Setting the record straight on kids and virus treatments

It’s beginning to look a lot like … cold and flu season. And with the wrong advice, you might spend the most wonderful time of the year worrying about your sick child.

Pediatrician Dr. Craig Davis at Novant Health Pediatrics South Ballantyne shares the facts you need to avoid wasting time, money and emotional energy.

Popular advice: If your child’s sick, it’s important to know what virus they have.

Truth: Testing can be invasive and expensive — and it’s often unnecessary. As Davis put it, “Most times, I try to only order tests if it’s going to change how I manage the patient.”

For example, acute bronchiolitis is a common winter infection that can affect babies’ lungs and breathing. Bronchiolitis is usually caused by RSV but there are several other viruses that can cause it as well, and parents often think it’s important to know if RSV is the cause. But the American Academy of Pediatrics discourages using X-rays and laboratory testing to confirm a cause for bronchiolitis, since the diagnosis and treatment should primarily be based on your child’s symptoms.

“The child’s respiratory status is most important — not whether that particular test is positive or negative,” Davis said.

“It’s often not important to know what specific virus we’re dealing with in the wintertime — what we need is to monitor for is any potential complications and to make sure that virus ultimately resolves,” Davis said. So if your child has cold or flu-like symptoms but is responding well to supportive care at home, don’t feel like you need to pay a copay or drag them to urgent care just to label the illness.

Popular advice: If your child’s starting to sniffle, a mega-dose of vitamin C will prevent worse sickness.

Truth: There isn't a lot of evidence that taking vitamin C will prevent colds, Davis said, so save your money and don’t buy expensive supplements.

But that doesn’t mean vitamins are useless: “Diet is one of the most important things we talk about at well checks for long-term health,” Davis said. But instead of prioritizing vitamins only during cold and flu season, feed your child a balanced diet full of naturally occurring vitamin A, K, E, D, and C and limit processed foods year-round. Their future self will thank you.

Even small efforts to eat healthier add up, Davis said, adding, “If your child eats even one more fruit or vegetable as a snack in the coming weeks because of this conversation that we have about healthy diet and limiting added sugar and ultra processed foods, then this discussion was worth my time.”

Popular advice: High fevers in children are an emergency.

Truth: It depends on your child’s age and how they’re behaving.

At the beginning of their lives, fevers are potential emergencies: If a child 6 weeks old or younger has a fever, contact your pediatrician right away; for babies this young, fevers can be the only sign of a potentially serious infection. Almost all pediatricians have a 24-hour triage line staffed by experienced nurses who can help you know what to do next.

But if your child is older than three months, isn’t considered medically complex, is breathing well and is not especially ill-appearing, their fever likely isn’t an emergency. Although fevers can be scary for parents, a fever “means that the body's putting up a fight,” Davis said. “It’s a sign that the immune system is doing what it should to protect your child.”

With a viral infection, it can often be normal for these children to have a fever for several days. If they’re fussy or uncomfortable, give them fever-reducing medicine, such as acetaminophen or ibuprofen. If they still have a fever after a few days or if the fevers are getting higher, call your pediatrician.

If your child is developing concerning symptoms, it’s never wrong to contact your pediatrician to discuss that and see whether they need to be seen. And if your child is being treated for a serious illness, defer to their specialists for guidance about fevers.

Popular advice: If your child’s been vomiting, feed them as soon as they stop vomiting so they don’t get too weak.

Truth: If your child has been vomiting due to a virus, Davis tells parents, “I’m more concerned about their hydration than their appetite in the short term.” They don’t need to eat on the first day after vomiting; instead, the No. 1 mantra is “Keep the fluids going.”

What’s the best fluid if your child’s been vomiting or having diarrhea? Davis recommends Pedialyte, since it is more rapidly absorbed by the gut than even water. “Every few minutes, give your child a sip or two,” he said. “It can sometimes avoid the need to go to the ER and get an IV placed, which is painful.” If your child doesn’t like Pedialyte, Davis suggests taking equal parts Gatorade and water and mixing them together in a 1 to 1 ratio. (He doesn’t recommend straight Gatorade due to the high sugar content, which can worsen diarrhea.)

If you’re struggling to feed your infant, call your pediatrician. If your child usually drinks breastmilk, milk, or formula and isn’t keeping it down, Davis said it’s OK to give them small amounts of Pedialyte until symptoms have resolved.

If your child is still unable to keep down these liquids and is showing signs of dehydration like chapped lips and a dry mouth – in babies and toddlers, making less than five wet diapers per day; in older children, urinating only one to two times per day – notify your child’s pediatrician immediately.

Popular advice: Your child doesn’t need vaccines if they’re not in day care.

Truth: You don't have to be in day care to contract a virus that can make your child sick — one trip to the store, park or church could be all it takes.

Davis tells parents: “In my opinion, not having your child vaccinated is like going down the freeway without your seat belt on (which I definitely do not recommend). Most times you’re going to get to your destination unscathed. But in the event that there’s an accident, that extra level of protection can save your life.”

In this analogy, vaccines are the seat belt keeping your child safe. “Are you going to get active face-to-face time with someone with measles or pertussis? Hopefully not, but if you do have exposure to that or other vaccine-preventable illness, that vaccine may make it a milder illness or may even save your child’s life,” Davis said. And since measles has unfortunately found its way back into the U.S. — including a recent outbreak in South Carolina — your child does have a chance for exposure to this potentially serious illness, and to other vaccine-preventable illnesses as well.

Yes, most common viruses resolve at home without any need for hospitalization. But Davis has seen common viruses lead to complications.

“After practicing pediatrics for over a decade, I appreciate the potential for any given infection to lead to complications. Most infections resolve without major complications, but not everything in medicine is predictable,” Davis said.

“That’s why we as pediatricians advocate for everything we can do to protect kids against complications and infection, and vaccines are the most central part of what we do. In my personal opinion, the development of vaccines to protect babies and children from potentially life-threatening infections is one of the greatest advances in the history of medicine.”

Popular advice: Don’t bother your pediatrician. If you have a question, just Google it.

Truth: It’s tough to sort through all the information out there to figure out what is true and applicable to your child. That’s why your pediatrician wants to partner with you.

“I think it’s hard to separate fact from fiction, particularly in the age of the internet,” Davis said. “There’s just so much out there. Ideally, your pediatrician can serve as an invaluable resource to provide context and help you filter.”

Unlike social media influencers who are trying to sell you products or websites that are generic in nature, your pediatrician’s advice will be based on their clinical experience, their knowledge of your child and family, and scientific evidence.

And unlike websites or influencers, they can answer your questions in real time. “I welcome parent questions — when it comes to your baby and your child, there are no stupid or silly questions,” Davis said.

Davis points out that many pediatricians are also parents, who understand how precious your children are to you. “Our oath is to ‘Do no harm,’ and we take that responsibility seriously,” Davis said. “Trust that your provider will treat your child like their own and give you the best advice we can.”