Dispelling myths about pediatric illnesses

Each of us has received advice about an illness from a friend, family member, doctor, nurse, pharmacist, etc.  Often the advice we receive is welcome and helpful, but other times, we wonder if the given guidance is accurate. Though there are reliable internet resources, there is plenty of information online that may not be correct.   Because we often hear similar questions as we travel from exam room to exam room, we want to shed light on some common myths regarding childhood illness.

Myth: Green nasal discharge means my child has a bacterial infection.

While nasal discharge that has been green in color for many days may mean a bacterial infection is present (most likely if there is fever as well as other symptoms), the color of drainage alone can’t be used to indicate this. In fact, “during a common cold, nasal mucus may start out watery and clear, then become progressively thicker and more opaque, taking on a yellow or green tinge. This coloration is likely due to an increase in the number of certain immune system cells, or an increase in the enzymes these cells produce. Over the next few days, the discharge tends to clear up or dry up.”  Therefore, green nasal drainage which resolves over the course of days without fever or other symptoms, is typical for the common cold.

Myth: Frequent nosebleeds mean my child has a serious medical problem

“Your child is almost certain to have at least one nosebleed—and probably many—during these early years. Some preschoolers have several a week. This is neither abnormal nor dangerous, but it can be very frightening.”  Nosebleeds have many causes but the most common include nose picking, cold symptoms, cold air during winter months, dry air, and seasonal allergies. Though a problem with blood clotting can cause chronic nosebleeds, this is rarely the cause.  For the child who has nosebleeds often, preventative measures include using a humidifier at night, using saline nose spray, and applying a small amount of Vaseline or antibiotic ointment inside the nostrils. It is also helpful to keep fingernails trimmed to avoid trauma caused by picking  For tips on how to stop a nosebleed, read more here:  https://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/How-to-Stop-a-Nosebleed.aspx

Myth: I should avoid milk products when my child has a cold.

In a blog called Two Peds In a Pod, 2 pediatricians explain why milk should not be avoided during a cold.  “As long as your child is not vomiting, milk is a perfectly acceptable fluid to give your febrile child. In fact, it is superior to plain water if your child is refusing to eat, which is very typical of a child with a fever. Fevers take away appetites. So if your child is not eating while he is sick, at least he can drink some nutrition. Milk has energy and nutrition, which help fight infection (germs). Children with fevers need extra hydration. Even febrile infants need formula or breast milk, NOT plain water. The milk will not curdle or upset them in any way.   

There is NOTHING mucus-inducing about milk. Milk will not make your child’s nose run thicker or make his chest more congested. Let your runny-nosed child have his milk!”

Myth: My child will get sick if he goes out in the cold without enough clothing.

We have all likely heard the words “bundle up, or you’ll catch a cold.”  Though it is important to wear appropriate clothing when out in the cold, exposure to cold air outside, with or without appropriate clothing, will not cause your child to catch a cold or other virus, such as the flu.  Colds and other viruses are spread through close contact with another person with the illness.  Though spending time outside in cold weather does not cause illness, for those with asthma, cold air can bring on or worsen asthma symptoms.  It is true that a runny nose can temporarily be caused by cold air; this is called nonallergic rhinitis.

Myth:  High fever will cause my child harm and fever should always go back to normal when fever reducers are given.   Fever tells us that your child’s body is working well to fight off infection. Fever is not harmful, will not cause brain damage, and does not require drastic measures such as ice baths to lower the temperature.  The main reason we, as parents and providers, don’t like fever is because if makes our child feel lousy!  Because of this, we do recommend using fever reducers if “the side effects of the fever are causing harm. Reduce fever if it prevents your child from drinking or sleeping, or if body aches or headaches from fever are causing discomfort. If your child is drinking well, resting comfortably or playing, or sleeping soundly, then he is handling his illness just fine and does not need a fever reducing agent just for the sake of lowering the fever.”  When fever reducers are given, it is normal for temperature to only lower 1-2 degrees; this is frustrating for parents but is not concerning and is expected.  Temperature only lowering 1-2 degrees with fever reducers tells us that your child’s body is doing an excellent job fighting infection. 

We recommend evaluation of infants and children with fever anytime you as a parent are worried.  Additionally, “any temperature in your newborn infant younger than 8 weeks old that is 100.4 (rectal temp) degrees or higher is a fever that needs immediate attention by a health care provider, even if your infant appears relatively well.  Any fever that is accompanied by moderate or severe pain, change in mental state (thinking), dehydration (not drinking enough, not urinating because of not drinking enough), increased work of breathing/shortness of breath, or new rash is a fever that needs to be evaluated… In addition, a fever that lasts more than three to five days in a row, even if your child appears well, should prompt you to call your child’s health care provider. Recurring fevers should also be evaluated.”

In a blog called Peds In a Pod, 2 pediatricians explain more about fever.  Read this great post at https://twopedsinapod.org/2016/12/fever-whats-hot-whats-not-and-what-to-do-about-it/