Edna Pytlak, MD

For years researchers have been trying to find ways to prevent and treat the common cold. Given the wide array of common respiratory viruses and the way we live modern life, however, complete prevention is not practical.

Preventing a virus from infecting a young child or an infant is a particular challenge; their immune systems are new and they are surrounded by germs. Here I will share a few observations on how the little ones get sick, how they share what they catch, and what parents can do to protect the whole family. 

Young children who go to nursery school or other indoor play centers typically contract 8 to 12 respiratory illnesses per year. Most of the colds, fortunately, will be limited to the upper airway. How sick a child becomes each time is determined by factors such as age, nutritional reserve, and immune resilience. Some common viruses, such as respiratory syncytial virus, cause cellular injury to the lower respiratory tract lining in infants. Influenza weakens local tissue defenses, allowing increased adhesion to respiratory epithelial cells of pathogenic bacteria such as pneumococci.  
 


  
The size of the viral “inoculum” also plays a role. The greater the exposure, the sicker the child is likely to be. The germs in a cough will travel about an arm's length and then drop to the floor. If someone inhales while another person coughs directly into his or her face, the respiratory air stream will carry germs deep into the lungs. When a few germs land on a person's hands, however, or are inhaled in a large spacious room or outdoors, the immune system starts to process the pathogen in the tonsils and adenoids. This immune surveillance system can be effective enough that a person exposed to a bug doesn't get sick. In the days before the chickenpox vaccine, some children suffered milder cases than others. The kids who were exposed to the virus in small doses over several days (ie, in a well-ventilated classroom with all the desks facing forward) tended to have a milder version than those whose first contact was more intense, ie, with an affectionate sibling during the most contagious phase of the virus when the spots were just beginning to appear.


One reason children in nursery school or daycare are so prone to getting colds is that they run around an indoor space all day with other children of the same size, coughing into each other's faces. When the children head home, they freely cough into their parents' faces and pass on the newest circulating virus. As the months go by, a new preschooler gradually builds up an elaborate library of antibodies. Often, by the time kids start grammar school, they get sick only rarely. In the 1950s a study reported that kindergarteners missed an average of 30 school days a year. The reason was their vulnerability to modern-day vaccine preventable illnesses: measles, mumps, rubella, and chickenpox.
 



The preschooler with a newborn sibling at home is a particular challenge. Parents can’t, and shouldn’t, keep the older sibling away from the newborn. The easiest way to protect the infant is to have the child wash his hands with an alcohol-based hand sanitizer as soon as he is picked up at school or when he enters the house. Have the affectionate older child learn to kiss the baby on the feet (or top of the head or hands) instead of the face. At family gatherings, infants should be kept out of the coughing and touching range of other partygoers. Infant carriers are particularly helpful because they help keep the baby in the respiratory air zone of the parent and less likely to be passed around the room, from person to person.

 
There are many over-the-counter products from A (Airborne) to Z (zinc tablets) that are marketed as adjuncts in the prevention of common colds. Some alleviate symptoms, others enhance resistance. The human immune system is elaborate and many of the processes behind the immune response are still unclear. I don’t have the magic potion for prevention or cure, but here I offer some nutritional approaches and home treatments I’ve found helpful.  



 contains catechins which have been shown in studies of nursing home residents to help decrease the adhesion of influenza virus to receptors on the back of the throat. Green tea gargles were proposed as a possible preventive measure for nursing home staff and patients. 
 


, and several other fruits contain proanthocyanidins, which inhibit several viruses and also help block the viral receptor hemagglutinin.
 


 has been shown to increase the efficacy of monocytes. Widespread vitamin D deficiency during the early years of the industrial revolution is now thought to have helped propel the spread of tuberculosis in city dwellers. 
 


 help reduce the viscosity of respiratory secretions and improve immune resistance within the mucous layer. 
 


 Sleep deprivation reduces human resistance.

 Include fruits, vegetables, and proteins; all help optimize immunity.

