Spotting Your Child’s Cold and Flu Symptoms at Every Age

children with the fluWhen adults get hit with the flu, there’s no mistaking it. You’re feverish, your head feels stuffed up and you ache everywhere. But with kids, the signs aren’t always as easy to detect.

“Young children with the flu can run the whole gamut of symptoms,” says Dr. Martha Snyder, a pediatrician and assistant professor of pediatrics at Duke University School of Medicine. “Some children have the mildest of mild symptoms, while for others, symptoms are very severe.”

Below is your guide to spotting flu symptoms no matter what your child’s age, and ways to bring relief.

Infants Under Six Months

Babies in the first six months of life are at the greatest risk of complications from the flu, says Snyder, because their immune system is not fully mature yet and their very small airway makes it easy for them to experience respiratory distress.

If your infant has a fever, call your doctor and watch for other signs of illness, such as dehydration. “When babies this age don’t feel good, they usually don’t want to drink,” she adds. Provide plenty of water to keep an infant hydrated.

Children Six Months to 2 Years

Kids under the age of 2 who come down with the flu often have respiratory symptoms (cough, runny nose, sneezing), high fevers (sometimes as high as 104 F), diarrhea and vomiting. “But while many kids have all of these symptoms, others may only have one,” says Snyder.

Recognizing the early signs in toddlers is especially important, she says, because they can also get dangerously dehydrated very quickly. In addition, because of their smaller airways, babies can quickly progress to having wheezing and labored breath, which requires medication. Signs that a child’s breathing is compromised include wheezing, fast breathing or shortness of breath, and nose flaring.

Children 2 to 4 Years

A child who can’t talk yet (or can’t talk well) obviously can’t tell you that his body aches all over, so you need to be alert for behavioral changes, says Snyder. For instance, in many cases, children with the flu will have shaking chills and refuse to walk, because their legs are very achy.

“With kids under the age of 4, you really have to watch them to see how they’re acting. Respond to anything that seems out of the ordinary,” adds Snyder. “Young kids often have a limp look to them. Or they’re so uncomfortable they just want to be held.”

Children 4 to 6

Once kids can tell you how they feel, listen for complaints similar to an adult’s. But be aware that if your child is under the age of 6, oral over-the-counter cold and flu medications are not recommended. “You should never give children this age decongestants, cough suppressants and other OTC cold remedies, because of the side effects,” says Snyder.

But there are other things you can do. “It’s OK to give your child acetaminophen or ibuprofen for fever or pain reduction,” adds Snyder. It’s also safe to apply topical soothers to help relieve symptoms. And some children don’t mind saline nasal sprays for stuffy noses but be careful not to use them too often (more than six times a day), since overuse can cause swelling of a child’s nasal passages.

Other beneficial non-drug treatments for colds and flu include chamomile tea with honey, and a cool mist humidifier. Just be sure to use one that has a humidity gauge and to keep the level at no higher than around 50 percent to avoid a mold problem.

Children Over 6

For children over the age of 6, symptoms are essentially the same as adults’. And at this point, OTC decongestants and cough suppressants are generally safe, although they’re not recommended for children with certain health conditions. For instance, if your child is taking medication for ADHD, ask your doctor before giving your kid a decongestant, since the combination of the two drugs has been shown to cause heart problems.

In addition, kids with asthma or any kind of respiratory problem should stay away from cough suppressants, says Snyder, because these products may make it harder for them to clear secretions from their lungs, which can lead to pneumonia.

Who is on your babysitter list?

I love my neighborhood! One of the great initiatives came from a woman who started a mom’s Babysitter playing with kidse-mail network. We are 200 strong now and on any day a range of requests comes from our dedicated leader. The requests range from the simple – ‘Who knows a good plumber? Does anyone have a coonskin hat for the school play?’ – to the serious, ‘Who can provide meals for a family in crisis?’ or ‘Keep your eyes open, there has been a rash of burglaries in the area’. It feels good to know that if I need something, 200 moms have my back.

My most used and treasured resource from the mom’s network is the babysitting list. Almost 2 pages of babysitters in my town, with name, mom’s name, age, school and experience. And guess what stands out on the experience column? Red Cross Babysitting class or First Aid class. That tells me, in no uncertain terms, everything I need to know if I’m leaving my children in someone’s care. First, they showed the initiative to spend their free time learning how to care safely for young children. Second, if there is an emergency, they are more likely to respond correctly, to not panic, to get my child the correct attention immediately. Third, they are mature. They can think outside of their own needs to anticipate helping someone else.

