
is that time of year again! The busy
time of year when everyone is preparing for the holidays is also when children
are getting more colds and other respiratory illnesses. These are the most common type of illness
that children will see their doctor for, and it is important to recognize when
to worry or not. Most of these will be
simple colds and resolve on their own, but there are some that can be serious.
The
Common Cold; also called an Upper Respiratory Infection.
The
common cold is caused by several different viruses and is the most common of
all the respiratory illnesses. In the 1st 2 years most children will have about
3 to 5 colds per year. Older school age children and children in daycare can
get sick even more often, because they are exposed to others. Fortunately, most of these are just colds and
will go away on their own and not lead to anything worse.
Symptoms
of the Common Cold:
- Low
fevers (101-102 degrees F).
- Runny
nose, nasal congestion comma and sneezing.
- Sore
throat.
- Cough.
- Not
eating well.
- Fussiness.
Most
children will be better after 7 to 10 days of illness, but some may take up to
10 to 14 days to get better.
When
to worry with the common cold:
Most
children will not need to see their doctor with a common cold or upper
respiratory infection. Infants younger
than 3 months should see their pediatrician because they are at higher risk of
getting very sick.
See
your doctor immediately if your child or infant is having:
- Trouble
breathing or fast breathing – using their muscles in between their ribs to
breathe or the openings of the nose get larger with every breath.
- Nails
or lips turn blue.
- The
symptoms are lasting longer than 10 to 14 days.
- Dehydration
or not drinking well and not urinating well.
- Child/infant
is too sleepy or very fussy and not consolable.
- Ear
pain or any other concerns for child/infant not improving or getting worse.
Antibiotics
do not treat the common cold since it is caused by a virus.
Supportive care includes:
- Increased
fluids.
- Use
of pain/fever medication such as acetaminophen or ibuprofen.
- Nasal
saline with suctioning for congestion.
- Honey
for cough in a child OLDER than 1 year (NEVER given an infant <1 year of age
honey).
- Use
of a humidifier may provide relief.
The
Flu; sometimes called Influenza.
The
flu is also caused by respiratory viruses called influenza and can present very
similar to the common cold. Children
with the flu feel much worse and are sicker than with the common cold. The flu can have very serious complications
including need for hospitalization and sometimes death.
Symptoms
of the Flu:
- Rapid
onset of high Fevers (above 101 degrees F), chills.
- Headaches,
body aches.
- Runny
nose, nasal congestion.
- Chest
pain and cough.
- Sore
throat.
- Poor
appetite.
- Feeling
tired and weak.
Most
children will get better after 2 weeks. Fevers from the flu can last up to 5 to
7 days.
See
your doctor immediately if your child or infant is having:
- Trouble
breathing or fast breathing – using their muscles in between their ribs to
breathe or the openings of the nose get larger with every breath.
- Nails
or lips turn blue.
- Dehydration
or not drinking well and not urinating well.
- Child/infant
is too sleepy or very fussy and not consolable.
- Ear
pain or any other concerns for child/infant not improving or getting worse.
Young children and
infants as well as children with high-risk medical conditions should see their
pediatrician as soon as possible.
These high-risk medical conditions include:
- Heart
defects.
- Chronic
lung issues.
- Asthma.
- Low
immune system.
- Diabetes.
- Cancers.
Supportive
care includes:
- Increased
fluids.
- Use
of pain/fever medication such as acetaminophen or ibuprofen.
- Nasal
saline with suctioning for congestion.
- Honey
for cough in a child OLDER than 1 year (NEVER given an infant <1 year of age
honey).
- Use
of humidifier may provide relief.
Outside
of supportive care, there is an antiviral medication called Tamiflu which may
be indicated and started if the flu is diagnosed within the first one to 2
days.
Bronchiolitis.
