In the new "super flu" era, who among us hasn't thought of bundling up our kiddos in hats, gloves, and surgical masks this winter? Better yet, how about plastic bubbles? (Remember that true story?) Pediatricians' offices have been fielding calls and visits from worried moms since news of the novel flu strain -- originally called "swine flu" but now known officially as the H1N1 virus -- broke last spring and a global pandemic was declared. Yikes! How concerned should you really be? "You should take H1N1 seriously because the flu is a serious thing, but it's not necessarily any worse than other flu strains," says David Goldberg, M.D., chief of pediatric infectious diseases at St. Joseph's Children's Hospital in Paterson, NJ. What you should watch for in your family: the usual flu symptoms of fever, cough, sore throat, congestion, body aches, headache, chills, and fatigue. In addition, a significant number of H1N1 sufferers have experienced vomiting and diarrhea.
The good news is that the Centers for Disease Control and Prevention (CDC) has been reporting from the onset of the outbreak that most H1N1 victims have experienced only mild symptoms, and at press time that continues to be the case. But there's still a lot that's unknown, and that's the main reason people are freaking out. Scientists can't predict how the H1N1 virus will behave or what its potential for harm is. What they are sure of: the same illness-prevention strategies that you already know are the key to beating back the flu and other pesky winter bugs. Follow our easy stay-well prescription and watch your family thermometer collect dust in the medicine cabinet. Your most uneventful cold-and-flu season ever awaits!
- Wipe down the handle of your shopping cart, the doorknobs of public bathrooms, even your kid's menu (just think how many tots have licked the photo of that ice cream sundae).
- Bring your own books, toys, or a portable video game to play with at the doctor's office. Yes, offices clean their toys, but the odds are huge that a sick kid had his hands on them not long before you arrived.
- Use your own pen at the doctor's office, pharmacy, and checkout counter (adults carry germs, too!).
- Spray down the bathroom with a household disinfectant such as Lysol or Clorox Clean-Up if a family member has been sick. Other germ magnets that could use a spritz: phones, remote controls, microwaves, and refrigerator door handles. You can also spray down toys at the end of the day -- once the disinfectant dries, it's no longer hazardous.
- Try not to hug soiled linens close to you to avoid spreading germs from dirty laundry to your body. Wash your hands afterward.
- Sanitize like crazy if you go to an indoor play space!
The immune system functions better with a healthy diet, notes Atlanta pediatrician Jennifer Shu, M.D., the coauthor of Food Fights, so kick off your family's day with a breakfast rich in protein and colorful fruits and vegetables. Think pepper-packed omelettes, broccoli or spinach quiche, pumpkin or zucchini breads. Be sure to include some whole-grain carbohydrates to keep them pumped until the lunch bell rings. Start a healthy competition to see who can eat the most colorful foods over a week. Post a chart in your kitchen and have everyone fill in what they had daily. Got a kid who tolerates only one food group (toast, anyone?)? Ask your doctor about giving him a multivitamin to make sure he's getting all the nutrients he needs, recommends Dr. Shu.
Avoid Wardrobe Malfunctions
From chilly bus stops to stuffy classrooms to hot gym classes: Most kids could use a series of costume changes throughout the day. Temperature fluctuations alone won't make him sick, but overheating can lead to dehydration, leaving him run-down and more vulnerable to a bug lurking in another kid's sneeze or on that shared math book. Layers that can be easily snapped on or zipped off with confidence will keep kids comfortable -- and looking cool.
Dish Up Vitamin D
Making sure your kid is getting enough vitamin D should be another one of your first lines of defense because it helps activate immune cells. Trouble is, most kids aren't these days because the main source of D is sunlight. Between slathering on sunblock in warm weather and spending a lot of time indoors during the winter, seven out of ten children in the U.S. have low levels of vitamin D, according to a study done by Albert Einstein College of Medicine in New York City. Good food sources of vitamin D include fortified milk and juices, cheese, eggs, and salmon. Still, it's tough to get the recommended 400 international units (IU) daily. Unless your child is a big milk drinker -- to help you do the math, one cup of milk has about 100 IU of vitamin D -- you should talk to your pediatrician about a supplement; the American Academy of Pediatrics now recommends one up until age 18.
Just For Baby
Vitamin D is the one thing breast milk unfortunately doesn't have enough of, so if that's what your baby's drinking exclusively, ask your doctor for a 400-IU supplement. Infants who are consuming at least 32 ounces of formula daily are covered, but once solids are added to their diet, they're likely to need a supplement, too.