As a mother, I want to know that my children are safe and well-cared for, so knowing my babysitter has the equivalent of a ‘gold stamp of approval’ means I can enjoy myself during those rare ‘grown-up’ evenings. As an entrepreneur, I applaud the kids who took the time to enhance their skills and make themselves more marketable by getting appropriate training, because am I more likely to hire them for that peace of mind? You bet!

Brecker Bunny Safety Books

You don’t leave the hospital with an instruction manual on how to protect your child…you learn only by doing. I would do anything to not have learned this lesson the way we did, but it is our reality. Laying on the hospital gurney, cradling my 21-month-old, I sang our favorite lullaby, “Gentle Breeze” through tears. I tried to wish Brecker Bunny Learns to be Carefulaway the moment, but his screams and cries of, “Mama hurts, mama hurts” kept me firmly grounded in the heartbreaking reality…this was happening…and it was happening to my baby. All the wishing and singing could not ease his pain.

On April 6, after returning home from a walk, I received a frantic call from my husband. He was in the ER. Our son had been badly burned in the tub. Now, my initial thought, before I reached the hospital, was that it couldn’t be too bad. Like all concerned parents, upon moving into our newly constructed home, we made sure to have our son’s tub installed with a device to prevent him from turning the water on too hot. We also had asked to have our water temperature set appropriately. After seeing our son in the hospital, I knew something had gone horribly wrong.

In the time it normally takes for our son to go upstairs and get his blanket and then come back down, my husband heard screams. Rushing up the stairs with our one-week-old in his arms, my husband found our son sitting in our master bath whirlpool tub, crying frantically as the skin peeled away from his legs and feet. His diapers and overalls provided some insulation for the rest of his body, but his feet were horribly damaged. After three weeks in the hospital and skin grafts, our son was allowed to come back home. But care was not over. He had compression socks for over a year and another surgery as well. And the time it took for this to happen?

Less than 10 seconds…

After careful investigation, it was discovered that our water temperature was set above 135 degrees Fahrenheit, which can cause third degree burns for a child in 10 seconds. At 126, third degree burns can occur in under two minutes. Legally, all water heaters must be set by the manufacturer at 125 degrees Fahrenheit, however, it is best if temperatures are set at 110 when there are small children in the house.

Sitting in the hospital and feeling helpless and like a failure did nothing to help Breck or heal the emotional wounds my husband and I had, so we began the process of reaching out. What could we learn? What could we do to teach our child and ourselves about safety? We were disappointed by what we found. We decided to do something about it.

It became our family’s mission to find out the top reasons why toddlers get burned and create a book that was a bedtime story with a purpose. Brecker Bunny Learns to Be Careful was born. It is the loving collaboration between burn nurses and doctors at University of Madison Hospital and Clinics , Wisconsin Alliance for Fire Safety (WAFS) and me, the mom. After meeting with experts from the Burn Center in January of 2005, much research, finding an illustrator, a partner (WAFS), funds, a printer, and learning the publishing ropes, the first printing of Brecker Bunny Learns to Be Careful! A Lesson in Fire and Burn Safety was handed out to survivors and supporters at the WAFS Camp for Burn Survivors in August of 2007.

To date we have delivered over 120,000 of this title alone. We printed it in Spanish and Brecker has a lighter safety book called Brecker Bunny Asks for Help too! Next on the agenda…the rest of the safety series: water safety, passenger safety, bicycle safety, even stranger danger. All books with real lessons, about real kids (now bunnies), made easy and fun to read at bedtime. I wish that my Breck never had to experience his burns, but seven years later, my eight year old has helped to keep many children a little safer…and he even has the thank you letters to prove it!


1. Tips when reading a safety book:

  • Sit in close proximity with your child while reading. A snuggle goes a long way to help children’s brains chemically calm making them more receptive to what they are learning.
  • Choose one to three things to emphasize each time you read a safety book. To stop and point something out on every page is confusing and overwhelming.
  • Don’t be afraid to get up and move the book. Most kids and adults learn best by moving their lesson. If you are learning to stay three feet away from a fireplace…pace of three feet and practice.
  • Make children partners in safety, rather than merely the recipient of the lesson. Look for opportunities to ask them how they can make a room or situation safer.

