Caring for Kids…at Billings Clinic

Endless Boogers

Until I became a mom I had no idea I would be covered in snot, with pockets full of dirty Kleenex from October to March hoping and waiting for the day I no longer have to go running for a tissue every time I hear a sneeze, because even without looking I know we have what my 5 year old calls a “booger emergency” (You know, the two yellow columns of snot draining from the nose to chin). Ah…the joys of motherhood.

So what is with all this snot? The average kid gets around 12-14 viruses a year, each lasting up to 2 weeks and most occurring in the winter. So, yep, that means 28 straight weeks of snot! The good news is that it gets better and for every virus they get now, it’s one they won’t get later. The bad news is the only cure for colds is time. For infants, using saline drops and suctioning (yes the blue torture bulb) can be helpful. I would use this only if they are struggling to breathe or struggling to eat. Most of the time, the noisy congestion annoys us but isn’t really bothering the babies. Resist the urge to suction every booger as it can cause swelling of the nose and worsen the congestion.

For older kids, just saline spray for the nose can work, and even better, nasal rinses work well for anyone you can talk into it. For children over 6 months of age, ibuprofen can decrease the swelling of the nose and help drainage so is great to use just before bed. Even if they don’t have fevers it helps with the all-around icky feeling. Running a humidifier is great, especially in our dry Montana winters. Make sure to clean and sterilize once a week as they can grow mold which can be irritating (increasing not decreasing the boogers). If they are coughing, honey works great for kids over 1 year of age. Kids can take it straight or in teas or mixed with lemon. Plain honey is great and is usually cheaper than the natural cough medicines mostly made of water and honey. Cough and cold medicines are not recommended for anyone under 8 years old. They are usually ineffective and can have unacceptable side effects even if used at proper dosing. In studies, honey has been shown to work as well as cough medicine. Remember, no one under 1 year of age should have honey or honey-based cough medicines.

So when should you be concerned? First, anytime your child looks very ill. Especially if given proper doses of ibuprofen or acetaminophen without showing signs of improvement. Three other things I tell all my families is to see a doctor for (1)fever of >101 for more than 5 days or if they seemed to be better and the fever returns (2) trouble breathing (3) signs of dehydration.

  1. Fevers are not harmful. They are the body’s way of fighting infection. The body has a natural thermostat that will not allow the child to get to a temperature high enough to cause damage. Translation – fever will not melt the brain. High fevers do not cause seizures; some kids are just prone to fever seizures (a discussion for another time, but be reassured febrile seizures are generally harmless). I treat the child not the fever. If they are miserable at 101 degree fever, treat it. If they are happy and running around at 103 degrees, let them be. But fever over 5 days is unusual for viruses, thus these children need to be seen by a doctor. The one exception to this is children less than 3 months old. For infants, a temperature is consider 100.4 or higher and all of these temperatures should be reported to a physician. (Thankfully this doesn’t happen that often).
  2. Difficulty breathing can be seen best by taking the child’s shirt off and watching them. Pulling in at the abdomen and/or ribs or pulling hard at the throat is concerning and should be evaluated. If they are breathing rapidly this is also a concern. With fevers children can have a rapid, almost panting breathing pattern, but this should get better when the fever improves. If it doesn’t improve, they should be evaluated.
  3. Dehydration occurs with prolonged time without drinking or with excessive vomiting and/or diarrhea. A happy child, running around and playing is not dangerously dehydrated. More concerning would be an ill child with no spit in their mouth, no tears in their eyes, or no urine in 8 hours. At home, encourage small frequent amounts of clear fluids, but contact your doctor if you are worried.

Above all, trust your instincts. If you are worried, get them seen. And yes it may be “just a virus” but piece of mind is worth the trip. Below are some medication dosing charts that can be helpful.

Dosage Acetaminophen

 

Dosage Chart Ibuprofen

 

About
Kathryn Lysinger, MD

I am a part-time pediatrician and full-time mom of 5 year old Jacob and 3 year old Lauren. After several years away in the “big city” my husband Jeri and I are excited to be back home in Montana. When not working I love to travel, cook and can’t wait to get the entire family back on the slopes in my hometown Red Lodge, MT.

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