What's Your Cold and Flu IQ?

Pediatric health experts answer parents' top 10 questions about sneezy, sniffly cold-weather maladies.


Chances are your child will develop between eight and 12 colds every year during childhood, says Harley A. Rotbart, MD, pediatric infectious disease specialist at Children's Hospital Colorado and author of Germ Proof Your Kids: The Complete Guide to Protecting (Without Overprotecting) Your Family From Infections."That's because there are lots of [cold] viruses out there, and kids' immune systems haven't seen them."

The flu (also known as influenza) is pretty rampant as well. Between 5% and 20% of Americans will get the flu this year, and 20,000 children under age 5 will be hospitalized because of complications like pneumonia. "Influenza can make children more susceptible to catching a secondary bacterial infection that leads to pneumonia," explains Michael J. Smith, MD, MSCE, assistant professor of pediatrics in the Pediatric Infectious Diseases Division at the University of Louisville School of Medicine.

What's a parent to do? We went to WebMD's online parenting communities and picked their top 10 questions about the cold and flu.

 

1. ?What's the difference between colds and flu?

"They're caused by different viruses," says Rotbart. More than 100 varieties of the rhinovirus and hundreds of other viruses produce upper respiratory infections -- in other words, the common cold, says Smith. The flu, however, is caused by a much more limited number of influenza viruses. "They are tricky because they mutate every year," adds Rotbart. "That's why you need a flu shot every year."

In the early stages, flu symptoms are nearly identical to cold symptoms: runny nose, cough, congestion, and sore throat. The flu is "like a ramped-up version of a cold," says Rotbart. It comes on fast, and a flu patient is more likely than someone with a cold to have fever, chills, muscle aches, and fatigue. Plus, the cold's upper respiratory symptoms are typically worse than those of the flu.

One way to tell if your child has a cold or the flu? "A head cold is something that kids deal with but still run on the playground, wiping their noses on their sleeves," says Rotbart. "The flu frequently knocks kids for a loop and makes them not want to play at all."

 

2. ?Will the flu shot give my child the flu?

"No. You cannot get the flu from the flu vaccine," says Smith.

The injectable vaccine is made from inactivated or dead virus. The inhaled nasal spray flu vaccine is a live weakened virus that can reproduce itself in the nose and throat, but "it doesn't cause the flu," says Smith. "It can give you a little bit of a runny nose and can lead to wheezing in some people who have asthma, so we usually don't give the nasal spray to adults or children with asthma."

If you're between the ages of 2 and 49 and otherwise healthy, you can ask for the nasal flu vaccine instead of the shot, says Rotbart. This option might be more comfortable for your child.

3. ?Does being out in cold weather cause colds?

"It's not totally a myth," says Rotbart. While catching a chill does not seem to increase your chance of getting a cold, extreme weather conditions may play a role. For example, researchers found that people who soaked their feet in near-freezing water for 20 minutes were more likely than others to catch a cold. But most research does not support the idea that being cold causes you to get sick. More influenza and cold viruses circulate during the winter months, "their preferred season," says Rotbart, which is a better reason so many of us catch a cold or the flu.

During the winter months, kids also tend to spend time indoors, where they are in close contact with others and can easily transmit germs and contaminate classroom surfaces.

 

4. ?Is it true you should starve a cold and feed a fever?

"No. That's nonsense," says Rotbart. "There is no medical condition where starving anything is healthy for you. We encourage kids to eat and drink to the best of their ability." Full meals aren't necessary if your child doesn't feel like eating. However, hydration is crucial. "Drinking water is mandatory," says Rotbart.

 

5. ?When is my child too sick for school?

Two issues are at work here, says Rotbart: "What's best for your child? And what's best for everybody else in school? My threshold for parents is if their kid has a fever of more than 100 degrees, he or she should not go to school." Most schools will not let kids with a fever attend, Smith adds.

Perhaps the most important reason to keep your child home is to help prevent colds and the flu from spreading. Children who have obvious cold symptoms -- coughing, sneezing, dripping nose -- should be kept at home for the benefit of the teachers and other children, says Rotbart. "Kids rarely fake this."

