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Daily Dose

Do Essential Oils Boost Immune System?

1.30 to read

Although it is still hot and officially summer, soon everyone will be heading back to school  and coughs and colds (and eventually flu, another topic) will be just around the corner. I had a patient ask me about the use of essential oils. Her 2 1/2 year old daughter is heading to preschool for the first time and she “had heard from her friends that essential oils help a child’s immunity during cold season”.

Unfortunately, there is very little data at all to confirm that statement. I only wish that rubbing a bit of lavender oil on would help prevent the common cold. While it may smell great and be relaxing....there is no data that I can find to show that there is any reproducible science to the claims that essential oils boost the immune system.  

While I was researching I found many sites stating that “eucalyptus oil is an anti-viral” and “peppermint oil is an anti-pyretic (fever reducer)”.  Tea tree oil is touted as being “both anti -bacterial and anti-fungal” (I don’t know of other drugs that can claim both!).  But, I just don’t see any data to support all of this. 

The word essential refers to the essence of the plant the oil is derived from, rather than being “essential” to your health. While in most cases essential oils (which are highly concentrated) used as aromatherapy are not harmful for adults, it may be a different story in children, especially those under the age of 6. While labels may say  “natural” it may not always mean safe.  Many oils are poisonous if ingested and there have been reports of accidental overdoses in children with several different oils. In one report tea tree oil and lavender oil applied topically have been shown to cause breast enlargement in boys.  Oil of eucalyptus and peppermint are high in menthol and cineole.  These substances may cause children to become drowsy have decreased respirations.  While there are articles stating that the use of menthol (Vicks) on a child’s feet may be helpful during a cold for reducing a cough, do not use this if child is young enough to put their feet in their mouths. 

I must say that I sometime use a few drops of eucalyptus oil in the shower when I have a cold as I think it smells great and seems to help “open up” my head. Whether this is in “my mind” or a response from my olfactory centers which sends calming messages to respiratory center is not clear. But, I am not ingesting it or using it topically. 



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Treat Your Child's Cough & Cold!

Daily Dose

The Best Cold Treatment

1.30 to read

Alright, enough is enough! How could I possible have another cold?  I routinely tell patients with children that it is not unusual for kids to get 8-10 colds a year which seems like once a month from September through April!

If you also think that the average cold lasts anywhere from 7–14 days, then it seems like a child has a cold that lasts most of the year. That is how I am feeling right now.

A cold usually starts off with a little “sniffles” and maybe a sore throat, and you pray that it is just your imagination, and then over several days you  realize that you now feel “yucky”, have more congestion, the sore throat is still there and you are coughing. That is a cold!!!! That is not allergies, nor is it flu. It is that pesky cold virus of which there are an infinitesimal number, and you have succumbed once again. That is my story!

So, with those symptoms AGAIN, and a day in the media research office, I went back to the literature to see if I could find ANYTHING that might lead me to preventing  a cold, curing a cold or making this nasty thing go away any faster. I mean, I am a busy woman and like everyone else, “I really don’t have time for this!” There have been thousands of studies done over the years looking at cold symptoms and their prevention. Studies on Vitamin C from the days of Linus Pauling, to more recent studies for prevention and treatment of upper respiratory infections have really found no benefits to taking vitamin C.

There was one study that showed taking vitamin C might reduce the duration of cold symptoms if taken before a cold begins.  My question is, how do you know that you need to start Vitamin C in anticipation of a cold?  Also, too much vitamin C may cause an upset stomach and diarrhea.

How about Echinacea?  I have been taking Echinacea for years in hopes of “warding off colds”, but the review of the data  showed that Echinacea had no effect in preventing the common cold, studies did show that it might reduce cold symptoms in adults, but studies in children did not produce the same results.  It was also found to increase rashes in those who had eczema (atopy), and allergies to ragweed. I am still taking it, but personally “can’t tell a difference”. You do realize that my opinion alone is not statistically significant. Then there was the whole zinc movement and there are numerous studies that show conflicting results. Some studies did show that those who took 15 mg of zinc daily had a lower mean number of colds and also a shorter duration of cold symptoms.

