When it SNOT a Virus
Understanding when to come in for Upper Respiratory Symptoms.
During the cooler months of the year, I spend many visits with patients and parents discussing the difference between a viral and bacterial upper respiratory infection. Although it can sometimes be difficult to determine, there are some key factors that help differentiate the two.
What is an upper respiratory infection (URI)?
URIs go by many namse such as cold, flus, sinus infection and are caused by a pathogen (usually viral or bacterial, in rare cases fungal) that has an affinity for the tissues of the upper respiratory system (eyes, nose, throat, sinuses upper lungs, and even ears). There are BILLIONS of cases reported per year in the US alone (don’t believe me, check out the CDC: https://www.cdc.gov/antibiotic-use/community/for-patients/common-illnesses/colds.html).
Most of the time these infections are viral and only about 2-3% turn into bacterial infections that require antibiotics. In addition, greater than 80% inner ear infections that are secondary to URIs in children 3 and older resolve on their own without the use of antibiotics.
Symptoms can widely range but commonly include: Less common, but possible symptoms include:
- Runny/stuffy nose - Worsening Eczema
- Fatigue - Urinary Symptoms
- Cough (a cough up to 4 weeks can be normal) - Rash
- Sore throat - Green, snotty drainage in eyes (more
- Ear pressure or Pain (including muffled hearing) common in younger children)
- Fever
- Muscle aches
- Headache
*note: SNOT COLOR DOES NOT MATTER. GREEN SNOT CAN HAPPEN WITH A VIRUS AND ONLY SUGGEST THAT THERE ARE WHITE BLOOD CELLS IN YOUR BOOGERS (cool, huh?)
“When should my child come to TRF Pediatric Health?”
I get this question frequently, and although I am happy to see patients the same day for all concerns, here are a few guidelines to apply to your child or infant:
- If a fever of 100.4 for more than 3 days
- If symptoms are not improving by Day 7
- If there are signs of increased work of breathing (rib retractions, abdominal breathing, pursed lips, nasal flaring)
- If a cough is resulting in vomiting or gagging
- Signs of dehydration (not crying tears, dry mouth, dry/cracked lips, pale, sluggish capillary refill when pushing on the nails)
- Any other severe/concerning symptoms
*if your child is under 12 weeks, follow up right away if fever (100.4 F)
“So, if most are viral and do not require antibiotics what can I do to treat/comfort my child?”
Here are some effective ideas to minimize symptoms during these pesky illnesses:
- Rest (sleep and rest are the most effective ways to boost immune function, see my post on sleep)
- Hydrate (drink ½ your body in ounces of water; this will help keep secretions like snot thin and not sticky. Sticky snot is a breeding ground for secondary bacterial infection like ear infections and sinus infections)
- Bulb suction when under 2 (LOVE the Nose FRIDA, so much more effective than the average bulb). Apply 1-3 drops of saline a massage and suction to loosen hard and thickened snot in the nose
- OTCs (make sure to read the label or call to get more information on effective for your individual child)
- Vitamin C (studies suggest that it can decrease the length and intensity of URIs)
- Alternating Tylenol and Ibuprofen every 3-4 hours for fever, body aches, headache, ear pain
For children under 10 years of age, cough suppressants are no longer recommended as this is the primary way of clearing out the lung. Suppressing the cough reflex may allow snot to sit in the lungs, resulting in pneumonia.
“I am not into medications and would like to take a more holistic approach, are there things I can do to minimize my child’s chance of infection or help when my child is sick?!”
YES! This is often overlooked and may be the MOST IMPORTANT part of keeping your child healthy:
- Hydrate
- Adequate sleep
- A healthy diet (high in fruit and veggies that are nutrient-dense)
- Probiotics
- Multivitamin (with Vitamin D)
- Fish Oils
(Check out this blog by my good friend and functional guru, Dr. Lisa Miller detailing supplements that minimize and prevent URIs including the flu: https://www.excellforlife.com/2019/09/cold-flu-prevention-and-treatment-2019/)