If your kids are anything like mine, they are bound to catch something this winter. Get the low down on 10 common childhood ailments and equally important, tips on helping them recover faster. Recognizing the common symptoms and when your child needs to see a doctor, can make this cold and flu season a more manageable one.
Expect up to five bouts this year.
You probably know the drill: Treat a mild fever, congestion, coughing, and a sore throat with lots of fluids and rest. If your child seems uncomfortable, children’s ibuprofen or acetaminophen can help reduce the fever (follow directions carefully, and consult your pediatrician if your child is under 6 months old), but steer clear of cough and cold medicines. “These don’t really help, and the dosage can be confusing and might lead to an overdose,” says pediatrician Fred Hirschenfang, M.D., section chief of ambulatory care at Hackensack UMC, in New Jersey. Use saline drops or spray to moisturize your child’s nasal passageways and an aspirator to remove excess mucus. A cool-mist humidifier can be helpful, provided that you clean it regularly to prevent mold. Most kids bounce back from a cold within five to seven days.
First aid Essentials:
Note: Please read the instructions on any product before you give to your little ones.
- For a fever, start with acetaminophen. This drug, found in Tylenol and many other products, is often safer than alternatives, including ibuprofen (Advil and generics) or naproxen (Aleve and generics). And you should avoid aspirin altogether for infants and use it with caution for other children because it can trigger a rare but serious disorder called Reye’s syndrome.
- Use nasal decongestant sprays briefly. For children ages 6 and up, nasal sprays including oxymetazoline can sometimes help. But they should be used only for a short time—three days maximum. Extended use can actually cause congestion to worsen.
- Check for age limits. Look carefully at the packaging to make sure your child is old enough to take the medicine, says H. Shonna Yin, M.D., who is conducting FDA-funded research on improving the labeling and packaging of OTC cough and cold products for kids and is an associate professor of pediatrics and population health at NYU Langone Health. For example, a cough medicine label may indicate it’s not for children under age 4; some antihistamines are labeled not for children under 6, unless directed by a doctor.
- Make sure that medications don’t overlap. If you’re giving your child acetaminophen for a fever and pick up a cold and cough medication that also contains acetaminophen, you may unknowingly be giving a double dose to your child. Check all ingredients.
- Choose single-ingredient products. Many OTC cold meds contain several ingredients meant to treat multiple symptoms at once, a shotgun approach that increases the risk of side effects. Instead, choose products that target your child’s specific symptoms, such as fever, runny nose, or cough.
- Understand dosing instructions. Most OTC cough and cold medicines for kids have a chart showing different levels of dosing by age. Find the appropriate dose for your child’s age. Acetaminophen or ibuprofen labels sometimes list doses by weight and age. When given the choice, go with the weight, Yin says.
- For liquids, always use the dosing tool that comes with the product. Kitchen spoons are not meant to measure medication. Use the syringe, dosing cup, or dropper that came with the medicine, and read the markings on it carefully. For prescription drugs, you may not get a dosing tool with your medication. If that happens, ask your pharmacist for the right dosing tool for your medication.
- Keep all medicines up high and out of sight. Kids find a way to get into medications and end up in the emergency room. A scary figure: About one in 70 children ends up in an emergency room by the time he or she reaches the age of 5 as a result of getting into medicine when an adult isn’t looking, according to the Centers for Disease Control and Prevention.
- When in doubt, ask. Check with your pharmacist or healthcare provider if you’re unsure about any medication.
Kids under 2 are most susceptible.
Respiratory synctial virus affects the lungs. In most cases, the symptoms are relatively minor and mirror those of a cold. But for preemies and children who have a compromised immune system, a congenital heart condition, or chronic lung disease, it can become serious in a hurry, causing either bronchiolitis (an infection of the small airways in the lungs) or pneumonia. About 150,000 children a year are hospitalized due to RSV, according to the Centers for Disease Control and Prevention. Call your pediatrician immediately if your child is wheezing, breathing very fast, or struggling to breathe, refuses to drink anything, appears to be extremely lethargic, or starts to develop a bluish tinge on her lips and in her mouth.
Good news: It’s usually over by age 2, and always by kindergarten.
Chances are your child’s roseola symptoms will be so minor that you won’t even realize he’s under the weather. However, some kids come down with a high fever, congestion, coughing, and, later, a patchy rash that starts on the chest and spreads. Although roseola usually runs its course within a week, contact your pediatrician if your child’s fever spikes or lasts longer than three days. In the meantime, relieve his discomfort with children’s ibuprofen and keep him home until the rash disappears.
It’s a lot worse than a tummy ache.
This illness, better known as a stomach bug, causes vomiting, diarrhea, and abdominal pain. A variety of viruses, including norovirus—which often sweeps through child-care centers (not to mention cruise ships)—can cause gastroenteritis. Most stomach viruses clear up within a few days to a week and require nothing more than rest and TLC. Still, you should make sure your child is drinking enough fluids to prevent dehydration. “The biggest mistake most parents tend to make is giving too much liquid at once, which a sick child may not be able to hold down,” says Maria Conwell, M.D., a pediatrician at The Children’s Hospital of Philadelphia. Start with just a tablespoon of an electrolyte solution (such as Pedialyte) every 15 minutes and slowly increase the amount. If your child prefers Gatorade or juice, water it down by half since these drinks are high in sugar and can exacerbate diarrhea. Once she feels like eating, offer her small amounts of bananas, rice, applesauce, and toast (the BRAT diet). If she keeps these down, slowly return her to regular meals. You might also try feeding her Greek yogurt. It’s high in probiotics (which promote healthy flora in the gut) and contains less sugar than the regular kind, says Dr. Conwell.
