Common Cold in Babies

Catrina Skepper: It’s that time of the year when every child seems to have either a runny nose, a high temperature, or a horrible cough. Su Laurent, Consultant Paediatrician from Barnet Hospital is here to guide all you mums and dads and your snotty children through this winter season, what a lovely term, welcome Su. Dr. Su Laurent: Hi Catrina? Catrina Skepper: But it is true, I mean from practically every child, whether they are yet in nursery or school, even babies succumb to the common cold and distressing coughs. Su Laurent: Yes. Catrina Skepper: What can we do about? Su Laurent: Not a lot is the answer. First of all, be prepared, expect that make sure you got plenty of paracetamol or nurofen, whatever you like –- Catrina Skepper: Calpol. Su Laurent: A liquid form calpol is what we use all the time. Try to give a sugar-free if you can. Catrina Skepper: Yeah. Su Laurent: And make sure you have plenty of that, make sure you give your child plenty of fluids, and just recognize the fact that it’s common and is normal and in fact, there is some evidence that if our children get exposed to lots of viruses when they are young, they may be less likely to develop allergies. Catrina Skepper: Oh, really? Su Laurent: So think positive. Catrina Skepper: There’s a link directly, link there is a common viruses? Su Laurent: They are recent and commonly seems to be, they are just hygiene theory at the moment about allergy. The theory is that, we all will treat our children to such clean environment incidents time at the moment. But in fact, the body doesn’t have enough to do with this immune system so it goes off becoming allergic to things it shouldn’t be allergic to. And so -- and there is some evidence that second and third children in the family are less likely to develop allergies than first, because they get all the viral infections the older ones bring back from school. Catrina Skepper: Very valid, I say there is some comfort in that, in my case when you got three children and –- Su Laurent: Exactly. Catrina Skepper: Separates one from the other. Obviously, they are mostly transmitted by contact I would think. Su Laurent: Contract and due to drop the aerosol spray. Catrina Skepper: Aerosol spray, yes. So you shouldn’t seen be rushing around your house with a Dettol spray? Su Laurent: No, absolutely no, I don’t – but there’s any Dettol at home. Hand washing is very important, and that’s what you know, in hospitals, it’s got stressed all the time, it’s handwashing and sort of -- you know, using tissues that kind of thing, sensible things rather than just sort of spraying out everything all over the place. Catrina Skepper: Yeah. Su Laurent: Is it difficult to get children to use tissues? Catrina Skepper: Very difficult. Su Laurent: Yeah. Catrina Skepper: Although second of mine quietly enjoys, and then the third one copies the first. Su Laurent: Yes. Catrina Skepper: It doesn’t need one but uses anyway but –- SU Laurent: Yes. Catrina Skepper: I remember very well that distressing cough that my first born had on age much of I think 6, 7 weeks and developed a kind of rattly throat or rattly cough, and I rushed to the pediatrician and I was given this some advice. Su Laurent: Yes. Catrina Skepper: But massage can be something that can help in theory. Su Laurent: Well, certainly, I mean if you’ve got -- Catrina Skepper: So too I am trying to get -- Su Laurent: Exactly, because rattly just often do not blow their noses and in fact they won’t learn to blow their noses, in my experience until they are quite – they getting old quite a bit, I mean it’s very hard to get young children to blow their noses, but trying to clear their nostrils is very important. And to small babies, what happens is they can only breathe through their nose, they do not understand how -- they don’t open their mouths to breath. So, if you got a small baby with a blocked up nose, a lots of sound far works than they are. Catrina Skepper: Yes. Su Laurent: And saline nose drops you can buy from the chemist. Catrina Skepper: It’s brilliant and there’s a spray called Stermimol, they are just fantastic. Su Laurent: Yeah, that you got, I mean there are lots of things, just simple things, like sort of mechanical things you can do to help them. But there is one particular illness at this time of year which is just coming - is around at the moment and it’s called bronchiolitis. Catrina Skepper: I know it well. Su Laurent: You know it well. And in fact, you’ll find that -- if you got planning when your baby should be born, now is not the time, and of course, you know, I had one in November in the worst possible time to have a baby in terms of bronchiolitis. What bronchiolitis is, is a virus called a respiratory syncytial virus that actually goes and sits in your little tiny airways, your bronchioles. And when your baby -- Catrina Skepper: It sits in the on little throats all the time? Su Laurent: Little throat, that’s right, little throats. And when babies get it, they get a horrible persistent cough, they get very wheezy and they often breath so fast and with just difficulty – they can’t actually feed and breath at the same time. A quite a number of children with bronchiolitis or babies with bronchiolitis will need to be in hospital. There is no specific treatment, it’s one of those viruses that you will hear about so many times. Catrina Skepper: Why do they need to be in hospital? What can they do in hospital that you