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Our project is set up to translate and adapt the Good Home Treatment of Influenza, a 17-page booklet anyone can download and print, into as many languages as possible. The booklet is © Dr Grattan Woodson MD, and the translation (a cooperative effort) is hosted by Flu Wiki. A big THANK YOU to all involved!
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Treatment of cough
Almost every child with bird flu will cough. Cough has a useful purpose, to help rid the lung of mucus and phlegm. A dry cough is usually due to an irritated breathing passage. In this case, cough makes things worse not better. If persistent, the coughing can bruise the voice box and breathing tubes in the lung. These bruises cause pain when breathing. In the case of a dry cough due to flu, use of a cough syrup containing dextromethorphan (DM) is helpful. This drug can cause hallucinations if given for more than several days or in high doses. Keeping the child hydrated is very important for treatment of cough. Another useful technique is humidified air. Using a room humidifier is useful it available.
If mucus comes up with the cough, this is known as a wet cough. We want to encourage a wet cough to help the child clear the mucus from the lung but too much coughing can damage the lung and chest and stomach muscles. So in some cases, use of a little cough suppressing cough syrup is useful for an aggressive wet cough.
Treatment of runny nose
The best treatment for runny nose is use of a salt & soda saline solution made of ¼ tsp of salt and ¼ tsp of baking soda added to a cup of clean water. The best approach is to spray the solution into the nose as a mist. Alternatively, an ear bulb syringe works well for this purpose. The salt & soda solution will help remove mucus and irritants that clog the nasal passage and will help these tissues heal. Use of good nose blowing technique by the child is important to successful nasal solution use. Teach children to wash their hands after they blow their nose or cough into a handkerchief.
Antihistamines are an effective treatment for runny nose. Diphenhydramine, the generic name for Benadryl®, is an antihistamine recognized as safe and effective in children. Commercial children’s Benadryl is widely available as an oral tablet that melts in the childs mouth. This product is easy to use and a good treatment for runny nose. Oral diphenhydramine has few side effects including its tendency to sedate. This side effect actually can be an advantage if the child needs help in sleeping. Sometimes people have an atypical hyperactive response to antihistamines, and if this is the case, they should be avoided, especially in children.
Treatment of fever in children
Children can mount impressive fevers quite suddenly. It is common for fever to go up and down during the day and night. Aches and pains parallel the fever. Fevers can have a daily pattern, and it is common for a childs temperature to reach 104 F during a severe infection. A goal of therapy is to lower the fever to between 100.5°F and 101°F, where the body’s immune system is most effective at eliminating the infection. If the temperature rises above 105°F, seizures or even brain injury are possible. So, it is important to aggressively manage the child’s fever before it becomes extreme.
Restoring fluid losses due to fever or other causes is always the first step in treatment of fever. Failure to restore the child’s fluid volume will make it nearly impossible to lower the temperature. Acetaminophen reduces temperature and helps with aches and pains. Be sure to use it in full children’s doses rather than partial doses. Use the weight and age-based dose guidelines provided with the children’s acetaminophen product. A tepid water sponge bath is a useful method in lowering a fever. Never give a child or an adult an alcohol sponge bath, which can be toxic. In rare instances, using all the methods above fails to lower the temperature to below 101 F. In this case, lower the temperature of the water you use for the sponge bath or fan the child to speed the evaporation of fluid from the body. An additional measure, if absolutely necessary, is to place ice or snow packs in plastic zip lock-type bags wrapped in kitchen towels under both arms, around the neck, and between the legs on the groin. High volumes of blood are cooled with this technique as it passes by these areas. This method is difficult for the child, but it is a fast way to lower core body temperature in an emergency.
How to take your child’s temperature accurately
To measure your child’s fever accurately use:
- A rectal or tympanic (ear) thermometer for children less than 3 years old
- A digital (not glass) oral thermometer for children over 3 years old
- Avoid using an ear thermometer until your baby is at least 3 months old. It may not be accurate, because young infants have such narrow ear canals.
Temperature readings are different from different parts of the body (rectum, ear, mouth). Your child has a fever if her temperature is above:
- Rectal 100.4°F (38.0° C)
- Oral 99.5° F (37.5° C)
- Axillary (underarm) 98.6° F (37.0° C)
- Tympanic (ear) 100.0° F (37.8° C)
Keeping your child comfortable with a fever
- If the child is shivering, keep her warm until the shivering stops.
- If the child is not shivering, you can remove her warm clothes and encourage her to drink plenty of fluids.
- Keep your child rested, quiet, and comfortable in a cool room.
- Place a cool washcloth on your child’s forehead or sponge her with tepid water. Stop if your child starts to shiver.
- Never use rubbing alcohol to cool your child’s skinthe vapors are toxic and can be absorbed through the skin.
- Acetaminophen in childrens doses is a safe and effective way to lower the fever in kids. It takes from 30 to 60 minutes to begin working.
- Monitor your child’s temperature, appearance, and behavior periodically, “keeping an eye out for signs of a more serious illness” until she seems to be back to normal.
Treatment of nausea, vomiting, and diarrhea in children
The most important treatment for nausea, vomiting, cramping, and diarrhea is to stop feeding the child and place them on a clear liquid diet. Start with the Oral Rehydration Solution plain or with a little powered fruit-flavored drink mix for taste. Give the child small amounts of the ORS solution in sips from the baby bottle. This will help prevent dehydration and is not likely to make cramping worse. Meclizine 25mg given every 4 to 6 hours can help reduce nausea in children age 12 years and older. It is not US FDA approved for use in younger children.
To stop diarrhea, consider using a small dose of the diphenhydramine. The anticholenergic effect of this drug will calm the intestine. Use a low, age/weight appropriate dose every four to six hours as needed. For children over age 2 years, loperamide 1 to 2 mg every 4 to 6 hours can be used for diarrhea and abdominal cramping.
Acetaminophen use in children
Acetaminophen, best known as the brand name product Tylenol®, is an excellent drug for treatment of pain and fever in children from toddlers to teens. It also helps children sleep when given at bedtime. It is very safe with the only issue related to total daily dose, which must not be exceeded to prevent liver injury. In children, the safe dose limit changes with age and weight. The younger a child or the smaller, the lower the safe dose limits. The easiest thing to do is use Johnson and Johnson’s brand name Children’s Tylenol® or Infant’s Concentrated Drops® or the identical generic drugstore brand of these products.