Other studies did not find a statistical significance for either reducing the number of colds or decreasing symptoms. I have tried all sorts of zinc preparations over the years (even when it was such a hot item I had to order lozenges off of QVC-should I admit that?) and besides tasting horribly I think my cold lasted the same number of days.  Another study of one (not significant), and most would say that the data is still inconclusive.

The hottest new topic is vitamin D.  A study published in the Archives of Internal Medicine in early 2009, analyzed information on vitamin D levels in adult and adolescents.  The results showed that those people with the lowest vitamin D levels (less than 10 ng/ml) were 36% more likely to report having upper respiratory infections that those with higher vitamin D levels (above 30 ng/ml).

Vitamin D is also important for bone and general health, so it is a good idea to be making sure that you are getting adequate vitamin D. The AAP increased the recommended daily intake of vitamin D to 400 IU. I am currently taking a vitamin D supplement in hopes of boosting my immunity as well as keeping my bones healthy.

If you have any ideas or PROVEN remedies, potions, concoctions please send them my way. In the meantime, I continue to drink lots of herbal tea, take hot showers and baths to help the congestion, go to bed earlier than usual, suck on my honey throat lozenges and pray. I also wash  my hands incessantly and even resorted to wearing a mask over the last several days in hopes of warding off germs. My patients think I am playing dress up!

That's your daily dose for today.  We'll chat again tomorrow (cough)! 

Daily Dose

Dealing With Runny Noses

With the combination of back to school germs and fall allergies, every child I see seems to have some sort of nose or throat symptom.

Cooler weather is here and with fall it seems runny noses begin to abound. With the combination of back to school germs and fall allergies, every child I see seems to have some sort of nose or throat symptom. Unfortunately there isn’t much to do for those first fall colds except to push fluids, encourage a good nights rest and lots of Kleenex.

Fortunately, fall viral respiratory infections don’t seem to be as miserable or last as long as the ones that are lurking around the corner for the winter. But, allergies are treatable and there are more and more over the counter medications available. Children under 2 typically don’t have a runny nose caused by allergies, but older kids may. It may be worth trying a product like Claritin or Zyrtec for several days to see if the itchy eyes, runny nose and intermittent sore throat improve. Benadryl is still an excellent antihistamine to use, although it may cause drowsiness, so try taking at bedtime. Nasal irrigation is also a good idea and there are many products available or make your own salt water solution at home (be thrifty). Lastly, although you can’t prevent the common cold, it is already time to be thinking about flu shots, so get yours scheduled. That’s your daily dose. We’ll chat tomorrow!

Daily Dose

Plenty of Colds Going Around

1.30 to read

I have been looking at the data from the Center for Disease Control and Prevention and it looks like flu season has made an early exit from many parts of the country. That would be a welcome blessing. But cold season is still in full swing and so many of the parents I am seeing in the office continue to say, “it just seems impossible that my child can have this many colds in one year!”.  If you have a child between the ages of 6 months and 3 years of age, and they go to school, you are probably one of these parents.

The first several winters that you child starts day care or pre-school are pretty tough....not only in terms of “being away from your child”, but also for the number of viral illnesses they get. Many a parent has called me “CRAZY” when I tell them that it is not unusual at all for your child to get 7-10 viral infections during the first fall/winter season that their child is around other children. In fact, I know that there have been several families over the years that changed pediatricians just because the parent felt certain that their child had an “immune problem” due to their frequent coughs and colds. True problems with immunity do exist in pediatrics but they don’t typically present with recurrent coughs and colds, but rather with far more serious illnesses.  Thankfully these are rare.

Parents with younger children know their pediatrician far better than they really want to during those first several years. That is another reason that you want to find a pediatrician that is not only close to your house but that you really get along with!

