Acute respiratory infections in children. Honestly about how to treat a cold in a child

A cold in a wide circle of ordinary people is called a condition when the nose is blocked, a runny nose in three streams, a high temperature on the thermometer, a cough is likely to break through and a tickle in the throat. The set of “options” may vary. One thing is clear: with a cold, life literally ceases to please with colors and tastes for a while.

Medicine is a dry science. Vivid images and colorful metaphors are alien to her. Therefore, in her language , a cold has a clear and comprehensive name: ARI is an acute respiratory disease. But most often the pediatrician writes a different set of letters in the patient’s card: ARVI – acute respiratory viral infection. What’s the difference? Healthy people were helped to understand by Lidia Matush, Candidate of Medical Sciences, associate professor of the Department of Pediatric Infectious Diseases of BSMU.

Honestly about how to treat a cold in a child

Colds in children

Acute respiratory infections are a collective concept of all respiratory diseases. Acute respiratory infections are flu, bronchitis, laryngitis, pneumonia, and a banal cold. Thus, respiratory diseases include acute respiratory viral infections. But it is this diagnosis that appears most often when it comes to children’s colds, since viruses cause malaise in more than 90 percent of cases.

— The body of every person, both large and small, is populated with a wide variety of microbes. It is believed that in the total weight of an average adult, 1.5-2 kg is occupied by microorganisms and viruses, including those that, under certain circumstances, can become active and cause a cold.

The child has an insufficiently mature immune system. Any “unfamiliar” microorganism, getting from the outside (someone nearby coughed, sneezed), can cause respiratory manifestations. This is just one of the reasons why children begin to get sick more often when they go to kindergarten: the circle of communication expands, and contacts become more not only with peers, but also with “alien” microorganisms and infections. Some of the viruses live in the human body constantly and at the same time do not manifest themselves in any way. But it is only necessary to create comfortable conditions for them, as they become more active, and a person begins to get sick. The child is small enough (again due to immaturity of immunity): get overcooled, drink cold water, afford an extra portion of ice cream… The fact that the virus has “woken up” will be indicated by high fever, runny nose, possibly sore throat and cough…

It is quite a popular misconception that getting sick with a cold up to 10 times a year is normal for a child. This is not the case, and any figure should not be a yardstick for everyone. A lot depends on the state of the baby’s immunity, conditions and lifestyle. But, strange as it sounds, having a cold, the child trains the defenses of his body. And, by the way, it is possible to help him in this – to get sick less often, it is easier to tolerate ailments, – strengthening the child’s immunity from early childhood.

How to properly treat colds in children

The most thankless thing you can think of is telling moms how to treat a child’s cold. First of all, the topic in the mass media is traveled far and wide. Secondly, at least once having dealt with a child’s runny nose, cough and fever, each mother develops for herself a certain algorithm of actions for the future and to convince her of anything is a vain labor.

If we discard the thin layer of those who rely on the district pediatrician from cold to cold and clearly follow his recommendations, most caring mothers are divided into two opposite camps. Some are firmly convinced that it is not necessary to treat a cold – it will pass by itself. Others are just as firmly convinced that it is necessary to treat – necessarily and thoroughly. Both of them periodically step on the rake of their unshakable beliefs. Because the truth, as you know, is somewhere in the middle.

Considering that respiratory infections are caused by dozens of different viruses, the choice of treatment tactics directly depends on the causative agent of the infection, as well as the clinical manifestations of colds, the condition of the child. So the answer to the question: “How to properly treat a cold in a child” can only be given by a pediatrician and only after an in-person examination of a small patient.
What should be done at the first manifestations of the disease:

Call a doctor. Even if it seems to you that you know everything and even more about a child’s cold, do not ignore this step. At least to make sure that you are doing everything right in the treatment of your baby.
If the doctor confirms the presence of a viral infection, most likely no specific treatment will be required: taking antipyretics if necessary, bed rest, copious drinking and vitamin C “for dessert” to increase the body’s resistance. With a classic cold, this is quite enough to last a week or a week and a half until the virus itself leaves the body.
Do not prescribe medications yourself, no matter how much you would like the child to recover as soon as possible. The expediency of taking any medications: antiviral, antitussive or expectorant, vasoconstrictive and especially (!) antibiotics – must be confirmed by a qualified pediatrician!

