Home care advice for winter coughs, colds, more Published Jan. 27, 2017 By 48th Medical Group Pediatric Clinic 48th Medical Group Pediatric Clinic ROYAL AIR FORCE LAKENHEATH, England -- Children get sick more often over the winter season, and it can be scary for parents, but did you know some illnesses can be treated at home? Below are some of the most common illnesses with home care advice to help you potentially avoid a trip to the clinic. Still have questions? You can call the nurse advice line 24 hours a day at 01638-52-8010 or send your child’s Primary Care Manager a message through the MiCare portal at https://app.relayhealth.com/security/login/default.aspx?bid=DHA. Cough Coughs are annoying and can keep you and your child up at night. However, did you know that most coughs can be treated without a trip to your PCM? • For coughing fits or spells, try a warm mist (run a hot shower in closed bathroom and stay in the bathroom, but away from the shower with your child). • If your child has a fever above 102 F, give over-the-counter pain medication such as Tylenol or Motrin, as instructed on bottle for age. • Encourage drinking extra fluids to prevent dehydration. • Avoid tobacco smoke as it can worsen the cough. • Try homemade cough medicine for younger children, as over-the-counter cough medicine has no proven benefit for children and is not approved for children under the age of four. For children 3 months to 1 year, give warm clear fluids such as water or apple juice to thin mucus and relax airways (5 to 15 milliliters up to four times daily). For children 1 year and older, give honey (2 to 5 milliliters) as needed to thin secretions and loosen cough. Make an appointment if: • Your child is having difficulty in breathing • You hear wheezing • Fever greater than 101 F lasts for more than three days • Coughing lasts over three weeks with no improvement • Your child is getting worse Fever Fevers in young children can be quite scary, but most are caused by a virus and the fever actually helps the body fight the infection. • Provide ample fluids. • Dress in one layer and a blanket. • There is no need to give fever medication for temperatures between 100-102 F. Fevers at this temperature help the body fight the infection. • Children may shiver when fever is rising and warm clothes should be worn until shivering stops. • Viral fevers can last for two to three days without any intervention needed. • Children can return to school/daycare 24 hours after fever has subsided. Make an appointment if: • Your child is under 2-months-old and has a fever of 100.4 F or above. This will require an immediate visit to the emergency room. • Fever lasts over 72 hours • Fever goes above 105 F • There is any difficulty in breathing along with the fever • Severe pain is suspected or your child is very irritable or inconsolable • There is burning or pain with urination • There are signs of dehydration such as a very dry mouth, or no urine if the child is older than 12 months • Age 3 to 6 months with fever greater than 102 F • Age 6 to 24 months with fever greater than 102 F and present over 24 hours with no other symptoms, such as cough, cold, diarrhea, vomiting, etc Rash A rash is most likely part of a viral illness. Such rashes are harmless and usually follow a fever, cough, cold or diarrhea. They can be red or pink and range from small to solid spots. Most common ages are 6 months to 3 years of age. • Cool baths are great for itchy rashes. • Keep child home if they are irritable. • No medication is available to treat a viral rash. • Increase fluid intake. • Children can return to daycare/school once rash has gone in most cases (no exclusion for hand-foot-and-mouth disease). Make an appointment if: • Rash is purple with a fever. This will require a trip to the emergency room. • There is bright red skin that peels off in sheets • A wound infection is also present • There are bloody crusts on lips • Rash is present and not improving after 3 days • A sore throat accompanies the rash Diarrhea An increase in the frequency and looseness of two or more bowel movements may be diarrhea. Loose stools may not cause dehydration, but frequent, watery stools may increase the risk of dehydration. Most diarrhea is caused by a viral infection of the intestines and causes loose stools to get rid of the germs. • Continue with liquid intake and offer frequently, but avoid fruit juice. • Encourage child to eat starchy foods such as crackers, bread and rice. • If breastfeeding, increase frequency and offer after every loose, watery bowel movement. • Offer an oral rehydration solution such as Pedialyte if the infant/child is not breast-fed. Offer after every loose, watery bowel movement. • Offer probiotics containing lactobacilli (available in most health food stores) or use yogurt if the child is over 12 months. • Wash perineal area after each stool to prevent diaper rash and use protective ointment to soothe skin around area. • Children can return to school/daycare when stools are normal and fever has gone. Make an appointment if: • Child has signs of dehydration, such as no urine in more than 8 hours, no tears when crying, or a dry mouth • Blood is observed in stool • Fever is above 105 F • Abdominal pain is present longer than 2 hours • There is very watery diarrhea and vomiting three or more times • Age is less than 1 month with three or more diarrhea bowel movements • Age is 1 year or less with more than eight diarrhea bowel movements in last 8 hours • Fever persists more than 3 days • There has been travel to a country at risk for bacterial diarrhea within the last month • Diarrhea persists longer than 2 weeks (Information referenced from Pediatric Telephone Protocols - Office Version. 15th edition, by Barton D. Schmitt, American Academy of Pediatrics, 2016)