The Back-to-School Crud Has Arrived: What to Do When the Germs Come Home

The backpacks have been on the floor for a couple of weeks now, the new-school-year excitement has started to wear off, and there is a new addition to many Louisville households: the back-to-school crud.

Runny noses. Coughs. Sore throats. Fevers. Stomach bugs. Pink eye.

If you feel like your child has been sick since the first week of school, you are not alone.

As a pediatrician and a mom, I know how frustrating this time of year can be. You finally get everyone settled into a school routine, and then your child wakes up coughing at 2 AM. Or you get the dreaded message from school that your child has a fever. Suddenly, you're rearranging work schedules, figuring out who can stay home, and wondering, "Does my child actually need to be seen?"

The good news is that most of these illnesses are common childhood infections, and most children recover without anything more than supportive care and a little extra rest.

So, what can you actually do when the back-to-school crud comes knocking?

First, Don't Panic About Every Runny Nose

One of the hardest things about having a young child in school or daycare is realizing just how many germs they are exposed to.

Children are learning, playing, sharing toys, touching the same surfaces, and putting their hands everywhere. It is essentially a very efficient germ-sharing environment.

It is normal for young children to have several respiratory infections each year, especially during their first few years of group childcare or school. One cold can also seem to last forever, particularly when another virus shows up before the first one has completely disappeared.

A runny nose that changes from clear to yellow or green does not automatically mean your child has a bacterial infection or needs an antibiotic. Coughs can linger for a couple of weeks after a viral infection, too.

That doesn't mean you should ignore symptoms. It just means that not every cough or runny nose needs a prescription.

Treat the Child, Not Just the Temperature

When your child is sick, it is easy to focus on the number on the thermometer.

But I am often much more interested in how your child is acting.

Are they drinking?

Are they urinating normally?

Are they breathing comfortably?

Are they waking up and interacting with you?

Are they having periods where they seem like themselves?

A fever is one way the body responds to an infection. The goal of treating a fever is not necessarily to make the thermometer read 98.6. We treat a child who is uncomfortable.

Fluids, rest, and keeping your child comfortable are often the most important things you can do at home.

And remember that children don't always need medication for every fever. If your child is comfortable, drinking, and otherwise doing well, you don't necessarily have to treat the number.

If you do use acetaminophen or ibuprofen, make sure you are using the correct dose for your child's current weight. If you're not sure about the dose, ask your pediatrician rather than guessing.

The Most Important Thing: Hydration

When children don't feel well, they often don't want to eat.

That is okay for a few days.

What I care much more about is whether they are drinking enough to stay hydrated.

Offer small amounts of fluid frequently. Water is great, but depending on your child's age and illness, milk, oral rehydration solutions, or other fluids may also be appropriate.

Don't worry if your normally excellent eater suddenly survives on crackers, applesauce, and popsicles for a couple of days.

When they feel better, their appetite will usually come back.

What About the Cough?

This is one of the most common questions I get from parents.

Unfortunately, there isn't a magic medicine that makes a viral cough disappear overnight.

For children over one year old, a small amount of honey can help soothe a cough. Saline drops or spray can help loosen nasal congestion, and a humidifier may make your child more comfortable, particularly while sleeping.

Be cautious with over-the-counter cough and cold medications in young children. Many of these products are not recommended for young children, and giving multiple combination products can accidentally result in giving too much of the same medication.

When in doubt, ask your pediatrician before reaching for the medicine cabinet.

When Should I Call the Pediatrician?

This is where having a pediatrician who knows your child can make a huge difference.

You don't need to become an expert in diagnosing every illness that comes home from school. That's my job.

I want parents to call when something doesn't seem right, even if they aren't sure exactly what is wrong.

Some reasons to contact your pediatrician include:

• Your child is having difficulty breathing or breathing much faster than usual.

• Your child is struggling to stay hydrated or is urinating significantly less than usual.

• Your child is unusually sleepy, difficult to wake, confused, or not acting like themselves.

• Your child has severe or worsening pain.

• A fever is persistent or you are concerned about how your child is responding to the illness.

• Your child seems to be getting better and then suddenly becomes much worse.

• You simply have a feeling that something isn't right.

And if your child is having significant difficulty breathing, is difficult to wake, or you believe they have a medical emergency, seek emergency care.

Sometimes You Just Need to Talk to Someone

One of the things I hear from parents over and over is, "I didn't know if this was worth calling about."

I understand that feeling.

As a mom, I have had plenty of those moments myself. You are staring at your child at bedtime wondering whether that cough sounds normal, whether that fever is too high, or whether you should wait until morning.

You shouldn't have to Google your way through those moments.

One of the reasons I created Little Hearts Pediatrics was to make it easier for parents to have access to their pediatrician when they actually need them.

As a member, you can text, call, or email me with questions. Sometimes we can talk through the symptoms and make a plan without an office visit. If I need to see your child, I can often get them in for a same-day or next-day sick visit.

No spending an hour trying to get through to the office. No wondering whether you should take your sick child to urgent care just because you couldn't get an appointment.

Just access to your pediatrician.

And Yes, They Will Probably Get Another Cold

I wish I could end this blog by telling you that if you follow all of these recommendations, your child will avoid the rest of the back-to-school germs.

Unfortunately, that's not how childhood works.

They will probably get another cold.

They may bring home a stomach bug.

Someone will probably get pink eye.

And there is a very good chance that the carefully planned school week you had scheduled will be completely derailed by a fever at 3 AM.

That's parenting.

But you don't have to navigate it alone.

My goal at Little Hearts Pediatrics is not to keep your child from ever getting sick. That's impossible. My goal is to be here when they do—whether you need reassurance, advice, an office visit, or simply someone who knows your child well enough to recognize when something is different.

The back-to-school crud is here. Take a deep breath, keep the fluids flowing, get everyone some extra sleep, and remember that most of these illnesses will pass.

And when you're not sure what to do, call your pediatrician.

That's what we're here for.

Hang in there, parents! We will get through this germy season together.

Dr. Meagan Peek
Little Hearts Pediatrics