Its Back to the Basics for Fighting Childrens Cold, Flu Symptoms Safely

The headlines alone are enough to make any parents head spin: Cold Meds Send 7,000 Children a Year to the ER, FDA Warns Cold Drugs Are Too Risky for Babies, and Flu Drugs Causing Problems in Kids.  But then add such alarming reports as Common Cold Virus Turns into a Killer, Flu Deaths Associated with Staph Infections Increase Five-Fold Over Last Year, and Flu Shot Might Not Help, and parents are left both worried and wondering how best to protect their children during cold and flu season. 

Recent concerns about the safety and effectiveness of childrens over-the-counter cough and cold medicines, coupled with reports of virulent cold and flu viruses, have prompted many questions from worried parents, said AmericanCollege of Emergency Physicians (ACEP) president Linda Lawrence, MD, FACEP. Parents want to know how to make their youngsters feel better, and how to tell the difference between a simple cold or flu virus, versus a serious illness that requires emergency medical attention.

Each year, flu-related symptoms are among the top five causes of emergency department visits with the Centers for Disease Control and Prevention (CDC) attributing more than 5 million visits to fever and 3.3 million visits to cough nationally in 2005. In addition, this year the CDC is reporting that nearly half of reported flu cases are being caused by strains that are resistant to the flu vaccine and to the antiviral drug Tamiflu. As of Feb. 2, widespread flu activity was reported by the CDC in 31 states, up from 11 the week before.

An added complication this year is a new Food and Drug Administration (FDA) warning advising parents not to give over-the-counter (OTC) cough and cold medications to children under age 2 (with possible further restrictions in children up to age 6), and a study published in the journal Pediatrics, which found that 7,000 children a year wind up in the emergency department after taking cold medications. Meantime, other studies have questioned the effectiveness of cough and cold remedies in general.

So, what patient-care options are left for concerned moms and dads?

Were back to relying on the basics, while also asking parents to monitor for symptoms of more serious illness, said Lawrence.

While most cold and flu cases last about a week, parents should call a doctor if the child has serious cough or fever symptoms that get worse (or get better then suddenly worsen), or if he or she exhibits any of the following:

-- severe dehydration

-- fast or difficult breathing

-- bluish skin (or gray for darker complexions)

-- not awakening or interacting

-- a fever greater than 102 Fahrenheit for more than a few days, or that is accompanied by a rash

-- a cough that produces discolored mucus

-- in infants, extreme irritability and aversion to being held.

Other symptoms that warrant immediate medical attention include a stiff and painful neck with severe, persistent headache, fever, confusion and possible vomiting; seizures; or a severe earache. In addition, sick children who also have chronic medical conditions, such as severe asthma or cystic fibrosis, may require hospitalization.

As for treating colds and the flu, Lawrence advises using fever and aches-and-pains-reducers, such as acetaminophen or ibuprofen. (Infants under 6 months should not receive ibuprofen. Do not give children under the age of 18 aspirin or other salicylate-containing medications; these medications can cause Reyes Syndrome, a potentially fatal illness. Also, for breastfeeding mothers, avoid taking medications that should not be given to babies since they can be passed on through breast milk.)

In addition, its important to keep the child warm, comfortable and hydrated. Babies should be nursed or bottle-fed often. Breast milk is generally best because it contains germ-fighting antibodies. And children should be given plenty of water and other beverages. Cold and frozen liquids, such as sorbet, help soothe sore throats, and hot beverages, such as soup and tea, have natural decongestant and anti-inflammatory properties. Caffeinated beverages should be avoided because too much caffeine can lead to dehydration.

A mixture of honey and lemon in hot water or (herbal or decaffeinated) tea also helps, as does mint although honey should not be given to children under age 2 because of botulism concerns, said Lawrence. Honey helps coat the throat, while the acidity in lemon juice breaks up mucus. And mint desensitizes nerves that get irritated by frequent coughing.

Other ways to help kids get through the week or so of misery associated with colds and the flu:

-- Use steam from a bath, shower or a humidifier to loosen mucus and clear up clogged nasal passages.

-- Keep the head elevated above the heart to decrease congestion and aid with sinus drainage. For best results, place an extra pillow under the head or under the mattress (especially in the case of infants).

-- Squirt saline (either a homemade or OTC preparation) into the nose to keep nasal passages irrigated.

-- Apply cold or hot compresses to congested sinus areas.

-- Dispense sore-throat lozenges, which help stimulate antibody-rich saliva and relieve sore, scratchy throats. (Children under age 3 should not be given cough drops because of the possibility of choking.)

-- Gargle using a teaspoon of salt dissolved in warm water, or a mixture of one teaspoon of honey (for children over age 2), one tablespoon of lemon and two cups of hot water, cooled to room temperature.

-- Give strict stay-at-home bed-rest orders. Getting lots of sleep and relaxation is the best way to help the immune system fight off nasty invaders. And staying home when sick prevents viruses from spreading.

-- Prevent the spread of germs to others through frequent handwashing and disinfection of surfaces, and by sneezing or coughing into tissues or the crook of ones arm at the elbow. (Also, avoid touching mucous membranes.)

-- Dab mentholated ointment (containing menthol, eucalyptus and camphor) around the base of the nose to help open up clogged nasal passages and soothe raw, red nostrils.

-- Avoid air travel. The changes in air pressure during takeoff and landing can cause a broken eardrum, especially in babies. If flying is a must, administering saline to the nose, chewing gum (if the child is old enough) and drinking a beverage prior to reaching cabin pressurization (at 10,000 feet) can help.

-- Get vaccinated. Experts note that the flu vaccine still works against at least half of the flu viruses currently circulating in the Northern hemisphere, and it also still has some degree of effectiveness even against strains that are showing resistance to it. (Those cases are more likely to be milder, in other words.)

Source: ACEP