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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. 

 

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

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

Dealing With A Baby's First Cold

1:15 to read

With the "sick season" upon us, I'm starting to see more babies with cold symptoms and their concerned parents wondering "what can I do to help their precious bundle of joy?"

In pediatrics, we often say “children are not little adults” but in the case of the common cold, they really are. They have the same symptoms, runny nose, red-rimmed eyes, cough and they just FEEL YUCKY! With those symptoms most babies are fussier than usual and don’t sleep well at night, which is just like an adult with a cold (or maybe just me). One of the main differences is that an adult cannot wake up off and on all night and have someone really “care” that you can’t sleep because you are so congested, or your throat hurts. As much as your spouse loves you, the most common response is “just deal with it” and go back to sleep. Not so for an infant, they are usually up and down all night, don’t feed as well, and just want to be held a little more. We the parents are also up and down with the baby with a cold and so it goes as a parent. When an infant get’s a cold it is not uncommon for them to run a fever along with the cold symptoms. This usually only lasts a day or two and then resolves, but the other common cold symptoms may last from seven to 10 days.

The first several days of a cold usually begin with a runny or congested nose and a cough. With a cold they may not want to nurse or drink their bottle as well as they have a hard time breathing and sucking. These leads to a cranky baby, who may take less with each feeding, but will need to eat more often. It is important to make sure that they stay hydrated. Contrary to popular myth, drinking formula or breast milk does not make a cold worse, and fluids are the most important thing. If your baby is having difficulty taking the bottle or latching on due to the congestion, you may use the “bulb syringe” that is sent home with the baby after birth. Place the tip of the bulb syringe inside the baby’s nostril to remove mucous and help them breath and eat. You may also use a little salt water nose drops to squirt up their nose to help the mucous come out. It also helps to get a cool mist humidifier to place in the room at night to help put some moisture in the air while the heat is running and the air is dry. The cool mist will also help alleviate some of the thicker mucous and also help the cough that accompanies the cold.

The most important thing to watch for is any sign of respiratory distress. A child’s breathing may “sound noisy” but it is important once again to look at their chest to make sure that they are not using those muscles between the ribs and “pulling” when they are breathing. They may also have a congested cough and it can sound “junky” but they should still not be showing any signs of difficulty with breathing. Coughs are also protective in that they help move mucous and keep the airway clear to prevent pneumonia. Lastly, your child should look a little better after the first several days of their cold. They should not develop fever later in the cold, and if they do it would be worth a pediatrician visit to check their ears. Not every baby with a cold gets and ear infection and they usually develop after they have had several days of cold symptoms, and not on the first day of a cold.

The only way to diagnose an ear infection is for the doctor to visualize your child’s eardrum, even with email, and phones, you just can’t get a picture down the ear canal! That’s your daily dose, we’ll chat again tomorrow. Send your question or comment to Dr. Sue!

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

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

It's Cold Season!

1:30 to read

It is already starting....fall and colds and parents are already wondering why their toddler or young child may have already had 2 colds and it is not even winter!  It is incredible how often a toddler can get sick....I even had a hard time believing there were so many viruses for one child to get.

But, I do know that there does not seem to be any way “around” the frequent runny noses, coughs, mystery fevers, and episodes of vomiting and diarrhea that a parent has to get through!! There is not a short cut to get through this desert of illness...you have to walk the walk.

Yes, it takes a lot of little viral illnesses to help build a child’s immune system. We can give vaccinations to prevent meningitis, whooping cough, polio, mumps, measles and rubella.  But there are hundreds of viruses that cause colds and coughs....and there is not a vaccine for any of these viruses.  

So, once your child reaches the age where they are walking and touching a million things a day (even though you wash their hands), you should not be surprised or alarmed that they seem to have a new illness every few weeks. Parents ask me everyday, “what vitamin works to prevent colds?”, “do probiotics prevent those fever viruses?”. If I had the “secret” potion, trust me I would tell them, but I would also bottle it and sell it on the internet and retire to an island , after receiving the Nobel Prize in medicine for finding the “secret”.  But in the meantime, I will continue to reassure parents that they will get through these early illnesses.....everyone does. 

Daily Dose

Colds & Nosebleeds

1.15 to read

The cold weather is gripping a good portion of the country......and that means the heat is now on your house. With the dry air in the house, and lots of sniffles and colds, before you know it I am hearing from parents concerned about nosebleeds.   