 

6. ?How long is my child contagious?

After your child is exposed to the flu virus, it takes one to four days to develop symptoms, and no one knows exactly what the incubation period is, says Smith. That means your child can be contagious for a few days before showing any flu symptoms. With colds, kids are usually contagious two days before any signs, depending on the virus.

What about after a cold or flu? Children generally are not contagious after two to three days of cold symptoms and after four or five days with the flu, says Rotbart. "The general rule is when your child is feeling better, it's safe for others to be around them," he says. "There may be a smidgen of virus hanging around, but when they're feeling better, they're not sneezing and coughing as much and are less likely to spread the virus."

7. ?When should I treat my child's fever? Can I give over-the-counter cold medicines?

"I don't think there's a magic number when it comes to fever temperatures," says Smith. "It depends on how your child is feeling. If your child complains of a headache, body aches, or sore throat, you can give acetaminophen or ibuprofen to help bring the fever down and make your child more comfortable."

You should never give aspirin to treat the flu (or a cold) in children. Aspirin can lead to Reye's syndrome (brain damage and liver failure), a condition linked to taking aspirin during an influenza infection and other viruses, such as chickenpox.

Also, never give children under 4 any cold or cough medicines, the FDA warns, because they may produce serious side effects. For older children, you can give these medicines occasionally, but many children's health experts feel there isn't enough proof they are effective for symptom relief.

 

8. ?What about home remedies? Do any work?

Yes, says Rotbart. "Honey is as good for a cough as any cough medicine. For kids older than 1 year, a teaspoon or tablespoon of honey is a safe and quite effective home remedy." Honey is not safe for children younger than a year because of the risk of botulism.

Homemade saline nose sprays can help with congestion and unblock stuffy noses. Breathing in steam -- by standing in a steamed-up bathroom, for example -- also helps relieve nasal congestion, Rotbart says.

Rotbart is a big fan of chicken soup as a home remedy for cold and flu symptoms. Not only is the soup hydrating, but the steam may help with congestion.

"It's never been shown in a controlled trial with real people," he says. "I can't say with honesty that there's science in humans to back it up. But as my grandmother would say, 'What could it hurt?'"

 

9. How long until my child feels better?

"The typical cold will last about three to five days," says Smith, and your child will probably feel lousy for the first couple, then start to feel better. "The influenza virus can really knock your kid out for a bit longer -- usually at least five to seven days."

 

10. ?How can we avoid colds and the flu altogether?

Make sure your kids frequently wash their hands, says Smith. And if your child is the one who's sick, reminders to practice "good cough etiquette" -- coughing or sneezing into an elbow or upper arm -- can help reduce the spread of infection.

Getting adequate sleep and exercising help bolster immunity against cold viruses, says Rotbart.

Finally, "Everybody really should get a flu vaccine," says Smith. "It's what we call a universal recommendation. The CDC recommends everyone over 6 months be vaccinated. That's really the best way to prevent the flu.

Cold and Flu: Should Your Child See a Doctor?

The answer is yes if your kid has any of the following symptoms.

High fever. A fever of 101 degrees or higher lasting more than a couple of days warrants a call to the doctor. A baby younger than 6 months with a fever of 100.4 or higher should see a doctor. An unimmunized child who has a fever needs to be checked right away as well.

Breathing problems. Difficulty breathing or working hard to breathe -- at any age, not just in childhood -- is "a medical emergency more than anything else," says Michael J. Smith, MD. Call your doctor right away.

Dehydration. Inability to keep fluids down or infrequent urination could signal dehydration. Make sure your child is drinking water or juice mixed with water. Left untreated, severe dehydration can lead to shock.

Swallowing problems or wheezing (including stridor, a harsh, raspy sound when inhaling). Both are reasons to go to your doctor, says Smith.

Unusual behavior. If your child is acting differently than normal, pay attention. "Every child has their usual trajectory when they are sick," says Rotbart. "Some kids are more feverish, and some are more coughing and sneezing kids. But when your child is not following the pattern that you're accustomed to, that's the time to go to the pediatrician."

 

 

Christina Boufis - WebMD