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Live health chat

Winter illnesses

1:00 PM EST, February 15, 2011

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Join us at noon CT (1 p.m. ET, 10 a.m. PT), Feb. 15, to chat about family winter illnesses with Dr. Ari Brown.

Chicago Tribune reporter Julie Deardorff will moderate the "winter illness survival guide" discussion with Dr. Brown, who can address everything from how to tell the difference between a cold and the flu--the flu is treatable if medical care is sought early enough--to whether antibiotics should be used to fight ear infections, and myths and misunderstanding about the flu shot. Dr. Brown can also talk about which symptoms deserve a trip to the doctor, home remedies that can provide relief and red flags to look for when your child comes down with an illness.

A trusted source for child health and development, Dr Ari Brown is a pediatrician in private practice, co-author of the best-selling books "Expecting 411," "Baby 411" and "Toddler 411," and a spokeswoman for the American Academy of Pediatrics.

Can't make the chat? E-mail questions in advance to jdeardorff@tribune.com

 Health chat: Family winter illnesses(02/15/2011) 
11:47
Chicago Tribune: 
Thank you for joining our chat. We will start taking questions at noon. Stay tuned.
Tuesday February 15, 2011 11:47 Chicago Tribune
12:00
Julie Deardorff: 
Hi everyone, let’s get started. I'm Julie Deardorff, your moderator, and today we'll be talking with Dr. Ari Brown, a full-time pediatrician in private practice, co-author of the best-selling books Expecting 411, Baby 411 and Toddler 411, a spokesperson for the American Academy of Pediatrics, a parenting and health blogger and a mom. I have no idea how she gets it all done. It's her busy season, so we're lucky she is able to take the time to join us. So, Dr. Brown, are you seeing lots of cases of the flu these days?
Tuesday February 15, 2011 12:00 Julie Deardorff
12:00
Dr Ari Brown: 
Yes! Flu season is definitely here in my home state as well as across the country. We are seeing flu virus, cold viruses, and Strep throat as the top bugs right now.
Tuesday February 15, 2011 12:00 Dr Ari Brown
12:01
Julie Deardorff: 
I think many parents want to know how they can tell whether it's strep throat or just a cold. Are there telltale signs?
Tuesday February 15, 2011 12:01 Julie Deardorff
12:03
Dr Ari Brown: 
Strep throat, caused by a bacteria, usually has isolated symptoms of sore throat with a fever. Some children will also complain of headache or stomachache. Occasionally there will be a red, raised, pinpoint, rough (like sandpaper) rash too. But the key difference between Strep and just a cold virus is that there usually is NO runny nose or cough with it.
Tuesday February 15, 2011 12:03 Dr Ari Brown
12:04
Julie Deardorff: 
And since strep is caused by a bacteria, antibiotics might be in order, right? Can you use antibiotics with a cold?
Tuesday February 15, 2011 12:04 Julie Deardorff
12:07
Dr Ari Brown: 
Good question. Strep does need to be treated with antibiotics. While the throat infection may clear on its own, Strep bacteria (officially called Group A Strep) that isn't treated can damage other body parts--like the kidneys or heart...which is why it is so important to treat it with the entire course of antibiotics. Colds are caused by viruses, so antibiotics won't help at all to change the course of the illness.
Tuesday February 15, 2011 12:07 Dr Ari Brown
12:08
Julie Deardorff: 
Is it OK to alternate Tylenol and Motrin for fever?
Tuesday February 15, 2011 12:08 Julie Deardorff
12:10
Dr Ari Brown: 
Many parents worry about fevers. Fever is the body's way of fighting infection, so the fever itself is not dangerous. (What's important is to figure out what is causing the fever). That said, there is no need to alternate fever reducing medications unless your child is prone to having febrile seizures. Using the medication as directed (Ibuprofen dosed every 6 hrs or Acetaminophen dosed every 4 hrs) should be enough to keep your child comfortable and bring the fever down by a couple of degrees.
Tuesday February 15, 2011 12:10 Dr Ari Brown
12:12
What home remedy are you most likely to try for a cold?
Soup
 ( 58% )
Homeopathic medicine
 ( 17% )
Herbal medicine
 ( 0% )
Honey
 ( 25% )

