Respiratory illnesses in children: When and where to seek medical care for your child

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Atypical for summer, pediatricians’ offices, urgent care clinics and emergency centers have been inundated with large volumes of children with fever, runny noses, nasal congestion and coughing. Most healthy children have mild, cold-like symptoms and recover in less than two weeks. However, some children, particularly those younger than 2 years old, were born prematurely, and/or have chronic medical illnesses (such as asthma, cancer, diabetes, heart disease, kidney and liver disorders, neurological conditions, and sickle cell disease) are at risk for developing more concerning symptoms and complications. Parents should be aware of when and where to seek medical care for their child.

How can I care for my child?

Fever and pain in children can be safely treated with two medications, acetaminophen (i.e., Tylenol) and ibuprofen (i.e., Motrin). Because these medications use different active ingredients and mechanisms to treat symptoms, parents can use both acetaminophen and ibuprofen (alone or in combination) to safely treat their child’s fever and pain. Although, acetaminophen can safely be used in infants and children of all ages, fever-reducing medications should not be given to babies less than two months of age prior to speaking with a pediatrician or healthcare provider.

Also, it is important to remember that over-the-counter cold and cough medications should NOT be used to treat infants and children less than six years of age. Research does not support or show that these medications provide any symptomatic relief or improvement in younger children, and have been associated with serious and potentially life-threatening side effects related to their use. Alternative medications and products, such as normal saline (salt water) sprays, suction bulbs/syringes/aspirators, and cool mist humidifiers, can all be safely used in young children.

Is it safe to care for my child at home?

Fortunately, most colds are mild and symptoms get better on their own. If your child is interactive (awake, babbling/talking, recognizing family, playing, watching TV), drinking fluids and staying hydrated, and tolerating fever/pain medications, caring for him or her at home would be a safe choice.

When should I take my child to the pediatrician’s office?

Children who are at high-risk for developing respiratory complications or have prolonged or worsening symptoms should be evaluated by their pediatrician. Parents should speak with their child’s pediatrician to determine the best place for medical care if their child has a temperature greater than 101 (if younger than four months), fever lasting more than five days, worsening cough/breathing difficulty, persistent vomiting and poor appetite.

Is my local urgent care clinic a safe choice?

Although ill children should ideally seek care with their pediatrician, scheduled clinic hours and availability may not allow for an immediate, walk-in visit. Pediatric urgent care clinics may be a safe alternative and are typically equipped to diagnose and treat a variety of common pediatric illnesses and minor injuries.  Prior to going to a local urgent care, parents should ensure that a pediatrician will be evaluating their child and their health insurance covers the cost of the urgent care visit.

Is it time to go to the emergency center?

Knowing when and when not to take a child to an emergency center can be a difficult and stressful decision for many parents. This time of year, most emergency centers are extremely busy, and parents may find themselves waiting for long periods of time before seeing an advanced practice provider (APP) and/or physician. Parents should seek medical care in an emergency center if their child exhibits the following symptoms:

• Difficulty breathing (fast breathing or trouble breathing)
• Persistent vomiting and not drinking any fluids
• Dehydration (no tears with crying, dry lips and mouth, no urination in more than 8 hours, not waking up or interacting)
• Poor skin color (pale or bluish skin color)
• Abnormal or altered behavior
• Severe pain

Here’s a friendly reminder: Viruses that cause colds and other respiratory illnesses can easily spread through the air and close personal contact. To reduce your child’s risk of getting sick:

• Keep babies under 4 months of age at home and limit their exposure to visitors. This is the best prevention to reduce the spread of germs.
• Teach children to cover their mouths and noses when sneezing and coughing, and avoid touching their eyes, nose and mouth with unwashed hands
• Ensure children are frequently washing their hands with water and soap or using an alcohol-based hand sanitizer
• Encourage and remind children to wear their masks indoors and during high-risk gatherings

As the school year quickly approaches, teaching and reinforcing these easy tips will help keep your children healthy and those around them, as well. But, if your child does get sick, here is a helpful guide to determine when to take your child to an urgent care versus a pediatric emergency center.