Updated: Jan 6, 2020
Influenza, strep, coronavirus, respiratory syncytial virus, influenza, parainfluenza, norovirus, pertussis, pneumonia, rhinovirus, parovirus….winter is coming!
The “common cold” has a fancy name in medicine: URI, which stands for Upper Respiratory Infection.—A URI is an acute, self-limiting viral infection of the upper respiratory tract characterized by variable degrees of sneezing, nasal congestion and discharge (rhinorrhea), sore throat, cough, low grade fever, headache, and malaise.
A URI is usually a mild and self-limiting viral illness, usually caused by rhinoviruses. Antiviral therapy is not available for the viruses that cause the common cold with the exception of influenza virus.
In infants and young children, the symptoms of the common cold usually peak on day 2 to 3 of illness and then gradually improve over 10 to 14 days. The cough may linger in a minority of children but should steadily resolve over three to four weeks. In older children and adolescents, symptoms usually resolve in five to seven days (longer in those with underlying lung disease or who smoke cigarettes).
While most clinic, urgent care, and ER visits are for the common cold, many other more serious illnesses have similar symptoms. It is never a bad idea to see a medical provider if you aren’t sure.
Why does it seem there is more illness in colder months? Simple answer: we are inside more, where microscopic droplets from that cough or sneeze are invisibly suspended mid-air, just waiting for you to walk through the nebulous of contagion as you practice your deep-breathing. It is a good thing our immune systems are primed for systemic, underground warfare, ready to protect us with layers of defense. One our most under-appreciated defense systems works as a physical barrier: our skin.
Beneath our skin circulates our under-armor powerhouse: antibodies. Our intelligent body provides us antibodies in various methods, via natural exposure to a pathogen (virus or bacteria), via maternal antibodies, and via immunization.
Our immune system is incredible, but there are certainly ways in which we can either help or hinder our body’s ability to fight the Yuck. Here are some suggestions (not in any particular order of importance) for the general population.
1. Encourage sleep! Without sufficient sleep, our body goes into a stress response, which lowers immunity. This is true for all ages. As a general rule, preschoolers (ages 3-5), should get between 10 -13 hours, ages 6 to 13 should get 9- 11 hours, and adolescents ages 14-17 need between 8- 10 hours. Insufficient sleep reduces the body’s ability to produce proteins called cytokines that help fight infection and reduce inflammation.
2. Decrease the pressure—take the pressure of your child to go-go-go or perform, perform, perform. Teach your child healthy coping mechanisms and mindfulness. Anxiety, stress and depression often result in higher levels of the stress hormone cortisol, which lowers the immune system.
3. Increase the joy and cuddles: the mind-body connection is powerful! Multiple studies show that those who are joyful and positive tend to have more robust immune systems. Even laughter has been documented to increase immunity! Hugging your child, cuddling up for story-time, and doing skin-to-skin with your newborn does wonders for both mental and physical health.
4. Choose warm water and soap over hand sanitizers whenever possible. Wash those hands! Recent research has found that preventing flu is more successful with even just rinsing our hands in water versus using a hand sanitizer. Also, most hand-sanitizers contain some ingredients that may be more harmful than good, as do many anti-bacterial soaps. Opt for the simple, most natural soap.
5. Protect your barrier defense mechanism: the skin. Keep it free from cracks by using a thick moisturizer, staying hydrated, and being mindful of what products you do use on your largest organ. I like to verify ingredient safety on the Enviromental Working Group website.
6. Food as medicine: whenever ever able, choose organic, colorful fruits and vegetables and add them to every meal. Choose organic whole grains for carbohydrates—instead of white rice, choose brown. Instead of “wheat bread” which is most white flour, choose “whole wheat bread” or sprouted grain bread (I love Ezekiel bread). Non-organic costs less, it is true, but often has pesticide contamination and is grown in nutrient-depleted soils. I also opt for non-GMO whenever possible. If you drink milk, choose milk from cows that are pasture-raised and not given growth hormones nor antibiotics. Limit your child’s consumption of meat in favor of a plant-based diet to increase nutrient-dense calories. There are many other ways to get complete proteins and iron.