Nevertheless, complete inaction before the arrival of a doctor is almost as unacceptable as self-medication. The child can and should be helped. The main thing is not to overdo it. According to our expert Lydia Matush, the correct algorithm of actions to alleviate the condition of a child with a cold is as follows:

Nasal hygiene in case of a runny nose is mandatory. It is important to avoid stagnation of mucus in order to

minimize the risk of bacteria joining. Besides, if you don’t clean your nose, it’s high
the probability that its contents will fall into the Eustachian tube, which in infants is short, wide and is almost in a horizontal position. In this case, the inflammatory process in the middle ear – otitis media – is almost guaranteed. By the way, excessive diligence when blowing your nose can lead to the same deplorable result. So it is better to carry out nasal hygiene with the help of saline nasal sprays or saline solution. They will perfectly clean the nose from viscous secretions and moisturize the mucous membrane.
Copious drinking for colds is one of the key conditions. It’s not for nothing that people say: to cure a child is equal to drinking. It’s worth mentioning right away: heavy drinking does not mean that the baby should be required to empty half a liter of liquid at a time. Rather, on the contrary. Drinking can be fractional, but frequent. A competent drinking regime for acute respiratory viral infections is necessary for several reasons. Firstly, the child’s body needs water to prevent dehydration at high temperatures. Secondly, the liquid helps to remove toxins from the body faster, as a product of the vital activity of a rampant virus. Thirdly, it ensures the normal discharge of mucus, and also moisturizes the oral mucosa if the child has to breathe them due to nasal congestion.

As a drink, any liquids are suitable – water, decoctions of chamomile and lime, weak tea, compotes, fruit drinks, milk with honey (if there are no allergies), mineral water without gas. The main thing is that the drinks are not carbonated and too sweet. Prerequisite: the drink should be warm – about 37-39 degrees.

Comfortable humidity in the apartment and fresh air are just as necessary for a sick child as the two previous conditions. Sufficient humidity in the room – at least 50-60 percent – will facilitate breathing and prevent the mucous membranes from drying out. Frequent ventilation of the room is a sure way to prevent the constant circulation of the virus indoors.
Antipyretic measures, if necessary. It makes sense to talk about a decrease in temperature during a cold separately.

Again 38.5. When and how to reduce the temperature of the child

Immediately it is worth mentioning that the temperature of the child should be measured only with a thermometer! Not with your lips, not with the back of your hand, as some mothers and grandmothers quite often like to do. It’s not bad if you trust your intuition, but when it comes to a child’s health, it’s wiser to rely on the accuracy of the thermometer. Because in medical practice, no, no, and there are cases when the absolute trust of parents in their tactile sensations leads kids up to 3 years old to intensive care with kidney failure against a background of high fever.

Hyperthermia, or simply put, elevated body temperature is the main sign that the body is fighting infection,” explains Lydia Matush. – At high temperatures, the vital activity of viruses is suppressed, and the body’s defenses, on the contrary, come into full combat readiness. That is why it is necessary to approach the temperature decrease very carefully and not to grab antipyretic drugs as soon as the thermometer showed figures above 37 ° C.

Unjustified intake of antipyretics does not contribute to the speedy recovery of the child. In addition, antipyretic drugs, like any medicine, are not absolutely harmless to the body and can lead at least to allergic reactions, at most to severe kidney damage.