2. Tips on Burn Safety in and around the home (based on the top 3 accidental reasons toddlers in my area end up in the Burn Centers):

  • Keep children 3 feet away from stoves, ovens and microwaves. There are so many children in burn clinics who have been scalded by caramel, coffee or hot water spilling as it comes out of the microwave. Usually these burns occur on little ones’ faces.
  • DO NOT TRUST YOUR HAND TO TAKE THE TEMPERATURE OF THE BATHTUB! Test your water temperature by holding a water thermometer or candy thermometer under the stream of water after it has had the opportunity to heat up. If it is over 120 degrees Fahrenheit, change your water heater immediately. Consider setting the temperature below 110 degrees Fahrenheit if you have very young children or elderly people in your home. Their skin is thinner and easier to burn. Also, it is more difficult for them to get out of tubs quickly to avoid a burn.
  • Candles and fireplaces should never be allowed to burn unattended.
  • Keep a three foot rock perimeter around campfires and do not allow children within the ring. I get letters from moms telling me that they thought if they were standing next to their child, the child would be safe; yet, one quick trip or fall and hands and feet can end up in a fire.
  • Most importantly, stay vigilant. Periodically do safety checks around your house. There are many great checklists online and of course, in the back of Brecker Bunny!

Be Bunny Buddies and keep your family safe!

A Pediatrician’s Guide to Potty Training

The Problem:

One of the most frustrating and exasperating experiences of parenthood is the socialization process of potty training their children. This is a function unique to human beings and distinguishes the very first level of independence for both the child and the parent who now is no longer tied to the ever present diaper bag. Somewhere along the way, the thought of having a child not yet potty trained by the age of eighteen months or even younger has been viewed as being an “abnormal” developmental milestone and poor parenting performance. I’m not sure exactly how this occurred, but conversely, a child potty trained at an early age demands respect for potty-training success :)him/her and his/her parents. Of course the non-need for diapers is a well deserved and less expensive rest for parents who have been struggling through the “diaper game” for at least the past year. But, just as children acquire speech at different ages, walk at different times, get their teeth in different order, so it is that not all children are emotionally or physically able to be toilet trained at the same age. There is a wide range of “normal variability” and parents need to understand that, contrary to what they are told by “friends” whose children were toilet trained at a young age, their child may not be ready yet.

As usual, there are a lot of brain neurons and cells that need to make the correct connections in order to coordinate “complicated” functions. This takes time and may be the deciding factor in determining when to begin the process of toilet training. We have all heard stories from well meaning and bragging parents who claim to have toilet trained their children by the age of one year old; and this may very well have been the case in one particular circumstance- perhaps by chance- but it certainly does not represent the norm. More parents who attempt to toilet train their young toddlers find it to be a very frustrating experience, fraught with feelings of guilt over their inability to complete their mission at this time.

The Fix:

There are many formulae for both rapid and slow methods of potty training a child. I have found through the years that a relatively simple and guilt free approach is the best. This is what works for me:

  1. Do not attempt much of an effort prior to the age of two years old. It could even wait longer depending on the societal pressure a parent feels.
  2. When your child is “ready”, sit him/her on the potty seat for about 1 minute per day with his/her clothes on, hopefully at the time of day your child has a bowel movement.
  3. Be sure that the child’s feet are not dangling in the air but are given a platform from which to “push off”. Use of the correct muscles for defecation requires a solid base.
  4. If your child is fearful of just sitting on the potty, back off and try again a month later.
  5. Once your child is comfortable sitting fully clothed on the potty seat for a minute a day over a 2 week period of time , take his/her clothes off and begin again one minute a day (around the time of bowel movements) until he/she is comfortable.
  6. At this point take all his/her clothes off and do the process all over again.
  7. Reward your child with something of “value” just for the process of getting on the potty, not for only a productive visit.
  8. At this point let him/her follow you (and other cooperative family members) around to the bathroom and observe the “correct method”.
  9. If he/she is wearing a diaper at this time, and has a bowel movement in the diaper, quietly take him/her to the bathroom, empty the products of defecation into the toilet and show him/her graphically where such a deposit is supposed to go. Calmly put the diaper back on, pick him/her up and hug.
  10. Time to raise the stakes and increase the value of the “reward” if your child should do everything you have been teaching for the past 2 months.
  11. Don’t forget that washing one’s hands is also part of the process.

Be patient, remain calm, no punishments but reward, reward, reward for appropriate behavior and stop getting on the internet or speaking to your friends and family about the topic. There is no relationship to the time of potty training done correctly and any disruption of normal behavior or activity in otherwise healthy children. This too will pass.

Pediatric Safety Announcement: April 5, 2010

Bill Williams expert picPlease join us in welcoming our new dentist Dr Bill Williams to the PedSafe Expert Team!