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Ask the Pediatrician: Cold and flu season tips

Lanre Falusi, MD, MEd, FAAP, American Academy of Pediatrics on

Published in Health & Fitness

In most parts of the U.S., fall marks the start of cold and flu season. This means kids will face higher risks of getting sick. Respiratory viruses are usually the culprit and the symptoms they cause can make your child feel miserable.

What can you do to ease aches, sniffles and fever so your child can get better? Here's a closer look at the viruses that cause colds and flu and helpful tips for treating your child at home, mostly without medicines.

The viruses that cause colds and flu thrive in cold, dry air. This might explain why there's a distinct season when we're more vulnerable to them. Fall and winter are often considered prime times for colds and flu, but some viral illnesses surge in the spring, too.

Most colds are caused by rhinoviruses, which can lead to sneezing, sniffling, cough, stuffy, runny nose, headache, body aches, sleepiness, sore throat, watery eyes, chills and a low-grade fever (around 99.5 to 100.3 degrees).

Kids with infections triggered by non-polio enterovirus or adenovirus might have some of these symptoms, but may also experience diarrhea, vomiting, nausea, stomach pain, eye redness and skin rash.

Is it the flu?

Influenza—or "flu" for short—is triggered by a virus that infects the nose, throat and lungs. Two main kinds of flu virus (A and B) cause seasonal outbreaks of flu each year.

If your child has seasonal flu, they might experience cough, sore throat, runny or stuffy nose, muscle and body aches, headaches, tiredness, vomiting, diarrhea and fever or chills though not every case of flu triggers fever. These symptoms can also be caused by human parainfluenza virus, which may trigger extra troubles like ear pain, irritability and decreased appetite.

Colds and flu are common in childhood, partly because your child's immune system is still developing. In most cases, time is the best treatment. In the meantime, here are some simple ways to keep your child comfortable while they get well.

Consider a fever reducer. Not every fever needs to be treated, but if your child can't sleep, acetaminophen or ibuprofen can help. Keep the right formula for your child's age on hand—chewables, liquid or infant drops. Follow the package directions carefully to make sure you're giving the right dose. If your child can't keep food and liquids down, a suppository may help. Never give your child aspirin for fever or pain, since it can seriously harm their health.

Keep your child hydrated. Kids fighting colds or flu need plenty of fluids, especially if diarrhea and vomiting are involved. Electrolyte drinks can help restore the minerals your child's body needs. Once they're able to keep food and liquids down, you can switch to plain water. Warm liquids like hot water with lemon, broth and caffeine-free tea are a double remedy, since they replenish fluids and ease sore throats.

Relieve sniffles without drugs. Little noses will feel much better after you gently clear away congestion with a bulb syringe or nasal aspirator. Saline drops, sprays and mists or rinses are often part of this therapy and can be used on their own to help clear nasal passages. These remedies are safe to use multiple times a day.

 

Reach for honey instead of cough syrup. There are many over-the-counter medicines to treat a child's cough, but health experts point to the benefits of honey for children over 1 year old. This simple treatment works by soothing your child's throat and coating cough receptors. Dissolve a half to full teaspoon of pasteurized honey in a warm liquid for your little one to sip. Older children can take honey directly from a teaspoon every 2 hours. Make sure your child's teeth are brushed afterward to avoid tooth decay, especially before bedtime.

Add a cool-mist humidifier. Keeping the air in your child's space humidified can relieve a stuffy nose while easing dry coughs. Cool, moist air can also thin congestion and makes it easier to cough up.

Try mentholated vapor rub to ease nighttime symptoms. This is a time-tested way to relieve aches and pains and relieve coughs, especially at night. Menthol—the scented, cooling ingredient in the rub—helps open nasal passages so your child can breathe easier. Apply the rub to your child's chest, leaving clothing loose so the vapors reach their nose and throat while they sleep. It's safe for children who are at least 2 years old.

Most kids recover from colds within 7 to 10 days. Flu might pass more quickly, often within 5 days. But since these illnesses are very contagious, kids should not go to school, community events or play dates until vomiting and diarrhea pass, cough is improving for at least 24 hours, and they have been fever-free for at least 24 hours.

Keep a close eye on your child when cold or flu symptoms show up, especially if your child has asthma or a history of breathing problems such as bronchitis or pneumonia. Kids with weakened immune systems or those taking oral steroids should be watched more closely, too. Take the child to the emergency department if they can't stay awake, are too weak to move or stand, are struggling to cry/speak or are gasping for every breath or have severe wheezing.

Reach out to your pediatrician if the child experiences severe vomiting or diarrhea for more than 8 hours, stomach pain when not vomiting, a fever of 104 or higher or fever of 100.4 or higher in a child under 3 months of age, a fever of 5 or more days, quickened breathing or significant breathing struggles, a blue coloration to the lips/face or a lack of urination or other signs of dehydration.

Babies under 12 months may need a doctor's care if they vomit after two or more feedings (aside from normal spit-up), struggle to breathe or have loose stool that lasts more than a day. If you're worried, don't wait—call your pediatrician for help.

Cold and flu symptoms can also be signs of more serious illnesses such as COVID-19 or respiratory syncytial virus (RSV) so when in doubt, contact the child’s pediatrician for help.

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Lanre Omojokun Falusi, MD, MEd, FAAP, is a pediatrician in Washington, DC. She is a member of the American Academy of Pediatrics (AAP) Councils on Community Pediatrics, Communications and Media, and Immigrant Child and Family Health. Dr. Falusi is also past president of the District of Columbia AAP chapter and serves on the AAP Committee on Federal Government Affairs.


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