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Daily Dose

Cold & Cough Relief!

1:30 to read

Although it is just getting really cold across the country, it feels as if we have been in full cold and cough season for awhile.  The office sounds like what I call “kennel cough” as every child seems to be coughing…. even those who are just coming for check ups.

Parents often ask, “what is the best way to keep from catching a cold?” and the answer continues to be, “wash your hands and try not to touch your hands to your eyes, nose and mouth”.  Easy enough for an adult (well maybe not), but trying to tell your toddler not to put their hands in their nose or mouth is nearly impossible! That is one reason that children get so many colds in the first several years of life. Toddlers typically get the most colds as they have just started having playmates with whom they share not only toys but their germs…all part of growing up.

I remind parents that coughs are there for a reason. While they are a huge nuisance, and cause a lot of sleepless nights for both the child and parent, a cough is there to keep the lungs clear, and a cough is actually protective. In other words, coughing helps you clear the lungs of mucus that comes with a cold and helps to prevent pneumonia and secondary infections.  But, with that being said, learning to cover your mouth when you cough is not only polite, but it is also protective for others. It is a big day when your children learn to cover their mouths with the crook of their arms (better than the hand). Who knew as a parent this would be a milestone for your child?

Whenever your child is sick and has a cough and cold it is important to not only listen to their cough but to actually observe how they are breathing.  Parents send me videos or voicemails of their child coughing, but I am usually more interested in seeing their chest and watching their breathing. Your child may have a huge productive cough and sound terrible, but have no respiratory distress. With that being said, your child may also have a tiny little non-productive cough and be struggling to breath. In most cases the visual is more important than the audible.

To help symptoms like stuffy noses, try irrigating your child’s nose with Little Remedies® Sterile Saline Nasal Mist and then suctioning his or her nose to clear the mucus and make it easier for him or her to breath, a warm bath or shower before bed to open up airways and a cool mist humidifier in the bedroom.

Don’t panic if your child gets sick, as each time they fight off a cold and cough they are actually boosting their immune system…small victories.  It is not unusual for a toddler to get 6 - 7 colds in one season (and their parents get half as many as that from them). Once your child turns about 3 you will see that he or she doesn't get a cold every other week and also seems to handle the viruses a bit more easily.

If your child has any difficulty breathing you need to call your pediatrician! For more information on these products visit





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Treat Your Child's Cough & Cold!

Daily Dose

Got a Virus? Treat it with TLC

1.30 to read

I was on call this week and I think I saw “a million” kids with colds!

Everyone, from 3 months – 20 years, seemed to have runny/congested noses and coughs.  Interspersed with all of these colds were a lot of wheezing kids too, as these winter viral upper respiratory infections will trigger a lot of wheezing in very young children or those with asthma. Thankfully, none of them were “very” sick.

We have all been fortunate this year as most of the country is not seeing much flu, and I have my fingers crossed that this trend will continue!  Flu will usually make children (as well as adults) much sicker than these upper respiratory viruses.

Parent after parent kept asking me, “what is causing all of this?” “ If not flu, then what?”  Well, I can tell you that we are seeing RSV, rhinoviruses, para-influenza virus and metapneumovirus, just to name a few.

Unfortunately, there is not “a magic treatment” to cure these viral infections. With that being said, the treatment is entirely symptomatic. In other words, treat the symptoms with fluids, fever reducing meds if needed, rest, cool mist humidifiers, hot steamy showers, chicken noodle soup, and anything else that makes the symptoms seem to improve. (I am currently into ginger tea for my sore throat.)

So, after explaining viral infections and treatments, I often end the discussion with, “your child just needs some TLC”.  Well, I know I have said before that many of my “young” parents were not quite clear what TLC stood for. But this weekend I really had to laugh!

As I explained colds and symptomatic treatment to a mother with a 2 year old I told her to try a little TLC.  She looked at me slightly puzzled and said, “I have to go to THE LEARNING CHANNEL to find out what to do for this cold?”  “Do they have shows about treating colds?”

Just another reminder that not everyone knows the same acronyms! I just laughed (LOL) and told her that I meant Tender Loving Care and that she did not have to search her TV guide for treatment of colds!

