It’s the time of year when children are always sick. I’m not using hyperbole; small children have multiple episodes of upper respiratory illness every year. This is very frustrating, in part because there’s ultimately so little we can do to fix it. For the majority, which are viral, antibiotics are not useful.
Fever is normal and can be controlled with acetaminophen and ibuprofen. For nasal congestion and cough, nasal suctioning is useful for infants; over-the-counter medicine may help the older kiddos. (Incidentally, after age 1, honey can actually ease cough. It’s unsafe before age 1 due to risk of botulism.)
While kids aren’t just “little adults” in the medical sense, it is useful to think about ourselves when we try to treat their maladies. Parents often say to me, “She won’t eat, but she is drinking. And she won’t play except when her fever is down, and all she does is lie around!”
To which I respond, “The last time you had the flu, did you go dancing?”
“Well, no, I felt too badly,” parents reply.
“Exactly,” I say.
Infants and children with fever, cough and cold feel badly. They are achy and restless, and few things ease their general discomfort. Hugs, baths, cuddles, fluid and comfort food are very helpful in getting them through their assorted maladies.
This is not to say, however, that we should ignore them. And this is key. Parents often worry. Jan and I raised four children to (almost) adulthood. I understand the anxiety of childhood sickness.
Fortunately for me and all the other physicians out there, good parents know their own children. As a physician, I ask, “Is this very different from normal, or is it like when he had other colds in the past?”
Astute parents will say, “Well, this is just like every time before. I was just worried.”
And I can work with that. I can rule out most of the bad things and say, “This looks like a cold.” (See above guidelines!)
Others may say, “The last time she did this, she had pneumonia and was in the hospital for a week.” We’ll be checking for it. “His cry is just different and I’m concerned.” In which case, I’m concerned, too. “Doctor, she just looks different. I can’t put my finger on it, but I’m worried.” Me, too.
So much of the practice of medicine, and of parenthood, is establishing baseline. For physicians, it involves thousands of hours and thousands of patients so that we can separate good from bad, and normal from abnormal. For parents, it involves constant, careful observation of those sweet, treasured children so that Mom and Dad, Grandma and Grandpa can come to me and say, “This is new, help us out.”
We have a few months of this agony to go. I may be seeing you or your little ones at some point. But until then, try not to worry. Most colds are just that. But if you’re really worried, tell me, or the doctor who sees your little one.
Because that’s as important as any test I can do.