It’s 2 a.m., and the coughing starts again. Anyone who has gotten a baby through cold season knows that sound, and the worry that comes with it. As a pediatrician and a mother of two (soon to be three), I’ve been on both sides of that bedroom door.

Cold and flu season is here, and parents often ask me what to do when their child, especially a baby, catches a cold, gets congested or seems to be coughing too much. The good news is that most colds can be handled at home. The key is knowing what helps, what to avoid, and when to call.

Coughing at night

Coughs often seem worse at night, just when parents are running short on sleep themselves. You may hear your baby coughing, or breathing harder or faster than usual, and wonder if something is wrong.

Since babies can’t tell us how they feel, we have to watch and listen. For the most part, a moderate cough in a baby with a cold is a good thing. It’s how the body clears out congestion.

During the day, gravity is your friend, and mucus drains more easily. When your baby lies down for the night, things can get a little backed up. Even so, always put your baby to sleep flat on their back, alone in the crib, with no pillows, wedges or inclined sleepers. Clearing the nose before bed is the safer way to help.

A typical cold lasts seven to 10 days, and the cough can hang on for two or three weeks after that. That’s normal.

Keep nasal passages clear

Babies breathe mostly through their noses, so a stuffy nose can make eating and sleeping hard. A couple of saline drops in each nostril, followed by gentle suction with a nasal aspirator, can make a big difference. Do it right before feedings and bedtime. A few times a day is plenty, since more than that can irritate the inside of the nose.

A steamy bathroom can also help loosen mucus. Run a hot shower, close the door and sit with your baby in the steam for a few minutes, well away from the hot water.

Skip the cough medicine

I don’t recommend over-the-counter cough and cold medicines. They haven’t been shown to help young children, and they can cause serious side effects.

For children over a year old, a spoonful of honey, alone or in a warm drink with lemon, can soothe a cough or sore throat and may help everyone sleep. Never give honey to a baby under 12 months, not even a taste. It can cause a serious illness called infant botulism.

If you want to be really popular with your toddler or older child, a popsicle soothes a sore throat and helps with fluids (you can make healthy versions yourself).

Keep babies and children hydrated

Many children lose their appetite when they have a cold. That’s okay for a short time, but staying hydrated is critical.

For babies, keep offering the breast or bottle, in smaller amounts more often. Babies under 6 months shouldn’t be given water; breast milk or formula is what they need. Older babies and toddlers can have sips of water throughout the day.

Most babies have about six wet diapers a day. Watch for signs your child isn’t getting enough fluid: fewer wet diapers than usual, a dry or sticky mouth, few or no tears when crying, or a sunken soft spot on top of the head. If your baby hasn’t had a wet diaper in six hours, call your provider.

Other times to call

Children’s breathing is my specialty, so here is what I want parents to watch for. Call your provider right away if your child:

• is breathing fast while resting
• has skin pulling in between or under the ribs with each breath
• has flaring nostrils or makes a grunting sound when breathing
• is too out of breath to eat
• is unusually sleepy, hard to wake, or won’t eat or drink
• has a fever lasting more than three days, or seems to get better and then gets worse

When the nearest emergency room may be a half-hour drive away, your provider’s 24-hour line is a good first call. If you’re worried, it’s always okay to call. I’d much rather see your baby and send you home reassured than have you tough it out. And if you come in, we can show you how to use a nasal aspirator gently and correctly.

When your baby or child gets sick, a little TLC with purpose goes a long way. In my next column, I’ll talk about steps you can take to help keep your child from getting sick in the first place.

A board-certified pediatrician, Dr. Sarah Alexander serves patients in Crawford and Orange counties. She has specialized fellowship training in pediatric pulmonology and brings advanced expertise in children’s respiratory health to her clinical practice in English and Paoli, Indiana.

The post What do you do when your small child gets sick? appeared first on Southern Indiana Community Health Care.

As the end of summer nears, two things happen with great reliability in southern Indiana. The corn gets tall, and my phone starts ringing with parents who need a physical signed by Friday.

I understand completely. The summer gets away from all of us. But if I could give parents one piece of advice before the first bell rings, it would be this: the annual well-child visit deserves a spot on the back-to-school list, right up there with the new backpack, as well as the shoes that fit in June and mysteriously do not fit in August.

Why the well-child visit is important

A yearly physical is more than a signature on a form. It’s a chance to see whether your child is growing and developing the way we’d expect, to make sure vaccinations are current, and to confidentially talk through balanced meals, sleep, exercise, and any worries about learning, behavior, or mood. It’s also when we can knock out those annual forms, the ones that always seem to turn up in a folder the night before they’re due.

As a reminder on vaccines, Indiana requires certain immunizations for school attendance, with additional ones at key grade levels. These include kindergarten, sixth grade, and twelfth grade. That list generally includes DTaP/Tdap, polio, MMR, chickenpox, hepatitis A and B, and the meningococcal vaccine for middle and high school students.

Since they don’t come up every day, that may sound like a lot, and parents oftentimes have questions. This is one of the reasons it’s good to have a direct conversation with a qualified medical provider.

