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April 11, 2019
For the past month, my entire family has been battling winter and eary spring illnesses. First my five-year-old woke up with a wet cough that lasted three weeks and prompted phone calls from the school nurse. Then, my youngest caught the same bug and ended up with a secondary ear infection four days later. My nanny followed suit in what seemed like 48 hours: she let me know with a 5 a.m. text that she had pink eye and couldn’t see, much less take care of my kids, for a few days. Then a round of stomach flu came through, knocking down almost all of us in a slough of vomiting and diarrhea episodes that severely challenged my cheap Target sheets and forced us to buy multiple sets of new pillows. The pièce de l résistance came when I awoke one night to my oldest child LITERALLY vomiting onto my hair from where she was sleeping behind me. Thank goodness we just took a vacation, resetting the sickness cycle in our home, but I’m just holding my breath waiting for the next round of illnesses to start up again.
Worrying about a sick child is one thing but, when you’re a working mom, the additional stress that comes with navigating care logistics for that sick child is quite another. As a pediatrician, I see how competely devastating illnesses can be for moms when it comes to maintaining their own presence in the workplace. And, while sometimes kids really are so unwell that they need constant supervision and isolation to get better, a lot of times parents don’t realize that there are tricks many of us use with our own kids to get through sick season with a little more sanity. Here are my top strategies for dealing with winter and spring sickness worries:
Not all illnesses are avoidable (you read what I just said about the last month at my house, right?), but environmental factors do play a role. A kid that goes to indoor play facilities (like a children’s museum or indoor play gym) multiple times a week will be more likely to catch whatever viruses are floating around there. I’m serious—I swore off almost enclosed shared play places during peak sick seasons once I went through one winter with my first child. Anything with “Children’s” in the title is a no-go for me during peak winter weeks. I’m not a shut-in, I just pick and choose activities based on the scientific fact that more kids plus more germs equals more chances of your kid getting germs, too. During
Likewise, a kid in daycare will be exposed to more germs on a daily basis just due to the sheer number of other children they’re around. Yes, over time that can contribute to a stronger immune system but, for some (especially those gentically predisopsed to specific conditions like ear infections) it can mean a world of hurt every winter. In my office, we sometimes refer to the constant runny nose we see in our daycare patients as “daycare-itis”, since it seems like it never, ever goes away. Every child is different—some kids seem to skate by without a cold or rash—but it is a recurring theme.
It’s not that the choice to do daycare versus in-home care is better or worse—Lord knows there are about a billion other factors to consider wehen you make that choice (like money)—but the sickness factor is a big one. Even though a nanny or smaller in-home setting can seem more expensive on the surface, your cost-benefit childcare analysis should also account for potential days of work missed due to your child’s illnesses if they’ll be in a group care setting. In my profession, it’s not impossible to take a day off but it is a huge inconvenience to my patients and to my business partners. So that I can avoid missed work days, I look for ways to avoid my kids catching major illnesses in the first place.
There are a few basics of good health that every parent knows are important but, if you’re a working mom, these things are critical:
Wash Those Hands!
Parents often spend a ton of money on fancy, cold-busting vitamins and supplements, but the best way to prevent catching most germs is free: hand washing. Teach your kids to thoroughly scrub with warm, soapy water for at least 20 seconds each time they wash and to head to the sink before meals, after using the bathroom, and after they cough or sneeze.
Keep Your Febrile Child Home
There is a (very good) reason most child care centers and schools have a policy that students should stay home if they’ve had a fever within the previous 24 hours: when a virus or bacteria attacks the human body, fever is part of the body’s attempt to fight back. Schools and care centers don’t want kids hanging out in classrooms while the illness battle is still raging, as the bacteria or virus may make its way to another student in the process. Instead, use the time at home to help your child focus on fluids and rest so he can re-enter care ready to learn and play.
Teach Your Child About the “Cough Pocket”
When you sneeze or cough, little virus or bacteria particles go shooting through the air (I know, science is kinda gross, but it’s also kinda cool). They can travel up to 50-200 miles per hour. In an ideal world, kids would catch all those nasties in a piece of tissue, but youngsters often don’t have that much foresight. Be practical instead. Show your child how to make a cough pocket with his elbow. Don’t be surprised if this takes quite a bit of reinforcing. Good habits take time to ingrain.
Attend to the Basics
Our bodies avoid and fight illnesses best when they’re in prime shape. Eating a healthy diet rich in vegetables, fruits, and whole grains sets kids up for health success. Give your kids plenty of exercise and water, focus on healthy sleep habits, make sure they’re up to date on all their vaccinations.
