According to the CDC, wrongly giving kids antibiotics for viral infections, and taking antibiotics just long enough to feel better but not finishing the medication, are creating antibiotic-resistant bugs. When you really need to knock down an organism in your child, these "superbugs" may laugh off the antibiotics and take over. So what should a parent do instead, as cold winds blow and illnesses flare?
"Parents are the frontline clinicians," Richard P. Walls, MD, a pediatrician in private practice in La Jolla, Calif., tells WebMD. Walls served on a complementary and alternative medicine task force created several years ago by the American Academy of Pediatrics (AAP). "While families should not believe everything they read on the Internet, I try to teach parents how to assess both wellness and illness."
Walls says he believes in the "Three to Five Day Rule." If a child comes down with a viral illness, they should be markedly better in three days and almost well in five days. If there is deviation from this, the pediatrician should be called. "Fever in the first 24 hours is normal," Walls says. "If the fever starts after a few days, though, a secondary infection might be setting in." If the child not better in five days, a trip to the doctor also may be in order. Parents need to use their best judgment -- does this seem like a cold or might it be something different?
"Antibiotics don't work for viral infections," Kathi J. Kemper, MD, professor of pediatrics at Wake Forest University in Winston-Salem, N.C., tells WebMD. "The average 3-year-old who comes home from day care with a cold does not need antibiotics."
So what should a parent do? "I ask them what they have done before that worked," Kemper says. "There is no data that say over-the-counter cough and cold medicine works for kids, but if parents have tried them and they do, then I say OK." (Give as directed, of course.)
Other Home Remedies for Colds
A lot of dealing with winter illnesses involves removing discomfort and instilling comfort, rather than "curing" the ailment. Kemper recommends extra attention for the child. "What did your mother do for you?" she asks. Social support is good, as are being tucked into a special bed or couch with sheets, fresh jammies, and favorite foods and juices.
Chicken soup is still a mainstay. Some data even show it has healing powers. At very least, it's light, nutritious, and tastes good to jaded little appetites.
Kemper and Walls both say acetaminophen (Tylenol) and ibuprofen and are fine to ease aches. Kemper says ibuprofen lasts longer and goes to work faster.
Aspirin is not recommended for children with fevers and may cause complications.
Steam from a hot shower can ease congestion. Be sure the child is not asthmatic, though. Changes in humidity can cause bronchospasms, Walls says.
Menthol salves and rubs can make congested chests feel better. Alcohol rubs are not recommended anymore -- the fumes are too toxic. A plain backrub can be relaxing.
Have children with nasal congestion sleep on their sides. It keeps gunk from falling down their throats.
A cool mist vaporizer can ease discomfort. Forget the hot ones -- they can burn! You can add menthol or peppermint to the water.
Serve light snacks. Some "old wives" recommend no solid foods if fever is present, but both doctors laughed at this. "Let them eat whatever sounds good to them," Kemper says.
Be sure to push fluids -- ice water or juice, anything the child will drink. If the child isn't thirsty, try a Popsicle or two.
If your infant has croup, try a trip outside into the cold air for a few minutes. "So many parents think the child is about to die of croup and by the time they get to the ER, the time in the cold air and in the car have resolved it and the child is jumping around," Walls says.
Fever May Not Require Home Remedies
"Fever is a defense put up by the body," Kemper reminds. "The body is trying to reset the temperature to kill bacteria and viruses. It is a symptom, not something that needs to be cured." Acetaminophen will bring the temperature down, but that is not always necessary.
Cold baths also used to be used. Kemper discourages that now. "Let the fever work."
Walls agrees. "Fever is an ally," he says. "People used to believe it destroyed brain cells, but it doesn't. What about convulsions in children with high fevers? "If this is going to occur," Walls says, "it will be at the first fever spike. You won't have time to bring the fever down to prevent it."
Walls is more worried about the timing of the fever. At the onset the illness, it's probably OK, "If the child has the symptoms awhile and then develops a fever, call the doctor," he says.
Home Remedies Abound for Ear Infections
Although many parents are accustomed to the trip to the doctor for the "pink medicine" (amoxicillin), many doctors are getting away from that for ear infections these days. "No high fever, no antibiotics," Walls says. (So at least don't insist if your doctor has changed tactics.)
If the pink stuff is needed, it's being given in more intensive doses. Times are changing.
Both doctors recommend over-the-counter remedies such as Auralgan (an ear drop that reduces the inflammation and pain of ear infections) or various oils such as almond, olive, garlic, and other herbs. "I have had kids brought in that smelled like a Greek salad," laughs Walls.
Kemper notes that oils can help equalize pressure on the eardrum and ease discomfort.
Acetaminophen and ibuprofen are also good for pain. "We treat the pain now and let the child's body resolve the inflammation," she says. "Even if we can look in and see pus, we leave it alone."
Earaches also hurt more when the child is lying down. Prop the youngster up, recommends Kemper.
Home Remedies for Sore Throat
The major concern with sore throat is to be sure it's not strep. Kemper says. "If it's summer, it's probably not," she says.
Strep builds slowly, Walls says. "The child usually does not wake up with it."
Walls lets his older patients gargle with benadryl. "If they swallow, they may get sleepy," he warns.
Kemper recommends gargling with salt and baking soda (half a teaspoon of each in a cup of warm water). Herbal teas, such as slippery elm, cherry bark, or licorice (not anise) are also soothing. If the child prefers cold on the throat, try Popsicles or ice cream. Kids over the age of 4 can suck on a cough drop or horehound drop.
Zinc lozenges are sort of out now, Walls says. Zinc tends to make females nauseated, Kemper observes. Kids can get diarrhea from it, too.
Both doctors recommend flu shots for anyone over 6 months. Walls is a little more cautious, however. "What if kids take those all along, go off to college and don't get one -- they could be clobbered." Like all of this advice, discuss it with your doctor if you are doubtful.
The surgeon general, along with the National Council on Patient Information and Education, also has set up a web site to help you choose over-the-counter medications more responsibly. Follow labels carefully, keep bottles up high and away from kids, and inform your doctor of anything you do decide to give your child -- Popsicles excepted, of course.
About 30% to 70% of his little patients receive complementary therapies, Walls estimates. Sometimes a story or glass of juice with a "bendy" straw does the trick.
Star Lawrence is a medical writer based in the Phoenix area.