Addressing physical issues that can inhibit learning

Vision and hearing are worth a look, too. In three decades of practicing medicine, I have never once had a child walk in and announce in a voice that only children have, “Doctor, I believe I need corrective lenses.”

What I hear instead comes from parents: “he squints,” “she gets headaches,” or “he asks us to repeat everything,”

The point? Sometimes the difficult issue that seems to come across like a school problem is really an eyeglasses problem.

When you should connect with the school nurse

If your child manages asthma, diabetes, allergies, or seizures, please connect with the school nurse before the year starts. Send updated medication orders, refresh emergency contacts, and check the dates on inhalers and epinephrine auto-injectors. Expired rescue medication in the nurse’s office does nobody any good.

School issues:  simple worry, or attention-sapping anxiety?

Mental health belongs on the list as well. Going back to school brings excitement and, for plenty of kids, a knot in the stomach. Ask how they’re feeling about it. Ask about friendships, about bullying, about what they do when something feels like too much. If you notice changes in sleep, appetite, mood, or behavior that stick around more than a couple of weeks, a one-on-one talk with your provider is a good idea.

The rest is old-fashioned and still true. Think about starting bedtimes and wake-ups a week or two early, because nobody adjusts to a 6:30 alarm overnight. Children ages 6 to 12 need nine to twelve hours of sleep; teenagers need eight to ten. Eat breakfast. Move every day. Put the screens down before bed. Wash hands, cover coughs, skip the shared water bottle, and stay home with a fever or a stomach bug.

And you athletes: drink a lot of water, wear the gear, and tell a coach immediately about any head injury.

Finally, don’t wait. Schedules usually fill fast as summer comes to a close, and the calendar always wins. Call now, and help your child start the year healthy, confident, and ready to learn.

Board-certified in family medicine, Curtis Thill M.D. has seen multiple generations of children at Southern Indiana Community Health Care on their way back to school.

The post If I Could Give Parents One Piece of Advice… appeared first on Southern Indiana Community Health Care.

Can you name a highly contagious virus with no known cure that spawned epidemics and killed multiple millions of people? We don’t think about it much today, but the now-eradicated threat from the deadly smallpox virus once wreaked havoc upon numerous millions of people, leaving a trail of death, disfigurement, and blindness across the globe.

Despite its fearsome reputation, smallpox was officially declared eradicated in 1980. How did that come about?

No known cure

While there is still no known cure for smallpox, a highly effective vaccine was developed and administered around the world. The ancient plague was stopped in its tracks. The same is true of polio, once a feared incurable childhood disease that can lead to irreversible paralysis. Only a few cases of polio are reported worldwide each year, due to effective vaccines and public health campaigns.

These critical advancements demonstrate the importance of timely vaccinations for both personal and community reasons. Being vaccinated in an appropriate way can help protect both you and your family, including friends and community members.  

Why is this important? In addition to protecting you personally, effective vaccines help limit the spread of a disease to those who are more vulnerable. These include infants, seniors, and people with weakened immune systems. 

Today, the flu season is upon us. We also see patients with pneumonia, RSV, and shingles who could have benefited from a timely vaccine. And as you can see in the news, a new XEC variant of Covid-19 has appeared, which could elevate new infection rates as we approach winter, the time when COVID-19 infections and related hospitalizations tend to peak.

The point? Effective vaccines – including a new updated COVID-19 vaccine – are now available for the flu, pneumonia, RSV and COVID-19. They help boost and train your immune system to effectively fight such diseases.

Elevating health, saving lives

Considering whether to get vaccinated? Here’s an important fact: many vaccine-preventable diseases – like pneumonia, RSV and even the flu – can quickly lead to both severe medical complications and longer-term health issues. 

Complications from an ordinary flu infection can lead to complicated respiratory problems that can be difficult to treat.  If you delay a measles vaccine and come down with the disease, that infection can lead to pneumonia, encephalitis (inflammation of the brain), and even prove deadly.

Being properly vaccinated can greatly reduce the potential for more challenging issues. Your medical provider can answer any questions that you may have (such as whether you should be vaccinated if you’re pregnant) and can make informed recommendations.

As a long-time physician working in southern Indiana, I – like many other providers – know from experience that vaccines offer an effective and cost-effective way to both prevent disease and promote health. Vaccines represent a critical aspect of strong public health. They are called a cornerstone of public health for good reason. Compared to the cost of treating a disease (especially in an advanced state) the cost of a vaccine is much lower.

Vaccine hesitancy 

During the COVID-19 crisis, a considerable amount of distrust arose from misinformation, especially on social media and certain podcasts. That situation unfortunately led to some hesitating to receive vaccinations, which has the opposite effect of increasing the possibility of higher rates of infection and loss of protection.

As noted at the beginning of this column, vaccines for smallpox and other viruses have caused these incurable and often deadly diseases to basically vanish. They have high value. We recognize that in some cases not all vaccines are necessarily 100% effective, but we also recognize from experience that the benefits of making an informed decision and getting properly vaccinated can literally save a life.

Want to promote good health? Talk to your provider today about vaccine options.

Board certified in family medicine, Yolanda Yoder, M.D. has served patients and families in southern Indiana for more than 30 years.

The post Are you protected from flu and other issues this season? appeared first on Southern Indiana Community Health Care.