Tuesday February 15, 2011 12:12 
12:13
Julie Deardorff: 
Is it better, then to let a fever run its course, as long as the fever isn't too high?
Tuesday February 15, 2011 12:13 Julie Deardorff
12:15
Dr Ari Brown: 
Actually, the body will fight the infection even if you help reduce the fever by a degree or two (which is at best, what the fever reducers will do...they aren't fever eliminators). So, it is fine to give either type of medication if your child has a temp of 100.4 or greater.
Tuesday February 15, 2011 12:15 Dr Ari Brown
12:15
[Comment From LaurenLauren: ] 
Is there a benefit to choosing one over the other? Ibuprofen vs. Tylenol?
Tuesday February 15, 2011 12:15 Lauren
12:17
Dr Ari Brown: 
Hi Lauren,
For children at least six months of age and up, I prefer ibuprofen because it is effective and lasts for 6 hours--acetaminophen only lasts for 4 hrs. And in the middle of the night, those 2 extra hours are a good thing! What is NOT recommended is ibuprofen for kids under 6 months of age or if a child is really dehydrated.
Tuesday February 15, 2011 12:17 Dr Ari Brown
12:17
[Comment From GuestGuest: ] 
what are the best ways to keep germs at bay? Washing hands, of course, but what other ways are used to fight germs and keep adults and kids healthy?
Tuesday February 15, 2011 12:17 Guest
12:18
Julie Deardorff: 
Especially since it's impossible to keep their hands out of their mouths!
Tuesday February 15, 2011 12:18 Julie Deardorff
12:20
Dr Ari Brown: 
Using really good hygiene is best for kids and adults. Yes, that means washing hands--everytime before your hands go up to touch your face or put things into your mouth. You'd be amazed how many times you touch your face during the day without thinking about it. And, germs are everywhere. Computer keyboards, phones, doorknobs, pens, etc. And, having everyone cover their coughs goes a long way too. Don't share food or drinks with family...that leftover chicken nugget may be a real mistake when your child wakes up vomiting later that night!
Tuesday February 15, 2011 12:20 Dr Ari Brown
12:20
[Comment From DarleneDarlene: ] 
What is the best way to take the temperature and do you add a degree for underarm temps?
Tuesday February 15, 2011 12:20 Darlene
12:22
Dr Ari Brown: 
For kids under a year of age, I always recommend taking a temperature rectally. Babies really don't care about having it taken that way. After a year, it is less critical to get an exact temperature. You just want a ballpark idea of fever vs no fever. Under arm temps are not very reliable, but if you want to take it that way, just report it to the doctor as what you read on the thermometer. Do not add a degree. Newer temporal artery scanners are kind of cool, and fairly accurate. Just still kind of pricey.
Tuesday February 15, 2011 12:22 Dr Ari Brown
12:24
Julie Deardorff: 
Several people on this chat have voted for homepathic medicines as the remedy they'd most likely try for a cold. These are much different than herbal medicines. Can you talk a little about whether there is any evidence of efficacy?
Tuesday February 15, 2011 12:24 Julie Deardorff
12:27
Dr Ari Brown: 
Despite their popularity, the scientific evidence is lacking to show that these products actually reduce the severity of a person's symptoms. I always encourage people to check out the National Center for Complementary and Alternative Medicine at nccam.nih.gov to read about the products before purchasing them.
Tuesday February 15, 2011 12:27 Dr Ari Brown
12:27
[Comment From GailGail: ] 
My daughter is pregnant with twins. (yay!) We'll be having a family gathering soon and I was wondering if I should urge all the rest of the family to get flu shots before everyone gets together. Is this critical for my pregnant daughter's safety or am I worrying too much? (BTW, my husband and I have already had our flu shots.)
Tuesday February 15, 2011 12:27 Gail
12:29
Dr Ari Brown: 
Great question Gail. Pregnancy puts a woman in an immune-compromised state, which means that her body's immune system may not fight infection off as effectively. So, having the flu as a pregnant woman can be much more serious. So, yes, I would suggest that people attending the family gathering get flu vaccine to protect her.
Tuesday February 15, 2011 12:29 Dr Ari Brown
12:30
[Comment From TiffanyTiffany: ] 
How can you tell the difference between a cold and potential "cold" symptoms, like a runny nose, with teething?
Tuesday February 15, 2011 12:30 Tiffany
12:32
Dr Ari Brown: 
Hi Tiffany,
It's true that teething gets blamed on a variety of symptoms. But, rarely is it the cause of any of them. So, if your baby has a runny nose, it is more likely to be a cold than just teething. If the runny nose persists more than a couple of weeks or if it is associated with a fever, disrupted sleep, really grumpy mood, or labored breathing...see your baby's healthcare provider.
Tuesday February 15, 2011 12:32 Dr Ari Brown
12:32
[Comment From MaryMary: ] 
Began with sore throat, now lost voice for past 3 days, coughing, a little mucus, no fever, otherwise feeling fine. Any suggestions for over the counter treatment for a cough?
Tuesday February 15, 2011 12:32 Mary
12:36
Dr Ari Brown: 
Hi Mary,
Yes, it sounds like a viral illness. Assuming this is you, an adult, who is sick, I personally would recommend a cough lozenge and lots of fluids. Using a humidifier also helps keep the airway most and mucus/secretions loose. That helps reduce the need to cough. When I am sick, rarely do I use cough and cold meds. They really don't help much. Occasionally, I will use a decongestant nose spray for a couple of days...just know that those have potential for the nose getting addicted to them so it's important to stop using after a few days.
Tuesday February 15, 2011 12:36 Dr Ari Brown
12:37
Which herb are you most likely to use for a cold?
Ginger
 ( 0% )
Tea (ex. Chamomile, green, brown)
 ( 86% )
St. John's Wort
 ( 0% )
Garlic
 ( 0% )
Echinacea
 ( 14% )