7. Teach your children to cough and sneeze (into their elbows) rather than into the air.
8. Surround yourself as able with healthy people and caregivers
9. Choose your supplements wisely and be conservative. I appreciate many non-prescription options for health and often integrate herbs and supplements into my medical practice. However, I urge all my parents to exercise caution with supplements, especially pregnant or breastfeeding mothers, infants and young children. Some are safe while some are not so safe. Some can interact seriously with prescription medications or exacerbate health conditions. Supplements are not regulated by the FDA, so what is in the actual product may not be what is on the label, or may be contaminated.
Comprehensive reviews on multiple studies provide conflicting data, making it hard to know if there is much benefit of taking supplements compared to a placebo pill. A systematic review of two randomized trials in children found that zinc sulfate, taken for a minimum of five months, decreased the rate of development of colds and school absence. However, most children poorly tolerate zinc due to nausea and “taste.” The US Food and Drug Administration (FDA) issued a public health advisory advising that over-the-counter zinc-containing intranasal products (Zicam) should not be used because of multiple reports of permanent loss of smell.
A 2013 meta-analysis of 29 trials showed that regular supplementation with vitamin C did not significantly reduce the incidence of colds but often caused diarrhea if taken in high amounts in children. However, small amounts are generally regarded as safe and may be helpful. Be careful not to "mega-dose" your child — kids should have no more than 500 milligrams (mg) of vitamin C a day. (A cup of orange juice has about 120 mg, while many chewable vitamin C tablets have 500 mg.)
That said, I do believe that nature gives us a magnificent medicinal cabinet, and when my littles are sick, I make soups, smoothies and popsicles packed with nutrition. I am a believer in putting my money into high quality, nutrient-dense organic foods for prevention and well-studied immunizations rather costly remedies that have not been rigorously studied for safety in young children. There are many wonderful herbs that can help the body be more resilient if taken in safe forms and dosages, but sadly research is often lacking on safety and dosing for tiny bodies, and there is lack of regulation.
10. Breastfeed if able. I was one of those who really struggled to breastfeed, for many reasons outside of my control, so I’m not standing here shouting from a podium of success. However, if you are able to breastfeed, you will be able to provide your baby your own antibodies, which can really benefit your child’s health on many levels. If you can’t breastfeed, don’t lose heart! There are many other ways (some listed here) that can keep your baby healthy.
11. Hydrate! Our body is mostly water, so it seems to reason that it works better when watered. Maintaining adequate hydration may help to thin secretions and soothe the respiratory mucosa. Warm liquids (eg, tea, chicken soup) may have a soothing effect on the respiratory mucosa, increase the flow of nasal mucus (possibly also mediated by the inhalation of steam), and loosen respiratory secretions, making them easier to remove. If you have infants or very young children, invest in a “Snot Sucker” such as the NoseFrida or NeliMed Naspira.
12. Avoid foods that hinder the immune system, such as processed foods (foods far from their original form and most foods with a long shelf life), certain preservatives, white breads, most breakfast cereals, anything high in sugars.
13. Get OUTside. There is a reason our clinics and ERs are busier in the winter: all those pathogens having a party in one tiny room.
14. Get sunshine and vitamin D. There is no clear nor conclusive evidence that taking a Vitamin D supplement results in lower incidence of winter illness, but many providers agree that getting enough Vitamin D3 in one’s diet, especially in the darker winter months can be beneficial. Breastfed infants are encouraged to be receive 400 IU daily of Vitamin D drops. Wild salmon is a natural source of vitamin D3. On average, wild-caught salmon packs 988 IU of vitamin D per 3.5-ounce (100-gram) serving. If you aren’t into fish, one typical egg yolk from chickens raised indoors contains 18–39 IU of vitamin D, which isn't very high--However, pasture-raised chicke