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by Julie Revelant

Related: kids, children, child, parents, parenting, sick, health, bug, illness, cold, flu, flu season, tips, advice, symptoms, treatment,

What to do when your child gets sick   There's a good chance that your child has already visited the nurse's office this year complaining of congestion, body aches, and/or a stomachache. The season for sickness is in full force and since the symptoms are often the same across the board, they can indicate a variety of illnesses. So how do you know if your child has just a cold or the H1N1 flu? We consulted some of the best doctors in the area to understand the most common sicknesses going around this season, when to seek medical attention, and how to get better, stat!


The Common Cold


   Colds or upper respiratory infections, as they are known, are situated in the nose and throat and are characterized by sneezing, runny nose, nasal congestion, low-grade fever, cough and sore throat. "The cold is extremely common, with children getting 6-10 colds each year. There are many types of viruses that cause the cold and children can get them over and over again," says Dr. Jennifer Trachtenberg, a pediatrician in Manhattan, author of Good Kids, Bad Habits: The RealAge® Guide to Raising Healthy Children, and chief pediatric officer for RealAge.com.


When To Call The Doctor

   "Colds last seven to ten days and they get worse before they get better," according to Dr. Trachtenberg who says that congestion is usually worst on the second and third days. "If the cold isn't getting better after seven days, if your child has severe headaches or ear pain, or if the congestion is thick, green, or yellow, definitely see a doctor," she says. If your child has a fever above 100.8 F accompanied by a sore throat, she may also have strep throat. "Unlike a cold, which is caused by a virus, strep throat is a bacterial infection which should be treated with antibiotics," says Dr. Stuart Beeber, a pediatrician at Chappaqua Pediatrics and an attending pediatrician at Northern Westchester Hospital in Mt. Kisco. A cold can also progress to an ear or sinus infection and even pneumonia. "A cold that doesn't seem to be turning the corner or seems to be getting progressively worse, especially with a decreasing appetite and an increasing fever, is no longer a cold and needs a doctor's attention," says Dr. Gary S. Mirkin, a pediatrician in Great Neck and CEO of Allied Pediatrics of New York.

How to Treat It

   A cold must run its course, but there are ways to help ease the symptoms, such as drinking lots of fluids, resting, using saline nose drops or sitting in a steam-filled bathroom to ease congestion. In recent studies, honey in hot tea has also been shown to be an effective cough suppressant but it's important not to give honey to babies under age 1. "It's important not to treat children under the age of 4 with over-the-counter medications since they have not been shown to be effective and have side effects," says Dr. Joshua Chesir, a pediatrician in New City. Dr. Chesir also stresses that antibiotics are not appropriate for treating colds since they are viruses.




   Pneumonia, an infection of the lungs, can be bacterial or viral, with varying degrees of severity. Pneumonia is typically marked by high fever, cough, difficulty breathing, decreased appetite, fatigue, and occasional abdominal pain, nausea and vomiting. "Children look sick," according to Daniel Rauch, M.D., F.A.A.P., F.H.M., Associate Professor of Pediatrics at Mt. Sinai School of Medicine, and Associate Director of Pediatrics at Elmhurst Hospital Center in Queens. "Pneumonia can happen as a 'super-infection' where the child starts with a mild cold and then suddenly gets much sicker because the first mild illness allows a more severe bacterial infection to occur," he adds.


When To Call The Doctor

   "Your child should be evaluated if increased fever, progressive coughing or difficulty breathing develops," according to Leonard Krilov, M.D., F.A.A.P., Chief of the Division of Pediatrics and Vice Chair of the Children's Medical Center at Winthrop University Hospital in Mineola, who says that a chest x-ray may be ordered to confirm the diagnosis. "If your child continues to experience distress, you should see your doctor as soon as possible," says Dr. Norman Edelman, Chief Medical Officer of the American Lung Association in Hauppauge.


How to Treat It

   "Bacterial pneumonia treatment starts with being appropriately vaccinated," says Dr. Rauch who points to the Hib vaccine which has virtually eliminated the bacteria that causes pneumonia and is required in New York State and Connecticut for children under the age of 5 in school or day care. If your child has not received the vaccination, or the pneumonia is believed to be bacterial, antibiotics are usually administered. "It's sometimes difficult to tell the difference between the two but viral pneumonia will usually get better on its own," says Dr. Cecile Windels, a pediatrician at The Healthy Child, LLC in Darien, Connecticut.


The Stomach Virus


   Although it's often referred to as the "stomach flu," gastroenteritis - or inflammation of the stomach and intestines - is not caused by influenza; rather, it's an infection caused by a variety of viruses. "Stomach viruses typically start with vomiting which can often last for 12 hours. Diarrhea usually follows and can last up to one week; the smaller the child, the faster they can dehydrate," says Dr. Windels. "These viruses are very contagious and often affect an entire family," according to Scott Klein, M.D., F.A.A.P., Vice Chairman of Clinical Services at Maimonides Infants' and Children's Hospital of Brooklyn, who says that hand washing is the first line of defense against contracting and spreading stomach bugs. Some children may also have stomach cramps, a low-grade fever, and headaches. Rotavirus, which is characterized by extreme diarrhea and is responsible for more than 55,000 hospitalizations each year, is usually diagnosed in babies and young children.


When To Call the Doctor

   As a result of vomiting and the limited amount of liquid intake, dehydration is the biggest concern when your child has the stomach virus. "If your child is not tolerating fluids after 24 hours, not urinating, and the lips are dry, those are some telltale signs that your child may be dehydrated and you should speak with your doctor," says Dr. Trachtenberg.


How to Treat It

   Introducing food and liquid into the diet should be done slowly, even by the spoonful. "Stop all solids and all liquids and give your child Gatorade, weak tea, or an over-the-counter oral replacement electrolyte solution such as Pedialyte. If your child is very dehydrated, intravenous fluids and prescription antivomiting medicine is needed," says Dr. Beeber. To prevent rotavirus, the Center for Disease Control recommends parents vaccinate their children.


H1N1 Flu


   Much like the seasonal flu, the H1N1 flu's characteristics include fever, chills, aches, headaches, a runny or stuffy nose, coughing, wheezing, sore throat, chills, bluish skin color, irritability and sometimes vomiting and diarrhea. "Children have higher fevers, more muscle aches and more lethargy compared to the common cold," says Dr. Klein. The main difference seems to be in what age groups are most affected. "It appears to be that H1N1 targets older children and young adults whereas the seasonal flu strikes worse at the very young and aged," says Dr. Rauch.


When To Call The Doctor

   "You should seek help if your child has any underlying illness, especially heart or lung problems, and starts to develop any combination of flu-like symptoms," according to Dr. Rauch. Children will most likely get better within a week and will not need to see the doctor, but if symptoms suddenly get worse or dehydration occurs, pick up the phone. "If a parent is worried about a child with influenza, call the doctor; in most cases reassurance can be given on the phone. The emergency department should be reserved for true emergencies," says Dr. Klein.


How to Treat It

   "H1N1 is simply a different type of influenza virus and we treat it the same," according to Dr. Chesir, who advocates that all children under 18 and especially those under 2 receive the vaccination when it becomes available. With rest, lots of fluids, and acetaminophen for aches and fever, the flu should subside on its own. Antiviral medications like Tamiflu® are available, yet Dr. Chesir advises that Tamiflu® only be used for children with chronic medical problems like diabetes or congenital heart disease or for children under 2. 


To find a flu clinic in your area, visit www.flucliniclocator.org.


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