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Ten Frequently Asked Questions

My child is getting sick all the time. Is there something wrong with his/her immune system? Many children go through a phase where they have a fever every month, or have one illness after another for months. This is a natural phenomena when a child starts nursery school. Children typically get 6-8 respiratory viruses per year, but those in day care get 30% more illness. A respiratory virus can easily last one to three weeks. As one is on the wane, the child can be exposed to another. Also, certain illnesses associated with a high fever, such as Roseola, make the child more likely to respond with a high fever if they get exposed to another virus within a month. This is because the immune system had mobilized lots of T cells with the first illness, and they can still be circulating and ready to “gear up” quickly when confronted by another virus. The child can be visiting the pediatrician every month with a ‘new fever’. Also, some illnesses, such as measles, mononucleosis, influenza, are known to mildly suppress the immune system, making the child more prone to coming down with another illness.
My child has a barky cough. What should I do? Many viruses cause a honky, barky cough. When the vocal cords and upper trachea are affected by a virus, the cough becomes more squeaky and the child has “croup”. With croup, the child makes a squeaky sound as he/she breathes in. It can be very scary for parents. The child often awakens in the middle of night with the characteristic squeaky or barky cough. It is very common and usually treated at home, but children with severe croup are seen in the ER. For more info, see the article on this web site Croup, and visit www.aap.orgwww.AskDrSears.comwww.familydoctor.org .
We are going to visit relatives and someone in the family has a cold. Should we go? Most colds are spread by hand contact and respiratory droplet. If you have a newborn, or child with an underlying medical problem, it is critical that no one touches the baby unless they wash their hands. Alcohol based hand sanitizers inactivate most respiratory viruses. It is important for the infant to be kept in a well-ventilated, non crowded area, and about 3 feet away from others, especially toddlers, preschoolers who might not be sick, but could be incubating a cold. Read the articles on Contagiousness of Childhood Illness, Grandparents Guide to the holidays.
My baby has a cold, what should I do? Your baby might have been exposed to a respiratory virus and having increased nasal congestion. As phlegm trickles down the back of the throat, cough receptors are activated. The best thing for a cold is fruit, juices, especially cranberry, and rose hip tea. Vitamin C containing foods help keep secretions loose and less prone to secondary bacterial infections. If a child is having a hard time falling asleep because of nasal congestion, an antihistamine such as benadryl can be given. An over the counter decongestant like Dimetapp, Triaminic or Pediacare can be given. Most over the counter decongestants contain phenylephrine HCl and brompheniramine maleate. They should not be used throughout the day – in that they can make some children slightly hyper. Most over the counter cough medicines contain dextromorphan and/or guanifeisin. They help a cough by loosening secretions. You can find the doses on the article on this web site on Over the Counter Cough and Cold Medicines. Also, visit the web site of the American Academy of Family Physicians: www.familydoctor.org or AskDrSears.com.
Can I get sick from a flu vaccine? No, the flu vaccine has no active virus. It contains proteins on the outer surface of three different flu strains. There are a few adults who report feeling “under the weather’ after a flu vaccine. It is thought that they might be responding to the immune stimulation, and perhaps the adults had already had one of the strains present in the vaccine. Children don’t seem to have any reaction to flu vaccines, because they have a large background of influenza antibodies, and don’t seem to experience this at all.
Can I get a flu vaccine if I have a cold? Yes, as long as the child is not having a fever, or is in midst of a new illness, i.e. vomiting, sore throat. When a child has a respiratory virus, he/she can be congested for weeks. During this time, he/she may receive vaccines, including the flu vaccine.
Tamiflu? Should I have a prescription? NO. Resistance of the influenza to Tamiflu can rapidly rise if people use it unnecessarily, making it ineffective when a patient really needs it. Children have such a strong immune system, and rally against flu rapidly. Using Tamiflu on them could propel more community resistance. If a child had an underlying illness, or other extenuating circumstance, our practice does not give Tamiflu. There were recent reports of children in Japan having some “confussional” states after being it. I read the news release but haven’t read anything in pediatric journals about it.