can’t do at home? Su Laurent: Majority of will be at home and that’ll be fine, the ones who are feeding, ones who are nice and pink and they not in distress, they’ll be at home, but the ones who actually need extra oxygen need to be in hospital. And the ones you really aren’t feeding and keeping in the fluid down. Catrina Skepper: Can it cause them to vomit, because they? Su Laurent: Some babies will vomit, yes. Catrina Skepper: And swallow obviously mucus and -- Su Laurent: And some just can’t suck and breathe adequately. And in fact, having a full stomach is also not very good for their breathing. If you’re really working hard on breathing and then you have a full stomach, it’ll just make things much worse. And it’s -- an important thing for our viewers is that, it is known as to last at least 2 weeks. So often, poor mothers will be going back to their doctor saying, he is no better and the truth is he wouldn’t be better for about two weeks and will get worse for the first few days and then it will get better again. Catrina Skepper: It’s not any sign because a parent might worry if they hear that wheezing sound, they might think, oh, my child is asthmatic. Su Laurent: The majority of children with bronchiolitis do not go on get asthma, some of them will, some of them will, about a 20 to 30% will probably go on to get asthma and nobody really knows if it is the bronchiolitis that causes the asthma, more likely as a child who have the underlying tendency to having it anyway who have bronchiolitis. Catrina Skepper: And again, for very small babies, is there anything if they got fever, obviously it’s the paracetamol. Su Laurent: Yes. Catrina Skepper: Is there any medicinal substance is given for bronchiolitis or there’s no such thing as cough mixture? Su Laurent: No, there is no such thing and in fact, you will find if you got to try cough mixture on your chest, cough mixture just doesn’t work. Catrina Skepper: No it doesn’t, it really doesn’t. Su Laurent: So it just a waste of money. The only thing that’s -- Catrina Skepper: So glad you said that. I bought so many of these bottles of I won’t say what, but you know it just -- it never makes any different. Su Laurent: As a parent, you want to give your child something, there’s an overwhelming need to give something your child to make them better and that’s why you buy cough medicine. The only source of cough medicine and that help a little bit is a decongestant, so there is something which contains something, or it might dry up secretions. Catrina Skepper: And might help them sleep at night. Su Laurent: And might help them sleep at night, that might help. Also something sort of on the soil, well that sort of thing that you can actually put a little few drops off on their pillow which while they can breath in, it carve out. There is that sort of things which sometimes help breathing. Catrina Skepper: And steam, that’s the one thing that I really so into at the moment but it does really help them at night to steaming, they just feel quite warm in the room when you go in the same thing, make sure you have all the window open so the -- Su Laurent: Yes. Catrina Skepper: Compensation can actually go off the steam really does help especially with heating. Su Laurent: Yes, exactly. Catrina Skepper: What about just, you know I think part of them is stressing things when you got a young child or a baby and they vomit unless again you don’t know why or they’ve got chronic diarrhea. What are tend to be those sort of? Su Laurent: Okay, well, I think you can probably divide these into sort of the acute vomiting episodes so your normal baby or your normal child suddenly starts vomiting and the most likely cause is going to be an infection and it could be something they’ve eaten, in the older child. But more commonly, it’s going to be a virus that causes it, and they will often start off by vomiting and the next thing is they start to develop diarrhea. Now this is where you need to, for 24 hours or so, the best thing to do is to avoid milk, use anything except milk. Catrina Skepper: All dairy. Su Laurent: All dairy because it’s not so easy to digest dairy when you -- particularly when you got diarrhea. Catrina Skepper: What was the a sort of lie in the stomach or -- Su Laurent: Well, to be honest, you can try getting it. If the diarrhea is not particularly bad and is not made worse by milky things, then you’re not going to do a child any harm, but very often, just stopping milk completely for 24 hours, except breast milk. Catrina Skepper: Okay. Su Laurent: Breast milk should be continued because breast milk is the best possible thing. Catrina Skepper: Yeah. Su Laurent: After you’re stopping milk, what should you give instead? And the answer is, some sort of oral rehydration solutions such as Dioralyte and what this comes in little sachet. Catrina Skepper: Just the same for adults? Su Laurent: Same for adults, actually the same, little sachet, you make up with cooled boiled water and you give to your child. It contains the right combination of salt and sugar to replace what they are missing and it will be help the diarrhea to get better quickly. Catrina Skepper: Even a very young baby, you can give salt and sugar. Su Laurent: Even in young baby, you can give Dioralite. Catrina Skepper: Only in this particular formula? Su Laurent: And this particular -- and that you can’t make it up yourself. Catrina Skepper: Yeah, it sounds good. Su Laurent: If you got an older