Tuesday February 15, 2011 12:37 
12:37
[Comment From DarleneDarlene: ] 
When should a child be seen for vomiting?
Tuesday February 15, 2011 12:37 Darlene
12:40
Dr Ari Brown: 
Hi Darlene,
Here are some red flags for vomiting:
1. Persistent vomiting with no obvious cause (e.g. no diarrhea to go with it)
2.Vomiting with a head injury.
3. Vomiting bile (bright yellow or green)
4. Vomiting over 12 hours straight.
5. For babies: projectile vomiting more than 3 times in a row.
6. Vomiting only in the mornings.
7. Vomiting blood or something that looks like coffee grounds.
8. Abdominal pain THEN vomiting.
Tuesday February 15, 2011 12:40 Dr Ari Brown
12:41
[Comment From CarrieCarrie: ] 
Warm or Cool mist humidifier? What's the difference?
Tuesday February 15, 2011 12:41 Carrie
12:43
Dr Ari Brown: 
Hi Carrie,
I recommend cool mist humidifiers for really practical reasons. A warm mist humidifier makes the room really toasty and uncomfortable to sleep in. And, if you have a baby or toddler roaming around on the nursery floor, he might be able to grab the humidifier and sustain a burn (they get pretty hot).
Either product is effective in helping loosen up mucus.
Tuesday February 15, 2011 12:43 Dr Ari Brown
12:43
[Comment From TiffanyTiffany: ] 
Is there anything that a 14-15 mos old can safely take for a cough that is somewhat disruptive to her sleep?
Tuesday February 15, 2011 12:43 Tiffany
12:47
Dr Ari Brown: 
Hi Tiffany,
Children over one year of age can try a teaspoon of honey before bedtime. There is some actual research that shows it can be effective. (Note: Honey is not recommended for infants as there is a risk of botulism). You can also try using some Vapo-rub. As you probably know, all the cough and cold remedies for children under 4 years of age were taken off the market for safety concerns. As an aside, they weren't very effective anyway. If your child is truly up night after night with a cough, it is time to check in with the doc anyway. There are some prescription cough medications available if really necessary (I am not a huge fan of those either to be honest)
Tuesday February 15, 2011 12:47 Dr Ari Brown
12:47
[Comment From MaryMary: ] 
What about a professional back massage to treat a cough? Do you have a view about a treatment like that?
Tuesday February 15, 2011 12:47 Mary
12:50
Dr Ari Brown: 
Hi Mary,
When people are hospitalized with pneumonia or people have cystic fibrosis, respiratory therapists will perform "chest physical therapy". In essence, it helps to mobilize the thick secretions in the lungs. I am not sure a certified massage therapist would perform the same maneuvers while doing a back massage, but it wouldn't hurt to ask.
Tuesday February 15, 2011 12:50 Dr Ari Brown
12:50
Julie Deardorff: 
I keep hearing Vapo-rub works if you put it on your feet. (But then I've also heard that sleeping with wet socks helps with insomnia. ) Really??
Tuesday February 15, 2011 12:50 Julie Deardorff
12:52
Dr Ari Brown: 
Funny! Yes, many, many of my patients parents swear by putting the Vapo Rub on the feet. The only thing I can figure is that placing the Vapo Rub right near the nose can be a bit overwhelming and perhaps more bothersome than useful for a person with a sensitive sniffer! I cannot comment on the wet socks and insomnia. I think I would have insomnia with wet feet, but that is just me!
Tuesday February 15, 2011 12:52 Dr Ari Brown
12:52
[Comment From LauraLaura: ] 
How much does sleep position have to do with your health? Does it mean anything if you consistently wake up on your back with your arms above your head in the morning?
Tuesday February 15, 2011 12:52 Laura
12:55
Dr Ari Brown: 
Sleep position can be a real issue, particularly for people who have sleep disordered breathing or sleep apnea. These people are constantly repositioning their airway while trying to sleep so they can breathe effectively. As a result, they wake up hundreds of times a night and never get quality sleep.