Walking outdoors, and particularly in the cold, makes the nasal passages produce a wave of protective clear mucus that helps clear away germs.

 It’s also important to stay warm during the cold months. Prolonged sitting/standing in cold temperatures can weaken immune defense. We have all heard people complain of a cold getting worse after they’ve been “chilled.” The influenza virus prefers a cooler nostril and prolonged cold can even promote replication. Drinking warm liquids after exercising in the cold helps prevent the virus from settling in.   
 

Articles

Dr Pytlak offers tips on what parents can do to protect the whole family from colds and flu this season with some seasoned home remedies.

Warding Off the Common Cold in Young Children

Over the years grandmothers from around the world have come to Brooklyn where I practice to help their daughters adjust during the newborn period. Here are some of the functional foods I have learned about that are used to help improve breast milk and help general healing for infant and mother.  
 


Functional foods to help improve breast milk

: “Black” beer (ie, Guiness-like dark beers)
 


Fennugreek tea and/or fennugreek pudding  (in Sudan, it is served to mothers as a porridge; in the United States, it is available in capsule form) 
 
 


 can be used to wipe the eyes of a baby with newborn conjunctivitis. A small amount of chamomile tea (1 ounce/day) also can be given to babies with colic to quiet symptoms. A soft cloth soaked in chamomile tea and placed on the sore nipples is also soothing for the mother.

 is also helpful for an infant with colic. From 1 cup of brewed tea, 1 ounce/day can be given to the baby and the mother can drink the rest.

 is used as an ablution for the perineal area after childbirth. A tea leaf is allowed to soak in hot water which is then poured over the perineum to help the healing process. Guava leaves are also used to soothe older boys after circumcision. The leaf is wrapped around the penis after the procedure and rinsed off after 1 or 2 days.

For a mother who is overdue (also from Germany) 

will help induce uterine contractions. It is thought the tea might help bring on labor and mothers who are not ready to go into labor should not drink it at all.

Functional foods for post-partum mothers include galactagogues to enhance breast feeding and teas to soothe colic.

Postpartum Remedies for Better Breast Milk

Pediatricians, during residency, will learn how to manage acute diarrhea and rehydration in young patients. However, once in practice, they will probably see many children whose parents have brought them to the office only after 1 or 2 days of diarrhea. These children aren’t usually dangerously dehydrated but can become so if fluid intake doesn’t keep up with ongoing loss.

There are quite a few dietary tactics you can recommend that are simple for most parents to use and provide replenishment and comfort for the child. 
 
First, remind the parent that diarrhea often takes about a week and a half to resolve. This is because the intestinal tract needs time to replace the many cells lost during the acute illness. During the recuperation phase, nutrients will not be as well absorbed so careful attention to a child’s diet is helpful. Partially digested foods, particularly sugars, will act like osmotic stool softeners so should be avoided. On the other hand, an overly restrictive diet that avoids, for example, fats and protein, can prolong recovery. Without fat in the intestinal lumen, it will take much longer for the intestinal brush border to reestablish its enzymatic machinery.


A recipe for homemade rehydration fluid: 
• 1 liter of water
• One-half teaspoon of salt
• 8 teaspoons of sugar

This solution lacks potassium, so the child should have some banana, potato, or carrots. Some parents turn this into an orange smoothie by mixing the salt/sugar/water solution in a blender with a quarter cup of orange juice and half a banana.

Homemade chicken or vegetable soup makes excellent rehydration fluid: 
• Place unboned chicken thighs in a pot of water; bring to a boil.    
• Add one-third teaspoon of salt per 1 liter of water (some of the water will evaporate). 
• Add carrots, peas, or squash; all contain natural sugar and potassium.

Dietary tricks to help support gut recuperation 



. Taken as a soup, helps by “blotting” up bacterial by-products and cellular debris. Rice bran has a spiral structure that acts like a cotton mop as it travels down the GI tract.


