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How Pediatricians Treat Their Own Kids

Sure, they went to medical school and have cared for thousands of children, but what do pediatricians do when their own children have a hacking cough, a stuffy nose, or a fever?

 

Cold Wars

When her kids have a cold, Joanne Decker, M.D., assistant professor of pediatrics at Children's Hospital of Philadelphia, lets a shower run to steam up the bathroom, then puts Madeleine, 6 1/2, Jack, 4, and Will, 1, in a tepid bubble bath filled with tub toys. "The steam loosens up the mucus in their stuffy noses, the bath brings down their fever, and the bubbles and toys keep their minds off their symptoms," says Dr. Decker. (When they were babies, she'd just take them into the shower with her.) To relieve congestion, she relies on over-the-counter nasal saline sprays and cool-mist vaporizers in their bedroom at night. For mild sore throats, Dr. Decker gives them frozen fruit-juice pops. "And watching extra videos can help take their minds off their misery," she says.

Elizabeth Alderman, M.D., associate professor of clinical pediatrics at Albert Einstein College of Medicine, Montefiore Medical Center, in New York, says, "I try to reduce the physical discomfort and stuffiness that come with a bad cold." She makes sure her two children, ages 9 and 6, drink lots of fluids and get plenty of rest and TLC - and acetaminophen when needed. And to encourage them to use a tissue for more than just wiping, she tells her kids to pretend they're blowing out their birthday candles with their nose. Beyond that, says Dr. Alderman, "a cold bug usually just needs to run its course. But when one of my kids sounds super-stuffy, sometimes I'll give him a dose of Dimetapp before he goes to bed to help him sleep through the night more easily."

Achy Ears

"My son was plagued by one earache after another when he was an infant and a toddler," says Dr. Alderman. "I'd wrap a warm towel over his achy ear and prop his head on a few pillows to relieve the pressure on his eardrums." Over-the-counter eardrops (such as Auralgan) also helped ease his pain and discomfort, especially at night, when his earaches hurt most. "And I'd always give him acetaminophen or ibuprofen as soon as I suspected that he had an ear infection," says Dr. Alderman. If the pain persists, check with the doctor to see if it's caused by an ear infection that requires antibiotics.

Because antibiotics can take a couple of days to work, patience is also prescribed, says Perri Klass, M.D., a Parenting contributing editor and mother of three, ages 5 to 16. "I walked the floors a lot with one of my sons during his many ear infections," she says. "And I just hoped he'd outgrow them." He did, as most kids do when their eustachian tubes widen with age and allow the ears to drain more easily.

Feeling Flu-ish

Dr. Decker's drill: rest and acetaminophen. She says, "If this doesn't bring down the fever, I sometimes use ibuprofen." (Never give aspirin to children under 18; it's been linked to Reye's syndrome, a serious disease that affects the brain and the liver.) Dr. Decker also keeps cool, wet washcloths by her children's beds when they feel feverish so they can wipe their faces when they feel warm. "But the main thing I worry about with the flu is that the children get enough fluids, so I keep their favorite drink nearby and remind them to keep drinking."

Why are fluids so important? When we're sick, all of the body's metabolic processes - such as nutrient transport and temperature regulation - depend on fluids, due to the energy it takes to fight the infection. If a sick child doesn't get enough fluids, her symptoms - in particular, aches and pains - may worsen.

Fluids are especially important when the flu is accompanied by bouts of vomiting or diarrhea. When that's the case, Dr. Decker gives her children small, frequent doses of a commercial rehydrating solution (such as Pedialyte or Rehydralyte) until they can keep fluids down. "I had been teaching this to parents in the ER, but I hadn't done it myself until Jack was a baby and he had an awful case of vomiting and diarrhea," Dr. Decker says. "I was surprised at how fast it worked to hydrate him and make him better." Slushy drinks work well for kids over 2: Fill a super-size cup with crushed ice and their favorite soda or juice, and then pop in a silly, swirly straw. Marianne Neifert, M.D. - a.k.a. Dr. Mom - a Parenting contributing editor and the mother of five, says that when her kids were little, she gave them Popsicles and Jell-O to hydrate them: "These were always a hit when my kids had the flu."

A Croupy Child

"There's nothing scarier for a parent than to see her child gasping for breath," says Steven Kairys, M.D., professor of pediatrics and adolescent medicine at Robert Wood Johnson Medical School, in New Brunswick, New Jersey. Dr. Kairys knows this from experience because his two kids came down with croup when they were little.

Characterized by a barking cough, croup usually hits kids between 6 months and 3 years old. It often follows a viral infection (such as a cold or flu), so antibiotics rarely help. Attacks usually subside when a child breathes in either very cold or very hot air, which relieves the inflammation that triggers the severe coughing. "When my kids had croup, I'd take them for a ride with the windows down," says Dr. Kairys. "It would pass the time until the cold quieted their cough."

A tip on croup from Dr. Decker: "Wrap your child in a blanket, and sit on the front porch and study the snow." Too cold to venture outside? "Open the freezer door and let him breathe the frosty air," she says. "He'll probably start to feel better within fifteen minutes. Once his cough calms down, give him lots of fluids, not only because they can prevent a recurrence but also because his sick body will need a lot."

The most important thing when dealing with the croup, says Dr. Kairys, is to stay calm: "If you're relaxed, your child will be too, and he'll be able to focus on breathing." Sit your child on your lap; try sweet-talking, rubbing her arm, or telling her a story. If her attacks are severe or she has difficulty breathing, call 911 or head to the emergency room. She may need steroids or a bronchodilator to open up her airways and help her breathe.

When it comes to treating their own kids, pediatricians are like the rest of us as parents: They make mistakes, use creative tactics, and keep trying until they get it right. "The best advice I can give you is to trust your gut," says Dr. Neifert. "It's your best tool."

Health writer Maureen Boland has contributed to American Health, Fitness, Family Circle, and Prevention. She is the mother of a 3-year-old daughter.

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