Why Sniffles Hit Hardest at Night

When your child wakes up coughing or complaining of an earache, it's tough to know what to do. And many common ailments -- from asthma to croup -- worsen in the wee hours.

Lying down plays a role in most colds and sinus symptoms "because it causes secretions to drain into the throat and may obstruct drainage happening during the day," says Dr. Michael Steiner, pediatrician and chief of the Division of General Pediatrics and Adolescent Medicine at the University of North Carolina at Chapel Hill. "Plus, any pain, discomfort or fever will seem worse when children and parents are tired."

Children may also feel sicker at night because they're less distracted by activities, adds Dr. Mobeen H. Rathore, chief of Pediatric Infectious Diseases and Immunology at Wolfson Children's Hospital and the University of Florida, College of Medicine in Jacksonville.

Learn how to help your little one feel better when he's sick at night, no matter the ailment. Just remember, says Rathore: Call the pediatrician whenever you're unsure or concerned, day or night.

EARACHES
This common childhood pain is usually caused by a bacterial or viral infection in the ear (sometimes due to a nasty cold or allergies). Fluid builds up behind the eardrum, and lying down adds pressure to spots that are already sore and inflamed.

Treatment: According to the American Academy of Pediatrics, approximately 80 percent of children with middle ear infections recover without antibiotics. Shocking, since about 50 percent of antibiotics for American preschoolers are prescribed for ear infections! If the pain isn't severe, help your child feel more comfortable with a pain reliever such as acetaminophen, says Rathore. (Don't use aspirin, which has been associated with a rare but potentially deadly condition called Reye's syndrome.) A warm compress may also help.

When to call the doc: If symptoms get worse or don't improve within 24 to 48 hours, you should consider calling your pediatrician. Chronic ear infections can cause hearing problems, so it's important to monitor symptoms. Red-flag symptoms include severe ear pain and discharge from the ear.

STUFFY NOSE OR SORE THROAT
Symptoms from the common cold tend to flare up at night. "When you lie down, the airways are more likely to become clogged with mucus," says Dr. Neil Schachter, author of The Good Doctor's Guide to Colds and Flu and the Medical Director of the Respiratory Care Department at Mount Sinai Hospital in New York City.

Treatment: While there is no cure for the common cold, moms can employ a few simple, reliable tactics to help kids feel better. In addition to age-appropriate OTC remedies, a humidifier or steam from a hot shower may also ease congestion so your child can breathe easier. Rathore suggests using acetaminophen to relieve sore throat. Schachter also suggests gargling with salt water before bed "to remove virus-laden mucus from the throat, which relieves both sore throat and coughing."

When to call the doc: Routine colds don't require a doctor's care, but watch out for any other unusual symptoms, including a high fever, distressed breathing or a sore throat that's severe or lasts longer than a week.

CROUP
Most common in children 5 or under, croup causes swelling in the trachea and larynx. It's usually caused by a virus and characterized by a loud, barking cough. "Croup symptoms seem to worsen at night, possibly because the upper airway naturally relaxes during sleep, so it narrows," says Steiner. "It's also possible that using a heater at night dries out the air and makes symptoms worse."

Treatment: Although mist treatment was long thought to manage croup, a 2006 study published in the Journal of the American Medical Association found that high humidity didn't seem to help moderate to severe cases. Still, for mild bouts, a warm, steamy bathroom may soothe symptoms. A dose of children's ibuprofen or acetaminophen can bring down swelling of the airways. More severe cases may require a prescription drug to open airways. 

When to call the doc: If your child makes noisy and high-pitched sounds when inhaling, struggles to breathe, develops blue or grayish skin or has a fever of 103.5 F or higher, it's time to see the doctor. Also get in touch if symptoms last longer than a week or are reoccurring.

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6 Reasons to Call the Pediatrician

Sick children at home? If they’ve got a cold, they'll usually recover on their own within seven to 10 days, but in some cases, those sniffles can develop into a more serious condition that requires medical attention. If you notice any of the following warning signs in your kids, you've got reason to call the pediatrician.

Warning Sign No. 1: A high fever 
A fever of 105 F or more can mean your child has another problem, like strep throat. If your baby is younger than 3 months old, you should also call your doctor if he or she has a fever of 100.4 F or more.

Warning Sign No. 2: Symptoms that persist after the fever subsides 
Most kids start to perk up after their fever goes down. But if your little one still seems tired and miserable after the number on the thermometer drops, it could mean she's dehydrated -- or even has a more serious infection such as meningitis, so get a hold of your doctor's office as soon as possible.

Warning Sign No. 3: Wheezing or vomiting while coughing 
Call your pediatrician if coughing causes your child to gasp for breath or throw up. She may want to screen for asthma or whooping cough.

Warning Sign No. 4: Symptoms that don't improve 
Kids sometimes catch two colds in a row, so they can be sick for longer than the normal weeklong span. But if it doesn't seem your child is improving and her runny nose remains consistent for more than 10 days, it's worth calling your doctor.

Warning Sign No. 5: Rash with fever 
Children can get rashes from viruses and allergic reactions. But if the rash doesn't blanch -- or fade -- when you press on it, call your pediatrician immediately. It may be a sign of a serious infection.

Warning Sign No. 6: Gut feeling that something's wrong 
I'm a firm believer in a mother's "sixth sense," or gut intuition. You know your child best, so if something doesn't seem right, call your doctor. It's better to address your concerns early on, so we can catch any illnesses as soon as possible.

