Doctors’ Notes
BackWhen My Own Kids are Sick
All children get sick, including mine. Those vile snot germs don’t care that they’re dealing with the kid of a pediatrician. So what do I do when my own kids are sick?
In addition to scrambling to find child care when they have to miss school — all you working parents know what I’m talking about — here’s the low-down on how I manage my own kids’ fever-and-a-snotty-nose, throwing-up-in-the-middle-of-the-night, and I-don’t-feel-good illnesses.
Coughs & Sniffles
When my kids have a runny nose, I don’t reach for medicines. Most over-the-counter cold medicines just aren’t very helpful in kids. Acetaminophen, ibuprofen, and the occasional cough drop (once they get old enough not to choke) are pretty much all my kids get for this sort of thing. Except in rare situations, I don’t bother with cough suppressants, decongestants, or expectorants.
I’ve tried giving them honey, hot tea, soup, and turning on the humidifier to clear up congestion. It does make ME feel better to be able to do something for my kids when they’re miserable, but whether or not it actually makes THEM feel better is up for debate. Since all of these thing are just for temporary comfort anyway, I only use them occasionally.
My kids almost never take antibiotics for cough and congestion, either. That’s because the most common illnesses in kids are caused by viruses, and, as you may have heard, antibiotics don’t kill viruses. Don’t get me wrong: there have been times when my kids have needed antibiotics. To treat strep throat, for instance. But the majority of the time, I let them get better on their own.
(Side note: As you might imagine, this do-nothing approach drives my mother-in-law crazy. But the fact is, kids are better off without a lot of medicines they don’t need.)
Once they’re feeling better, I’m okay with letting my kids cough for a few weeks after a cold. They’re not contagious, and I know it can take that long for the symptoms to clear up. Green mucous in an otherwise energetic kid doesn’t bother me. I don’t worry when they get a new cold before they are fully recovered from the previous one, or when they get “one cold on top of another.” That’s just childhood.
There are certainly some things that make me look twice. When they were babies, for instance, every symptom had to be taken seriously. Even now that they’re older, fever with a sore throat, headache, cough, or ear pain requires further evaluation. And of course, difficulty breathing at any time is a reason to seek emergency medical care.
Mystery Fevers
Fevers do get my attention, especially high fevers or fevers that pop up after my kid has already been sick for several days. Since most fevers happen at the beginning of viral illnesses, a new fever after being sick for a week could mean that something different is starting.
In older kids, most fevers will come down temporarily with acetaminophen, and most kids perk up while the fever is down. As long as that happens, and the fever’s only been going on for a day or two, I’m not worried. But a kid that doesn’t perk up, or a fever that doesn’t go away after a few days, is worth worrying about.
I should add that fevers in newborns are always a reason to seek medical care, because newborns (even breastfeeding ones) are not immune to the scary germs we vaccinate against. I worried a whole lot less after my babies got their 2-month shots!
Tummy Bugs
Vomiting-and-diarrhea viruses are miserable. They’re messy, inconvenient, and contagious. Dehydration — even mild dehydration, which can throw off the electrolytes and prolong vomiting — is a real concern. Because I do worry about dehydration, I don’t restrict food or fluids for long periods of time after vomiting. In fact, I let my kids have tiny sips of water right away if they want them. Within a few minutes, I give them a small handful of dry cereal: maybe a dozen dry Cheerios. And because eating or drinking too fast can provoke vomiting, I tell them to eat slowly, one Cheerio at a time.
I don’t buy electrolyte drinks, although I do think Pedialyte and oral rehydration solutions can be useful in little ones. Sports drinks and pop don’t play a role for my kids. I do hold back on milk, because the fat doesn’t absorb quickly and dairy products can prolong diarrhea. But if milk is the only thing my kids want to drink, I do let them have it, in moderation.
Once they get their appetite back, I stick my kids on the BRAT diet (Bananas, Rice, Applesauce, & Toast) for a while — sometimes even as long as a week — until their tummies are back to normal.
The “I Don’t Feel Good”s
Much to my kids’ annoyance, they aren’t allowed to miss school just for vague feelings of crumminess.
If I wake my daughter up for school and she makes a horrible face and moans about something not feeling good, I tell her to get up, get dressed, eat breakfast, brush her teeth and hair, and THEN tell me how she’s feeling. Almost always, by the time those things are done she’s forgotten all about it. (Of course, I’m watching the whole time. And if she really is sick, Mommy can tell.)
I’m fortunate. My kids are healthy most of the time. I keep them that way by making sure they get all of the appropriate vaccines, including annual flu shots. We talk about germs and handwashing, getting adequate sleep, and keeping our bodies strong. None of this will keep all the germs away, but it does protect against a lot of the bad stuff.
Knowing when to seek medical advice is a challenge for parents. It takes practice to recognize when an illness is minor enough to wait out at home. In general, if you’re not sure, it’s a good idea to give Kids Plus a call and talk it over. Our triage nurses can help you decide when a closer evaluation is needed.
Dr. Kerry McGee is a former Kids Plus provider.