Child with Cold or Flu? When to Visit the Doctor

Local pediatrician offers tips on children’s health

It’s cold and raining outside. The flu bug is going around and it seems like much of the neighborhood is down with a winter cold or the flu. What guidelines should a parent follow when a child becomes ill?

A child who has been sick should only return to school or daycare when his/her fever has been gone for at least 48-72 hours without the use of any fever-reducing medicine, and received a negative COVID test according to Dr. Bhaskari Peela, a pediatrician with Washington Township Medical Foundation in Warm Springs.

Children should also be kept out of school or daycare if the child doesn’t feel well enough to participate comfortably in activities. Dr. Peela adds, “Certainly, the child should be seen by a physician if he/she appears to be severely ill, with symptoms including: difficulty breathing; irritability; lethargy; poor fluid intake or not urinating normally; or a rash that has not been evaluated.”

Children who are at high risk of flu complications should see a doctor for even suspected influenza of any severity, Dr. Peela emphasizes. These are children under the age of 5, particularly those under the age of 2. This would also include any children with chronic medical conditions, including asthma.

Siblings of children who are younger than 6 months or those having chronic medical conditions that put them at risk of complications of influenza, should be brought in if they have flu-like symptoms so they do not pass it on to the more vulnerable group.

Additionally, the vulnerable group can get antiviral medications to prevent them from contracting the flu, if they have been exposed. Antiviral treatment is most effective if started within 48 hours of noticing symptoms. Even outside the 48-hour mark, the medication could still be considered if the illness is severe or progressive. "Although children with mild illness who are not at high risk of flu complications may also be treated, most children who are otherwise healthy and get the flu do not need to be treated with antiviral drugs. So we use these meds for severe illnesses, hospitalized children, or the children who are at risk to get complicated flu," Dr. Peela notes.

Dr. Peela explains that viruses can be spread by children without symptoms and by children who no longer show symptoms of the illness. “People with the flu may be able to infect others beginning one day before symptoms develop and five to seven days after becoming sick.”

While mainly spread by sneezing, coughing or through air contact, viruses also may be spread by touching surfaces exposed to the virus. “That means hand-washing is extremely important and surfaces that may have been exposed to the virus must also be cleaned thoroughly,” she says.

Dr. Peela offers several suggestions for keeping children healthy including: a healthy diet, good quality and adequate amounts of sleep, sufficient exercise, avoiding close contact with those who are sick, having a child cover his/her nose and mouth with a tissue when coughing or sneezing, washing hands often with soap and water, as well as keeping surfaces such as door knobs, handles, keyboards, etc., clean and disinfected. Everyone older than 6 months should be vaccinated against the flu.

As a final note, Dr. Peela counsels, “Wellness is not simply physical health including nutrition, exercise, and vaccinations. To maintain overall health, in addition to the physical health, emotional, spiritual and social dimensions of health also need to be well. These are mutually dependent.”