How To Prevent Cold and Flu in Kids, According to an MD

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When you’re a caregiver for little kids, you get used to what feels like an endless parade of coughs and sniffles through the colder months. But as any parent will tell you, this current cold and flu season has been something else entirely. Rates of respiratory syncytial virus (RSV), the flu, and some new Covid-19 variants have meant crowded pediatrician offices, canceled travel plans, scrambled work schedules, and pharmacy shelves picked bare of over-the-counter essentials. It’s been a rough one. With the coldest part of the winter still ahead, some parents are grimly accepting that their kids will be stuck inside swapping viruses for the foreseeable future, while others are curious about ways to prevent cold and flu in kids.

While there is no magic pill to ensure your kids won’t get sick at all, Kristina Deeter, MD, a pediatric intensive care doctor and a specialty medical officer for pediatric critical care at Pediatrix Medical Group in Nevada, and a parent herself, has some tried and true tips to that she swears by to keep her kids as healthy as possible during cold and flu season.

What do we know about this year’s cold and flu season?

First, it’s helpful to recognize that you’re not imagining it: this flu season really is a doozy. What’s been referred to as a respiratory “triple-demic” has impacted millions of families with young children.

Dr. Deeter explains that while the Centers for Disease Control and Prevention (CDC) is working on a real-time data collection system that tracks which viruses are on the upswing, we currently have to rely on estimates based on small sample sizes to guess how many people are infected with, say, RSV. With that being said, we can see there have been approximately 2.1 million cases of RSV based on this year’s testing, and that RSV peaked in early December according to the information we have. RSV is typically mild for children over two and for adults, but it can be really scary for infants who contract the virus.

Influenza has also been infecting more people this year, but Dr. Deeter says it’s actually not at a history-making high. The U.S. peak for flu cases was late November and early December of 2022, according to the CDC’s flu tracker. It’s quite rare, but pediatric cases of the flu can result in hospitalization—so avoiding it, if you can, is worth trying to do.

And then there’s COVID-19. The severity of that virus continues to be far lower in kids than for adults, Dr. Deeter says, although there was a spike in pediatric hospitalizations when the Omicron variant first became widespread. Children account for about 20 percent of all COVID cases, but they tend to fare well in terms of recovery. Still, avoiding COVID-19 whenever you can is a smart idea.

“As a family, we are careful to carry hand sanitizer, wash our hands frequently, and avoid crowded settings with strangers.”—Kristina Deeter, MD, a pediatric intensive care doctor at Pediatrix Medical Group.

As a parent, what can you do to prevent colds and flu in your kids?

Dr. Deeter does a few things consistently to minimize her family’s risk factors for severe disease. The good news is that they’re all relatively simple things that don’t require any medical training.

We’ve all learned a lot about infection spread from working at a hospital during the COVID-19 pandemic, and Deeter says she’s carrying that knowledge into her daily habits going forward. “As a family, we are careful to carry hand sanitizer, wash our hands frequently, and avoid crowded settings with strangers,” she says.

Deeter’s husband also works in a hospital, which means they’re both especially mindful of infections they could bring home from their workplace. But she says that she’s no longer worried about contact with surfaces spreading the COVID-19 infection. She and her husband wear PPE at work as well as gloves to minimize the spread between their patients. She also says she does her best not to touch her face during the day and that wearing a mask through her public interactions really helps to prevent the spread of infection.

What if they do get sick and you can’t find any OTC children’s medication?

Even with precautions, it’s inevitable that kids will pick up germs during the winter. Over-the-counter drugs can help make them comfortable and manage symptoms while they recover. One additional layer of concern that parents have this year is national shortages of these drugs, including children’s Motrin and Tylenol, as well as some antibiotics.

“The shortage of over-the-counter medications is alarming at this point,” Dr. Deeter says. “I have had many parents tell me that they drove to every drug store in town unable to find acetaminophen, for instance.” She cautions parents in this situation to avoid panic since for the most part stores are still able to restock on a regular basis. “My advice is to remember that most of the generics are just as effective as the brand names. Motrin, Advil, and ibuprofen are the same medication, though they can be packaged differently.”

If you have a child under six months, she says, save the liquid Tylenol for them and give your older kids the more readily-available ibuprofen.

If you’re concerned about your child’s fever, it’s always best to talk with your pediatrician, particularly for infants with an elevated temperature, and children who have a high fever (over 104 degrees Fahrenheit) or have had a fever for more than four days, says Dr. Deeter.

For everyone else, she says, “remember that our bodies are smart and actually mount a fever to kill viruses and bacteria that are trying to hurt us. Having a fever between 100 and 102 can make us better faster.”

In other words, even if we can’t get our hands on that OTC fever reliever, we can usually wait for nature to take its course. Dr. Deeter calls out lukewarm baths, popsicles, and cool washcloths on the forehead as ways to keep a kid comfortable when they have a fever within a safe range. “When a child has a febrile illness, remember that they need even more fluids (water and electrolyte solutions are best) than usual. Track the temperature and make sure the fever is going down,” she advises.

As far as other medications meant to decrease cold symptoms in children, Dr. Deeter says not to stress about having them on hand—in fact, you might be better off without them. “I am not a big believer in OTC drugs sold to decrease cold symptoms in children. Some of them can actually cause harm,” she says.

It might be hard to listen to your child coughing and sneezing, but kids with an upper respiratory infection actually need to be coughing up mucus when they get these types of infections so that the disease doesn’t worsen and get stuck in their lungs. Drying up a cough too much with a decongestant can make it harder for kids to get rid of that mucus. Plus, common side effects of those drugs include an increased heart rate, irritation, and sleepiness, which are all things kids need to avoid as their bodies work to get better.  So, even though you may not be able to totally prevent cold and flu in your kids—when it comes to helping them recover, the usual rest, fluids, and snuggles are typically the best way forward.



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