Fall is in swing, kids are back in school, and now everyone seems to have the sniffles. While you may be tempted to book an appointment with a pediatrician at the sight of a runny nose, several symptoms can be managed with at-home remedies and over-the-counter medications. Beth B. Kantrowitz, MD, a pediatrician at Mount Sinai Doctors-Brooklyn Heights, explains what can be done at home, when you need to see the doctor, and how best to protect your child during cold and flu season.
Help, my child is sick! What can I do about it?
First off, don’t panic. Many symptoms can be managed or treated at home without taking a trip to the pediatrician.
If your child has nasal congestion with or without cough, try using saline drops or nasal spray along with a humidifier or steam from the shower or bath. The humid and moist air along with the saline help to loosen congestion and allow mucus to drain. For children not old enough to blow their nose, use a nasal aspirator or bulb suction to clear away the mucus.
Should I use over-the-counter medications?
Forgo traditional “cough and cold” medicines as studies show they are neither effective nor safe, especially in children under six years old. Additionally, ingredients in many of these combination medicines overlap, putting children at greater risk for overdosing. If your child has a cough, honey is a helpful soother, although it is not safe in infants under one year.
Fever can be treated with acetaminophen for any child older than two months and ibuprofen for any child older than six months. Be sure to check the medication’s label—or consult a pediatrician—as dosing will depend on your child’s weight.
What is considered a fever? When should I be concerned?
A fever is defined as a temperature of 100.4°F or higher. It is helpful to know your child’s exact temperature as the trend of temperatures can help indicate whether the illness is improving or worsening.
Be sure to accurately check your child’s temperature. Remember, feeling his or her forehead with your hand will not give a sufficient measurement. A rectal temperature should be done for any baby six months of age and under. Rectal thermometers provide the most accurate temperature until age five; however, after six months it is okay to use a forehead (temporal) or ear (tympanic) thermometer. Oral thermometers should only be used after age five.
Seek medical help immediately if your child has a fever above 104°F or one that does not respond to fever-reducing medication.
When does my child need to see the doctor?
If your baby is under two months old and has a fever, they need to be taken to the emergency room. A fever in babies this young is taken very seriously and needs an evaluation that goes past what a doctor can do in the office. Between two and three months old, a baby with a fever should always be seen, but can first be evaluated by a pediatrician rather than going directly to the emergency room. For older babies and children, a fever lasting two days or more should be checked by the doctor.
In addition, although congestion and cough do not always need to be seen in the office, any child with difficulty breathing as well as these symptoms needs to be checked.
When in doubt, it is best to have your child checked by the doctor. Call your pediatrician if there are ever any questions about when to come in.
How can I prevent my child from getting sick?
The best way to protect your child from illness is to keep up to date on immunizations, including the annual influenza vaccine. While immunizations do not prevent all childhood illnesses, they protect against many serious infections as well as the dangerous complications that may arise from some of these infections.
Frequent hand washing, either with soap and water or with an alcohol-based hand sanitizer, is also an important way to prevent illness. When washing with soap and water, scrub for at least 20 seconds and rinse soap fully.
Finally, if your child is in school, preschool, or daycare, please keep them home if they are sick. Coughing, sneezing, and runny noses can linger from an illness so it is not imperative that these symptoms be fully resolved before returning to activities. However, children should be fever-free for 24 hours and back to their usual energy and activity level before returning to school. This will prevent further spread of illness in their classroom.
Beth B. Kantrowitz, MD
Pediatrician, Mount Sinai Doctors Brooklyn Heights
Dr. Kantrowitz has a particular interest in well child-care, newborn medicine, breastfeeding, asthma, childhood nutrition and obesity, infant colic, and developmental screening. She sees patients at Mount Sinai Doctors Brooklyn Heights at 300 Cadman Plaza West from Monday through Saturday.
