Influenza season is upon us – focus on pediatrics cold and flu with some general tips

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January 6, 2014

With cold and flu season upon us, it’s a good time to remind ourselves of what we can do to keep our little ones healthy and treat the symptoms when they arise despite our best efforts. A central theme to pediatric care is prevention, which is why we advocate so strongly for immunizing the entire family (and any live-in caregivers) against the seasonal flu strains. It’s important to remember that each year, the flu vaccines are designed to be most effective against the current circulating viruses.

In addition to vaccination, the other key step in prevention is hand washing – but with what? There are lots of products on the market including antibacterial gels and antibacterial hand soaps. When it comes down to it, you can never go wrong with good old soap and water, remembering to wash your hands fully and for at least 20 seconds. There’s good evidence to support the use of antibacterial gels when soap and water is not readily available. In December 2013, the FDA proposed a rule that would require soap manufacturers to demonstrate a greater efficacy of “antibacterial” soaps over regular soaps in preventing infection or transmission of bacteria. There is growing evidence from research that indicates long term exposure to some of the active ingredients in these antibacterial soaps (like triclosan), may actually contribute to the increasing problem of bacterial resistance, making it harder for us to eliminate bacterial infections with the antibiotics we currently have.

Even when we’ve done our best to prevent seasonal viruses from wreaking havoc in our homes, we are still vulnerable. So what can we do for our young children when their noses are stuffed and no one is sleeping through the night? Unfortunately, for our youngest ones (under 4 years of age), there are no over-the-counter cough and cold preparations that are approved for safe or effective use. The short story is that research showed that the mix of ingredients was unlikely to yield much relief while there was an unacceptable risk of side effects.

What we can use:
Honey – shown in research studies to have some benefit in relieving the cough that keeps so many children up all night. Try a spoonful at bedtime for ages over 1.
Vaporizers – cool mist can help keep tiny nasal passages clear through the night. The same concept applies to a steamy bathroom. It’s important, however, to keep these machines clean and free of mold growth with daily washing.
Diphenydramine – a basic antihistamine can provide some relief of symptoms, especially for those difficult nights.
Acetaminophen or Ibuprofen — in appropriate doses can help with fever and body aches. Remember, no aspirin (even baby aspirin!) in children under age 18 years when there’s the possibility of a viral infection because of a risk of Reye’s syndrome. Reye’s is a poorly understood but potentially fatal syndrome associated with aspirin use in children with chickenpox or viral illnesses that causes serious liver and brain damage.
Nasal saline – these drops can loosen nasal congestion and make it easier to either blow out or remove with a bulb suction device, depending on the age of the child.

It’s also key to avoid the use of antibiotics, a topic which is gaining increasing attention in the pediatric and adult populations as we try our best to limit the use of these medications to when they are truly necessary. Antibiotics are not harmless. They can cause stomach upset, persistent diarrhea, mild to serious allergic reactions and lead to strains of resistant bacterial organisms. New guidelines have come out recently to encourage pediatricians to decide whether or not an illness/symptoms warrant the use of an antibiotic or if the child can be observed. This is best done in a partnership with the child’s parent(s) and requires that all involved understand the importance of clear communication, medical follow up and the long and short term benefits of avoiding unnecessary medication exposure.

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