Power Up the Probiotics
Sign us up! A recent study showed that kids who were given twice-daily probiotic supplements for six months experienced fewer fevers, coughs, and runny noses during the cold and flu season than children who were not. But what the heck are probiotics? Good germs that restore balance to the digestive system, thereby boosting immunity. You can find them in: foods Stonyfield Farms and Dannon make yogurt and yogurt drinks with probiotics. Stir in a spoonful of honey (after age 1) -- it's also believed to trigger immune function. Whole grains and bananas contain prebiotics, a type of fiber that fosters the natural growth of probiotics. supplements Ask your pediatrician about a supplement like Florastor Kids or Culturelle for Kids -- both can be mixed into juice or soft foods. Probiotic supplements may also be used to treat diarrhea when it's a side effect of antibiotics.
Kids put their fingers in everything from their friends' cupcake frosting to their own noses, and they may not always have the time -- or the inclination -- to wash their hands during the busy school day. Pack travel-size, alcohol-based hand sanitizer gel or wipes in your child's lunch box, backpack, and gym bag. And check the labels: Studies show that hand sanitizers should have a concentration of at least 60 percent alcohol or they won't work.
Nose Blowing 101
It sounds easy enough, but many younger kids reflexively inhale instead of blowing out. Try these tricks: solo-nostril blow Place your finger over a nostril. Dangle a tissue over the other and ask him to "push" his boogers out. When he blows correctly, he'll see the tissue flutter and understand that the air (and boogers!) are coming out of his nose and making the tissue move. oink it out Give your child a tissue and tell him to make a piggy face by scrunching his nose, then "oink" while blowing hard enough into the tissue that his tummy sucks in.
When To Do It You know the drill -- have your child wash her hands before meals, after using the bathroom, after coughing, sneezing, or nose picking, after touching animals (and cleaning up their waste), and after she's come in from outside. The trick is not to slack off. Ever.
How Long For at least 15 to 20 seconds, or long enough for your child to sing the alphabet or "Happy Birthday" twice.
What Temp Have your kid wash in water that's warm but not too hot. Heat isn't going to kill the bacteria or viruses anyway. Washing removes them, and if your kiddo is comfortable, she's more likely to do it.
How Much Soap Some, but not gobs (skip antibacterial soap -- it may promote resistance). Effective hand washing requires soap and friction, says Dr. Shu, so make sure she rubs her hands together vigorously.
Is It Contagious?
Cough As a general rule, if a child has an occasional cough but his energy is up, he's probably not still sick -- tickles and hacks can linger long after a cold has run its course. Dry coughs from allergies and asthma are also not contagious. But if a child has a persistent cough and is acting tired or irritable, he is more likely to be coming down with something. Cough accompanied by a fever should be considered contagious. A barking cough may be croup or whooping cough, while a loud, loose cough from the chest may indicate bronchitis or pneumonia, all of which may be contagious and should be checked out by a doctor.
Fever A child is sickest the day before a fever begins and for the first three days she is unwell (if it lasts that long). Once a child is under 101°F for 24 hours (without medication), she is much less contagious.
Flu A child is most contagious the day before she comes down with the flu, and she remains contagious until she is under 101°F for 24 hours (without medication). The fever can last from three to seven days.
Runny Nose A runny nose is indicative of a cold, which is most contagious for the first three days. Clear, green, yellow, and even rust-colored boogers are all created equal, and while thick, green ones can mean the cold is settling in, they are no more indicative of contagiousness than the clear kind. If the nose is still running after seven to ten days, it can be a sign of a sinus infection, which needs treatment but is not contagious.
Sore Throat A sore throat with other symptoms, especially fever, is possibly strep or something else contagious, so consult your doctor.
Stomach Bug Kids are most contagious the day before they begin to vomit or develop diarrhea (which is probably why the darn bugs spread at lightning speed) and remain contagious for the first three days (again, if it lasts) or until they have not vomited or had diarrhea for 24 hours.
Hello, inevitable: Despite all your best efforts, your kid got sick. A quick checklist for keeping her comfy:
- Give her a pain reliever if she has a fever of 101°F or higher. Call your doctor to confirm the dosage.
- Fill her up with extra fluids Offer water, juice, ice pops, or Pedialyte.
- If she has chills, wrap her up so she feels warm but not bundled.
- Prop up her head to allow her nose to clear if she's stuffed up.
- Help her breathe easier by applying a menthol rub like Vicks VapoRub to her chest (for kids over 2).
- Serve her chicken soup According to some studies, it can actually loosen congestion.
- Give her a shot of saline nasal spray if she'll tolerate it.
- Add nose-and-throat-soothing moisture to her room by turning on a humidifier or vaporizer.
- Run her a bath Cool water may help bring down a fever. If she's coughing or congested, run a hot shower to steam up the bathroom.
- Air out her room while she's taking her bath or shower so it feels fresh and clean for bedtime.
- Keep your cool -- even in the age of H1N1, your child will get better!