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You'll Catch Cold...

In the winter, I make my daughter Josephine's life miserable by nagging her about wearing slippers in the house. She comes out of the bathroom in her pajamas, her hair soaked from the shower, and crosses the living room on silent bare feet -- and from two rooms away, I yell, "Put some slippers on! It's freezing outside!" She has pointed out to me that it is not, in fact, freezing in the living room.

She has also reminded me, repeatedly, that I've explained that colds and flu are caused by viruses, and have nothing to do with whether or not you go outside with your hair wet or wear slippers in the house.

As a pediatrician with special training in infectious diseases, I know this is true. But I don't like to see a child walk around barefoot in the winter. It just doesn't seem healthy.

There are the things that you learn in medical school -- and then there are the things that you just know. These are the myths, the silly folklore of silly women, the old wives' tales. As a medical student, you snicker: Parents are so credulous, so unscientific! They believe a high temperature will melt their child's brain!

But as I watch my own kids grow, as I talk to the parents who bring their kids to my clinic, as I creep ever closer to old-wife status myself, I find that I'm quite often in sympathy with these beliefs -- and sometimes even encourage them. At the very least, I listen for their hidden messages, their layered meanings, and, yes, their wisdom.

So in comes the mother with a 9-month-old. She tells me the baby has felt warm the last few nights, her nose is running nonstop, and she's incredibly cranky. Do I think she might be teething? The belief that teething causes such symptoms is so common that there's actually a famous fake research paper titled "The Teething Virus." The truth is that this child, who's sitting on the exam table, her nose running like a faucet, probably has a viral illness in addition to teething. But then again, lots of children have lots of viral illnesses -- some have colds all winter. And if the teething is making her drool a great deal, exacerbating her chapped cheeks and chin, if it's making her uncomfortable, and that's magnified by the irritation of her runny nose -- well, why should I tell her mother, no, this has nothing to do with the teething? It's not necessarily a straightforward cause-and-effect situation, but the mother's diagnosis  -- that some of this misery is related to teething -- is worth addressing when we talk about how to make the baby more comfortable.

Or what about the husky 5-month-old whose parents brought him in for his shots last week and asked nervously if I thought they could start putting a little rice cereal in his bedtime bottle? They were hoping that the cereal would help him sleep through the night. Now the world is full of parents who believe that cereal helped their babies sleep. But there's no evidence that this strategy works -- the question has been studied, and no effect has been demonstrated. On the other hand, here were these parents with a good-size baby who was certainly old enough to sleep through. And as I know from maternal experience, when you want your baby to sleep all night, you'll try anything, everything -- and when he finally does, you credit whatever you tried last.

So I tell the parents of the 5-month-old the truth -- that there's no proof it works, and we don't recommend solid foods till the baby is 6 months old. But I also assure them that as long as they stick to rice cereal in the bottle, he'll be okay, and it's worth a try. I also talk about other sleep strategies, because I need to acknowledge that a baby -- however well loved he is -- who doesn't sleep through the night can stress his parents to the point where they need a little advice, a little cheering along.

Here's another belief: Children with bad colds can't handle milk or formula because it will make their congestion worse or cause them to throw up. Therefore those kids get switched to juice, water, or some other clear liquid -- which can actually be dangerous if the cold and congestion persist for days, because these fluids don't provide any protein or enough calories. On the other hand, it seems clear to me that some children, when they're sick, have strong ideas about what they'll eat and drink -- like my little boy, who goes on a hunger strike whenever he's ill and has narrowly skirted dehydration on multiple occasions. No matter what I tell parents to feed their sick child, I have never succeeded in feeding mine anything at all, and if he had been willing to drink apple juice, I would have bought it by the gallon.

All of which is to say that while I believe in scientific evidence, I also believe that you know your own child, and if he does better with clear liquids when he's sick, then you're probably going to go with clear liquids -- so let's talk about what the best ones would be (an electrolyte solution for babies, for instance), and how to move the diet forward as the child improves.

Some other potentially dangerous beliefs make their way into my office -- the parent, say, who doesn't want to give a child anything to eat or drink because he has gastroenteritis and it might just come right back up. But most old wives' tales are reasonably benign and occasionally helpful. My job is to listen to parents' concerns, fill in the information I have, and offer suggestions -- not to heap medical scorn on their observations and experiences.

And speaking as a parent, all I can say is, if you walk around without slippers or go out with a wet head, don't blame me if you catch cold -- and don't say I didn't warn you!

Contributing editor Perri Klass, M.D., mother of three, is a pediatrician at Boston Medical Center.

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