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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

Upper Respiratory Viruses

Why does it seem that our kids continue to get sick this time of year.I have been on call over the last weekend and I am beyond sounding like a broken record as I explain to parent after parent, “we are at the height of upper respiratory season”.

When you take weekend call in our practice you see patients in the office, you make hospital rounds at several hospitals and you also are taking phone calls from the answering service.  With that being said, parents are having a hard time understanding “how is it possible that my child is sick AGAIN?”  Said child was sick 2-3 weeks ago with something that seemed like the SAME thing, and here we are AGAIN.  You don’t even have to see their faces, you can hear the concern, disbelief and exhaustion in their voices! So, after finishing up hospital rounds and seeing all sorts of sick kids (these were not the hundreds seen in the office mind you, but the few that were sick enough to be hospitalized) it seemed like a great time to review respiratory illnesses. There are literally hundreds if not thousands of upper respiratory viruses that cause many similar symptoms, which are typically congestion, cough, scratchy throat, fever and just feeling “cruddy”.  A typical young child (under the age of 5 yrs) will get 7–10 of these viruses during a season which means at least one a month.  Unfortunately, this often means that parents with young children are also sick and it is even harder to take care of your child when you are sick and feeling terribly yourself.  Double whammy for sure! When discussing the frequency of upper respiratory infections parents wants to know “which virus is causing this?”  Surely you can name the virus, or do a test to confirm the virus or SOMETHING!!   Well, we can often name the viruses that are in the community, but again, naming the virus often does little good in diminishing the symptoms or expediting the length of the illness. Today was a good example of that as I was seeing our hospitalized patients. I saw a 6 month old with parainfluenza virus (this has nothing to do with flu either, so confusing), who had been admitted with croup and cough and needed oxygen.  Both of her parents are sick with colds too (probably due to the same parainfluenza virus). The next room was a 18 month old with wheezing who needed oxygen and bronchodilator treatments,  and he was found to have metapneumovirus.  Yet again, his 3 year old sibling and mother were coughing away and blowing their noses, somehow the father was yet to be sick and he felt quite smug! Several more rooms and 2 more children who had RSV and they too were coughing, having a hard time breathing and needed oxygen. Lastly was a child with rhinovirus who had developed a viral pneumonia and also required oxygen.  The point of this is that despite the fact that we “named” their viruses it really did not help very much in their overall care. All of these patients were under the age of 4 years, were otherwise healthy children and needed to be admitted to the hospital for a viral upper respiratory infection which required supportive care in order to maintain their oxygen levels.  In just one morning, I saw 4 documented different viruses, all causing similar symptoms and definitely lots of concern, exhaustion and frustration for their parents.  The best news is that they were all improving and would be going home over the next several days. Unfortunately, there will be new cases to fill their rooms. The list of respiratory illnesses seems just endless and by this time of year everyone, including children, parents and their doctors are “over it”.  In other words, when is this going to end?  We probably have 6 - 8 more weeks of this and then the viruses will diminish as the weather gets warmer and more humid. Viruses like cold dry temperatures like we have during the winter months .With warmer temperatures we will all spend a l more time outdoors and germs are not so easily spread. I too am hopeful for the end of upper respiratory season, as I was innocently sneezed on today by the little 6 month old with croup, and her mother said, “Dr. Sue, guess you will be the next one to be sick.”  Washing hands, and praying that I am immune. That’s your daily dose. We’ll chat again tomorrow.

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

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

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

Upper Respiratory Viruses

Why does it seem that our kids continue to get sick this time of year.I have been on call over the last weekend and I am beyond sounding like a broken record as I explain to parent after parent, “we are at the height of upper respiratory season”.

