The mom in the room looked exhausted. Her 3-year-old had been up all night coughing. Sick for two days, some low-grade fever, and many children in the daycare were absent. “I know it’s a virus, but isn’t there anything you can do?”
It’s a question commonly heard in any pediatrician’s office. Kids get six to eight upper respiratory infections a year, so it’s no wonder you feel like your child is sick all the time. While we wish there was a magic pill to help your child feel better, unfortunately viruses need to run their course.
Antibiotics only work on bacterial infections, and though some parents would like them just in case, antibiotics have significant downsides. Unnecessary antibiotics can lead to bacterial resistance and changing the body’s microbial balance, leading to diarrhea and possibly problems with gastrointestinal absorption.
So, if antibiotics are not an option, what is a parent to do?
It’s easy to look at all those shiny cold and flu boxes and bottles lining pharmacy shelves and be tempted to pick one up for your child. However, the sad truth is that in multiple trials, reviews and studies, these medications have been shown to work no better than a placebo. Wasting money is not the only downside — children have had fatal overdoses from using some of these over-the-counter medications.
The only medications that successfully treat the symptom advertised are acetaminophen and ibuprofen for fever reduction. However, it is very important to make sure that dosing is done correctly with measuring syringes, or even these medications can be overdosed. Above the age of 12, decongestants may provide some limited relief.
Luckily, children handle viruses well. In fact, the hygiene hypothesis, suggested by David Strachan, says that if humans are not exposed to a variety of microbes during their early years, they are at risk for autoimmune diseases and allergies.
That doesn’t make the days of watching your child suffer any easier, but there are natural ways to help them through the most annoying symptoms. Warm fluids may be soothing and help loosen and liquefy secretions. Research has shown that saline irrigation using a rinse bottle may be beneficial and results in decreased school absence. Cool humidified air may also be helpful for some children. One proven treatment is the honey in your cupboard. Honey has been shown to decrease nighttime coughing, allowing children to get the rest they need.
Unfortunately, vitamins D and C have not proved to be of value in children. The side effects of zinc, including stomach upset, limit its usefulness in children. Echinacea has not been shown to have a positive effect, and elderberry extract has some research support in adult air travelers, but no positive studies in children.
Is there anything a parent can do to help their child get better quicker? In adults, we know that obesity is related to more respiratory illnesses and hospitalizations. Given the simple mechanics of clearing secretions and ease of coughing, it would make sense that this would be the same with children. Add in the research on the increase in inflammatory factors produced by fat, and it is easy to see why healing might be compromised in people who are not making healthy eating choices.
This leads us back to the classic physician mantra that having our children eat lots of fruits and vegetables and spend time outside will lead to better health. Fruits and vegetables — all the colors of the rainbow — promote healing.
As a pediatrician, what can I say to the parent in the exam room with their sick child? Cuddle in bed next to your child and read a good book together. A warm oil massage never hurts, and tea with honey and a little sinus rinse before bed will help your child sleep more easily. Then, mark the calendar. It will be over soon.
Colds will go away in about five to seven days, although the cough may linger for an additional one to two weeks. Then you may have about two weeks before the next cold comes around.
Gwen Wurm, M.D., is a pediatrician and the director of Community Pediatrics at the University of Miami Health System. For more information, visit UHealthSystem.com/patients/pediatrics.