---

 

Childhood illness may not affect your family life until your child starts child care or school. After that, though, it may seem like he or she is sick all the time. This pattern is normal as your child builds a robust immune system. Resistance to infection develops only after exposure to a multitude of germs.

Young children in large groups are breeding grounds for the organisms that cause illness. Little hands rub drippy noses, and then transfer infectious agents to other children or to shared toys. Here's a lineup of the top five infectious illnesses that keep children home from school or child care.

1. Colds

The most common childhood illnesses are upper respiratory infections �?colds and other viral ailments that affect the throat, nose and sinuses. While adults average two to four colds a year, children typically have six to 10. Children also tend to have more severe and longer lasting symptoms than do adults.

Studies have shown no benefit from treating children's colds with antihistamines, decongestants or cough suppressants. The only medications that might ease the discomfort of a bad cold are acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin, others), which reduce fever. Do not give your children aspirin because it may trigger Reye's syndrome, a rare but potentially fatal disease.

2. The stomach flu (gastroenteritis)

The second most common childhood illness is gastroenteritis, more commonly known as the stomach flu. This childhood illness causes vomiting and diarrhea, and can lead to dehydration, particularly in very young children. Signs and symptoms of dehydration include:

• Excessive thirst
• Dry mouth
• Little or no urine, or dark yellow urine
• Decreased tears
• Severe weakness or lethargy

Oral rehydration solutions, such as Pedialyte, can help replace lost fluids, minerals and salts. When you reintroduce food, start with easy-to-digest items �?broth, toast, bananas and rice. Avoid dairy products.

Many parents assume that any kind of stomach upset in a child is the result of a contagious illness when the real culprit is simple indigestion or constipation. Some children get stomachaches when they're worried about things, either at home or at school. The dread of facing a bully or of taking a test, for example, can make a child's stomach hurt. It's important for a doctor to determine the cause of a child's digestive symptoms before prescribing treatment.

3. Ear infection (otitis media)

Ear infections most often occur in children under the age of 2, but the problem can also be common between the ages of 5 and 6 �?triggered by the respiratory illnesses picked up in kindergarten or first grade. Colds or allergies cause congestion, which may squeeze shut your child's eustachian tube, the tiny drainage pipe for the middle ear. Fluid trapped in the middle ear can become a breeding ground for viruses or bacteria.

It can be difficult to distinguish between ear infections caused by bacteria and those caused by viruses. The distinction is important, however, because antibiotics will cure bacterial �?but not viral �?infections. And using antibiotics when they aren't necessary has serious consequences, most notably fueling the emergence of bacteria strains with built-in resistance to many of the drugs that fight infection. For that reason, doctors today often wait to see if an ear infection will clear up on its own before prescribing antibiotics.

If your child has chronic ear infections, you may want to consider having a small tube placed in the eardrum, to help drain the excess fluid inside the middle ear.

4. Pink eye (conjunctivitis)

Pink eye (conjunctivitis) is an inflammation of the clear membrane that covers the white part of the eye and lines the inner surface of the eyelids. When caused by viruses or bacteria, conjunctivitis is highly contagious. It is typically treated with antibiotic eyedrops or ointment. Warm or cool compresses may ease your child's discomfort.

5. Sore throat

Most sore throats are caused by viruses and are usually associated with other respiratory signs and symptoms, such as a runny nose and cough. But about 15 percent of children's sore throats are caused by streptococci �?bacteria that cause strep throat.

Fevers above 101 F are common in strep throat, and swallowing can be so painful that your child may have difficulty eating. Antibiotics are required to combat strep throat. Left untreated, strep bacteria eventually can trigger an abnormal immune response, which is responsible for rheumatic fever. Complications of rheumatic fever include damaged heart valves and stiff, swollen joints.

Prevention

Your child's sneezes and coughs spray germs into the air, sometimes landing right on other children, who are then infected. Or a child's hand can become a vehicle carrying viruses and bacteria from toys and other well-handled objects to the eyes, nose or mouth �?the usual points of entry for germs that cause illness.

The single most important thing your child can do to prevent illness is to wash his or her hands thoroughly and frequently. The Centers for Disease Control and Prevention recommends that people wash their hands with soap and warm water for 15 seconds �?about as long as it takes to sing the "Happy Birthday" song twice.

Alcohol-based hand sanitizers also can keep hands clean. They come in disposable hand wipes or in gel form and require no water.

How long should sick kids stay home?

As a parent, you can help prevent the spread of illness by not sending a sick child to school or child care. Each facility generally has its own rules, but most won't let children attend if they have a fever of more than 100.4 F, are vomiting or have diarrhea. In addition, some facilities require that children with strep throat or pink eye be on antibiotic therapy for 24 hours before returning.

Generally, though, children can return to school when they:

• Have no fever
• Can eat and drink normally
• Are rested and alert enough to pay attention in class
• Have completed any period of medically recommended isolation

Resistance comes with time

Despite your best efforts, your child is going to get sick �?especially during his or her first few years of contact with larger groups of children. But a child's immunity improves with time. School-age children gradually become less prone to common illnesses and recover more quickly from the diseases they do catch.