By Nancy Gottesman
1) Colds/Respiratory Infections
Colds and respiratory infections are the most common ailments in babies and toddlers. While you probably average two to four colds annually, your child may get six to ten, with symptoms that are more severe and longer lasting (sometimes up to two weeks).
“The advantage of getting more infections at an early age is that the child will probably get sick less once he starts [kindergarten],” says Christopher S. Ryder, M.D., author of Take Your Pediatrician With You (John Hopkins Press, 2007) and assistant professor of clinical pediatrics at Penn State University at Hershey. “The disadvantage is that simple viral infections can lead to complications.”
For example, a common cold in a toddler can lead to an ear infection. Another major cause of respiratory illness in toddlers is RSV (respiratory syncytial virus), the symptoms of which are similar to those of a cold: stuffy or runny nose, sore throat, difficulty feeding, fever, cough.
Practically all kids are infected with RSV by the time they’re 2 to 3 years old, but it’s usually not medically necessary to distinguish it from a cold since complications are uncommon in otherwise healthy toddlers. Sometimes, however, RSV can lead to more serious infections such as pneumonia or bronchiolitis (an inflammation of the small air passages entering the lungs) in toddlers younger than 3. Call your pediatrician immediately if your child has a high fever, severe cough, wheezing, lethargic rapid breathing or bluish skin color due to lack of oxygen. (Sometimes hospitalization may be necessary.)
As yet, no clear evidence shows that children’s cough and cold medications work. Not only that, but an estimated 7,100 children under age 12 are treated in emergency rooms each year due to adverse effects from these medications—64 percent of whom are 2 to 5 years old!
The Food and Drug Administration has recently recommended that the medications not be used for kids under 6 years old because of the lack of beneficial evidence and increased risk of harm. So what can you do for your child’s cold? Treat aches and fever with children’s ibuprofen or acetaminophen. For coughing, try a bedtime dose of honey along with parental TLC: A new study revealed that 1⁄2 teaspoon of buckwheat honey given to children 2 to 5 years old helped provide relief for nighttime cough and sleep difficulties.
2) Stomach Flu
Also known as gastroenteritis, the stomach flu virus is the second most common tot ailment. “Gastrointestinal illness usually starts with fever and vomiting, then diarrhea,” says Rebecca R. Swan, M.D., assistant professor of pediatrics at Vanderbilt University in Nashville. “The vomiting usually lasts one to two days; diarrhea can last longer, sometimes up to 10 days.”
Many times, a stomachache isn’t the result of a contagious virus and may simply signal indigestion or constipation— which aren’t contagious—possibly caused by something your child ate or is worried about. (Constipation is common in “reluctant” toddlers in potty training!)
Stomach flu is usually more disruptive than dangerous. “Keep your child hydrated,” instructs Swan. “[Administer] small amounts of a fluid— a teaspoon every five minutes—or it will come back up.” Other tricks: a Pedialyte popsicle, slushy or ice chip. Once your child can begin eating solids again, you needn’t treat diarrhea with medicine, just be cautious about foods you serve. The BRAT diet—banana, rice, applesauce, toast—is tried and true, but after 24 hours make sure your child eats a wider variety of nutritious foods.
3) Strep Throat
Most sore throats are associated with colds and other respiratory symptoms, but about one-fifth are caused by bacteria called streptococci. “During the sick season of winter, 20 percent of sore throats are strep,” says Ryder. “The other 80 percent are caused by viruses.”
Symptoms include throat pain/ difficulty swallowing; red, swollen tonsils, sometimes lined with streaks or patches of pus; tender lymph nodes in the neck; fever; headache; rash; and, in toddlers, stomachache and possibly vomiting.
The good news about strep throat? Unlike other causes of a sore throat, it’s treatable! Your pediatrician will test for strep to make sure the sore throat isn’t caused by a virus or tonsillitis. For a positive result, he’ll prescribe antibiotics. Untreated, strep bacteria can lead to rheumatic fever, which can cause inflamed joints and may even result in damage to the heart. Fortunately, strep bacteria respond quickly to antibiotics.
4) Pink Eye
Also called conjunctivitis, pink eye is an inflammation of the membrane covering the white of the eye and inner eyelids—and it is highly contagious. “It can spread so quickly in a family,” asserts Swan. “Wash your towels, pillowcases and hands!” Symptoms can be “yucky”: a discharge in the eye that forms a crust as your child sleeps; itchiness; tearing; redness; and a gritty feeling in the eye.
Pink eye can be caused by a viral or bacterial infection and by allergies. “Most kids have bacterial infections and adults have viral,” explains Wolfson. When treated with antibiotic eyedrops, the infection subsides pretty quickly. If your child is really uncomfortable, apply warm compresses to the eye several times a day.
5) Ear Infection
When was the last time you heard of an adult with an ear infection? That’s because Otitis Media—an infection or inflammation of the middle ear—almost always affects children due to their smaller anatomy. “Ear infections are usually related to colds or upper respiratory illnesses,” states Swan. “A young child’s ear canal is small and horizontal, so fluids just sit there rather than draining.”
Seventy-five percent of children will have at least one ear infection before their third birthday; 50 percent will have three or more. They’re so common that medical costs and lost parental wages because of Otitis Media are estimated to be $5 billion in the U.S. In children who can’t yet talk, common symptoms to watch for are runny nose/sore throat, irritability, difficulty sleeping, pulling at an ear, fever, fluid draining from the ear or loss of balance. As your tot gets older, her ear canal becomes larger and more vertical, encouraging fl uid draining and helping to prevent infection.
Handling an ear infection can be tricky. A few years ago, antibiotics were the de rigueur treatment. Recently, research found that many ear infections resolve on their own. So the medical profession is taking a watch-and-wait approach in older children with uncomplicated ear infections. Doctors don’t have a way of looking at an ear drum to see if the infection is viral or bacterial, explains Wolfson. “Anytime we use an antibiotic, we want to weigh the benefits and risks.”
The benefits include curing an ear infection, reducing discomfort and preventing complications, but only if it’s caused by a bacterial infection. The risks: Antibiotics won’t work if it’s a viral infection; they kill organisms in the body that have beneficial effects, resulting in diarrhea; overuse leads to antibiotic-resistant strains of bacteria and increased susceptibility to new ear infections.
That said, most doctors prescribe antibiotics to kids under age 2 if pain is severe and fever is higher than 102 degrees F; older tots in severe pain may also get antibiotics. For others, it’s vigilance and a safety-net antibiotic prescription (SNAP). Over age 2, this is a safe approach to an ear infection with no eye or sinus infection or high fever as well, says Wolfson. “If your child is better in 48 hours, tear up the SNAP. If not, call your doctor and ask if you should fill it.”
Nancy Gottesman is relieved that her 13-year-old son, Robby, no longer gets ear infections.
Help your child stay healthy with these useful tips.