Fall and Winter Wellness

Though Texas winters are usually considered mild compared to much of the country, the fall and winter months can present special health challenges for children and adults alike. Students are back in school and spending more time indoors — which can create a perfect environment for the spread of highly contagious viral illnesses like colds and flu, as well as COVID-19 and respiratory syncytial virus (RSV) infection. In addition, we know that the holidays can be stressful for children and families on many levels.

Here are some tips on ways that children and families can be physically and emotionally healthy this fall and winter — and every day throughout the year.

Vaccines and boosters

Flu vaccine
Influenza, commonly called the flu, is a contagious respiratory illness caused by viruses that infect the nose, throat and lungs. For many people, the symptoms are like those of a severe cold, but it is important to understand that the flu can be fatal. This year throughout the United States, flu season began early — and it’s hitting especially hard. Influenza often results in thousands of hospitalizations in children under five years of age each year. At the end of October, the Washington Post reported that there have been more flu hospitalizations at this point in the year than there have been in more than a decade.

This has certainly been the case at Texas Children’s, where currently we have significantly more children hospitalized for the flu than we have had in any recent flu season. We’re also seeing that the number of children receiving flu vaccines is very low, and that’s a cause for concern. Flu vaccines are safe, effective and easily accessible — and they save lives. While the flu vaccine may not prevent someone from getting the flu, it is extremely effective in preventing severe outcomes like hospitalization and death.

For parents who have not already gotten flu shots for themselves or for their children, we strongly encourage that they do so as soon as possible.

COVID-19 vaccines and boosters
Texas Children’s offers both Pfizer’s and Moderna’s newly updated, bivalent COVID-19 vaccines as a booster dose. The Pfizer booster is approved for children ages 5 years and older, and Moderna’s is approved for children 6 years and older. These new boosters are specially designed to fight both the original version of SARS-CoV-2, the virus that causes COVID-19, and the most prevalent Omicron strain of the virus. Children can receive a bivalent booster of a different brand than they originally received.

The updated vaccines work to boost protection that has declined since the previous vaccination, and they target recent Omicron variants that are more contagious and immune-evading.

Texas Children’s also continues to offer Pfizer and Moderna vaccines for children 6 months and older who are unvaccinated.

Children and adults can safely receive both the flu vaccine and the new COVID-19 booster or primary series vaccine at the same time.

How to schedule an appointment
Parents can schedule vaccinations for their children and themselves at Texas Children’s locations through the COVID-19 Vaccine Appointments scheduler.

Patients of Texas Children’s Pediatrics (TCP) in Houston, Austin and College Station can schedule appointments:

• Through MyChart.
• By calling their TCP practice. (TCP practices are offering only the Pfizer booster).
• By visiting Texas Children’s COVID-19 Vaccine Hub.

What parents need to know this RSV season

According to the Centers for Disease Control, last month, over 30% of Texas babies needing medical care for respiratory issues tested positive for RSV, which infects nearly all children by the age of two. Though RSV is a common seasonal virus, it is the leading cause of infant hospitalization. Most older children with RSV have symptoms like those of a common cold; however, for young infants or those with special medical problems, RSV can become severe or even life-threatening. There is no treatment or vaccine for RSV, so prevention is the best defense.

Here are some things parents can do to help protect their children:

• Understand what puts babies at high risk. While all babies can potentially develop an infection from the virus, there are a few factors that can increase a child’s risk of developing severe RSV-related infection, including:
  • Being born prematurely (under 37 weeks gestation).
  • Having chronic lung disease.
  • Being born with certain types of heart disease.
     
• Take steps to prevent RSV infection. RSV is very contagious and can be spread easily through touching, sneezing and coughing. The virus also can live for hours on surfaces such as tissues, countertops and toys. It’s important to take steps to protect all babies from contracting the virus, including frequently washing hands, toys and bedding, and avoiding crowds. It’s also important for parents whose healthy babies contract RSV to avoid spreading the virus to babies who may be more vulnerable.
   
• Know the symptoms of serious RSV infection. RSV can result in more alarming symptoms than those resembling the common cold, including:
  • Severe coughing or wheezing.
  • Difficulty breathing or rapid, gasping breaths.
  • Blue color on the lips, mouth or under the fingernails.
  • High fever.
  • Difficulty feeding or decreased intake of liquids.
  • Excessive fatigue.
    
    If a child exhibits any of these symptoms, parents should contact their child’s physician or seek medical care.
    
    As is the case with virtually all other viral respiratory infections, the management of RSV is supportive. Dehydration is a common complication of RSV, so maintaining good hydration is critical. Reducing moderate to high fever with fever-reducing medications can help reduce the risk of dehydration, as well as provide comfort.
     
• Parents who suspect their baby may be high risk should contact their pediatrician. The pediatrician may recommend RSV prophylaxis, which can help protect high-risk infants from developing serious RSV infection.

Sleep
There’s a reason doctors ask about sleeping patterns during checkups. Sleep helps the body restore and repair itself, and it is so important for growth, development and staying healthy. Parents should help ensure that their children are getting enough sleep — the recommendation for school-aged children is nine to 11 hours per night. When they don’t get enough, they are definitely at increased risk of getting sick.

Diet
Like good sleep, a well-balanced diet is essential for maintaining good health. A poor diet can lead to inflammation in the body, which will stress the immune system and lead to further illness. When children’s diets include plenty of fruits and vegetables, they’ll receive all kinds of natural immune-boosting vitamins. Offer healthy, well-balanced meals, including afternoon snacks consisting of fruits and vegetables. A pediatrician can determine whether vitamins are recommended.

Exercise daily and limit screen time
Lack of physical activity is a major cause of illness. Children (and adults) need time away from screens to thrive. Try limiting all screen time to one hour on school nights and two hours on the weekend. In addition, try to ensure that children get one hour of physical activity daily, outside of school. Another positive benefit of exercise … it’s linked to better academic performance and improved mental health. Make it a family effort!

Hand washing
Doctors agree that hand washing is crucial to limiting the spread of illness — especially before and after meals, after using the bathroom and after being in public spaces. Hand washing with regular soap is the best way to prevent germs, as there is no evidence supporting the use of antibacterial soaps or heavy-duty cleaners for children. Using soap and water is the way to go!

Keep children home when they’re sick
When children are sick, try to keep them at home and make sure they get plenty of rest, fluids and supportive care. Giving children a chance to get some extra sleep and fight off minor illnesses not only minimizes the spread of disease in child-care settings, but also increases their chance for a quick recovery. When children go back to school too quickly — even after a mild illness — they’re more likely to catch a secondary infection, which could prolong symptoms.

Limit stress
Physical and mental stress can have a detrimental effect on the immune system. When the body is under stress, immune function declines. During the school year, parents should be especially conscious of their children’s stress levels and help minimize them when possible.

Lara Shekerdemian, MD
Pediatrician-in-Chief, Texas Children’s Hospital 
Chair, Department of Pediatrics, Baylor College of Medicine 

Stanley Spinner, MD 
Chief Medical Officer and Vice President, Texas Children’s Pediatrics and Texas Children’s Urgent Care 
Associate Clinical Professor, Baylor College of Medicine