Acute respiratory infections in children

Damage lungs, severe respiratory illness, pneumonia, ARDS, acute respiratory distress syndrome caused by the coronavirus

The World Health Organization offers the following recommendations for reducing the temperature in children (by the way, our pediatricians adhere to the same recommendations):

children under 3 months of age should lower the temperature at 38 degrees. As antipyretic drugs, candles are the most optimal;
children under 5 years old – at a temperature of 38.5 degrees. As a rule, antipyretic syrups and suspensions, as well as dispersible (water-soluble) tablets are suitable for preschool children;
children under 12 years old – at 39 degrees. Body temperature above 39 degrees is no longer considered physiological and can be fraught with negative consequences for the child’s body.

In Russian pediatrics, two antipyretic drugs are allowed: paracetamol and ibuprofen. They should be taken strictly following the instructions for use and according to the doctor’s prescription in the recommended dose!

It is strictly forbidden to use aspirin (acetylsalicylic acid) to reduce the temperature in children.

However, these recommendations are very conditional. In each case, it is necessary to take into account the degree of intoxication of the body (lethargy, drowsiness, lack of appetite), the general physical condition of the child, personal characteristics. For example, if a child has previously had at least one case of febrile convulsions (convulsions against a background of high temperature), it is too frivolous to wait for the boundary numbers on the thermometer. For such children, the temperature should be lowered already at 37.5-38 degrees. Also, antipyretic drugs can be used at a lower temperature than recommended in children, for example, with a heart defect.

In addition to medical methods of reducing the temperature, there are also physical ones. Do not neglect them. In some cases, they are quite enough to lower the body temperature by a whole degree without taking medications.

So, you can fight hyperthermia without connecting heavy artillery:

Undress the child as much as possible. Attention! This method is effective and applicable if a child has so-called red hyperthermia: his forehead and limbs are equally hot, a blush (it’s a pity that it’s not healthy) on his cheeks, while the child himself is quite active, and when the temperature drops, he is ready to walk on his head as if nothing had happened. In this case, it is reasonable to undress the child as much as possible, even to the underwear. No warm jackets, pants and socks. And a categorical “no” to hats and Orenburg down shawls on a temperature baby! You may be surprised, but up to 80% of the heat comes out through the head. The only acceptable headdress in this case is a cold compress on the forehead. Don’t be afraid, the naked baby won’t freeze. On the contrary, this harsh but effective method will help him not to “overheat”.
In the case of white hyperthermia, when the numbers on the thermometer indicate a fever, but the child is pale, his hands and feet are icy, he shakes with chills, warm socks, a blanket or a blanket are just useful. The baby should be wrapped up, warmed, and given a warm drink. It would not be superfluous to rub his palms and feet, as if you did it after a walk on a frosty day to expand the vessels.
Wiping with cool water can also reduce the high temperature. Vodka wipes were very popular with our grandmothers and mothers. However, now the expediency of these methods is questionable. Evaporating alcohol really cools the surface of the skin quite quickly. But it is also absorbed through it. So, by being too zealous with alcohol wipes, you can achieve with equal success both a decrease in the temperature of the child and, say, a slight degree of intoxication. Some “grandmother’s methods” in the treatment of colds are acceptable, but not in this case. It is much safer to limit yourself to wiping with water at room temperature.

If a viral infection is accompanied not by an increase in temperature, but by a decrease (it does not reach 36 degrees), pronounced symptoms of intoxication – lethargy, drowsiness, lack of appetite, unwillingness to drink, as well as intestinal disorders – loose stools, vomiting, it makes sense not to wait for the arrival of the district doctor, but to call an ambulance. And be prepared for the fact that the child is likely to need hospitalization in a hospital. In no case do not try to self-medicate!
How not to treat a child’s cold. Typical errors

There is no parent who does not want a sick child to get better sooner. For the sake of achieving the fastest possible effect, caring moms and dads are ready to do everything possible. Despite the fact that this “everything” is often a useless occupation, and sometimes literally harmful. Typical mistakes in the treatment of colds in a child, repeated from year to year, are as follows:

