It is a classic: they accompany the child from the beginning of autumn and do not want to leave until it is cold, especially if they are small, under six years old, and if they go to nursery and kindergarten. Colds, otitis, sore throat, bronchitis, flu, often with cough and fever: they are all infectious diseases, in the vast majority of cases caused by viruses, such as rhinovirus, adenovirus, coronavirus, influenza and parainfluenza virus, respiratory syncytial virus.
All in all a fortune, because the viral forms tend to resolve more easily and faster. Sometimes, however, bacteria are responsible. "Some diseases, such as nasopharyngitis (colds and sore throats) are little more than a nuisance. Others, such as bronchitis and pneumonia, are rightly more alarming," he comments , Head of the Bronchopneumology Department of the Bambino Gesù Children's Hospital of the city and President of the Del Paesena Society for Infectious Respiratory Diseases.
We have submitted to him the frequently asked questions from moms and dads about these conditions.
In this article
- At the nursery he is always sick
- Sore throat
- Flu vaccine
- Prevention of seasonal ailments
1 - At the nursery he is always sick
Since starting the nursery, my child has been getting sick all the time (fever, cough, cold) and I see that it happens to others too. It's normal? Why are children always sick in winter?
Yes, it is normal: in winter, respiratory infections are common and recurring events in the chicks that frequent the nest. Meanwhile, because in the cold season many germs are more frequent and find environmental conditions more suitable for "attacking". The sudden change in temperature between internal and external, for example, favors the implantation of viruses in the mucous membranes of the respiratory tract. Then there is the fact that, in a closed environment such as a nursery or kindergarten, the passage of microorganisms between children is practically inevitable. This is why it would be important, after an illness, to bring them back to school only when they are completely healed, but let's face it: in the case of a common cold it is difficult for working parents to keep them at home for long.
Finally, don't forget that children still have immature immune systems: for them, almost every germ represents a novelty, it is obvious that they get sick when they meet one.
2 - Cold: how to relieve the discomfort?
My six month old baby often gets cold. Is there any way to relieve the annoyance of him?
It is estimated that, on average, children under the age of six get colds 6-8 times a year. There are no cures: the cold passes on its own, usually within a week. To alleviate the discomfort caused by a blocked or runny nose, nasal washes are particularly suitable, with physiological solution or thermal, saline and hypertonic saline solutions. If the baby is very small, the wash can be combined with nasal aspiration. Yes also to aerosols with physiological solution, while products (sprays, aerosols, syrups) based on cortisone, vasoconstrictors or mucolytics are to be avoided. Other small strategies that can help are the humidification of the environment, the frequent supply of liquids to the baby (they thin the mucus), the placement of a pillow under the mattress of the cot, to let the baby sleep with his head slightly raised.
3 - Sore throat: what to give?
What can I give my three-year-old daughter to make her sore throat go away?
Pain in the throat, with difficulty or discomfort in swallowing, is a classic symptom of pharyngitis, sometimes accompanied by enlargement of the tonsils and lymph nodes in the throat, fever and difficulty in breathing. The Del Paesene guidelines for the management of pharyngotonsillitis in pediatric age make it clear: if pharyngitis is viral, nothing needs to be done, it will heal on its own in a few days.
If, on the other hand, it is bacterial (usually the cause is beta-haemolytic streptococcus), the antibiotic (amoxicillin for six days) is needed. Only the pediatrician can determine if the form is viral or bacterial, through a rapid test (a kind of swab).
In all cases, hot drinks with a little honey (if the baby is over a year old) will help reduce the discomfort. If this is intense, paracetamol can also be given.
4 - Cough and natural remedies
Are there any natural cough remedies?
La cough it is a defense system of the organism to keep the airways clean in the presence of irritants, such as viruses and bacteria, but also pollutants or allergens. This is why it is not an evil in itself: first of all we need to understand what causes it and, if necessary, intervene against the cause.
Having said that, coughing can be a nuisance, so small measures are welcome to mitigate it: if it is dry (without mucus) it helps humidify the environment, while if it is oily and maybe even the nose is full of mucus, it is the nasal washes with physiological or saline solution. Yes also to the frequent offer of liquids, especially hot drinks with honey (over one year of age), which is an excellent natural remedy.
Cough medications tend to be contraindicated in children, especially young ones. If the cough is very persistent and prevents you from sleeping, your pediatrician may prescribe a cough suppressant. But beware, it must be said that these products are never extraordinarily effective.
5 - Bronchitis in the child
My son has a cough, fever, runny nose. The pediatrician says he is bronchitis and advised to wait. I fear it could become pneumonia. Can I really be safe?
