Shoo flu shoo: Tips to know when to see (or skip) the doctor

by Lesley Politi on April 30, 2009

no secret that children from 6 months to 18 years visit the doctor and emergency rooms more than those 20 to 45 years old.

And it’s worse when it’s flu season. When a child gets sick with a communicable disease, his or her schoolmates become at risk. Parents become susceptible and stay home from work when they may not be able to afford it. Emergency rooms become flooded.

That’s why health experts have emphasized prevention this year, including hand washing and keeping sick children out of school. It will cut down on worries and cost.

Though federal health officials this year recommended that children from 6 months to 18 years receive their influenza shot, some will still get fevers, coughs and sore throats.

So we wondered: With the economy causing people to lose their jobs and their health insurance, those with children may be struggling, especially if their child gets sick. Parents may want to know: How long can they wait before taking a child in for a visit, or even to the ER, without waiting until things get too serious?

Also, what can a parent do to prevent a child from getting sick, especially during flu season?

Here is what some local pediatricians said:

“During the wintertime, children often develop viral illnesses, sometimes as frequently as once or twice a month,” said Dr. Margaret Stone, chief of the Pediatrics Department at Kaiser Permanente Woodland Hills. “Fortunately, most of these illnesses are 

self-resolving and can be managed well by parents at home.

“In the past, pediatricians commonly recommended over-the-counter cold and cough medications for these illnesses. However, we have become increasingly aware of potentially dangerous side effects caused by these medications, especially in young children, and so (on the basis of FDA warnings) we are less likely this year to recommend them. Instead, we are increasingly emphasizing traditional therapies such as rest, fluids, and time,” Stone said.

In the case of a sick child with a high fever, parents are facing a much more serious situation.

“Any young infant (under 2 or 3 months old) with a fever needs to be seen right away. Any child who is acting ill, even if there is not a significant fever, but who is breathing hard or fast, (or) seems more ill than they usually do, should be brought in,” said Dr. Howard Reinstein, spokesman for the American Academy of Pediatrics who practices in Encino and is affiliated with Providence Tarzana Medical Center.

“Any child with persistent vomiting within two or three hours, who can’t even keep down small amounts of liquid, that child needs to be seen.

“On the other hand, some people have fever phobia. You don’t have to rush to the emergency room if the child is not acting ill, and the fever doesn’t last for more than a couple of days. As long as he is acting well and drinking well,” Reinstein said.

Parents should also rely on their own past experiences with their children, advised Dr. James Henry of Glendale Pediatrics and Glendale Adventist Medical Center.

“If the parent has dealt with these symptoms before, they may want to treat the child themselves. On the other hand, if the symptoms are new and unfamiliar to the parent or the parent feels unsure, it is better to access the health-care system in some way.

“This may mean a visit to their pediatrician’s office, but often a triage nurse may be able to ascertain the severity over the phone and help advise the parent without actually bringing the child to the office or urgent care.

“Specifically, a fever lasting more than five days, severe lethargy, extreme irritability or any difficulty breathing should prompt a call to your physician’s office,” Henry said.

A Web site,, has some suggestions, he said.

“The economy shouldn’t affect child care, but we know it does,” said Dr. William E. Groves, on staff at Providence Holy Cross Medical Center.

“What do you do? Do you buy the milk your child needs or the medicine he needs? It’s hard to say when to bring a child in – it varies so much.

“But, for example, if the child has a cough and they’re not breathing well, by all means bring them in. If it’s a dry cough, you can give it a few days, but if the symptoms are severe, they must see their doctor,” Groves said.

As for prevention, if there are financial difficulties, Reinstein suggests parents utilize community clinics for vaccinations and to keep up with immunizations.

Groves recommends the following:

“Make sure they wash their hands and there’s not close contact – kissing and touching spread germs. The main thing is the hands – they’re the dirtiest part of our body. Keep them away from the mouth, the nose and the eyes. You can go through cold and flu season and stay well if you keep your hands out of your mouth.”

As for prevention, if there are financial difficulties, Reinstein suggests parents utilize community clinics for vaccinations and to keep up with immunizations.


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