The Cold and Flu “What to do” – Kid’s Edition
When flu season hits, I know its all we can do to try and keep our kids healthy. But many times, regardless of how much hand sanitizer you have stashed in your bag, the bugs find their way into your home.
It’s not always easy at first to tell if your child has the flu (influenza*) which comes on fast and is more intense than a cold (colds generally do not result in serious health problems.)
Infants less than 3 months old have immature immune systems. Some immunity is acquired from mom in utero, and even more through breast milk. However, newborns have had no previous exposures to trigger their own antibody response* (defense mechanism). Additionally, infants cannot effectively localize an infection. Infants less than two to three months of age are at high risk for becoming ill. After three months of age, children begin to develop their own protection against infection.
For this Blog, let’s take a closer look at two common Pediatric Viral Infections that our kids are likely to come in contact with:
RSV – Respiratory Syncytial Virus
RSV stands for Respiratory Syncytial Virus, and it’s very common in infancy and early childhood. In fact, RSV infects almost all children by the age of 2 years! Up to 40% of young children with their first RSV infection will develop noticeable wheezing, and up to 2% will require hospitalization. RSV tends to be milder in older kids and adults.
In premature babies (preemies) and in babies with certain lung conditions or congenital heart disease, RSV can be serious and cause infection of the lungs. If your infant is infected with a mild case of RSV, his/her infection will usually get better on its own, though your doctor may recommend treating symptoms such as fever. RSV infections tend to happen from fall to spring. If the RSV infection is becoming more serious and possibly spreading throughout the lungs, symptoms can worsen.
Croup refers to an infection of the upper airway, which obstructs breathing and causes a characteristic barking cough. Croup is an infection of the throat and vocal cords. It can be caused by several different viruses. If breathing becomes severely impaired, hospital treatment may be needed. However, most kids get better on their own in about a week. Croup is most common in children under 5. When children younger than 5 years of age have the infection, it’s called croup. In older children, it is called laryngitis.
Inflammation in the airway (swollen vocal cords) produce a noise similar to a seal barking when a child coughs. Likewise, taking a breath in can produces a high-pitched whistling sound (known as stridor*). In most cases, croup sounds worse than it actually is and will clear up on its own within 5 to 7 days. In severe cases, your child’s breathing can become difficult and they will have to be treated in hospital.
Viral infections or Influenza will cause similar symptoms such as:
- Coughing and sneezing
- Fever and chills
- Inflammation of airways (chest discomfort)
- Vomiting and diarrhea
- Aches and cramping
- Difficulty feeding/drinking leading to dehydration
It’s important to be aware of these symptoms in order to monitor and treat our kiddos at home. Additionally, the ability to recognize when symptoms are progressing to a point where you should seek medical attention is vital.
Influenza SYMPTOM Awareness
A major sign of viral illness is a high temperature. Taking your child's temperature under their arm with a digital thermometer is the easiest and safest way of checking to see whether temperature is normal.
Take your child’s temperature when they:
Feel warm to the touch or are flushed
Are more irritable than usual
Aren’t eating or drinking well
Have abnormal sleeping patterns (less or more than usual)
Have diarrhea or is vomiting
Appear or act sick
A normal temperature taken under armpit is between 36.5 °C and 37.5 °C
It is important to note that this is a “textbook normal” range and it is advisable for you to know YOUR child’s ‘normal’ by taking their temperature when they are healthy; A degree higher than their normal is considered a fever.
Infants younger than 6 months old with a fever need to be seen by a health care provider because they can become dehydrated very quickly.
Children over 6 months old need to see a health care provider if the fever doesn’t go down with recommended treatment or if it lasts more than 72 hours.
--> Give Acetaminophen (Tylenol) or Ibuprofen (Advil) to treat high fever or discomfort. Ibuprofen should only be given if your child is drinking reasonably well. Do not give ibuprofen to babies under 6 months without first talking to your doctor.
--> Give child a lukewarm bath for 20 minutes to help bring down temperature. Do not bathe in cold water as this can be extremely uncomfortable for them.
Coughing and Congestion:
The FDA has advised that children under age 2 not receive any cough or cold medications. Cough suppressants can actually be dangerous for young children. If a child is coughing so frequently and so hard that he or she is unable to sleep, there is likely more going on than a cold, and the underlying cause needs to be treated.
--> Use a cool-mist vaporizer to keep the air moist (clean it daily with household bleach or vinegar to discourage mold and bacteria growth)
--> If your child is uncomfortable and too young to blow his or her own nose, use a nasal aspirator and saline to remove sticky nasal fluids (Infants are primarily nose breathers)
--> Cool air can help "shrink" the swollen tissues in the upper airway which can make their breathing more comfortable and reduce coughing
Babies and younger children are at greater risk of dehydration because a greater percentage of their body weight is water. Additionally, Infants have a decreased ability to concentrate urine due to their immature kidney function- meaning that they are unable to hold on to water stores.
Watch for dry, cracked lips and a dry mouth, a decrease in urine output or no urine for eight to 12 hours, or dark-colored concentrated urine. Drowsiness, low energy levels or irritability may occur. Children may appear paler or have cool dry skin. Be concerned if a child has no tears when crying or sunken eyes. On infants check for a sunken soft spot (fontanel) on top of their head.
--> Provide plenty of fluids - offer fluids in small amounts more often. Consider electrolyte replacements drinks or juice if tolerated.
Prevent the Spreading of Germs…
A virus is spread by any physical contact such as touching, kissing or shaking hands with an infected person. The virus is also spread through the air when an infected person sneezes or coughs. A person can be exposed to a virus and give it to others without even knowing it.