child, who absolutely will not take Dioralite, and that will obviously happen from time to time, the next solution you can try is flat coke. Catrina Skepper: Yeah, I’ve done that too. Su Laurent: Okay. Catrina Skepper: That works beautiful. Su Laurent: Fantastic. Catrina Skepper: Yeah. Su Laurent: So you put a -- how to make coke flat? You put a spoonful of sugar in. Catrina Skepper: And other spoonful of sugar. Su Laurent: Another spoonful of sugar, they need sugar at this point. Catrina Skepper: Yeah, yeah, of course. Su Laurent: Zoom, all the bubbles will disappear completely, it’s miraculous, then they drink it and they drink a little sip. The other most important thing is don’t glah, glah, glah, glah, because that will just kind of keep back again. Tiny sips are using to again sip and wait a few seconds, a sip, wait a few seconds, it’s a question of doing very, very slowly. Catrina Skepper: And quite often the child – start with my experience, the child will continue to be sick in several episodes, every 15 minutes, sometimes up to 2, 3 hours. Su Laurent: Yes. Catrina Skepper: But you do continue giving them liquids. Su Laurent: Yes. Catrina Skepper: Don’t give them water –- Su Laurent: And slowdown. If you take water and you give them water, but ideally they need a bit of sugar and a little bit of salt because that helps the body to restore what it needs. Catrina Skepper: Because it becomes almost a chronic thing, isn’t that, the news, it’s not just what’s in their stomach, it just becomes a vomiting -- Su Laurent: Exactly. If you are vomiting, you are losing quite a lot of salt and potassium from your stomach and if you got diarrhea, again you are losing quite a lot of -- Catrina Skepper: And should you offer them food so at the next morning, say if they had a sudden expanding? Su Laurent: If they are feeling hungry, try giving them just very simple foods, so try giving them sort of bread toast, a biscuit, something very simple, and banana. Catrina Skepper: When can we give honey to children? What age can we give them honey? Su Laurent: I mean anything in any child, anything from six months really. Catrina Skepper: Yeah. Su Laurent: So, yes that’s fine. Catrina Skepper: Because honey also is a quite bit of, you know –- Su Laurent: Yes, yes, exactly yeah. Catrina Skepper: I mean, I think the common cold we know, there is not much you can do, the same thing applies to bronchiolitis. When would you say to parents, take your child to pediatrician or a doctor, because we tend to try and think why do I want to worry the doctor, I know this is probably a waste of time, we’ve seen this before, other then beside elder children who can have the flu jab, what -- when we should we really take notice? Su Laurent: Okay, I will think what, the common thing is -- the commonest presenters to GPs are first time parents and because you don’t know when to take your child to the GP so naturally you’re going to earn a side of caution. By the time you have your second or your third, you know very well that it is something that is going to get over and something that I need help with. So with a common cold, if the child isn’t breathing properly there, and distressed with their breathing,, and they’re really having difficulty breathing, if they change color, so if they’re not looking the nice rosy pink color then they are a bit blue, a bit purple. Catrina Skepper: Although is there any type of rash? Su Laurent: Yes, a rash that you don’t understand, I mean obviously lots of viruses do go with rashes. Catrina Skepper: Host viral rashes too? Su Laurent: Well, there are a lots of different rashes. And you can get – I mean, you know, chickenpox is a common example, isn’t it? The most parents will know chickenpox and you don’t have to take your child to the GP if they got chickenpox, you know the chickenpox, the GP is going to say, yup, that’s chickenpox, and that’s really whole world would say unless there’s something odd about the rash and that’s infected. With vomiting and diarrhea, it’s really -- if there are signs of dehydration and if they’re really not keeping -– Catrina Skepper: And what are the symptoms? Su Laurent: Besides all, first of all, dry lips and dry mouth. So if you look at the tongue, you look at the lips and they’re not looking moist anymore. Catrina Skepper: Yeah. Su Laurent: The eyes are looking sunken and the baby you know, the soft spot in the tender, we call that the fontanelle, if that’s getting in and dipping in. And also if their skin normally -- a child’s skin, you lift it up and then you let go, and you get it straight back down again. If the child’s skin is lifting up and staying up, that’s actually quite a late stage. Catrina Skepper: Late Stage. Su Laurent: So you really should be seeing your GP. Catrina Skepper: And how do they rehydrate the baby? Su Laurent: Usually the safest way is all over your dehydration. Even if you’ve tried at home, we’ll try again in hospital because we’ll be very disciplined about little sips very frequently. Catrina Skepper: Yeah. Su Laurent: And But if that doesn’t work, next step might be a nasogastric tube and then we put fluid down the nasogastric tube and the final step may a drip. Catrina Skepper: But this is all useful information and things that you should be obviously looking to for use of but go to your GP. Su Laurent: Absolutely, yes. Catrina Skepper: Su, thank you so much. Su Laurent: Thank you very much. Catrina Skepper: Thank you very much.