The telltale sign: painful sores in the mouth and throat
The Coxsackievirus pops up mainly during the summer and fall and is highly contagious, passing from kid to kid through touch, coughs, sneezes, and fecal matter. The sores are often accompanied by red blisters on the hands and soles of the feet that last seven to ten days. If your child also feels achy, give him children’s ibuprofen or acetaminophen. Ease his sore throat with ice pops and cold fluids, but avoid acidic juices, which can sting, says Parents advisor Jennifer Shu, M.D., a spokesperson for the American Academy of Pediatrics. You should also watch for dehydration, since some kids’ sores are so uncomfortable that they resist drinking at all.
You might know it better as “slapped cheek syndrome.
“Kids ages 3 and under are the most vulnerable to fifth disease, which causes a bright-red rash on the cheeks. Your child may not have any other illness symptoms, though she could also have a mild fever, a runny nose, and a secondary, lacy-looking rash on her torso. Fifth disease often spreads like wildfire through child-care centers and preschools. Once the rash comes out, your child is no longer contagious, and it will subside on its own. A small percentage of kids who get it will develop joint pain (let your doctor know right away if this occurs). Also contact your ob-gyn if your child gets fifth disease while you’re pregnant, as the virus can cause complications.
Babies and toddlers rarely get it.
Young kids are most likely to become infected by streptococcus bacteria if an older sibling has the illness. Although strep spreads mainly through coughs and sneezes, your child can also get it by touching a toy that an infected kid has played with. The classic symptom is throat pain, which can be so severe that he may have trouble swallowing or even talking. He may develop a fever, swollen lymph nodes, and abdominal pain. See your doctor if you suspect your child has strep. He may be given a rapid test (which won’t pick up every strep strain) and a throat culture (which takes 48 hours but is definitive), says Jay Homme, M.D., a pediatrician at the Mayo Clinic Children’s Center, in Rochester, Minnesota. If the test is positive, antibiotics will likely help your child feel better quickly, but keep him home for at least another 24 hours after his first dose to reduce the risk of passing the bacteria to someone else.
Get the vaccine early—it takes two weeks to kick in fully.
The flu comes on hard and fast: a fever of up to 103℉, body aches and chills, a headache, sore throat, cough, and sometimes also vomiting and diarrhea. It’s a miserable wintertime illness that often lasts for more than a week and can lead to dangerous complications, including pneumonia. Thankfully, you can greatly reduce your child’s risk by scheduling an annual flu vaccine, which can be given as a shot or, for kids over 2, as a nasal spray. The vaccine isn’t foolproof (since strains of the virus vary year by year), but if she gets influenza despite being vaccinated, her symptoms should be far less severe, points out Dr. Hirschenfang. If you suspect your child has the flu, make an appointment with your pediatrician right away. He may recommend putting her on an antiviral medication such as Tamiflu, which can help speed her recovery.
Beware: It can spread through your household quickly.
This inflammation of the tissue lining the eyelids (also called conjunctivitis) causes redness, yellowish discharge, blurry vision, and crusty eyes. Pinkeye in younger kids is most often caused by a bacterial infection, which must be treated with antibiotic drops. (Note: It can also result from a virus, which doesn’t require medication, or allergies or an irritant in the air, which can be addressed with allergy eyedrops.) Your child shouldn’t return to class until he’s been treated for at least 24 hours. Have him wash his hands regularly and avoid touching his eyes and sharing hand towels, blankets, or pillows so he doesn’t infect anyone else in your home.
See your doctor if you notice your kid scratching her bottom.
Blame kids’ poor hygiene for the prevalence of these tiny parasites. When an infected child scratches her bottom and doesn’t clean her hands, she can easily pass them on to other kids (who get infected when they put their hands in their mouth). The eggs move down the digestive system, hatch, and lay their eggs around the anus (yuck!). Your doctor will give you special tape to affix at night and will analyze it for pinworms and eggs. Only one or two doses of prescription medication are needed to get rid of them, but you’ll have to wash her towels and bedding in hot water.
When to Call the Doctor
Most childhood illnesses run their course without any big worries. But for some symptoms (and for certain kids) they may warrant a consultation with your pediatrician. Watch for:
Dehydration. Your child may have sunken eyes (or, if he’s a baby, a sunken fontanel, or soft spot on his head) or seem extremely lethargic, or his mouth might be sticky or tacky to the touch. Also beware if he’s urinating fewer than three or four times a day.
High fever. In newborns, any elevated temperature warrants a call. For infants 3 to 6 months old, phone if the fever hits 101℉; for older babies and children, the threshold is 103℉.
Breathing difficulty. Phone right away if your child is wheezing, his breathing is fast or labored, or you notice long pauses between each breath.
Not eating. It’s normal for a sick child to have little interest in food. But if your kid is eating or drinking less than half of what she normally would for two days or longer, check in with your doctor.
Preexisting conditions. If your child has been diagnosed with asthma, diabetes, a suppressed immune system, or another chronic medical condition, speak to your pediatrician every time he comes down with a virus that could compromise his health.