Frequent hand-washing is the most important. Also keep your child away from anyone who's sick, and encourage your child to cough or sneeze into his or her elbow.
When disinfecting your home, make sure to focus on areas that are frequently touched by everyone at home. In the home, these surfaces consist of cupboards, drawers, taps, light switches, door knobs, remote controls, cell phones, the fridge door and toys. Be aware that influenza can remain infectious on surfaces for up to 24 hours.
To stave off more-serious infections, keep your child's vaccinations current. Children over 6 months of age should get a flu shot each year. AHS Immunization Schedule
There is research to support the use of anti-viral foods that may help reduce infection rates such as Citrus fruits, Cabbage family, Carrot family, Tomatoes, Whey, Ginger, Echinacea, Cinnamon, Habanero Peppers, Coconut, Organic Apple Cider Vinegar, Raw Onions, Garlic, Horseradish Root, Honey, Walnuts, Blackcurrants, Pomegranate and other antioxidant rich fruits. These foods are shown to build up the immune system in hopes that you will be less likely to become ill or better at fighting off illnesses. However, this is not the solution for treating illness when children become severely ill.
Additional at Home Considerations
- Make child as comfortable as possible, rest rest rest!
- Cough may become worse when children are excited, upset or overly active.
- Allow time for recovery
*Antibiotics are NOT used to treat RSV or Croup because they are caused by a virus and not a bacterium. Antibiotics are only capable of treating bacterial infections and are not effective in the treatment of viral infections.
*Aspirin should NOT be used in children for any reason; such use has been associated with Reye Syndrome, a life-threatening disease effecting the brain and liver.
When to Seek Medical Attention
You should see a doctor if your child …
- Makes noisy, high-pitched breathing sounds (stridor) when inhaling and/or exhaling
- Begins drooling or has difficulty swallowing
- Seems anxious and agitated
- Becomes fatigued, drowsy and listless
- Breathes at a noticeably faster rate than usual
- Has a hard time lying down flat due to difficulty in breathing
- Develops blue or grayish skin tone around the nose, mouth or fingernails
- Has a high or persistent fever or a mild fever for more than 72 hours
- Is younger than 6 months and has a fever
- Persistent pain, such as an earache, sore throat, severe headache, or stomach ache
- Eye discharge that is thick, sticks the eyelids shut
- Is frequently vomiting or having diarrhea
- Is not able to keep down enough liquids to produce urine every 6-8 hours
- Has a stiff neck
- Seems to be getting worse rather than staying the same for more than a few days
- Known exposure to a contagious illness, such as mononucleosis (mono), influenza, chickenpox, or has traveled out of the country recently
Regardless of how hard we work to prevent viral illnesses, chances are your children will come into contact with germs that make them sick. Recognizing the symptoms early can aid in recovery and at home treatments are always the first step in helping your young ones recover quickly. Identifying when symptoms have progressed to the point where you should seek medical attention can not be stressed enough. If unsure, dialing 811 is a great resource to help you decide whether or not you should bring your child in to see a physician.
Antibody Response: the body’s ability to create antibodies to fight off foreign and potentially infectious antigens (germs)
Stridor: describes the high-pitched, wheezing sound caused by upper airway narrowing or obstruction
Influenza: commonly known as "the flu", is an infectious disease caused by an influenza virus
Disclaimer: The content of this blog, although cited and referenced, should be considered a matter of opinion. The content provided on these pages is not intended to replace medical advice. If you have concerns about the health of your child, call 811 and contact your health care provider directly. If your child has an emergency, go to the nearest emergency department or call 911. Cochrane Emergency Training Services strives to ensure that all material is correct and will not be held liable for errors or incomplete information contained in these pages.
Related CETS Blog Posts:
Tylenol Vs Advil:
Tik Tok it’s time to Talk Ticks:
Seasonal Allergies, Antihistamines and Decongestants:
Written by Chelsea Mann
Thank you for taking the time to check out the blog! I am a Pediatric ICU Registered Nurse and an owner of Cochrane Emergency Training Services (CETS)
CETS is a First Aid and CPR training company offering mobile in-home training as well as courses open for public registration.
CETS’ offers a specific 4-hour Child and Infant Health + CPR course.
Participants of this course receive a full Heartsaver CPR certification through the Heart and Stroke Foundation Canada that covers Infant, Child and Adult CPR/AED training and Choking Resuscitation; Valid for 1 year.
Additional Child and Infant Health + CPR course content developed by CETS includes:
Child and Infant Health Considerations for Airway, Breathing and Circulation
Treatment of Common Viruses
When to Seek Medical Attention
Social Media: @cets.firstaid
Reaching as many parents and caregivers as possible with this course content is something I am very passionate about. I find this to be the most rewarding class to teach! Please feel free to contact us if you have any questions or are interested in booking a private course. Dates for public registration in Cochrane are also available on our website.
- Website: https://resuscitation.heartandstroke.ca/guidelines/position/CPR
- Heart and Stroke Foundation BLS Manual, 2015 Canadian resuscitation & First Aid guidelines
- Heart and Stroke Foundation Heartsaver Manual, 2015 Canadian resuscitation & First Aid guidelines
- Heart and Stroke Foundation Standard and Emergency First Aid, 2015 Canadian resuscitation & First Aid guidelines
- Alberta Health Services, August 2015 Health Professions Strategy & Practice
- Dosing Information Source: Canadian Immunization Guide (2014)