healthcare from cradle to college

Dr Daniels' advice was featured today in the LEAP parenting section of the Bozeman Daily Chronicle.  Here's a copy of the article:

RSV is respiratory syncytial virus, a common cold virus that is prevalent at this time every year.  In school-age children and adults, it causes cough, congestion, and runny nose.  In younger children, especially those less than 1 or 2 years old, it causes a more substantial illness known as bronchiolitis.  This is caused by inflammation of the tiniest airways in the lungs called bronchioles.  Infants will have cough, bothersome nasal congestion, and often fever for a few days.  Many will also wheeze (a high-pitched whistle when they breathe out), breathe faster than normal, and have a diminished appetite. The illness usually lasts 2 weeks.  A small number of infants will be sick enough to require a stay in the hospital if they need oxygen or intravenous fluids to treat dehydration. 

So how worried should you be?  In general, not very worried, but it depends upon the age and medical history of your little one. 

If your child is generally healthy and older than two years old, he is unlikely to have wheezing or difficulty breathing.  Kids in this age group generally need nothing more than typical treatment for cold symptoms:  lots of tender loving care, extra fluids to drink, and children’s ibuprofen (Motrin or Advil) or acetaminophen (Tylenol) if they have fever or sore throat.  Decongestants (like pseudoephedrine) and cough medicines (like dextromethorphan) are not recommended as they are generally ineffective.  If a child has fever for more than the first few days of the illness, or if the fever goes away and then comes back, he should be seen by the doctor to determine if he has a bacterial ear infection or pneumonia.

For younger children under 2 years old, careful observation for more serious symptoms is needed, though the vast majority will weather RSV without severe complications or need for hospitalization.  Babies at the highest risk are those under 6 months of age, those born prematurely, and those with chronic lung problems.  A young child needs to be seen by the doctor sooner if RSV is suspected, especially if she is breathing fast or drinking less than normal.  Call your child’s doctor or 911 immediately if she has any bluish discoloration to her skin. 

As with big kids, treatment of milder symptoms in infants and toddlers includes lots of love, encouraging fluid intake and use of pain relievers (acetaminophen ONLY for infants under 6 months).  Nasal saline drops are also useful to help clear congestion.  You can buy these drops, or make your own.  Drip 2-3 drops in each nostril.  Often the baby will sniff or sneeze and this moves the mucus and makes breathing easier.  I recommend using the drops frequently but avoiding the bulb syringe to suck the drops back out since this is unnecessary and painful for the baby.  Running a humidifier at night is also helpful.  As with older kids, a baby should be seen by the doctor if he has more than 2-3 days of fever, or if the fever goes away and then returns.  A significant portion of infants with RSV will get a bacterial ear infection during the course of this illness.  Though older children may resolve an ear infection without treatment, this is less likely for children under two years old and they should have a visit to the doctor. 

 NASAL SALINE RECIPE:

Stir 8 ounces of filtered or distilled water together with ½ teaspoon of salt and ¼ teaspoon of baking soda in a clean container.  Store the drops at room temperature and discard every 2 days.

Try this remedy FOR KIDS OLDER THAN ONE YEAR OLD:

Add the juice from half a lemon and 2-3 tablespoons of honey to 1 cup of warm water.  Stir.  This tasty beverage provides fluid to help thin mucus (making it easier to cough out of the lungs), Vitamin C to boost immune function and the magic of honey to soothe a sore throat and quiet cough. 

NOTE:  NEVER given an infant under 1 year old honey.