Health

Artist Sandee Ewasiuk usually spends her days tackling a canvas with bold strokes and bright swaths of colour. But on a recent damp morning, she faced a different kind of challenge: Her eight-year-old twins, Hannah and Sadie, were coughing and aching. The Hamilton mom abandoned her brushes for the day and ministered to her daughters with lots of liquids, chest-clearing baths, rest and her trademark flourish — a little fun with papier mâché. “You have to keep their spirits up when their bodies are down,” she says.

Welcome to cold and flu season. Toddlers and preschoolers will catch an average of eight to 10 viral infections a year, with most occurring between October and April. But don’t throw in the towel (or tissue) just yet. We asked experts for their top 20 tips for fighting the cold wars.

1. Scrub-a-dub-dub
As advice goes, “wash your hands often” may sound as dull as dishwater, but it’s the first, and often best, line of defence against flu viruses, which can live on our skin for hours. “It’s the hand-to-hand and hand-to-nose touching that brings the virus in contact with the mucous membranes, from where it infects the rest of the body,” says Joanne Embree, a consulting paediatrician and chair of the Canadian Paediatric Society’s infectious diseases and immunization committee. Make handwashing fun for kids by singing as you scrub, and use the “10 seconds and flip” rule, so both sides of the hands get washed.

2. Give Coughs the Cold Shoulder
How likely is it your child will remember to cover her mouth every time she coughs? It’s even worse if she does remember, but then forgets to wash her virus-laden hands afterwards. Embree advises simplifying things with a one-step rule: “Have children cough to the side of or into their shoulders,” she says. “It’ll cut down on transmission.”

3. Don’t be a Clean Freak
Cleaning zealously won’t protect your family from viruses—and it may even do more harm than good. Children’s immature immune systems need exposure to a little dirt now and then to make them strong and help them develop antibodies against common bugs. “You don’t want to sterilize everything in the house,” says Earl Brown, a University of Ottawa professor of virology. “You kill one organism and you risk attracting another that’s resistant.”

4. Embrace the Great Outdoors
A quick dose of sunshine and fresh air is not only good for the spirits — it’s also good for what ails you. “The sun’s ultraviolet radiation kills off viruses on exposed skin rather quickly,” says Brown. So don’t hesitate to take a sniffly child out for a short walk in a stroller or wagon.

5. Drink up
A well-hydrated kid is a healthy kid. Viruses thrive in mucous membranes, and the drier the membranes, the more hospitable they are to winter bugs. Encourage your children to drink eight glasses of liquid a day, and try to get at least that much, and a little more, into them when they’re sick. To help all those bevies go down, serve them with brightly coloured curly straws or in a new cup festooned with a favourite cartoon character. Drinking fluids keeps the mucus flowing, says Brown, “and that flushes the virus out of the body.”

6. Squelch Sharing
Sharing is good — except when kids are down with a cold or the flu. Assign each child (and parent) a different-coloured hand towel, washcloth and drinking glass, and wash these items frequently. Replace germ-ridden toothbrushes too.

7. Keep ’em on the Bench
Give young athletes a pep talk. Subject: It’s not cool to play when you’re sick. “I discourage competitive sport until a child’s energy returns,” says Andrew Issekutz, an immunologist at Halifax’s IWK Grace Health Centre, who sees a lot of young kids masking or denying their symptoms in order not to miss a big game or race. But when a child’s body is fighting off infection, physical play becomes one more stressor to an immune system already reeling. Ignoring the body’s signals to rest can delay recovery and ultimately lead to complications such as pneumonia, says Issekutz.

8. Be a Vitamin C Conservative
Megadosing on vitamin C was once considered the silver bullet for fighting colds, but now most experts consider it a waste of money. “There’s no evidence to support that megadosing on vitamins has any benefit at all,” says Embree. Still, as a preventive measure, many doctors recommend regular, moderate doses of vitamin C — 50 milligrams a day at most for kids, says Issekutz. You can get that from foods like oranges, broccoli, strawberries and cantaloupe.

9. Go for the Garlic
Mississauga, Ont., naturopath Rana Singh swears by the cold-fighting power of the humble garlic bulb. If your child has a cold coming on, chop or crush two or three cloves of fresh raw garlic and add it to whatever he’s eating.

10. Don’t Rely on Echinacea
Before dosing your kids with echinacea supplements at the first sign of a cough or sniffle, consider the latest research on its effectiveness: A recent study in the Journal of the American Medical Association compared the herbal supplement — heralded for its immune-boosting benefits — to a placebo in the treatment of hundreds of children with upper respiratory infections (mostly caused by cold or flu viruses). There was no difference in the duration or severity of symptoms between the two groups of children. And many of the kids who took echinacea developed an allergic rash.

11. Tuck ‘em in
Studies have shown that too little sleep increases our susceptibility to colds. Singh is dismayed by how many of his young patients don’t get enough shut-eye. Children need eight to 10 hours of sleep a night, he says, especially when they’re not feeling well. Warm baths and drinks (see “Serve a Warming Brew” below) can help induce sleepiness, and an extra pillow under a child’s head (but not baby’s) will reduce coughing fits that interrupt sleep. Calgary master herbalist Judith Cobb dabs eucalyptus oil on the corners of bedding for a little nighttime decongesting (but avoid doing this if your child has epilepsy).

