Cold, flu, bronchiolitis? Between runny noses, coughs, fevers and sneezing, it's tough for parents to know exactly what's wrong with their child and how to best help them. The experts at Le Bonheur Children's Medical Center offer parents their tips to surviving the winter bugs.

Cold
You child will probably have more colds than any other illness during life. Because there is no cure for a cold, the best thing parents can do is make their children comfortable until the bug passes.

Recently several commonly used cold medicines for children were voluntarily pulled from drug store shelves by the manufacturers. These over-the-counter medicines may be dangerous for children under the age of two. Dr. Robert Riikola of Le Bonheur Children's Medical Center, recommends that parents should check with a pediatrician before giving children under the age of 2 any over-the-counter medicine.

When your child has a cold, Riikola suggests several things parents can do:

• Your child should drink extra fluids and get more sleep while he or she is not feeling well. When children are breathing more heavily, they tend to lose fluids and dehydrate more quickly.
• When your infant is having difficulty breathing, use a suction bulb to gently clear his or her clogged nose. If the secretions in your baby's nose are particularly thick, saline drops will help loosen them and allow your child to breathe more easily.
• If recommended by your pediatrician, acetaminophen or ibuprofen can be used to alleviate pain. Ibuprofen is approved for use in children six months of age and older.

Bronchiolitis
Bronchiolitis is an infection caused by a virus typically seen in children 2 years of age and younger. It typically begins like a common cold, but progresses into wheezing (which may last for 4-6 weeks) and coughing. Bronchiolitis also includes vomiting (in some cases) and a low grade fever (less than 101 F). It can sometimes hinder eating habits.

Dr. Barry Gilmore, chief of Emergency Services at Le Bonheur Children's, says parents should call or see a doctor if your child has difficulty breathing, is unable to eat or drink or has signs of dehydration. Dehydration signs include dry skin, dry mouth, no tears, does not wet diaper or use the potty.

Le Bonheur Children's recommends parents seek emergency care if the child's neck, chest or ribs sink in deep when breathing, if the child has trouble breathing or stops breathing, turns blue around the mouth or fingernails, has less than 3-4 wet diapers per day, or has trouble feeding after suctioning the nose.

If your child is playful, is drinking fluids and is not working hard to breathe, his or her body is doing a good job fighting the virus.

Bronchiolitis is caused by a number of different viruses, and one of those is Respiratory Syncytial Virus. RSV causes more than half of all childhood bronchiolitis cases.

Respiratory Syncytial Virus
RSV is a common winter-time virus that attacks the lining of the airways and lungs. Dr. John DeVincenzo, a leading investigator in the treatment of RSV, is based at the Children's Foundation Research Center at Le Bonheur Children's. He says the virus infects all age groups, but infants less than 1 year of age are most severely infected. It is the most common cause of pneumonia in infants and the most common cause of hospitalization in infants. About 3 percent of all babies less than 1 year of age are hospitalized for RSV infection. 

Early signs of RSV infection are the same as a common cold (runny nose, sneezing and mild cough).  However, opposed to the common cold viruses, RSV infection often turns into a deeper cough and difficulty breathing by the second or third day of runny nose.

"It is important to try to avoid RSV infections within the first few months of life and avoiding the infection during the entire first winter season of your child's life would be best," DeVincenzo says.

For premature babies and for babies with heart or lung problems, there is a medication that can help prevent RSV. For other babies, the only way to prevent RSV is to take these precautions:

From mid-October through the end of March, DeVincenzo recommends that parents try to ensure infants 6 months or younger aren't touched by adults and children with colds. RSV doesn't float through the air, but can be sneezed onto your infant or physically brought to your baby by direct physical contact.

Flu
The flu's peak season runs from late fall through mid-winter and symptoms usually hit hard and fast. Those include fever, headache, muscle aches, dry cough, sore throat and weakness and fatigue.

Once symptoms occur, they typically last anywhere from three to seven days. To relieve your child's pain and symptoms, first, administer fluids and make sure your child is getting plenty of rest. Acetaminophen helps with the aches, pains and fever reduction. There are several anti-virals that can be prescribed by your doctor, but your child must be seen shortly after experiencing symptoms, as they are only beneficial in reducing the severity of the illness in the beginning stages.

The first recommendation for flu prevention is the vaccine, which is available to all healthy children age 6 months and older. There are two forms - the nasal dose and the injection.

• Nasal dose - for kids age 5 and older who have no underlying health issues such as asthma. It is a live virus, so there can sometimes be side effects.
• Injection dose - Most commonly used. First time doses of the injection should be administered in two doses, with four weeks between. Although there is some protection from the first dose, the second dose improves immunity most. After the first year dose of two injections, only one dose per year is needed. Parents who have kids with underlying health issues are advised to talk to their doctor about getting their child the vaccine. This form of the vaccine is not a live virus and symptoms are typically minimal.

Flu prevention is easy and in some cases, life-saving. If you have any questions regarding the flu vaccine or the flu, contact your pediatrician or healthcare provider.

Prevention is key:

• Keep your children away from those with cold or flu symptoms.
• Teach your child how to cover his or her mouth and nose with a tissue when sneezing or coughing.
• Remind children to wash their hands with soap and water regularly to avoid transmitting the virus.

Your pediatrician is your greatest resource
When your child is faced with an illness or injury, it can be difficult to know where your child can receive the best care available. The most important resource you have for your child's care is your pediatrician. If your child does need medical attention, your pediatrician can help you choose the best options for their specific needs.

Because your pediatrician knows your child's history and current situation, he or she can help you make the best choice and get the best care available. By getting to know your pediatrician and taking your child in for regular office visits, your pediatrician can become a valuable resource to you and your child.