Q. My four year old son seems to get sick every single week from the start of preschool until the end of May. His seven year old sister did the same thing in past years. She seems to have grown out of the extreme frequency of illnesses and she survived and is a very healthy child. But, I don’t know what to do about my son’s colds, coughs, intestinal bouts and occasional fevers. We are in the doctor’s office way too often and the antibiotics we have received don’t seem to do enough.
A. I have a secret to tell you. Please don’t tell anybody else. The vast majority of sick children I see in my office every fall and winter don’t need to be there. They would have been better treated at home without medication.
The majority of times children receive antibiotics, they don’t need them, would have gotten better without them and often suffer side effects both major and minor.
Your toddler has a bad cold, might be teething, has a low grade fever and is pulling on his ear? Call your doctor if you must, but as long as he’ll drink a little, smile a little and play a little, don’t make that appointment.
Usual disclaimer is “This advice is not meant to replace the advice of your doctor.” Well, of course it is! If it weren’t, you be better off spending your time reading a magazine or watching TV. Babies under 3 to 4 months of age with fevers or babies and toddlers who won’t smile a little or respond as I’ve mentioned above may need a visit to the doctor. To summarize, if you don’t like the way your baby or child looks when you’ve done all you can to make him comfortable or if he stays sick or feverish for longer than you’re comfortable with, call the doctor. But, just one more time, most sick children are not made well by doctors and most parents evaluate their sick children better than doctors do.
The converse of the above is also true: If you feel you need a doc to look at your son or daughter, don’t let anybody (doctor, nurse, friend, spouse) talk you out of it. Nobody knows your child as well as you do.
Very few docs have read the latest recommendations about ear infections and many doctors don’t have enough time during regular office appointments to get to know you and your baby. This means that, when you call about illnesses, they don’t know you well nor trust your observations and judgments about your baby’s condition. And, just as importantly, you may not trust them to give opinions over the phone. This might mean that you need to go to the doctor in fall and winter a lot more often than is really good for you and your children. Therefore, insist on a lot more time and energy during well child visits. Make sure you get all your questions answered and establish a personal relationship with your doctor and his office.
I have another secret to tell you. Doctors and their staffs love to eat. Don’t bring candy! (Thank you.) Anticipating a nice visit, bring a little fruit basket or some excellent homemade muffins to your doctor’s office. This will distinguish you from even the managed care hoards that visit the office. You will be remembered. As I write this, I feel a little bit silly but I’m being very serious and giving you a piece of advice as important as any of the illness-specific answers in the paragraphs to follow. Oh, well.
As I was saying above, most sick children are better cared for in your home and not in my office. Most pediatric illnesses are caused by viruses. Viruses not only don’t respond to antibiotics but the medication can even make things a little worse and prolong viral illness. There are hundreds of viruses around and there might be 2 or 3 new ones each week of school. These last 3 to 7 days. If you do that math, you will see that it might not be unusual to have a child who is “always sick” during the school year.
I haven’t even mentioned one of the biggest risk factors for frequent illness: older siblings! His sister might not even get an illness herself but could still carry the virus home from school for her beloved little brother. Even when she remembers to wash her hands, she rubs her nose a couple times before giving him a hello hug. No way around it.