With the cold season the classic routine has begun again colds and other respiratory infections. It seems we don't have time to end up with an illness that immediately begins another one, at least until spring. It is a normal phenomenon in children, especially before the age of six: doctors talk about recurrent respiratory infections (the abbreviation is IRR), which include colds, tonsillitis, ear infections, pharyngitis, bronchitis and bronchopneumonia. And sometimes a fever also comes.
Read also: Fever children, everything you need to know
In this article
- First rule, don't get too scared
- What recurring infections depend on
- Why some children get sick more than others
- Colds and seasonal ailments: prevention
- What to do when the child is sick
First rule, don't get too scared
"The first thing to do is not to be too alarmed" advises pediatrician Marzia Duse, president of the Del Paesena Society of Pediatric Allergy and Immunology. "In the vast majority of cases, these are recurring infections physiological, in the sense that they are linked to a normal maturation process of immune system".
Experience shows that the younger the children, the more likely they are to get sick. "This happens because they are still 'virgin' from an immunological point of view, that is to say they do not yet know the various infectious agents and as soon as they come into contact with them they are infected" explains Maurizio de Martino, immunologist pediatrician, director of the Pediatric Clinic 1 of the City Meyer Children's Hospital.
This is why the phenomenon begins to diminish from the age of 4-6, as the immune system matures and its own 'wealth of experiences' begins to form.
Recurring infections, what they depend on
In the vast majority of cases, recurrent respiratory infections are caused by virus, such as rhinoviruses, adenoviruses, coronaviruses, influenza and parainfluenza viruses, respiratory syncytial virus. All in all this is fortunate, as viral forms tend to resolve more easily.
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.
Why do some children get sick more than others?
If it is true that recurrent infections are a physiological phenomenon, it is equally true that there are children particularly affected by these diseases. This can happen for various factors, including:
- biological and genetic factors which, for example, account for a greater slowness in the maturation of the immune system;
- social factors such as attendance of infant-toddler centers and kindergartens, closed environments where microbes circulate with particular ease, or belonging to large families;
- environmental factors such as exposure to city smog and passive smoking. Even the fact that Mom has smoked during pregnancy it doesn't help. A minor factor is the exposure to fireplace smoke: "The combustion of wood produces substances which, especially in children who are inherently weaker, decrease the defenses of the airways" underlines de Martino.
Colds and seasonal ailments, how they are prevented
Although these are generally not worrying conditions, there is no doubt that a child who is always sick can be difficult for the family, often trapped in a hectic pace of life. Fortunately, there are some useful prevention strategies. Let's see what it's about.
- Watch out for sleep and nutrition. The child must sleep at least 10-12 hours between 3 and 5 years, even more if he is younger, and must eat well: two measures that reinforce him in general. A healthy eating, rich in fruit and vegetables, guarantees a good intake of Vitamin Cwhich is important for the prevention of infections.
- In the first few months, if possible, breastfeed. A healthy diet with a preventive effect starts from birth: it is proven that theexclusive breastfeeding for at least six months reduces the risk of recurrent infections in children.
- Mani pulite: accustom the child to wash his hands well several times a day and especially before eating.
- Less pollution, no smoke. Of course, you can't necessarily move to the countryside, but at least you must avoid smoking in the presence of the child or letting him stay where you smoke, using the fireplace in the house or going out for a walk during the busiest hours.
- If possible, delay entry to the nest, or choose micronids or family nests, attended by fewer children. It is true that if the mother has to go back to work it is a difficult solution to adopt, but it is also true that a child who often gets sick he is forced to stay at home for many days, with all the organizational - and economic - difficulties that follow. "If children get sick often it is really worth trying to keep them at home a little longer," says Duse. This does not mean abandoning the idea of the nest forever, but proceed step by step.
- Do not force the times of convalescence. Better to send him back to the nursery or kindergarten when he is completely healed, otherwise there is a risk of encouraging relapses. "If he has not fully recovered, ends up getting sick again because the immune system is still weakened "Duse points out. The result is those cycles well known to many parents: two days at school, two weeks at home and so on ...
- Avoid intensive use of the pacifier. Although the mechanism is not yet fully understood, it has been seen that continuous use of the pacifier can favor the onset of ear infections. It is not necessary to eliminate it, but you can try to reduce its use.
Supplements and immunostimulants, the point about usefulness
We know that vitamin C and vitamin D they are important for the prevention of infections and children can sometimes be deficient. For this, it can be useful to take them as supplements, but always on prescription. From avoid DIY, because there is always the possibility of overdoing the doses, and overdose can lead to intoxication.
The same is true, as well as for vitamins, also for herbal products such as'echinacea: some studies suggest a (limited) usefulness, but it is better to seek advice from a specialist.
In recent years, moreover, the hypothesis of the usefulness of some substances for strengthening the immune defenses of children has been gaining ground. They are the immunomodulatory or immunostimolant, substances of bacterial origin or products by chemical synthesis (such as pidotimod or OM-85) capable of enhancing the ability of the immune system to be alarmed if a bad germ arrives, and to react accordingly. But are they really needed? The answer, for the moment, remains suspended.
Clinical studies conducted on children are few and, for now, discordant: in some cases the immunomodulators seem very effective, in others substantially useless. Because of this not all doctors agree in recommending them. In any case, they must always be taken on medical indication and knowing that miracles are not to be expected: they don't necessarily work and, even when they do, they often just mitigate the problem, not make it go away.
What to do when the child has a cold or other respiratory diseases, all good practices
- Nasal washings. According to many experts, nasal washes can be an effective one remedy against the annoyances of colds because they help clear the nose of mucus. So, if your child is in trouble and tolerates them well, it's definitely worth a try: they can be done using physiological solution, thermal waters or sterilized sea water, of course with delicacy.
- Aerosol with physiological. In addition to nasal washes, aerosol can be done, since the steam helps dissolve secretions. The important thing is to use saline only and do not add drugs, such as thinners or cortisones, which have no documented efficacy.
- Humidify the rooms. The dry and hot air of certain closed rooms can dry the mucous membranes and encourage the formation of scabs, which clog the nose even more. It is therefore a good idea to adjust the thermostat of the radiators to more reasonable temperatures; moreover, if the environment is really dry it could be useful to use humidifiers for rooms, at least in the room where the child sleeps.
- Lift the mattress. On days when the baby is cold, a pillow can be placed under the mattress of his cot: sleeping with the head slightly raised makes secretions flow better.
- Offer him a drink often. Drinking liquids is very useful for making the mucus fluid and clearing the nose: if the baby is breastfed, it is better to offer him the breast more often, if he is already weaned, give him water or lukewarm drinks to drink.
When should I contact the pediatrician?
While recurring infections are more annoying than anything else in most cases, that doesn't mean they don't need to be controlled. Here are all the situations in which it is necessary to consult the doctor, according to the indications of Maurizio de Martino:
if it occurs high fever, which does not pass after 2-3 days;
- are noticeable persistent greenish-yellow purulent secretions;
- if the child is particularly inappetent and whiny;
- one gets the impression that the child is feeling earache;
- il piccolo is less than 3 months old;
- infections really are too frequent or severe (more than twice a month for three months in a row, or more than one bronchopneumonia in a season). In these cases, infections could be caused by a malformation of the airways, by the presence of a foreign body or by a compromised immune system.
- 1-2 children years