Kids get tons of nosebleeds (not just from trauma) and even small noses will look like they are bleeding a lot.  For some reason a lot of children’s noses bleed during the night. That means lots of blood on sheets.  A little bit of blood on sheets, hankies, or Kleenex looks like a lot more blood than it really is, so don’t freak out. 

If your child has a bloody nose try to have them tip their head forward, breath through their mouths and pinch the nose halfway between the tip and the base of the nose. Don’t stick anything inside their nose at that may irritate the nostril even more. Don’t let your child sniff the clot or rub it during the pinching.  

In order to prevent nosebleeds during the dry cold months, it is often necessary to use a lubricant in your child’s nose There are several saline nasal sprays that help, some of which have lubricants like aloe in them as well. A minimal amount of Vaseline can also keep the inner nasal mucosa moist so that the clot that forms after the nose has bled can have time to heal.  Think of the clot inside the nose, just like a scab on your child’s knee. If it gets bumped before it is healed it will bleed all over again.   

Remember, if your child rubs their nose, “God forbid” picks their nose, or even blows their nose, once the nose has bled it is going to bleed again! If nosebleeds become recurrent, check with your doctor about taking a look inside your child's nose.

 

 

Daily Dose

Vapor Rubs: Do They Really Work?

1:15 to read

There was a great article recently published in the online journal of Pediatrics.  I had to read it as it was titled, “Vapor Rub, Petrolatum, or No Treatment for Nocturnal Cough”.  Having been a fan of both Vick’s Vapor Rub and Mentholatum since I was a child, I knew it was a MUST read article.

You can ask all of my family members, once we hit cough and cold season, the “vapor rub” jar goes next to my bed to help me during my frequent colds (see previous posts!).  I have such fond memories of being with my grandmother, Gaga, who at the first sign of a cold,  would rub Vicks all over my chest, which was then occluded by a warm damp CLEAN dishtowel, then followed by my flannel nightgown.  She would lovingly tuck me into bed, and shut the door and the whole room smelled like camphor, and menthol.   To me it was wonderful, my brother hated it!! As I grew older, my mother would hear me sniffle or blow my nose and down the hall she would come with the trusty Vick’s jar for self-application. Once I became a mother, in the family tradition, I too would rub a little Vick’s on my children’s chest, with no basis on medical fact, only what Gaga did. Funny thing, we all seemed to get better.

Two of my own children grew to despise the tradition, while one still asks for Vick’s or Mentholatum when he gets a cold.  There are old jars all over the house. I even bought several of the “plug ins” to use during cold season, which are the new fangled way to get that wonderful VR aroma into the room. They make a great stocking stuffer! So, with that history, what could be better than a study out of Penn State University that looked at the use of vapor rub (VR) to improve cold symptoms and nighttime cough.  With the recent FDA guidelines which limit the use of OTC cough and cold products in young children, many parents are at a loss as to what to do to help their child’s cold symptoms. The investigators looked at 138 children between the ages of 2 – 11 years. They were randomized to receive vapor rub (VR), petrolatum alone or no therapy.  Parents were then asked to grade their child’s symptoms and sleep on Day 1 when none of the children received therapy, and then again on Day 2 when they were randomized to therapy. 

The VR group scored best in improving cough, congestion and overall sleep for the children (and therefore their parents). This is the first evidence based therapeutic trial that I am aware of, for a remedy that is over a century old. As noted in the article, there were some irritant effects seen in the VR group with complaints of a stinging sensation to eyes, nose and or skin (I can hear my own children saying “it’s stingy”). Most of these complaints were transient in nature.  Despite older concerns about camphor when it was used as an oil that could cause possible toxicity if swallowed, skin exposure alone really has little systemic effect.   The FDA has approved camphor as an effective anti-cough preparation (anti-tusssive), but has limited concentrations to 11%. The concentration in VR is 4.8%. So, if parent’s are trying to improve nighttime cough and sleep disturbance in their children over the age of 2, there is a study to show it is time to go back to vapor rub preparations.  The mechanism for improved sleep is not really known, but whether it improves cold symptoms directly or through the aromatic effects, a better night’s sleep is good for everyone!!!  Could there be coupons to follow?

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

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