Other than that, I really cannot comment!
Tuesday February 15, 2011 12:55 Dr Ari Brown
12:55
[Comment From MaryMary: ] 
How contagious is a virus at cough stage? Would you recommend physical isolation if possible - or just the regular hygiene procedures to prevent others from catching a virus.
Tuesday February 15, 2011 12:55 Mary
12:55
Julie Deardorff: 
Also, if a child is on antibiotics, is it OK to have a playdate?
Tuesday February 15, 2011 12:55 Julie Deardorff
12:57
Dr Ari Brown: 
Great question Mary.
In general, people are contagious with a viral illness while they have a fever or for the first 48-72 hours of the illness. A person may be coughing from a common cold for 10-14 days. So, no, the lingering cough is not always spewing virus germs with it. However, doing good cough management (coughing into the crease of your elbow) is always a kind thing to do.
Tuesday February 15, 2011 12:57 Dr Ari Brown
12:58
Dr Ari Brown: 
Hey Julie--
As for antibiotics...once a child is on antibiotics for 24 hours (for instance for Strep throat), he can resume regularly scheduled activities for school and play.
Tuesday February 15, 2011 12:58 Dr Ari Brown
12:59
Julie Deardorff: 
That's going to wrap it up for today. I'm sorry we couldn't get to all the questions, but I want to thank everyone for joining and Dr. Brown for spending so much time with us. Our next chat will be at noon CT (1 p.m. ET/10 a.m. PT) on Tuesday, Feb. 22 and it will look at the results of alternative medicine.
Tuesday February 15, 2011 12:59 Julie Deardorff
12:59
Dr Ari Brown: 
Thanks for tuning in everyone. Stay healthy this winter!
Tuesday February 15, 2011 12:59 Dr Ari Brown
1:00