Doctor’s Rx: Caring for your sick child

Is your child’s cough just a symptom of a cold or could it be more serious? What do you do when your baby can’t hold down food? Parenting and medical expert Dr. Tanya Altmann discusses some of the common winter illnesses that young children face and answers parents’ frequently asked questions.

Runny nose
Many children spend a good portion of their toddler and preschool years with mucus running out of their nose. Luckily. most are just common colds and will go away by themselves, although they're often spread to every one else at home first.

If the stuffy nose is bothering your child, your best option is to try to clean it out so he can breathe and drink more easily. Try a few drops of nasal saline and gentle suctioning. He won’t like it, but often if you can get the gunk out he’ll feel better. Running a cool-mist humidifier or vaporizer at night can also help. As always, when your child is sick, make sure he drinks plenty of fluids.

Call your pediatrician if the cold symptoms are interfering with eating or sleeping or there is any associated trouble breathing. In older children, it’s often OK if a cold lingers for more than a week. However, your child should be examined if the symptoms seem to be worsening after five to seven days, there is a fever for more than four days or a new fever appears after several days of having a cold.

One of the most contagious winter cold viruses is RSV, respiratory syncytial virus. In older children and adults it causes a cold with a runny goopy nose — the one you get almost every winter, but in young children it can cause serious lung problems, especially in infants who were born early or have underlying heart and lung disease. For these high-risk babies, there is a shot available that's given once a month during the winter to help decrease their chance of catching RSV. As always, call your pediatrician right away if your infant has a cold and is breathing fast, you hear wheezing, or she is having trouble eating, drinking or sleeping.

Coughing
In children, more coughs are caused by postnasal drip from a cold rather than an actual lung infection such as a pneumonia. So how do you know the difference? In general, if your child has a runny nose and is acting well between bouts of coughing, you may be able to keep an eye on him at home. Although the cough may linger for a week, if it’s getting worse after five days, see your pediatrician. If in addition to a cough, there are any signs of trouble breathing, such as wheezing or skin sucking in above and below the ribs, call your pediatrician right away. In addition, if the cough is keeping him up all night or there is associated fever, or your child looks really sick, she should be seen.

Influenza
It’s flu season. When many parents hear the word “flu,” they automatically think of vomiting and diarrhea, but the actual flu is a respiratory illness, not a stomach bug. Symptoms include high fever, body aches, sore throat, runny nose, cough and extreme fatigue. For an otherwise healthy person, having the flu is probably the worst you will ever feel. Symptoms last for about a week, but some children can get much sicker and need to be hospitalized.

The best way to protect your family from the flu is to vaccinate. The flu vaccine is now recommended yearly for everyone 6 months and older. If you think anyone in your family has the flu, see your physician as soon as possible. In certain cases your doctor may prescribe an antiviral medication to help reduce the severity and decrease the chance that the rest of your family catches the virus.

Fever
If your baby is under 3 months and has a temperature of 100.4 degrees or higher, call your pediatrician, even if it’s the middle of the night. A newborn with a fever can get very sick very quickly and needs to be evaluated.

Over 3 months, it’s usually not the number on the thermometer that matters as much as the other symptoms, such as a cough or vomiting. So, if your older infant or toddler has a fever and isn’t keeping down fluids, is having trouble breathing, looks really sick, especially after you bring down the fever with appropriate medication or if the fever has lasted more than three days, call your pediatrician.

If your child is playing and acting fairly normal, keep an eye on her for a few days and see what else develops. If her fever lasts for more than three or four days, it’s best to check in with your pediatrician.

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