Read more about the author, Akiko Hall, MD, MPH or call for an appointment: (425) 412-7200 .
As published in the Greater Bothell Chamber of Commerce newsletter
Labor Day has come and gone, the kids are back in school, and that lovely liquid sunshine, which folks in other parts of the country call “rain,” has come back to grace us. Yes, fall is here, which means settling back into the comfortable routine of days marked by the ringing of school bells. It also means cold and flu season lurking just around the corner.
Every parent dreads their child getting sick, even if it’s “just” a cold. At best, you have a child not feeling well, not eating or sleeping well—a child missing school and parents missing work. At worst, a cold occasionally develops into something more, requiring a visit to the doctor and medical attention. What’s an overworked, sleep-deprived parent to do? Well, here are some facts and practical tips to help keep your family healthy this cold and flu season.
First, a little primer. Colds and flu are caused by viruses, not bacteria. Viruses are one type of germ that infects cells and makes us ill. Here are some common illnesses from viruses:
- Head cold. Many colds are caused by rhinoviruses. Rhino means nose in Greek, so these are viruses that infect the nose. We get runny and stuffy noses when we have colds because that is where the virus is setting up shop.
- Stomach flu. Rhinoviruses are actually one of a group of viruses called enteroviruses. Entero means intestine in Greek. These viruses infect our gastrointestinal tract, causing sore throat, nausea, vomiting or diarrhea—an illness some people call the stomach flu.
- Influenza. A stomach “bug” is different from the actual flu, which is caused by the influenza virus. Influenza comes from the Italian word for influence of the stars. In medieval Europe, people thought outbreaks of colds and flu were caused by the movement of the stars.
Ok enough of the etymology lesson, and back to the topic at hand!
Today, of course, we know that colds and flu are caused by viruses, not the movement of stars. In fact, hundreds of different viruses can cause cold and flu-like symptoms, making us feel lousy. Some of the discomfort we feel is the direct effect of the virus on our cells; some is the effect of our bodies’ immune systems fighting off the virus. Unlike bacterial infections, which can be treated with antibiotics, there are no medicines we can take to kill the viruses that cause colds and flu. We have to rely on our immune systems to do that job for us. What we can do is protect ourselves from getting infected in the first place. If we do get sick, we can treat the symptoms and help our immune systems do their job.
So, how do you protect yourself and your kids? Hand washing, hand washing, hand washing! Cold and flu viruses are not airborne. You can’t catch a cold just by being in the same room as someone who’s sick. You generally have to come into direct contact with their oral or nasal secretions. So, if someone with a cold sneezes into their hand and then pushes open a door with their virus-covered hand, and minutes later your child pushes open the same door and then eats a sandwich—she just ate a virus sandwich.
Good hand washing is the key to helping reduce the spread of cold and flu viruses. Teach your children to wash their hands frequently with soap and water—and always before eating, after using the restroom and after being in a public place. Regular soap is fine; antibacterial soap isn’t necessary because colds are caused by viruses not bacteria. Hand sanitizer works too, although soap and water is better, if available. Children can also help stop the spread of viruses by coughing or sneezing into a tissue or into the crook of their elbow instead of into a bare hand. When someone in the family is sick, avoid kisses (hugs are okay) and avoid sharing food, drinks, utensils, washcloths, toys, etc.
Helping Our Immune System
What else can you do to help prevent infection? Immunizations are important. Some routine immunizations prevent diseases from days gone by, for example polio, which is now virtually eradicated thanks to widespread vaccination. Other vaccine-preventable diseases such as pertussis (whooping cough) are alive and well in the community today, appearing as a bad cold in older children and adults, but potentially deadly to infants. Make sure you and your children are up-to-date on all your routine immunizations (particularly DTaP and Tdap—the ‘p’ is for pertussis).