Bronchiolitis
is another respiratory illness that can be commonly seen during the winter
months. There are several viruses that
can cause this illness but RSV, also known as Respiratory Syncytial Virus, is
the most common. RSV is an infection
that will affect almost all children at least once before they turn 2 years
old. It usually starts as a cold and is
followed by lower respiratory symptoms around 3 to 5 days of the illness. For some children the illness can be severe,
especially younger infants, preemies, and those with heart or lung
defects.
Symptoms
of Bronchiolitis:
- Cold
symptoms with fevers, runny nose, nasal congestion, and cough.
- Fussiness.
- Poor
Feeding.
- Wheezing.
- Difficulty
breathing.
See
your doctor immediately if your child or infant is having:
- Trouble
breathing or fast breathing – using their muscles in between their ribs to
breathe or the openings of the nose get larger with every breath.
- Nails
or lips turn blue.
- Dehydration
or not drinking well and not urinating well.
- Child/infant
is too sleepy or very fussy and not consolable.
- Ear
pain or any other concerns for child/infant not improving or getting worse.
Supportive
care includes:
- Increase
fluids.
- Use
of pain/fever medication such as acetaminophen or ibuprofen.
- Nasal
saline with suctioning for congestion.
- Honey
for cough in a child OLDER than 1 year (NEVER given an infant <1 year of age
honey).
- Use
of humidifier may provide relief.
For
infants who are high risk there is an injection that is given monthly during
the winter months called Synagis that can decrease the risk of severe RSV
infection.
Croup.
Croup
is a common respiratory illness during the Fall and Winter months and is
usually seen in infants and young children – children younger than 5 year of
age. It is caused by several different
viruses including the flu virus and some cold viruses. The illness is characterized by swelling of
the upper airways including the voice box (larynx) and the windpipe (trachea). Symptoms from Croup are usually worse at the
beginning of the illness.
Symptoms
of Croup:
- Fevers
which can be low grade or high.
- Cold
symptoms with runny nose and nasal congestion.
- Hoarseness
of voice.
- Barky
or “seal like” cough.
- Noisy
breathing when breathing in – stridor.
The
swelling of the airway can sometimes be severe and need immediate medical
attention.
See
your doctor immediately if your child or infant is having:
- Trouble
breathing – struggles to catch their breath.
- Noisy
breathing that is getting louder and child/infant appears to struggle to
breathe.
- Cannot
talk because of difficulty breathing.
- Lips/mouth
or nails turn blue.
- Drooling
and not able to swallow saliva.
- Dehydration
or not drinking well and not urinating well.
- Child/infant
is too sleepy or very fussy and not consolable.
Steroids
can decrease the swelling and can be given by mouth, injection, or in a
breathing treatment. If given early can
help decrease the need for hospitalization and improve breathing. There are breathing treatments with
epinephrine that can be given as well in severe cases, but these will require
careful observation in the Emergency Department or Hospital setting.
Use
of cold moist air can help improve mild symptoms as well and can be used at
home with a cool mist humidifier.
PREVENTION
TIPS
- For
all respiratory infections, the best form of prevention is to avoid exposing
infants/young children to people who are sick or crowded situations.
- Breastfeeding
infants as long as possible (at least 6-12 months) is also an important way to
help prevent and fight infections because breastmilk provides antibodies.
- Practicing
and teaching children good hand hygiene is key.
- Use
soap and water and scrub for at least 20 seconds (singing the ABCs). Another option is the use of an alcohol-based
hand rub if hands are not visibly soiled.
- Teach
children to cover their coughs and sneezes properly by using a tissue or
coughing in their arm rather their hands.
- Keep
children home from daycare or school when they are sick to avoid spreading the
illness.
- Eating
a healthy balanced diet high in fruits and vegetables can help boost the immune
system and help decrease the chances of getting sick.
At
NOAH, we’re here for you. If you have any questions for your child’s
pediatrician, give us a call at 480-882-4545. You can also send a message to
your pediatrician via your child’s MyChart account.