12. Feed that Cold
Cold-fighting antibodies are made of protein, says Brown, so serve up small, protein-rich portions of food throughout the day. Try mild lentil dahl, pea soup with ham or celery boats stuffed with peanut butter. Add some lightly steamed vegetables to increase your child’s intake of vitamins, minerals and fibre.

13. Serve a Warming Brew
As a herbalist and mother of seven, Cobb has seen her share of colds and flu. She relies on mild-tasting red clover tea to give her kids relief. “It breaks down mucus and supports the liver,” she says. If your children turn up their noses at the brew, try any warm drink with lemon and honey. Add a sprinkle of cayenne to increase the drink’s warming properties and unblock sinuses.

Here’s a simple recipe: Mix one part freshly squeezed lemon juice with three parts water. Add a pinch of cayenne and/or slice of raw ginger and bring to a boil. Add honey to taste and let cool to lukewarm before serving.

14. Make a Batch of Chicken Soup
It’s not just an old wives’ tale: Chicken soup actually does have cold-fighting properties. “There’s so much anecdotal evidence that you can’t ignore it,” says University of Alberta mucobiologist Malcolm King. The hot soup nourishes, hydrates and steams away nasal stuffiness, and studies have shown that it contains anti-inflammatory properties that ease congestion.

15. Jack up the Humidity
A humidified house alone will not prevent the spread of colds and flu, but adding moisture to heated indoor air will help children feel better and may hasten their recovery. “Dry air can inhibit mucus clearance,” says Brown. A cool-mist humidifier or vaporizer is the best way to add moisture to dry air. You can also leave pans of water by heat vents, or open windows in the house for a few minutes each day to let in natural humidity.

16. Run a Tub
A soak in a warm bath will soothe sick kids while loosening congestion. Cobb enhances the chest-clearing effects with a dash of essential oils — her favorites are sweet thyme, lavender and eucalyptus oils, all of which have relaxing, disinfecting and decongesting properties.

17. Swallow your Distaste!
When your child snuffles in that loud, gurgly way that tells you she’s clearing her nose by way of her throat, let her be. As yucky as it sounds, there’s no harm in letting kids swallow their mucus — in fact, it puts less of the viral material out in the open where it can spread to others. “The gut is a tough environment,” says Brown. “Most of the viruses are killed there by bile salts, so swallowing is not necessarily a bad thing.”

18. Ease Up on the Acetaminophen
Don’t be too quick to administer pain relief. Most of the aches and fever associated with colds and flu are mild and make kids lethargic enough to get the sleep they require. Research has shown that giving pain relief to a virus-infected animal worsens the symptoms and duration of the illness, says Brown. “If you take the pain and fever away, children believe they feel OK and will start moving around and depleting the energy that’s needed to fight the virus.” Fevers above 103ÞF, however, always require immediate attention.

19. Don’t Rely on Cold Remedies
There’s no cure for the common cold, and no magic in over-the-counter remedies — and there may well be ingredients you’d rather your kids avoid, like sugar and chemicals such as pseudoephedrine, which irritates mucous membranes. If you’re determined to buy over-the-counter products, expectorants are your best bet since they help clear phlegm, says Brown. Lozenges may provide some relief from sore throats, but they can be hard on children’s teeth.

20. Administer Lots of TLC
A sick child needs lots of love and reassurance. “Cuddling is almost as important as anything else we can do,” says Cobb. Keep it confined to your child’s own bed, to reduce the risk of transmitting germs.

At what age should children be vaccinated against influenza?
The flu shot is considered safe for infants six months and older. The Canadian Paediatric Society (CPS) recommends that all healthy children and adults get vaccinated every year.

Is the vaccine a guarantee against catching the flu this season?
No. Public health experts have to guess which strains of virus will circulate each season, and add these to the current year’s vaccine. If they guess correctly, your child should be protected two weeks after the shot is given and for most of the flu season.

Can my child catch the flu from the vaccine?
No. The vaccine is not a live virus.

What are the side effects of the flu vaccine?
Side effects can include mild fever, swelling and soreness of the arm and, possibly, body aches. These disappear within two days.

What’s the upside of vaccinating my child against the flu?
Joanne Embree, chair of the CPS’s infectious diseases and immunization committee, says we need to look at the flu shot as a public health decision as much as a personal one: “Children transmit these viruses to everyone else. Mortality may be low in children, but it is high in their grandparents.”

What’s the downside of the flu vaccine?
The vaccine contains a tiny amount of a mercury-based preservative called thimerosal, which is a known toxin and has been linked to autism in children. However, a recent major study has shown absolutely no connection. Keep in mind too that if a flu strain other than the ones in the vaccine circulates this season, your children may still get sick, even though they’ve been vaccinated.

When shouldn’t children be vaccinated?
The flu vaccine serum is egg-based, so children with egg allergies should skip the vaccine, as should babies under the age of six months and anyone allergic to thimerosal.

Which children need the vaccine the most?
According to the CPS, children at high risk of complications from flu should get a flu shot. This includes children with the following conditions:
• chronic heart or lung disorders (bronchopulmonary dysplasia, cystic fibrosis, asthma, etc.)
• immune deficiencies such as lupus
• metabolic diseases such as PKU
• cancer
• diabetes
• those required to take acetylsalicylic acid (ASA or aspirin) on a daily basis

Originally published in Today's Parent, October 2004