When you take weekend call in our practice you see patients in the office, you make hospital rounds at several hospitals and you also are taking phone calls from the answering service.  With that being said, parents are having a hard time understanding “how is it possible that my child is sick AGAIN?”  Said child was sick 2-3 weeks ago with something that seemed like the SAME thing, and here we are AGAIN.  You don’t even have to see their faces, you can hear the concern, disbelief and exhaustion in their voices! So, after finishing up hospital rounds and seeing all sorts of sick kids (these were not the hundreds seen in the office mind you, but the few that were sick enough to be hospitalized) it seemed like a great time to review respiratory illnesses. There are literally hundreds if not thousands of upper respiratory viruses that cause many similar symptoms, which are typically congestion, cough, scratchy throat, fever and just feeling “cruddy”.  A typical young child (under the age of 5 yrs) will get 7–10 of these viruses during a season which means at least one a month.  Unfortunately, this often means that parents with young children are also sick and it is even harder to take care of your child when you are sick and feeling terribly yourself.  Double whammy for sure! When discussing the frequency of upper respiratory infections parents wants to know “which virus is causing this?”  Surely you can name the virus, or do a test to confirm the virus or SOMETHING!!   Well, we can often name the viruses that are in the community, but again, naming the virus often does little good in diminishing the symptoms or expediting the length of the illness. Today was a good example of that as I was seeing our hospitalized patients. I saw a 6 month old with parainfluenza virus (this has nothing to do with flu either, so confusing), who had been admitted with croup and cough and needed oxygen.  Both of her parents are sick with colds too (probably due to the same parainfluenza virus). The next room was a 18 month old with wheezing who needed oxygen and bronchodilator treatments,  and he was found to have metapneumovirus.  Yet again, his 3 year old sibling and mother were coughing away and blowing their noses, somehow the father was yet to be sick and he felt quite smug! Several more rooms and 2 more children who had RSV and they too were coughing, having a hard time breathing and needed oxygen. Lastly was a child with rhinovirus who had developed a viral pneumonia and also required oxygen.  The point of this is that despite the fact that we “named” their viruses it really did not help very much in their overall care. All of these patients were under the age of 4 years, were otherwise healthy children and needed to be admitted to the hospital for a viral upper respiratory infection which required supportive care in order to maintain their oxygen levels.  In just one morning, I saw 4 documented different viruses, all causing similar symptoms and definitely lots of concern, exhaustion and frustration for their parents.  The best news is that they were all improving and would be going home over the next several days. Unfortunately, there will be new cases to fill their rooms. The list of respiratory illnesses seems just endless and by this time of year everyone, including children, parents and their doctors are “over it”.  In other words, when is this going to end?  We probably have 6 - 8 more weeks of this and then the viruses will diminish as the weather gets warmer and more humid. Viruses like cold dry temperatures like we have during the winter months .With warmer temperatures we will all spend a l more time outdoors and germs are not so easily spread. I too am hopeful for the end of upper respiratory season, as I was innocently sneezed on today by the little 6 month old with croup, and her mother said, “Dr. Sue, guess you will be the next one to be sick.”  Washing hands, and praying that I am immune. That’s your daily dose. We’ll chat again tomorrow.

Daily Dose

Sick Kids Home from School

1:30 to read

This "sick" season is a tough one. I'm seeing so many kids who are home from school with fevers, coughs and a variety of illnesses. Although it is never fun to be home with a sick child, especially as we enter the holiday season, parents and children can both try to make “lemonade out of lemons”. 

When a child is sick they often just don’t feel like eating (we are the same way right?), but they may like some “comfort” foods.  I remember being a little girl and being sick and my mother always made us stewed chicken and noodles. We also got to eat tapioca pudding and jello.  But half of the fun was making the pudding and jello. 

So, while I was talking to a mother with 3 year old twins who were both sick,  and I suggested jello and popsicles to help her feverish children. I asked her if she had ever made jello with the twins, and she loved the idea of going to buy a box of jello and then having the twins get to watch the liquid turn into a gel.  Jello is still somewhat of an early science experiment.  The pre-made jello cups are convenient, but cooking with a child is a great way to spend some “sick” time.  I am sure jello still has the jiggler recipe as well, and it is always fun for your preschool or early elementary school aged child to make cut out jello shapes. 

Popsicles are also soothing for a child’s sore and scratchy throat, and what about making homemade popsicles.  They sell the molds everywhere and you can make all sorts of crazy flavors as well.  Again, a bit of fun before a much needed nap and then popsicles are ready for “sick dinner”. No rules for meals when you are sick! 

Last activity for those at home children, slice and bake cookies. Even a sick child can often be tempted to eat a warm sugar cookie or gooey chocolate chip cookie right out of the oven. Decorating cookies is another fun activity and doesn’t take much preparation either. Sprinkles go a long way to distract and entertain a child who is feeling under the weather.  

I wish I could twitch my nose and put an end to the sick season before it even started, but I must say, besides all of the illness it is my favorite time of year.  Cold nights, warm fires, changing leaves, sweaters and coats are all delightful.  The only problem is that viruses love this weather too. 

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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New report says not enough babies are getting much needed tummy time!

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New report says not enough babies are getting much needed tummy time!

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