Has the same beneficial effect of mopping up cellular debris. It can be cooked to a soupy consistency and bananas can be added for flavor, texture, and potassium. 


. Their fibrous structure also is a good bacterial “blotter” and will help decrease the osmotic load of contents in the lower intestine. 


. Another good blotter for extra bacteria and their toxins.


. The yellow vegetables are thought to be good for intestinal healing. 


. All are great sources of potassium and trace elements and can be sprinkled with salt.

Remember to add some fat to the broths and the vegetable dishes.

 a “friendly” bacteria added to some commercial yogurt products, is thought to be particularly helpful in children with diarrhea because it competes with other intestinal bacteria. It is thought to float to the periphery of the intestinal stream and help crowd away the more pathogenic 

As long as an infant can tolerate cow’s milk protein, he or she can be given yogurt as early as 6 months of age. It’s not necessary to purchase the commercial “baby yogurt” brands; any reputable pasteurized brand that claims on the label to contain “active cultures” can be used.

For children who don't like yogurt or milk, there are several pediatric probiotic products available without a doctor’s prescription (ie, pediatric Culturelle and Florastor). The products are made to be sprinkled on and mixed into cold soft foods.

Prolonged diarrhea causes dehydration and cellular depletion in the gastrointestinal lumen. Sodium-rich liquids and functional foods help restore gut balance.

Diarrhea: Home Remedies to Help Rehydrate and to Soothe the Gut

Here, I offer a few old-fashioned and time-tested home remedies to relieve ear pain that typically follows a respiratory infection. I've found it helpful to share these tips with parents of my young patients.  



 Place a few drops of ice water into the affected ear. Be sure to forewarn the child that it’s going to feel “super cold” and maybe tell him/her that you are putting some melted snow into the ear to make the pain go away. Then have the child lie against your shoulder or sit propped up and gently stroke the side of the neck. The brief pulse of ice water causes the blood vessels of the inflamed tympanic membrane to constrict, and does bring some relief.
 
This trick works best if you administer ibuprofen first and try not to drip ice water on the external ear or down the child's neck.  



 Gentle warmth around the ear can also alleviate infection-associated pain and a homemade “salt sock” can serve as a natural heating pad for infants and young children. Put a cup of uncooked rice or other grain into a thick cotton sock. Add a tablespoon of Kosher or sea salt. Shake. Then tie the sock closed and put it into a microwave oven for 30 to 60 seconds. To minimize the chance of accidental burning, parents should place the heating pad on their chest and hold the child on his/her lap. The child can then gently lean against the salt sock rather than lying flat against it while prone.     




A young child who has a cold and must travel by air will be very prone to ear pain, especially when the airplane begins its initial descent. On a mid-winter flight to Florida, the cry of a young child is often heard about 20 minutes before landing-when intraocular pressure starts to shift. A warm moist poultice placed in the bottom of a cup can help. Parents will need to do a bit of advanced planning to make this tactic work. 

Tell them to bring along a plastic bag full of cotton balls and/or makeup pads and an insulated pack in their carry-on luggage. Once airborne and settled, moisten some of the cotton balls/pads with hot water from the beverage cart and put them in the insulated bag. By the time the flight is approaching its destination, the cotton should be sufficiently warm. Press a few of the warm moist, but not dripping, cotton balls or pads into the bottom of a small paper or plastic cup. Place the cup over the child’s affected ear to create a change in local barometric pressure that will help reduce the pain. The warm moist cotton can also be placed under the earpiece of a set of headphones.   
 
 

Pain from ear infections can be reduced at home and during plane travel using ibuprofen and home remedies: cold water, warm compresses, and paper cups

Edna Pytlak, MD

Articles

Warding Off the Common Cold in Young Children

Postpartum Remedies for Better Breast Milk

Diarrhea: Home Remedies to Help Rehydrate and to Soothe the Gut

Home Remedies for Ear Pain on the Ground and in the Air