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Weathering Cold, Flu Season

Cold & Flu Tips

Let your child’s behavior be your guide

With the cooler weather upon us, the threat of colds, coughs and flu is here, too. The good news is that for the vast majority of children, these are self-limited illnesses that run their course in a week or so – and only need a lot of TLC.

So what do you do when your child starts to have congestion and a runny nose? First, it should be emphasized that colds are caused by viruses and there are more than 200 strains that can infect your child. That’s why children may have six to 10 colds a year, even more if they are in day care.

Second, because colds are caused by viruses, there is no cure. Antibiotics don’t help at all. Thankfully, colds are benign. While they can cause some discomfort for your child and you, they aren’t serious. A typical cold lasts seven to 10 days. Symptoms include congestion, sneezing, nasal discharge, sore throat, cough, fever, headache, fatigue and body aches.

There are plenty of misconceptions about colds that make parents worry and think their children have a more serious condition. First, many people think that a fever is bad. Actually, fever is our bodies’ response to infection. It is helpful and good. Some of our immune responses to infection are enhanced by a higher body temperature, so fever, by design, is beneficial. And since our body temperature can range from 97 to 100.2 on a normal day, pediatricians only consider a body temperature above 100.5 to be a fever. Also, our body temperature is highest from 5-6 pm. So, if you check your child’s temperature from the time they come home from day care or school to around suppertime; expect it to be higher than the normal 98.6.

Remember that fever itself is not a disease. It is simply a symptom that your child has an illness.

So when do you want to treat a child’s fever? The point is not to treat a number, but rather to give a fever reducer based on your child’s behavior. If she has a fever of 102, but is fairly active, she doesn’t need any medication. However, if she obviously looks miserable and is just lying around, then giving a fever reducer to make her feel better would be appropriate.

One quick note about thermometers; those that measure temperature from the ear canal or forehead are not particularly accurate, especially at higher temperatures. So if your ear thermometer gives you a reading of 105, it may not be a true reading. The best way to measure a temperature is to take it either orally or rectally.

A second misconception concerns the nasal discharge your child may have. In a typical cold, the nasal discharge begins as clear, then becomes cloudy, and may even turn yellow or green. This is normal and does not mean that the child has a bacterial infection that needs antibiotics.

If you feel the symptoms of nasal discharge and coughing are significantly affecting your child, especially during sleep at night, call your pediatrician and ask for advice on what over the counter preparations might provide some temporary relief until the cold passes.

So what do you do for your child when she has a cold? Making your child comfortable is most important. If she has a fever and looks miserable, then give a fever reducer. Providing lots of fluids to drink also is very important, especially if your child has a fever. You can gauge how well your child is drinking by how often they urinate. If it’s significantly less than usual, then have them drink more fluids. For infants and small children, clear their nose of mucous with saline drop s. Older children can use saline nasal rinses. This will help them feel better and significantly reduce the coughing, which is often due to the dripping of mucous down the back of the throat.

When do you need to call your pediatrician or make an appointment to be seen? The easy answer is if you feel your child seems to be getting worse or is developing different symptom. If your child’s fever is consistently high, around 104, if the cough is so disruptive that your child is unable to sleep; if your child complains of significant ear pain, if your child refuses to swallow and is drooling; or if your child is lethargic and not able to ‘recover’ after a long nap, these can be symptoms of the flu, pneumonia, an ear infection or another serious illness. However, keep in mind that most children will recover fully and be up and running in no time.

For most people, the flu is no more than a bad cold, but with a headache, muscle aches, higher fever and intestinal symptoms, such as vomiting and diarrhea. Symptoms usually improve within four to seven days, though for some, the cough may last two to three weeks. Treatment is usually geared toward improving the symptoms. For fevers, acetaminophen or ibuprofen may be used and saline nose-drops may be given for nasal congestion.

Ask your physician for advice regarding the use of an antiviral agent and whether it is appropriate for your child. In general, the Centers for Disease Control only recommends using antiviral agents for those who are hospitalized or who are at significant risk of developing complications from the flu, such as those with significant underlying heart or lung illnesses. Thus, most healthy children do not need to be treated.

If you or your child is sick with a flulike illness, the CDC recommends you stay home for at least 24 hours after your fever is gone, except to receive medical care or for other necessities. Your fever should be gone without the use of a fever-reducing medicine. While sick, limit contact with others as much as possible to keep from infecting them.

Of course, there are simple yet effective ways to help weather flu season. Careful hand washing is of paramount importance. Wash hands often with soap and water, and if soap and water are not accessible, use an alcohol-based hand sanitizer. Avoid touching your eyes, nose and mouth, as germs spread this way.

Cover your nose and mouth with a tissue when you cough or sneeze and throw the tissue in the trash. Sneeze into your elbow to avoid spreading the germs. Try to avoid close contact with sick people.

Get vaccinated. Many people ask: what is the right time to get the flu shot? The answer is now. According to CDC, every person 6 months and older is recommended for annual influenza vaccination.

Seasonal flu vaccines have a very good safety track record. Be sure to consult with your primary care provider for further information.

Charles A. Welborn, MD, MPH, FAAP, FACEP, is medical director for After Hours Pediatrics Urgent Care. Visit for locations and hours.

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