Index | FAQs | Immunization Chart | About Vaccines | Tis The Season | Nutrition | Online Resources

Tis The Season - Winter Woes...

With the advent of cooler weather, children’s lives tend to shift toward more indoor activities. Closer quarters inside, and cooler weather outside, create ideal conditions for transmission of respiratory illnesses and other germs. Winter is certainly the busiest season for sick visits to the pediatrician’s office. It has been estimated that the average toddler develops 5 – 8 colds per year, with the average length of illness 1 – 2 weeks. With that many infections occurring over the cooler weather months, it may seem that your child is always sick. But there are ways to help your child avoid respiratory infections…

The most important protection your child can receive is immunizations. Be sure your child’s immunizations are up to date to avoid such vaccine preventable illnesses as diphtheria, pertussis (whooping cough), and meningitis. As discouraging as today’s common respiratory illnesses are, they are not as deadly as most of the illnesses children are currently immunized against. Attending daycare in the 1940’s and 1950’s potentially could have been deadly. Vaccines have remedied that situation and made daycare and school a safer place for all of our children. But failing to properly vaccinate your child could create resurgence in these deadly infections.

Another defense against infection is good nutrition. Trying to get your children to eat a healthy balanced diet with a variety of fresh fruits and vegetables will aid the body’s natural defenses against infection. Ensuring your children get an adequate night’s sleep will also aid the body’s defenses.

Most of the common infections of wintertime are spread when respiratory secretions come into contact with mucous membranes (mouth, nose, and eyes). Frequent hand washing is perhaps the single most important method of avoiding this contact. Discouraging your child from rubbing their eyes, picking their nose, and chewing on their fingers would also help to decrease their chances of germs on their hands coming into contact with their mucous membranes. Minimizing their contact to other sick children, to whatever extent possible, is always a good idea. It is well known that children in daycare are sick more often than their peers who do not attend daycare. Although daycare has become an economic reality for many families, parents are not powerless in trying to prevent childhood illnesses in this scenario…

Choosing a daycare with a lower teacher to child ratio improves the chances that sick children could be relatively isolated, as well as creating better opportunities to supervise proper hygiene (such as frequent hand washing)! The fewer number children in a classroom, the less chance of exposure to an ill child. Wash-less disinfectants (such as Purell) are often useful in daycare settings where access to sinks and hand washing is not always immediately available. But despite everyone’s best efforts, children are bound to get sick at some point during the respiratory season. Parents need to be prepared to deal with a sick child, or have plans for alternative care. If parents are unable to leave work, finding a neighbor or family member who could temporarily watch the child, instead of sending them to daycare, would ensure better care for your child, as well as reducing the chances of spreading infection to other children. It would also help your child recover more quickly without exposure to other infectious children.

Common Winter Ailments

Upper Respiratory Infections (URI)

By far the most common respiratory infection of winter, URIs are commonly known as colds. They are characterized by cough, nasal congestion or runny nose, sore throat, mild headaches, and an initial low grade fever (100 – 102). Most colds last between 1 and 2 weeks. Because they are caused by a virus, colds do not respond to anti-biotics. Colds can lead to secondary infections such as ear infections, sinus infections, and less commonly, pneumonia. Signs that your child may be developing a secondary infection include the presence of ear pain, severe headache or facial pain, sudden worsening of the cough, chest pain, vomiting, or a fever that begins late in the course of a cold.
Bronchitis is an upper respiratory infection with a prominent cough. Most cases of bronchitis in children are caused by viruses and will not respond to antibiotics. For more information about treating your child’s cold, please consult the Frequently Asked Questions section of this website.

