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Sunday, November 15, 2009

Constantly Sick: Is it A String Of Colds Or An Immune Deficiency?

It is not uncommon for parents to come in to the pediatrician's office concerned about the number of colds their child has had. That they seem to have had a cough for months and that surely this must be something more than a string of colds. Is it possible that there is something wrong with their immune system?

The answer is almost always that the number of colds they have had is absolutely normal. A child who has a perfectly healthy immune system gets on average 6-10 colds a year. Children in day care or who are exposed to second hand smoke tend to get even more. A common cold can last a week to 10 days sometimes with a lingering cough for an additional week. That can add up to over 100 days of viral illness in one year, which if clustered in the fall and winter months can seem like your child is continuously ill.

So when do you need to worry? A cold is a viral illness that generally causes cough, runny nose, fever, loss of appetite and sometimes vomiting. A child who has these symptoms, even if it is as often as 10 times a year, is most likely perfectly healthy. On the other hand, children whose colds almost regularly progress to more complicated illnesses such as bacterial pneumonia, children who get infections with rare organisms, or who have recurrent fungal infections may warrant a referral to the immunologist. For more information about immunodeficiencies, the Riley Hospital for Children's Allergy and Immunology has a very informative website.

When to visit your pediatrician? A run of the mill cold usually does not require a visit to the pediatrician's office, but if your child is experiencing any of the following symptoms you should notify your child's doctor immediately.
1. If your child is having difficulty breathing or is working harder to breath
2. If your child has asthma that is getting worse with the cold
3. If your child is having trouble keeping liquids down and is having decreased urine output
4. If your child is difficult to arose or is hard to keep awake
5. If your child has a low grade fever for a few days and then suddenly spikes a high fever
6. If your child develops a rash that looks like little red dots that do not turn skin colored when you press on them
7. If your child is 2 months or younger with a fever above 100.5 and/or symptoms of increased fatigue or decreased appetite

If you do need to call your pediatrician, going through a simple checklist before you call can help ensure that you give your child's doctor all the information they need to help you.

Colds are a common and normal part of childhood. Children under 6 years of age should not be given cold medicines unless instructed to do so by a doctor. While this may be frustrating, there are many home remedies that parents can use to ease the symptoms of a cold and help their little ones feel better.