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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 www.littleremedies.com.

 

 

 

 

Daily Dose

It's Cold Season!

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 mucous 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 child learns to cover their mouth with the crook of their arm (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. 

 

The best treatment for a cold and cough continues to be the tried and true…saline and suction to clear the nose of the mucous and make it easier to breath, a warm bath or shower before bed to loosen up the mucous, a cool mist humidifier in the bedroom and honey for the cough. Remember, you cannot use honey in a child under the age of 12 months! 

 

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 they don’t get a cold every other week and also seem to handle the viruses a bit more easily.

 

If your child has any difficulty breathing you need to call your pediatrician!

 

 

 

 

 

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!

Daily Dose

Does the Color of Mucus Really Matter?

1.30 to read

It is that time of year and everyone seems to have a cold, including me!! I am actually “on” my second cold of the month, so I am feeling like a toddler who gets sick every two to three weeks.  

This is really a good time to talk about mucus. I wonder how many people will keep reading now? But I do get lots of questions and comments from parents who are worried about the color of their child’s mucus. Runny noses and mucus color are discussed as often as color of poop. And just like poop, the color of your nasal mucus is usually not terribly significant. 

If you happen to have a cold yourself, you probably notice that your nasal discharge changes throughout the day, that is unless you are a teenager, and they swear they never look at mucus or stool color!! I think we notice “green snotty noses” among children between the ages of six months and four years, when they typically don’t blow their noses and many times the mucus is either wiped off of their face or they wipe it themselves on their shirt sleeve, (which then leaves a telltale sign of the color of the mucus). Once a child can blow their nose and dispose of the Kleenex, the color of the mucus does not seem to be a hot topic of discussion.

So, what does color of mucus mean? When you have a cold, the nasal discharge associated with that viral infection typically begins as a clear discharge, that changes over several days into a thicker and more purulent (green) discharge. The color may be due to the white cells that are in the mucus that are producing antibodies to fight the cold. 

As a cold progresses the green mucus then changes back into a more clear discharge and eventually goes away, but that is usually after a seven to 10 day course. It is also common to see thicker “booggers” in the nose in the morning or after your child’s nap as the dry air they are breathing makes the mucus thicker and they are not wiping or blowing their noses so the mucus is thicker. Same for us, we also usually have thicker greener nasal discharge in the morning, while the “snot’ has been sitting overnight. The best way to clear out any color mucus is by using saline nasal irrigation. It works great for all ages. By clearing the nasal passages, it will prevent a secondary bacterial infection which and cause a sinus infection.   

Most doctors use length of time of nasal discharge as more indicative of an infection than color of mucus. Typically in a pediatric patient an antibiotic for a “presumed” sinus infection is not even considered until a child has had over 14 days of a “gunky” green nasal discharge. Remember too, that the nose can clear up and the cold can go away, only to be followed in another week or two by another cold. It is the season. With that being said I am off to blow my nose again and wash my hands! 

That’s your daily dose, we’ll chat again tomorrow.

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 for....as 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

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

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

How To Treat a Cold

1.00

It’s the sick season and colds are rampant right now.  Everyone is asking: what is the “quick fix” to get rid of a cold?  Unfortunately, when it comes to a cold…nothing is quick. 

The common cold starts with a runny nose then a scratchy throat followed by a cough.  Your child may tell you they just feel “yucky”. 

Don’t be alarmed if your child’s mucous turns from clear to colored.   A green runny nose does not mean a bacterial infection, so need to  ask your doctor for an antibiotic…they do not help the common cold and are not needed. 

The only proven treatment for a cold is a tincture of time and treating your child’s symptoms will help them feel better, sooner.

Here’s what I recommend to my patients: 

-For a runny and stuffy nose…start with a hot shower to loosen up the secretions. 

-You can also try nasal suctioning with a bulb syringe or a nasal aspirator for young children. 

-For older children, I encourage saline rinses with an irrigation system like a Neti pot.  Many of my patients swear by it. 

At night, place a cool mist humidifier in your child’s room to add some moisture to the dry heat in the house.  

You can expect your child’s cold to last about 7 to 10 days.  Don’t forget to tell your kids to cover their nose when they sneeze and wash their hands to stop the germs from spreading to everyone in the family. 

I’m Dr. Sue with The Kid’s Doctor helping parent take charge.

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!

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