1. Taking antibiotics, haphazard and without indications. Kilometers of text and billions of words have been written about the uselessness and harmfulness of such treatment in relation to a viral infection. And still there are desperate heads who are ready to independently appoint and offer their child the “right remedy”. In this regard, it is not a sin to repeat:

Colds in children in 90-95% of cases are caused by viruses, against which antibiotics are as useless as whipped cream in a fire: you can water, but there will be no effect, rather, the floor of the house will burn. The metaphor is more than appropriate: unjustified use of antibiotics for acute respiratory viral infections increases the risk of bacterial complications in the future in children by 2 times, in adults – by 3.

Parents should clearly understand that antibiotics are by no means harmless drugs. Their independent appointment is the very initiative that is punishable. Taking antibacterial agents is fraught with allergies, dysbiosis, decreased immunity and, most importantly, contributes to the emergence of resistance (addiction) of microorganisms to these drugs. That is, in the case when an antibiotic is really necessary and could help, the body will remain insensitive to it, respectively, it will be much more difficult to get rid of a bacterial infection. That is why only a doctor should prescribe antibiotics and only if there is a real need!

Children under the age of 12 are allowed to have a fever during the first 5 days of the disease without prescribing additional medications. Only after that, taking into account the condition of the child, the severity of the symptoms of the disease, intoxication of the body, the doctor may consider prescribing antibacterial therapy, prescribing additional examinations beforehand, if necessary: blood and urine tests, lung X-rays, consultation of an ENT doctor.

2. Treatment with antiviral and immunomodulatory drugs. This point, rather, refers not to errors in treatment, but to common misconceptions. For example, interferon-based drugs are quite popular with parents. It is a universal protein in the human body, the first and main defender against viruses. When a foreign infection invades, cells begin to produce interferon en masse, which makes them insensitive to virus attacks.

In principle, taking drugs based on interferon may well take place if the doctor has confirmed that the infection is specifically viral. However, it should be borne in mind that they are effective only at the initial stage of the disease – the first day, maybe two. Then taking interferon drugs does not cause harm, but also tangible benefits, too. Therefore, if the first day is missed, it makes no sense to start taking interferon. It is better to follow the basic principles of cold treatment – copious drinking, nasal hygiene, antipyretics if necessary – and give the child’s body the opportunity to cope with the virus itself.

The same recommendations apply to antiviral immunomodulatory drugs, the main role of which is to stimulate the production of interferon. If we take into account that the sensitivity of immunity in different people to interferon inducers is purely individual, there is no guarantee of the effectiveness of these drugs. The probability that immunomodulators will help is 30%, at best – 50.

3. To be ill means not to walk and not to swim. Oddly enough, this is another of the most common mistakes in the treatment of colds in children, which has no basis. You can not walk outside if the child has a high temperature. But that doesn’t mean he doesn’t need fresh air. Frequent ventilation of the room is a prerequisite for viral infection. As soon as the temperature has subsided, it is necessary to go outside (an exception can be made if it is pouring rain or a cold gusty wind blows). Fresh air has a beneficial effect on the child’s body, and a light frost (if the case is in winter) perfectly narrows the vessels and facilitates nasal breathing. It is also necessary to bathe a sick child, even if the temperature is kept. Just in this case, it is enough to do with a light warm shower. But in any case, the water will wash away sweat and secretions from the surface of the skin, improve blood circulation, which will undoubtedly benefit the child.

4. Plentiful food is a sure way to recovery. No, no, and no again. And do not persuade. All the reserve forces of the child’s body are thrown to cope with the virus. And digesting high-calorie food also requires high energy costs, which the child may not have. As a result, “good nutrition” will be a dead weight in the stomach and obviously will not improve the condition of a sick baby. So it is better to leave a hearty lunch for the period when the child will be on the mend and he will need to regain his strength after illness.

Take care of yourself and be healthy!