The flu vaccine is another way to protect your kids and yourself this fall and winter. This year’s vaccine protects against both the seasonal flu and H1N1 (“swine”) flu. Everyone over the age of 6 months can get a flu shot. Most over the age of 2 years can get the nasal spray version. Talk to your doctor or pharmacist about eligibility requirements. Sure, with a flu shot your arm may hurt for a few hours or so—but it’s better than fever, chills, cough and body aches for a week or more!
And finally, to keep your family in tip-top shape this cold and flu season, make sure everyone is giving their bodies the resources they need to fuel their immune systems. What this means is good food and good sleep.
Good food translates into some protein, some carbs, not too much fat or sugar, and plenty of fruits and vegetables. Protein is needed to rebuild cells in our bodies; carbs are our major energy source. Fruits and vegetables are key because that’s where we get many essential vitamins, minerals and antioxidants. These naturally occurring chemicals help with many important functions in our bodies, including keeping our immune systems strong. Try to aim for at least five servings of fruits and/or vegetables a day. A multivitamin as supplement is okay, but shouldn’t be seen as a replacement. Avoid megadoses of any vitamin.
As for sleep - although in some ways still a mystery to researchers - we do know that good sleep is important for immune function. Studies have shown that sleep deprivation leads to an impairment in immunity, including fewer white blood cells (our bodies’ main cellular defense against infection) as well as fewer antibodies (one of the weapons our white cells use to fight germs). Although every child is unique, in general toddlers/preschoolers need about 11-13 hours of sleep a night, young school-age kids 10-11 hours, “tweens” 9-10 hours and teens 8-9 hours.
Treating a Cold or Flu
So, you wash until your hands are red, have gotten everyone their shots, have everyone eating their broccoli and in bed on time—and still someone in the family gets a cold. Despite our best efforts, we all will catch a virus at some point, kids more often than adults. While adults typically get 2–4 colds a year, kids average 6–8. Although you can’t take an antibiotic to make the cold go away, you can help manage symptoms and support the immune system in doing its job.
Headache, body aches and fever in older infants and children can be treated at home with acetaminophen (Tylenol) or ibuprofen (Motrin, Advil). Be sure to check on the proper dosing and how often the medicine can be given. Fever is a sign that the immune system is working hard. Although not necessarily dangerous, a fever can be uncomfortable for a child. If a fever greater than 100 degrees lasts longer than 2-3 days, however, it should be checked out by your doctor. And for ANY fever in a baby 2 months or less, you should always see your doctor.
Avoid combination cold medicines for kids that might contain two, three or even four different medicines in addition to acetaminophen/ibuprofen. Most of the extra medicines have unwanted side effects and aren’t very effective in children anyway. In a randomized controlled trial, cough medicine was no more effective than honey in treating coughs in children, but had significantly more side effects. (Note that you should never give honey to kids younger than 1 year.) Other symptomatic relief can be found with nasal saline drops for infants and nasal spray or saline rinse for older children.
Other than that, stick with the tried-and-true advice we all received growing up: rest and drink plenty of fluids. When your child is sick, his energy reserves are all going to his immune system to battle that nasty virus. He’s going to be tired and should rest so that his body can preferentially spend what energy it has on healing. He may not feel like eating much with his body’s priorities so shifted; it’s okay to eat a little less for a day or two; just make sure he’s drinking enough to stay well-hydrated.
Keep your child home from school until the fever has subsided and he’s feeling better. A mild cough and/or sniffles may persist for several days. It’s okay to go back to school as long as he’s generally feeling back to his usual self. And, of course, he should still practice good germ-control techniques, just in case there are still a few transmissible viruses lingering in his oral or nasal secretions.
So that’s it: wash hands, get your shots, make good food and sleep a priority, and if someone does get sick, stay home to rest and get better. With these practices, hopefully we can all stay as healthy as possible this cold and flu season.
Dr. Akiko Hall is a pediatrician at PacMed’s Canyon Park clinic location. She received her medical degree from the University of California in San Francisco, and she did her training at Seattle Children’s Hospital. Click here to learn more about Dr. Hall.