Influenza

Influenza, commonly known as the flu, is a respiratory infection characterized by a higher fever (101-105) than the basic cold, as well as nasal congestion, cough, headache, body aches, watery eyes, and less commonly, vomiting. Although the flu doesn’t usually last as long as a cold, it is generally much more severe, and has a higher rate of secondary infections, including pneumonia. Although there is no specific cure for the flu, there are anti-viral medications that can help shorten the course of the flu if taken early in the course of the illness. Getting an annual flu vaccine may also help prevent your child from getting the flu. For more information about treating your child’s flu symptoms, and questions about the flu vaccine, please consult the Frequently Asked Questions section of this website.

Croup

Croup is another common respiratory infection, prominent this time of year. Croup is usually caused by a virus that creates swelling in the upper respiratory tract around the vocal cords. Symptoms may include a barky-quality cough, sore throat, hoarse voice (laryngitis), and low-grade fever. Although croup may be preceded by typical cold symptoms, often the illness appears suddenly, in the middle of the night. Usually the symptoms are worse at nighttime. The cough can be very dramatic, and the child can have great difficulty breathing. It is important to try and keep your child calm in this situation, as crying and anxiety, as well as physical activity, will make these symptoms worse. Cool air and/or moist air often help the symptoms of croup, so taking your child outside or into the bathroom with steam, may help calm their breathing. Running a humidifier and keeping their bedroom cooler may also help the symptoms when they are less severe. Although there is no cure for croup, anti-inflammatory agents, such as prednisone, can help alleviate the symptoms and shorten the course of the illness.

Pneumonia

Pneumonia is a lower respiratory tract infection affecting the lungs. Pneumonia can be caused by either bacteria or viruses, and can also occur as a secondary infection of a cold or the flu. It is usually characterized by a cough and fever, but can also present with chest pain, shoulder pain, back pain, abdominal pain or vomiting. Whenever a cold or flu suddenly gets worse with a more prominent cough, or higher fever, a secondary pneumonia is a concern. Your pediatrician can usually hear a pneumonia on exam by using a stethoscope. “Gurgling” breath sounds that are heard without a stethoscope or by feeling the chest are not usually caused by pneumonia. Sometimes, the doctor may not hear the pneumonia but still suspect one based on your child’s symptoms. In these circumstances, your doctor may recommend obtaining a chest x-ray. Most cases of pneumonia can be treated with oral antibiotics as an outpatient. However, if your child is having a difficult time breathing, has a low oxygen saturation, or is vomiting and unable to keep medicine down, your doctor may recommend hospitalization with intravenous antibiotics. Another therapy often used in patients with pneumonia is nebulization therapy (or breathing treatments). Breathing treatments (identical to treatments used in asthma) can help dilate the small airways of the lung to relieve mucus trapping, and help the child expectorate (cough) these secretions.

Walking pneumonia

One unique type of pneumonia is known as “walking pneumonia” or “atypical pneumonia.” This type of pneumonia is caused by special types of bacteria that often behave more like viruses. Children with walking pneumonia may present with a chronic cough, often of several weeks duration. Typically, they do not act that sick… with only a low grade fever, or no fever at all! Although walking pneumonia can be clinically indistinguishable from viral pneumonias, it usually responds to antibiotics. Many of these children will also wheeze with their illness and require breathing treatments as well.

Strep Throat

Strep throat is an infection of the tonsils (tonsillitis) and throat (pharyngitis) caused by the Streptococcus bacteria. It is characterized typically by a sore throat and fever, but can present with headache, abdominal pain, vomiting, or pain that is referred to the ear. It is very contagious and often spreads through families and classrooms. Years ago, doctors would test for Strep by obtaining a culture of the throat. These cultures would take 2-3 days to obtain results. Recently, rapid strep tests have been developed that are as good as cultures at detecting Strep, but give accurate results in just a few minutes. Although Strep throat may have a typical appearance of white pus on the tonsils, and red spots on the palate, doctors usually rely on the results of the strep test, since some viruses are capable of mimicking strep throat in appearance and symptoms. Viral sore throats never respond to antibiotics. Strep throat, however, should be treated with antibiotics to prevent complications such as rheumatic fever.

to top