I’m on call again next weekend, so be prepared for a few more funny stories as I tend to get a bit slap happy after being sleep deprived.

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

Daily Dose

Colds & Suctioning Your Child's Nose

1:30 to read

I am beginning to sound like a broken record, but we are in the throes of cold and flu season and unfortunately there are a few more months of this.  As every parent knows, colds (aka upper respiratory infections) are “age neutral”. 

In other words, there is not an age group that is immune to getting a cold and for every age child (and adult for that matter), the symptoms are the same. Congested nostrils, scratchy sore throat, cough, and just plain old feeling “yucky”. When an infant gets a stuffy nose, whether it is from “normal” newborn congestion, or from a cold, they often have a difficult time eating as an infant is a nose breather.  When they are nursing and their nose is “stopped  up”, they cannot breath or even eat, so it is sometimes necessary to clear their nasal passage to allow them to “suck” on the bottle or breast. 

Of course it is self evident that an infant cannot blow their nose, or rub or pick their nose so they must either be fortunate enough to sneeze those” boogers” out or have another means to clear the nose.  This is typically accomplished by using that wonderful “bulb syringe”. In our area they are called “blue bulb syringes” and every baby leaves the hospital with one tucked into their discharge pack.  As a new parent the blue bulb syringe looked daunting as the tip of the syringe appeared to be bigger than the baby’s nose.  But, if you have ever watched a seasoned nurse suck out a newborn’s nose, they can somehow manage to get the entire tip inside a baby’s nose. For the rest of us the tip just seemed to get inside the nostril and despite my best efforts at suctioning nothing came out. Once a nurse showed me the right “technique” I got to be a pretty good “suctioner”.  With the addition of a little nasal saline, which you can buy in pre made spray bottles, or which may be made at home with table salt and warm water, the suctioning gets a little easier as the nose drops helped to suction the mucous.

Now, I have become a firm believer that there is a place for suctioning a baby’s nose, but once a child is over about 6 months of age they KNOW  what you are getting ready to do. I am convinced that a 6 month baby with a cold sees the “blue bulb syringe” approaching their face and their eyes become dilated in fear of being suctioned!!  Then they begin to wail, and I know that when I cry I just make more mucous and the more I cry the more I make. So a baby with an already stuffy nose gets even more congested and “snotty” and the bulb syringe is only on an approach to their nose. It also takes at least two people to suction out a 6 – 12 month old baby’s nose as they can now purposely move away , and hit out to you to keep you away from their face and nose. It is like they are saying, “ I am not going to give in to the bulb syringe” without a fight! I swore I would not have a child with a “green runny nose” that was not suctioned.

As most parents know, don’t swear about anything, or you will be forever breaking unreasonable promises to yourself!  I think bulb suctioning is best for young infant’s and once they start to cry and put up a fight I would use other methods to help clear those congested noses.  Go back to the age old sitting in a bathroom which has been steamed up with hot water from a the shower. Or try a cool mist humidifier with some vapor rub in the mist (aroma therapy).  Those noses will ultimately run and the Kleenex will come out for perpetual wiping. Unfortunately, it takes most children many years before they learn to blow their nose, but what an accomplishment that is!!!  An important milestone for sure.

That's your daily dose for today. We'll chat again tomorrow. Send your question or comment to Dr. Sue!

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

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

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.

Daily Dose

First Cold

1:30 to read

My office is hopping with a lot of little ones and their first colds. The worst cold that a parent experiences is not their own cold, but their child’s first  one.  Unfortunately, babies that are born in the fall and winter months often get their first cold earlier than a baby born during the spring and summer. 

It is such a helpless feeling for a new parent to see their baby with a runny nose, red rimmed eyes and a cough.  While newborns routinely experience nasal congestion, a cold is different. With a cold the baby’s nose will run and have clear to colored mucous,  and they will typically cough, just like all of us with a cold. They just look so pathetic...but you need to know what to watch there will be more colds throughout the winter.

A baby (over the age of 2 months) may run a bit of a fever with their cold. A fever is defined as a temperature over 100.4 degrees. I am old school and still do rectal temperatures....just don’t think the temporal and ear thermometers are accurate.  The fever, if they even have one, should not last more than a day or two and should respond to the appropriate dose of acetaminophen for your child’s weight.

