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Get Smart: How to help sick kids when antibiotics aren't the answer

For years, doctors have been prescribing antibiotics for illnesses as common as the cold. But, as doctors and health experts now know, those everyday prescriptions have led to some big problems.

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Sarah Lindenfeld Hall

For years, doctors have been prescribing antibiotics for illnesses as common as the cold. But, as doctors and health experts now know, those everyday prescriptions have led to some big problems.

For more than a decade, the Centers for Disease Control and Prevention and other agencies have warned against the overuse of antibiotics. The drugs' effectiveness has been reduced because the diseases that the antibiotics have been designed to squash have changed just enough that the drugs sometimes no longer work. That means the illnesses might no longer be treatable.
And now, patients aren't leaving doctors offices with those prescriptions for antibiotics when they come in with complaints about colds, the flu and even many sore throats and ear infections. For parents, it can be tough, especially if they see that their little one is in pain and uncomfortable.
Those antibiotics, however, wouldn't fix the pain and discomfort anyway, said Dr. Zack Moore, a pediatrician and medical epidemiologist in the N.C. Department of Health and Human Services' communicable disease branch. Late last year, state officials launched a campaign called Get Smart About Antibiotics to educate doctors and patients about antibiotics overuse.
"They're not pain medication," Dr. Moore said. "Whether or not your child gets an antibiotic, pain management is very important. The antibiotics aren't going to help that."
So how can you help your child when he has an illness that won't improve with a course of antibiotics?
Dr. Moore said over-the-counter pain medications such as acetaminophen and ibuprofen can make a child feel better and reduce fevers.
"Depending on the situation," he said, "there may be other things."
And home remedies, including chicken soup, rest and tender loving care, can help, according to Dr. Moore and the American Academy of Pediatrics.
A cool-mist humidifier or vaporizer can help relieve stuffy noses. Just be sure to follow the manufacturers' recommendations when it comes to cleaning the humidifier or vaporizer, Dr. Moore said.
Saline nose drops, which I started using when I caught a cold and was pregnant, also are a big help. At my house, we are all regular users of the drops, which can help with both colds and seasonal allergies. And they work for the youngest in the family. A few drops of the solution in an infant's nostrils, along with a bulb syringe, can ease tiny stuffy noses, according to the American Academy of Pediatrics. My kids have used them for so long that they usually ask for a fresh bottle when they start getting the sniffles.
To help with chest congestion in infants and young children, the pediatrics group recommends this technique: "Lay your child across your knees, face down; cup your hand; and gently tap your child's back. Or sit your child on your lap, lean her body forward about 30 degrees, cup your hand, and gently tap her back."
For coughs, spoonfuls of honey and hot water with lemon juice and honey are popular at my house. The American Academy of Pediatrics recommends a half teaspoon of honey for kids ages 2 to 5; one teaspoon for kids ages 6 to 11; and two teaspoons for kids ages 12 and older. (Honey is not safe for babies under age 1).

Dr. Moore steers parents away from over-the-counter cold medication for children. In 2008, the Food and Drug Administration issued an advisory saying that children younger than 2 years should not take cold medications because of serious and life-threatening side effects, according to the American Academy of Pediatrics. The pediatrics group takes it a step further, saying those medications do not work for kids younger than six years.

"A lot of them are sedating and a lot of the cough suppressants just really aren't effective," Dr. Moore said. "The decongestants are not safe for really young children."

Dr. Moore said that if symptoms continue for more than 7 to 10 days or get worse, it is best to get to the doctor. What starts out as a cold, which is caused by a virus, could eventually turn into a bacterial infection, which antibiotics can resolve.

"If it’s more than 10 days and they are still having fever and nasal discharge, ... it may have developed into a bacterial infection," he said. "It's important to be seen."

Go Ask Mom is partnering with the North Carolina Quality Center to help parents Get Smart About Antibiotics. For additional information and resources, see http://www.ncgetsmart.com.

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