When people ask me how I get everything done in my life—professionally, personally, when it comes to my kids—I always have a simple answer: Back Up. Help. Listen, Murphy’s Law seems to apply even more strongly when you have multiple balls you’re juggling because there are more chances for things TO GO WRONG. When I hear celebrity or CEO moms talk about how they do it all because they’re organized or because “somehow they just make it work,” I want to scream. It’s a lie—one that makes mega millionaires feel better about themselves but that makes the rest of us feel like we’ll never measure up or that we must be doing something wrong. It’s like they’ve photoshopped motherhood right along with their Instagram pages. Here’s the real truth: I get everything done because I have other people who help me do it all—when my kids are well AND when they’re sick as stink.
My first line of defense is my nanny. Yes, just like any other good mama, I feel guilty as all get-out when I think about my kids sick at home with a caregiver while I work. But, then I remember (when it comes to my nanny), THAT’S WHAT I PAY HER TO DO. She’s not just there for the trips to the zoo and the tea parties. She’s primarily there to care for my kids when I can’t be.
Family or Friends
You’ve got to build a network of people around you who can pitch-hit when necessary. This is one of the most important reasons for getting at least a small tribe of other moms around you unless you live in close proximity to your relatives. My parents live about 25 minutes away in a neighboring city—close enough to help out but no so close that it feels like we’re breathing down eachothers’ necks. They help out for weekend getaways, date nights, impromptu meetings on my days off. Most importantly, they help me when my kids are sick.
I fully realize that not all families live close by their extended relatives, and that some relationships make relying on family way more complicated. That’s okay. If family is not a realistic option, this is where that tribe of other moms and friends come in.
How do you find them? As my friend Ann Marie puts it, “Making adult friends is stupid. It’s way harder than it was when we were in preschool or kindergarten. Making adult friends requires forced vulnerability.”
That’s why those infant mommy and me classes are so great at helping you bond with all parents. You’re all scared, unsure of how to raise this little being, totally unprepared. When it doesn’t go well, you’re vulnerable enough at that moment to get help from someone else—even if you don’t know them well—and to build meaningful relationships.
Traditional mommy and me groups have never been quite my style, but I have developed those more vulnerable friendships through parallel learning activities like baby and me music classes (Music Together is a personal favorite) and postnatal mama-baby or mama-tot exercise classes. I’ve developed some of my closest mom friendships over shared hikes and crunches. Now that my kids are a little older, I make it a point to chat at school pick-up on my day off and to schedule play dates during times my daughters and I can attend. I’m intentionally, slowly connecting with other parents in my neighborhood. We may not end up as besties, but I know I can count on them if I am running five minutes late to pick up or need a 30-minute pitch hitter when the nurse’s office calls me away from work and I need a few more moments to wrap things up before heading home.
One year ago, my littlest came down with Croup and spent three nights hacking away like a baby seal. I came home from work to her lying on the rug in my living room, curled up in a tiny ball, clutching a stuffed animal while my husband rubbed her back. Then, New Year’s Day, she wound up in Urgent Care after waking from a nap with a 103 fever and labored breathing, bless her little heart.
Needless to say, the mama inside me outweighed my medical degree both of those evenings. I had to force my mind to “think like a pediatrician.” I also had to take a deep breath and try NOT to think about all the work I would inevitably miss, the wasted childcare dollars I would no doubt forfeit, and the sleepless nights I was bound to encounter before she recovered from her respiratory illness.
When your child is sick, it’s inherently emotional. You may feel like only YOU can be there to watch over your little one but remember to let your partner take the lead on bowing out of work or handling a sick day school pick up when it makes sense.
One mom I talked to explained: “Hey, I’ve got a job where, if I don’t go to work, we potentially lose out on thousands of billable dollars.”
If that mom doesn’t work for a day, no one brings in money for her small business. Her husband, on the other hand, works for a traditional organization that offers paid sick days and vacation days as part of his compensation package. If he misses a day of work, it’s stressful, but it’s not earth-shattering. While the world may still expect her to drop everything to pick up her child at daycare for an illness, that just doesn’t make sense for them.
“That doesn’t mean that, sometimes, my desire to be with my kids when there’s a problem doesn’t win out over left-brain analytics and money, but nine times out of ten, the choice is a no-brainer.”
As I remind myself to stay objective during cough and flu season, all the sick kid parenting pearls I try to share with my patients’ parents in clinic week after week, are at the forefront of my mind:
Follow Your Gut
If you are worried about your child, call someone. Make an appointment. Get them in front of a medical professional. You know your kid best so, if they seem off to you, listen to that little voice inside your head telling you to take action. Pediatricians aren’t irritated when a parent wants their child to be seen “just to be sure everything is okay.” Actually, we would much rather that than the alternative – a serious condition gone unchecked. Kids tend to rally well at first with sickness but then can crash pretty fast. It’s better to get the parenting tips you need early on so you don’t get to a more critical point.