So with all of that being said, hang in there for about another 6-8 weeks and the winter viral season truly will be exiting and children (and their parents) will all start to be healthier for the rest of spring.  I promise once your youngest child reaches 3 years of age your visits to the pediatrician during the winter months become less and less frequent.

Daily Dose

Airborne & Your Kids

1.45 to read

It’s cold & flu season and I have already been receiving emails from parents asking what works/doesn’t work.  I reviewed a recent note from a well-meaning dad asking if he could give his 3 year old son Airborne to help “offset colds”. 

I myself have just recovered from my first cold of the “season” and have looked high and low for ANYTHING that might prevent or treat the common cold. As I tell my own patients on a daily basis, if I had the “magic pill” I would certainly not only manufacture it to distribute to everyone, but I would also be getting ready to accept Nobel Prize in medicine for solving the mystery of preventing the common cold!!  Airborne is NOT the magic potion and I see no reason to use it period.

I recently did an extensive review of complementary and alternative medicine for the common cold (selfishly trying to cure myself) and once again came up empty handed for any proven remedies. There are still a lot of ongoing studies (someone will win the Nobel Prize one day), but nothing so far has really proven to be the panacea.

Many people “swear” by Airborne.  I am just not sure what they are thinking it does. If you read their website it states, “there are scientific studies that the ingredients in Airborne have been shown to support the immune system”. I can’t find those studies anywhere. 

In 2008 a class action suit against Airborne resulted in a $23 million dollar fine for “misleading consumers and making false claims”, when Airborne claimed to “ward off colds”. They have now changed their advertising to the wording, “boosting the immune system” which also seems like deceptive advertising to me. Regardless, they continue to make millions (despite that huge fine).  My mother even called to say she thought she might take some before flying to visit at Thanksgiving asking, “did I think that would help her from getting sick?” OMG!

The ingredients in Airborne include Zinc, ginger, Echinacea, vitamins, minerals, and herbs.  This is what I commonly call “hocus pocus”.  Many of the ingredients in Airborne have been studied for use during a cold, without a lot of success.  Zinc is still being studied with varying outcomes, but there are still no definitive guidelines on using Zinc for a cold. Stay tuned for more as more studies are completed.

In the meantime, the answer to the email is NO; I would not give a 3 year old Airborne. What I would do is make sure that your child is getting nutritious meals, adequate sleep and that they learn to wash their hands and cover their mouths when they cough (hand hygiene). I would put the money you would spend on Airborne in their piggy bank for future college expenses.   I would also make sure to get your child their Flu vaccine. We do have data that vaccines work!

That’s’ your daily dose for today.  We’ll chat again tomorrow.

Daily Dose

Cold Season is Here

School starts and colds start almost simultaneously no matter how old your child is.School starts and colds start almost simultaneously. It even amazes me to see kids with their first cold of the season within 15 minutes of starting school, whether it is Mother's Day Out or high school, it affects every age.

The worst part of a having a cold is knowing that it is going to last seven to 10 days, no matter what you do. The old adage of rest, fluids and nasal irrigation is still the mainstay of treatment. Remember that over the counter cough and cold medicines are not recommended for use in children under the age of 2 and really are not very effective in the overall scheme of things. There has been some renewed interest in zinc and reduction of symptoms and decreased duration of colds so stay tuned for more info on that. In the meantime, keep up hand washing and good cough hygiene to try and prevent getting one of the first colds of the season. That's your daily dose, we'll chat tomorrow!

Daily Dose

Asthmatic Kids & Colds

2.00 to read

Cold season continues to hang on and for anyone who has a child with asthma, you are aware that wheezing will often accompany winter colds.

I have spent a lot of time in the last week listening to wheezy chest, lots of coughing and seeing many children who need to be using their asthma medications. After a quiet summer of no coughing it is a good time to review asthma and the medications to use to treat as “wheezy season” is here!

