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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

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.

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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

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

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

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.

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