Bronchitis and pneumonia are also predominantly viral infections (more rarely the cause is bacterial). In fact, in case of bronchitis, the first step is usually waiting, putting in place those small measures that can help the child to cough less and breathe better (nasal washes, humidification of the environment, hot drinks with honey).
If after two to three days the situation has not improved, or even worsened (with more difficult breathing and possibly a darker cyanotic color around the mouth), the doctor will consider prescribing an antibiotic. If, on the other hand, the diagnosis is pneumonia, the antibiotic is prescribed immediately, because it is practically impossible to distinguish between viral and bacterial cases.
6 - Laryngitis: what to do?
My two year old has laryngitis. He has bad fits at night, but I never know when he really needs to go to the ER. What should I do?
Laryngitis is an infection of the larynx and vocal cords, usually viral. The characteristic symptoms are lowering or lack of voice, a characteristic "barking" cough, similar to the cry of a seal, difficulty in breathing (which usually appears suddenly, at night), a particular screeching at the moment of inhalation. The first time you have an episode of laryngitis it is good to consult your doctor or take the child to the emergency room, to be reassured and learn how to behave. The pediatrician will recommend the therapy, which is based on cortisone drugs, to be administered with aerosol or orally.
In severe cases, adrenaline aerosols are also used in the hospital. During the attacks, the child should be seated or erect to reduce the sensation of suffocation. (For this answer the advice was by Antonino Reale, head of the Emergency Department of Pediatrics of the Bambino Gesù Children's Hospital in the city).
7 - Vaccine against the flu?
I have two children aged two and five: can I vaccinate them against the flu?
The indications of the Ministry of Health for the control of influenza 2022-2022 recommend vaccination only for certain categories of people at risk, in particular the elderly over 65 years, women in the second or third trimester of pregnancy and children (over six months ), children or adults already suffering from other diseases that increase the risk of complications in case of flu (asthma, cystic fibrosis, diabetes, chronic inflammatory diseases). In all these cases vaccination is free and scheduled directly by the local health authorities.
The Ministry, however, reminds that "the flu vaccine is indicated for all those who wish to avoid the disease and have no specific contraindications". So, unless there are contraindications, children over six months can safely be vaccinated: in this case, the vaccine must be purchased at the pharmacy.11 PHOTOS
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8 - Prevention of ailments, is it possible?
Is there anything I can do to prevent seasonal ailments?
Place that some infections are difficult to avoid because they are very widespread, and that some children are more likely than others to get sick, some measures can reduce the risk of respiratory infections.
Starting with the hygienic ones: the number one rule is to wash your hands often, and always before going to the table. Another good idea is to cover your mouth and nose when sneezing or coughing, with your hands (or forearm) or with a handkerchief.
And again: it must be considered that some factors, such as cigarette smoke or air pollution, weaken the defenses of the respiratory tract, making them more prone to infections. Therefore, no exposure of children to secondhand smoke. Conversely, exclusive breastfeeding for six months protects against infections. As for the flu, an effective prevention strategy is certainly the vaccine.
9 - Antibiotics and respiratory tract infections?
When my child has a respiratory infection, my pediatrician suggests I wait a few days to see how it goes, while I see other children taking antibiotics very easily. What is the right attitude?
Obviously it is necessary to evaluate case by case: sometimes the wait-and-see attitude is correct, other times immediate intervention with antibiotics. On the use of these drugs, however, it is worth making some general considerations. They are very useful against bacterial infections (they have saved many lives), but completely useless against viral ones (that's why, if there are no other complications, in case of cold or flu they are useless).
The problem is that often too many are used, or used incorrectly and this causes the development of resistance on the part of the bacteria which, little by little, "learn" to defend themselves from the drug. The risk, feared and denounced by health authorities and scientific societies, is that, due to resistance, in the not too distant future diseases that are now easily treatable with an antibiotic will once again become incurable. Unfortunately, the Del Paese is one of the first countries in Europe for the consumption of antibiotics.
The responsibility lies partly with the doctors, who sometimes tend to prescribe them more than they should (also for cultural reasons: until recently it was thought that this was fine too), partly with the patients (or parents of young patients), who perhaps insist on a prescription.
So what to do? If in doubt, always ask the doctor why he is making that particular choice (to give or not to give the antibiotic). And learn how to use them correctly, at the correct doses and for as long as the therapy requires.10 PHOTOS
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Questions and answers
Why are children always sick in winter?
In winter, respiratory infections are common occurrences in chicks that frequent the nest. In a closed environment such as a nursery or kindergarten, the passage of microorganisms between children is inevitable.
The child often falls ill with a cold. How to relieve the annoyance of him?
Nasal washes are indicated, with physiological solution or thermal, saline and hypertonic saline solutions. Yes also to aerosols with physiological solution.
- 1-2 children years