The biggest concern for a baby with a cold is how they are breathing. While they may look pitiful with that gunky nose, and have a loose junky cough, how your child is breathing is most important. You need to actually look at your child’s chest while they are breathing and coughing to make sure that they are not having any respiratory distress. Undo their onesie or take off the nightgown and look at their chest.  You do not want to see your child’s chest moving in and out (which is called retracting) or see that they are using their tummy (which is going up and down) to help them breathe.  The cough may sound horrible, but always look at their chest (visual more important than audible). They should also be nice and pink...even when they are coughing.  A cool mist humidifier in their room at night will also help.

Best thing for gunky nose is a nasal aspirator or nose Freda with some saline drops. Clearing the nostrils is often one of the best ways to help your child breathe, which will also help them to take the bottle or breast. A baby may not eat as well when they are sick (same as you and me) but they will take enough to stay hydrated and have wet diapers.  Being sick at any age typically effects your appetite and as your child is feeling better their appetite will improve as well.

Getting past that first cold is a milestone for baby and parents....but if you have any concerns about your child’s breathing, hydration or persistent fever, always call your doctor.

Daily Dose

Alternative "Medicines" to Fight a Cold

What are some ways you can fight a cold using alternative medicines?I am still fighting (that is really a descriptive term) my latest cold and the office is engulfed in a cold virus epidemic. Children of every age have runny noses, are blowing noses, and there’s a cacophony of coughs.  So I thought I would finish discussing more alternatives for preventing the common cold and possible treatments.

A mother told me today about something called “boogie wipes” which are supposed to be far superior to a Kleenex.   Now you know that I am frugal but I do buy “fancy tissues with aloe vera etc. According to this Mom you can’t beat these new “boogie wipes” for keeping your nose clean as well as not chapped.  Best hint of the day!! Recently, I discussed the use of vitamins and minerals and their use to combat the common cold, but now want to look at some other interesting options.  Some herbs have been studied as well.  A. paniculata (king of berries) is a popular herb that is used to treat fever, sore throat and respiratory infections. In two different studies in children, one studying Russian children and another Chilean students, both found that those receiving this herb had a shorter duration of symptoms of their colds.  The Chilean study also showed that those who took A. paniculata had a 70% reduction in the number of upper respiratory infections than those given placebo. I found this very interesting!  I think I am going to head to store tomorrow to buy this herb which I had never heard of!  It certainly can’t hurt and I can just add it to all of the other stuff I am taking. What about probiotics (dietary supplements containing potentially beneficial bacteria or yeast)? Probiotics are being used in formulas and foods, to help prevent gastrointestinal issues as well as in the treatment of post viral gastroenteritis (vomiting and diarrhea).  How about to prevent or treat the common cold? A Finnish showed no difference in the symptoms of respiratory infection among those using probiotics as compared to placebo. Another study out of Israel also showed that those who consumed probitoics had no effect on the duration or frequency of respiratory illnesses. Honey has received a lot notoriety lately and is thought to have anti-inflammatory effects in general. Several years ago, a study with parent support reported honey was better for a nighttime cough than cough syrup containing dextromethorphan.  Buckwheat honey is considered safe for use to control cough in children who are over 1 year of age. The most interesting report I found was out of Australia.  This study  which looked at the effectiveness of mind-body therapies in combating cold symptoms. Children received stress management to deal with generalized anxiety and to promote positive self-esteem. Another group received guided imagery and relaxation therapy. The children who received either of these therapies had a shorter duration of upper respiratory symptoms than the control groups.  Many studies have looked at white cell function during times of stress and also So it looks to me like the use of elderberry and stress reduction may hold some value in combating common colds. I know there is much more data to come, but in the meantime it looks like another herb and a nap may help more than my current vitamin/herbal regimen. It certainly can’t hurt. I am also going to get my FLU SHOT tomorrow in hopes of keeping that virus at bay all winter long! That’s your daily dose for today.  We’ll chat again tomorrow. Send your question or comment to Dr. Sue!


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No need to be so structured when feeding your baby!

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