Respiratory Illnesses around the Holidays

WRITTEN BY ANGIE OSTROWSKI, MD PEDIATRICIAN, BOZEMAN HEALTH DEACONESS HOSPITAL
FORT PECK AND AFTER HOURS PROVIDER, MONTANA PEDIATRICS

As the holidays approach each year, I often witness parents’ concern about the inevitable cold and flu symptoms that will affect their children and families. These winter months are filled with school and community events, family and friends visiting in close quarters, travel and the numerous viruses that circulate this time of the year.

When the cold weather spell hits, it’s important to know whether your family is in a high-risk group for respiratory illness. These are families who have children under the age of 2 years, but especially under 1 year of age. In addition, children who were premature at birth or have chronic medical conditions, especially lung diseases such as asthma. Among these vulnerable groups, infants are particularly at risk, especially those with siblings in daycare or school who may carry and transmit respiratory viruses. There are many respiratory viruses such as RSV and influenza that can affect the lower airways and cause cough, wheezing, shortness of breath and low oxygen levels. In addition, some viruses can cause upper airway symptoms such as croup, which manifests with a barking cough, hoarseness and difficulty breathing.

During the winter months, regular prevention practices are crucial. Good hand hygiene and minimizing contact with sick individuals (as best you can) are powerful measures, along with maintaining a healthy diet and good sleep. With babies specifically, when traveling or flying take steps to shield them from unnecessary contact with strangers by covering their stroller or car seat. With children of all ages, keeping firm boundaries and advocating for your child’s wellbeing around contact and hygiene establishes a safe, protected environment for your little one. Influenza and COVID vaccines continue to be an effective and safe prevention measure for these viruses. If your child is too young for these vaccines, they still benefit from their regular caretakers and siblings receiving them. In addition, inquire with your healthcare provider about the new RSV monoclonal antibody (Nirsevimab) available for infants and high-risk children that has shown a significant decrease in hospitalization rates for RSV 1

If your child does fall ill, there are steps you can take to aid in their recovery. For younger children, using bulb suction or saline drops to clear their nasal passages can provide relief. Ensuring they remain well-hydrated and monitoring for signs of worsening respiratory distress are vital. Pay attention to indicators such as increased work of breathing 2, poor color, difficulty drinking and persistent fever that does not improve over several days. If you notice any of these worrisome signs, it is important to seek medical attention promptly. If your child is under 3 months old, it is even more imperative to remain vigilant and seek medical attention for any concerns or signs of illness.

As a pediatrician for 15 years, I have witnessed the extensive impact viral respiratory illnesses have on young children, families and our communities. My own twins were born in December and were particularly vulnerable to respiratory illness during their first winter season. As an active family that enjoys traveling and outdoor activities, we exercised hand hygiene and extra caution regarding our surroundings when out and about to prevent the transmission of winter germs. Taking these measures to reduce exposure can make a significant difference.

Remember, what is a simple cold for adults may be a different story when it comes to babies and young children who are more susceptible to respiratory illnesses and can experience more severe symptoms. By consistently practicing good preventative measures and promptly seeking medical attention when necessary, you can safeguard your child’s health and ensure a smoother winter season.

Written by Angie Ostrowski, MD
Pediatrician, Bozeman Health Deaconess Hospital Fort Peck and After Hours Provider, Montana Pediatrics

*1 - Caserta, M. T., & Jones, A. N. (n.d.). RSV: When it’s more than just a cold. HealthyChildren.org. https://www. healthychildren.org/English/health-issues/conditions/chest-lungs/ Pages/RSV-When-Its-More-Than-Just-a-Cold.

*2 - American Academy of Pediatrics. (2022). Signs & Symptoms of RSV in Babies | AAP. YouTube. Retrieved October 27, 2023, from https://www.youtube.com/watch?v=_2qh31Wndls.