Keeping your children well this winter

Ask The Doctor:
Keeping your children well this winter...

"My mother-in-law told me that the only way to keep my three month old from getting sick this winter is to keep her home until March. Is that really necessary? I am a stay at home mom, but I still have to take care things like grocery shopping that require me to leave home. Any advice?"

The answer is simple.  Avoid sick people, practice good hygiene, get the necessary vaccines and practice good nutrition.  Now, performing all these, consistently, is not as easy as it sounds.

Regardless of what your mother told you, it's okay to take your baby out in the cold as long as they are dressed appropriately.  Exposure to cold or damp weather doesn't increase a child's likelihood of catching a cold.  They may not enjoy the trip however if it's bitterly cold, windy, and you're going to be running about all day.   Kids 12 months of age and older require the same amount of clothing as an adult, those younger need 1 more layer.  A warm cap is a must for those less than 12 months of age.  Young babies don't regulate their temperature well and can lose heat quickly.

Avoiding sick people by staying at home all winter is of course not practical, but there are some things to keep in mind when you and your infant venture outside.  Don't take your infant shopping with you when you know the store is going to be crowded.  If you need to be at that big sale, get a baby sitter.  You may save even more money later in your child's medical expenses, and of course the value of your child's well-being in general is priceless.  Don't take your infant to the hospital or physician's office unless they are the patient.  Can you think of area where more sick would be?  At least most pediatrician's offices do their best to separate the sick children from those who are in the office for a checkup.  When you and your precious bundle are out, try to stay at least 4-6 feet away from someone who is sick, but remember people are contagious even before they develop symptoms.  So just keeping away from these folks is still no guarantee.

You are lucky to be a stay at home mom and not have to worry about your infant getting exposed to other children at daycare.  For those who are not so fortunate, here are some suggestions to minimize their risks.  Check out the center's “sick kid” policy.  Talk to other parents and find out how strictly it's enforced.  Observe how the daycare is set up, see if the employees are cleaning their hands before they touch an infant or prepare their bottle, notice if there are obvious ill infants or toddlers present.  Remember, you can't have it both ways.  Don't expect all the infants with a cough and runny nose to be banned from daycare, yet it's okay for you to leave your little wet-nosed bundle who “just barely started coughing”.  So if you need to use a daycare, have a back-up plan.  A relative, trusted friend or some of your own saved sick days.   Be aware that an infant's immune system is weakest between 3-12 months of age.  They catch illnesses easier and it takes them longer to recover.  So minor ailments such as nasal congestion, runny nose, and an occasional cough may last days after the acute infection.  It is just not realistic to expect all these infants to stay out of daycare until all of those symptoms have resolved.

Practicing good hygiene in regard to illness comes down to washing hands frequently and properly.  When using soap, wet your hands, apply the soap, lather and scrub for at least 20 seconds (be sure to wash between your fingers and the tops of your hands) and rinse for 10 seconds before drying them on a clean towel, preferably a disposable paper towel.  If you are using a Germ-X style hand sanitizer, apply the product (at least 60% alcohol) to the palm of your hand and then rub it to all surfaces of your hands, again be sure to get it on top and between your fingers.  Then allow to dry.  Now I am not just speaking about cleaning mom's hands, but also dad's, all caregivers, siblings, and even the infant's own hands need to be frequently cleaned.  This should occur especially when anyone returns from daycare, school, outings, and before feedings. 

Necessary vaccines to keep your 3 month old infant healthy certainly include those recommended by the America Academy of Pediatrics at the 2 month old checkup.  Caretakers and family surrounding your child should also have their immunizations up to date.  In particular, they should have had a recent flu vaccine and pertussis (“whooping cough”) booster.  Both of these illness can be fatal in infants.  Current pertussis rates continue to climb, in fact, we haven't seen these numbers since the 1950's.  Most of the serious illnesses come from infants that are incompletely immune and then exposed to their infected family members, the one with the cough that won't go away, whose waning immunity has allowed them to contract the condition.

Good nutrition to prevent infections, without question, includes breastfeeding your infant.  Breastfeeding provides immunoglobulins that significantly boost the child's immunity.  Not only that, but the skin to skin bonding between the mother and child naturally bolster the immune system of the baby and the mother as well.  Breastfeeding moms should be supplementing the feedings with 400IU of vitamin D.  This vitamin strengthens our immune system, is in short supply in breast milk, and during the winter months there is little chance for the infant's skin to be exposed to sunlight where it can be produced naturally.