If you’re a new parent, that may mean you call as soon as your child gets a small cough. No problem. Your doctor or their nurse can guide you through what to expect and what to do- consider it your sick kid mini-education. As you get more and more experienced, you’ll gain confidence, you’ll know the basic ways to handle minor illnesses and you likely won’t need as much assistance.
Whenever possible, you want a medical provider caring for your child who really knows their stuff – someone trained specifically in pediatrics (obviously, if you are on vacation or in an emergency situation, that’s not always realistic). When you do have a choice, choose pediatric-trained providers so they can get the most accurate medical history possible and can provide the most up-to-date care.
Understand Honesty is Important and Details Matter
If your child has had a fever for one day or for five days, those are completely different situations, each of which triggers different levels of testing and medical interventions, depending on age. As I sat in the urgent care clinic with my daughter last week and watched a practitioner shrug a little when I said she had just developed her fever, it was tempting to try to sell how bad her illness was. Sometimes, I know, it feels like elaborating a tiny bit to get the attention of medical providers will help when it comes to a sick kid, but that can backfire. You don’t want your child to have extra bloodwork, imaging (X-rays, etc) or medications when they don’t need them. It can lead to unnecessary and sometimes harmful side effects and even hospitalizations.
Believe That We Believe You
I cannot count the number of times someone has brought their febrile child into my office, completely miserable, so that I can see how sick they really are. No fever-reducers on board, the poor kids and their parents must have had a horrible time on their car ride over to clinic. But there’s no need to show us your child at their worst. It’s fine to give your son or daughter acetaminophen or ibuprofen (these medications can be age- and condition-dependent – check with your health professional if you’re not sure) before your doctor’s visit. In fact, the best way for medical professionals to accurately assess how your child is doing can be to see them WITHOUT THE FEVER when possible, since they sometimes look worse than they actually are when febrile.
Use Antibiotics Judiciously
Sometimes, a parent will seem disappointed when I tell them their child has an upper respiratory infection (aka a cold) and doesn’t need antibiotics. Remember, it’s a GOOD thing if there isn’t a need for extra medicine. You don’t want antibiotics unless you really need them.
Every drug has side effects and, if we give antibiotics for colds, the medication:
-Doesn’t change a thing about how fast a child gets better.
-May give them issues with diarrhea.
-Contributes to antibiotic resistance (when an antibiotic stops working against the bacteria it was designed to treat and makes it harder and harder to treat serious illnesses).
It’s hard to wait out a viral illness, letting the storm pass until the sun comes out again, but it’s worth it to concentrate on comfort care if your doctor prescribes it versus fighting for an unnecessary medicine.
Accept Illnesses Can Change Quickly
When we see you in the office, we’re catching your child at a moment in time. We hear about what has happened so far and we base our diagnosis on our exam that day. It’s one data point. Often, though, an illness can change within hours or days and, without a crystal ball, it’s impossible to predict which direction a sickness will go. It’s not surprising to us when we need to schedule a re-check appointment to make sure things are improved or when a parent calls us back to say a child is still sick. That’s why we give so many contingency after-visit instructions. Most of the time, we can solve an issue with one evaluation but it can take a bit more complex problem-solving with multiple visits at other times.
Find a Provider Who Welcomes Your Questions
Part of my job as a pediatrician is to make sure I translate all the medicalese for my patients and their parents, assuring they leave with a solid understanding of what’s wrong with their child and what they can expect as they recover. I know it is sometimes terrifying (or sometimes just super inconvenient) to have a sick kid and that parents need answers and explanations. I’m used to it. ALL doctors are. So, ask away. Clarify. Pull out the list of worries. Let us know the underlying issues (like, “When will my child be better and when will I be able to go back to work?”). We’re all ears and, in the end, it’s easier for all of us to be on the same page from the get-go than to let frustration or confusion play a role in your child’s illness.
I’m not gonna lie – having sick kids is one of the most challenging parts of modern parenting, especially for working moms. The schedule re-arranging, the miserable little one, the scary unknowns of illness – it all adds up. Remember, pediatricians know how hard it is to care for sick children (I do it myself all the time!) and we want your child to get better as fast as possible, too. Access the resources you have, work on prevention first, make a care plan, and get the answers you need. Above all, follow your gut – if you’re worried, get help (or just peace of mind).
Grab the book! Out March 17, 2020.
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