Many children will wheeze once in their lifetime and I tell parents, “everyone gets one free wheezing episode”. But if a child wheezes on several occasions and responds to bronchodilators they probably have asthma. If you throw in a positive family history of wheezing as well as wheezing that begins each time a child gets a cold it is time to discuss the diagnosis of asthma and the treatments that go along with the diagnosis.

The good news about asthma is that there are a lot of great medications available for treatment. With that being said I think it is important to teach parents about the pathophysiology of asthma and then talk about treatment. I tell my patients/parents that understanding wheezing is somewhat analogous to being a medical intern. You have to see the symptoms for a while and then you finally “learn it, and know it” and then can begin to understand treatment.

For a parent with a child with asthma it is the same process. Each repeated wheezing episode should get easier for a parent to know what they are dealing with and when and how to start treatment. Many times they will not need the doctor to be involved once they are comfortable with the medications.

In fairly simplistic terms, there are really two components to asthma, airway narrowing (brochospasm) and airway inflammation. In most cases it is important to be treating both symptoms. The most common trigger for asthma in children is a viral upper respiratory infection. When you get a viral upper respiratory infection the virus causes airway inflammation and irritation in all of us. That is one reason we all cough with a cold.

For an asthmatic child it also causes bronchospasm and resultant wheezing. By the time you audibly hear your child wheezing they are what we pediatricians refer to as “being tight”. The goal is therefore to treat the asthmatic episode early and aggressively; you never want to hear audible wheezing.

An asthmatic cough is often short, frequent, non productive and occurs throughout the day and often all night long. I love to walk into a room and hear a child with a productive, “phlegmy” cough, as these children are typically not wheezers but are good coughers! It is that dry little recurrent pesky cough that occurs incessantly that is often the hallmark of a child who is wheezing.

In severe cases of wheezing and bronchospasm the child will also show signs of respiratory distress, where their chest may show retractions (pulling in between ribs) or using their abdominal muscles to help them breath. These children look uncomfortable and are usually not running around the exam room as they are having a hard time getting air exchanged.

Some other children may not be in any respiratory distress but when listened to with the stethoscope you can hear the high pitched noise on expiration and sometimes on inspiration as well. You just have to get used to listening. Practice, practice and then a parent with a stethoscope gets better at understanding asthma.

When a child is actively wheezing it is time to start medications to relieve their symptoms. More on treatment coming.  Stay tuned.

Daily Dose

Don't Touch The T-Zone!

A lesson from a 4 year old patient!Well, even though spring is officially here, we are still seeing a lot of coughs, colds and lingering RSV in our community. Thankfully, flu is on the way out!

While I was examining a child with upper respiratory symptoms, I was taught a very clever bit of information.  Mind you, I am always learning from my patients, but this time it was from a very precocious 4 year old little boy. He had been coughing and I noticed that he was coughing into his hand. I told him that another way to cover his cough would be to cough into his elbow. While we were talking about the benefits of this form of cough hygiene, I demonstrated how to do this. He listened attentively and covered his next cough with his elbow. Quick study and a good listener! After finishing examining him, I was talking to his mother about her child’s illness.  The little boy interrupted and said, “Dr. Sue, I have something to teach you too”.  “You need to tell everyone not to touch the T-Zone”. Now I am used to talking to teens about the T-Zone and acne, but why would this 4 year old know about the T-Zone?  Well, he quickly told me “you should not touch your eyes, nose or mouth; this is the T-Zone”. If you touch the T-Zone, you might get germs and then get sick”.  What a clever way to teach a child about keeping their hands off of their faces!  It was one of those “ah-ha” moments for me. So now, not only do I talk about coughing into your elbow, I have added don’t touch the T-Zone to my “shtick” about preventing colds and coughs. Out of the mouth of babes! Do you have any clever tricks you talk about with your kids?  Share with us! I would love to pass it on.


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If your child snores, is this a sign of something more serious?


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