Pediatric Health

With kids in school, they can often come home with stuffy noses, sneezing, coughing, ear or sinus pain, and fever.

More than 200 viruses can cause the common cold and they can spread easily through the air and close personal contact. Rhinoviruses are the most frequent cause of colds in the United States.

When your child is suffering from upper respiratory infection (URI) symptoms (also known as the common cold), it is natural to want to help them feel better as quickly as possible. For many parents, that means asking the doctor to prescribe an antibiotic for their child. Unfortunately, most colds are caused by viruses, which antibiotics are not effective in treating. In fact, treating a viral infection with antibiotics can cause harm to your child.

Instead of antibiotics, your doctor is likely to suggest rest and fluids along with over-the-counter pain killers and decongestants to help reduce symptoms and help your child feel better. If your child’s cold lasts more than 10 days without improvement or they have symptoms that are severe or unusual, you should consult a doctor. The doctor will do a physical exam and, if they feel it necessary, they may swab the inside of your child’s nose or mouth to help determine what type of illness your child has and determine if any different treatment is needed.

If your child has cold-like symptoms and you suspect they may have COVID-19 or flu, consult your doctor about having them tested, especially if they or someone in the family are at higher risk of severe illness.

Source: Common Cold - CDC.gov

With sore throats, the cause will determine the treatment.

Most sore throats are caused by viruses and will go away in 1-2 weeks on their own, without an antibiotic. Antibiotic treatment in these cases may cause harm to your child. Some sore throats are caused by bacteria. Up to 3 in 10 children with a sore throat have strep throat, caused by Group A streptococcus bacterium.

You should consult a doctor if your child’s sore throat lasts longer than a week, if they have difficulty swallowing or breathing, and/or have drooling, rash, and joint pain. The cause could be a virus or bacteria. It can be hard for a doctor to tell the difference between a viral sore throat and a bacterial strep throat based only on a physical exam and symptoms. It is important for your doctor to know if your child’s sore throat is caused by a virus or streptococcus bacteria. They may swab your child’s throat for a rapid strep test (if available in the doctor’s office).

If the rapid test is positive, they may immediately prescribe an antibiotic to help prevent the complications associated with this bacterium. If it is negative, part of the swab will be kept for culture. Within two to three days, it will show if the strep bacteria are present and then treatment will be determined.

Risk Factors | Anyone can get strep throat; the following factors increase the risk:

• Age—strep throat is more common in children than adults. The most common age is children 5-15 and is rare in children younger than 3 years old.

• Proximity—Close contact with another person that has strep throat is the most common risk factor.

If your child’s sore throat is viral, treatment will focus on their comfort, as there is no benefit and may be harm in using antibiotics. The doctor may recommend rest, acetaminophen (for pain), increased fluids, and throat lozenges.

Source: Sore Throat Information - CDC.gov

General

Respiratory Syncytial Virus Infection, more often known as RSV, is a respiratory virus that generally results in mild cold-like symptoms, but in infants it can be serious. Between 58,000-80,000 children younger than 5 years of age in the United States are hospitalized by an RSV infection every year. It is the number one cause in the US for bronchiolitis and pneumonia in children younger than 1 year of age.

Symptoms

• Runny nose
• Decreased appetite
• Coughing; this can progress to wheezing and difficulty breathing
• Very young infants may experience irritability, a decrease in activity and/or pauses in breathing (more than 10 seconds).

Prevention

RSV can spread through direct or indirect contact with someone carrying the virus; some people may not display any symptoms of the virus but still be able to spread it. You are at risk of getting RSV if you touch your face after touching a surface that has the virus, are exposed to a sneeze or virus or kiss someone who has the virus.

Ways to help prevent the spread of RSV are:

• Perform good hand hygiene
• Clean frequently touched surfaces
• Avoid sick contacts
• Cover your coughs and sneezes

Immunizations to protect infants:

• CDC recommends all babies be protected from severe RSV by one of two immunization options (most babies do not need both):
  • A maternal RSV vaccine given to the mother during pregnancy, or
  • An RSV antibody given to your baby

• The maternal RSV vaccine is given during weeks 32-36 of pregnancy.** Maternal antibodies protect the baby against RSV for approximately 6 months after birth

• A long-acting infant RSV antibody (nirsevimab or clesrovimab) can be given to babies. This antibody provides immediate protection against RSV and lasts at least 5 months.

• Some young children may also be eligible for nirsevimab.

**Please contact the health plan to determine coverage for maternal RSV vaccine

Source: CDC.gov

Treatment

In most cases, RSV infections will go away within a couple weeks. Like many viruses, people are encouraged to:

• Manage pain and fever through over-the-counter fever reducer and pain relievers like acetaminophen or ibuprofen.
• Stay hydrated
• Discuss nonprescription cold medicines with health care providers prior to giving any to a child; some ingredients contained in cold medicine are not safe for children.

Contact your health care professional if your child is having difficulty breathing, not drinking enough fluid (not having as many wet diapers), or experiencing other worsening symptoms.

Seek emergency care immediately if your child has a bluish coloration around lips or nail beds, develops rapid breathing, or experiences retractions (chest appears to sink in below the neck or under breastbone with each breath)!

National Alliance on Mental Illness (NAMI)

NAMI provides education, support, and resources for individuals and families affected by mental health conditions.

Find your local NAMI affiliate

Monitoring

If your child or adolescent is aged 1-17 and is taking two or more antipsychotic medications listed below, they should have an annual blood sugar and cholesterol testing.

These medications can increase a child’s risk for developing serious metabolic health complications associated with poor cardiometabolic outcomes including weight gain, diabetes, and dyslipidemia.

Given these risks and the potential lifelong consequences, metabolic monitoring is important to ensure appropriate management of children on mental health medications. 

Monitoring

If your child is between 6-12 years old and has been newly prescribed attention-deficit/hyperactivity disorder (ADHD) medication, they should have three follow-up care visits with the prescribing doctor within a 10-month period to assure the medication is working appropriately and there are no adjustments needed:

• One within 30 days of when the first ADHD medication was filled.

• If the child remains on the following medication over six months, they should have at least two follow-up visits within nine months.