Kids get sick. Kids get sick a lot. When my own kids started daycare at the age of three months and had an ear infection every month for about the first year of their life, I began to wonder if they had some undiagnosed immune deficiency., asthma or other fearful and unknown medical disorder. They both took antibiotics for most of these ear infections and had to have tympariostomy tunes ("ear tubes") placed to keep the infections from starting again at about the ago of 12 months.

As a pediatrician, I deal daily with the effects of these minuscule microbial adversaries. Because antibiotics and steroids have the potential to cause so many problems both in the short and long term, being able to distinguish the usual patterns and physical findings of viral illness is vital in the work of anyone taking care of acute illnesses in kids and for parents to know when to take their children to medical providers. In the era of quick answers and our anxieties about uncertainties, I want to offer a few words of reassurance and advice.

Let's start with what is "normal". Preschool aged children will become ill with about 12-15 (as many as 20) discreet viral infections in a 12 month period. Attendance at daycare, preschool and other densely kid-populated environments increase this number. These will vary significantly in the clinical symptoms they cause and the duration of the illness. Viruses mutate rapidly, so it's possible to be infected by the same type of virus several times. Each of these infections has the potential to cause symptoms for up to 28 days. Often, fever will be present in the first week along with a gradual worsening of cough, congestion and runny nose. The illness will plateau and then begin to slowly wane over the course of the remaining month. Most of these viral illnesses will occur between late October and late March. Kids may seem sick "the while winter". Of course, there are scattered outbreaks at other times of the year too. 

The return for having been through all of these illnesses is a much more robust immune system. Kids will have about the same number of viral infections in their first 6-7 years of life, the question is when. If kids are exposed early (i.e. going to daycare, having school age siblings) they will be sick more often early, then have fewer and fewer infections when attendance counts, kindergarten. Children exposed to all of these viruses have their immune systems challenged and it appears, they develop asthma and allergies to a lesser degree than their peers as they age. Interestingly, having a dog at home providing a variety of environmental exposures imparts similar benefits. 

​Careful use of antipyretics (Tylenol and Motrin) and attention to adequate hydration during the acute phase of the illness is usually adequate. Other remedies to try include: honey (kids older than 12 months), menthol rubs (like Vicks) and humidifiers in the room. Generally, bring kids to the doctor if fevers last longer than five days, they seem to be getting worse after 1-2 weeks of being sick or you have worries about their being adequately hydrated. Hopefully this review has provided some reassurance and confidence in dealing with these ver common questions. Keep the Kleenexes handy.