Beat Home Allergens

To ease your child's allergies, you probably encourage her to stay inside when the pollen count is sky-high. But what if it's your home that is causing those sniffles? Many parents don't realize that kids with seasonal allergies may also be sensitive to allergens indoors, like dust mites, mold and pet dander. If your little one tends to have symptoms year-round or sneezes like crazy after petting Rover, see your health care professional. Then, consider making these moves to beat home allergens:

1. Leave your shoes at the door.
Place a bin and clothes rack by the door and ask family members to take off their shoes, jackets and bags before entering. That way, you'll prevent tracking pollen throughout your home. If your child is particularly sensitive, you may also want to change your outfit and rinse off any residual pollen in the shower too.

2. Run the air conditioner.
Pollen can enter your home through open windows and settle on furniture, while fans may stir up dust. Try shutting your windows and using your air conditioner in your home and car to block out those allergens. Just make sure to clean the unit's air filter regularly.

3. Keep tabs on Rover.
When your pet comes in from the outdoors, wipe him down with a wet towel to remove any pollen clinging to his fur. If your kid is also sensitive to dander, teach your pet to stay off furniture and out of your child's bedroom.

4. Wrap up your bed.
Keep dust and pollen from burrowing into your pillows and mattress by encasing them with covers.

5. Do laundry regularly.
To remove allergens, wash bedding weekly in hot water that's at least 130 F (54.4 C). Dry bedding in a dryer -- don't hang it up outside -- and remember to remove it promptly. Leaving it in the machine can encourage mold growth. Cold temperatures also kill dust mites, so pop delicate items, like soft stuffed animals, into the freezer for 24 hours.

6. Ban cigarettes.
It's a no-brainer, but some parents need reminding. The chemicals in smoke can aggravate allergies, so declare your home and car smoke-free zones.

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The Science Behind Your Favorite Remedies

When you were sick as a kid, what was your mom's go-to comfort trick? Turns out some of your favorite nostalgic remedies have research-proven benefits. Here, we'll discuss which ones really work -- and which ones miss the mark.

Mom's Remedy: Chicken Soup

Chicken noodle soup just might be the perfect recipe for cold relief: A recent University of Nebraska Medical Center study found that this time-held favorite is anti-inflammatory and can actually help ease illness. When researchers tested homemade and several pre-made chicken soups, they found that all varieties were effective in reducing symptoms, like cough and congestion. Here's the kicker: Broth alone wasn't effective, and it didn't matter whether there were veggies or not as long as the soup contained both chicken and noodles. Researchers suspect that the combo improves hydration, offers solid nutrition and has a strong placebo effect on coughs.

"I recommend drinking warm liquids and eating hot soup for all of my sick patients," says Dr. Clement Bottino, a fellow in academic pediatrics at Children's Hospital Boston. During a cold, blood vessels get leaky, causing dehydration, he explains. The water provides fluid, the salt prevents liquids from escaping and the warmth relaxes the vessels to improve circulation."This is the same idea as when we give IV fluids to patients in the hospital," he says."The saline solution is made of warm water and salt, just like chicken soup."

Mom's Remedy: Orange Juice
Moms are always pushing OJ, and for good reason: Oranges are high in vitamin C, an antioxidant your body uses to help repair its tissues. A 2007 analysis of results from 30 clinical trials found that vitamin C didn't prevent colds, but it slightly reduced the severity and length of symptoms.

Even so, experts agree that the jury's still out on whether the vitamin is effective in preventing or ending colds. In fact, doctors don't recommend doling out vitamin C supplements to kids, even when they're sick."The thing with vitamin C is that your body excretes what it doesn't need," explains Dr. Wendy Sue Swanson, a pediatrician at Seattle Children's Hospital and author of the Seattle Mama Doc blog."So there's no evidence that a supplement will provide any additional benefits."

For a revved-up immune system, Swanson advises opting for foods that are high in the vitamin and in other nutrients, such as oranges, strawberries and tomatoes."The fiber in whole fruits also slows the absorption of sugar," adds Bottino."And that's better for your health in general."

Mom's Remedy: Ginger Ale
Research shows that ginger root is effective for treating morning sickness and nausea post-surgery. But studies on ginger ale for flu symptoms are inconclusive, and the spicy root shouldn't be given to children younger than 2 years of age."Most ginger ales don't contain that much natural ginger," says Swanson."And you get 200 calories from the sugar."

Instead of serving up this particular fizzy drink, provide plenty of clear liquids, like electrolyte drinks that contain the right balance of sugar and salt, to help kids recover.

Mom's Remedy: A Steamy Bath
Numerous studies have shown that this nighttime ritual is an effective cold treatment; steam moistens nasal passages and eases congestion."It's the same theory as when our grandparents used to boil water, put a cloth over the pot and have us stand over it," says Dr. Heather Lubell, a pediatrician at St. Christopher's Hospital for Children in Philadelphia."It doesn't make the cold go away, but it does lessen symptoms in the short term."

What's more, a Cornell University study found that a drop in core body temperature is a signal that helps you fall asleep faster and reach deep sleep more easily. Because a bath mimics this drop in temperature, a pre-bedtime soak tells your child's body it's time to doze off. Lubell recommends also placing a humidifier in your child's room to safely relieve stuffiness and improve breathing -- especially in the wee hours, when coughs are more likely to pop up.

Mom's Remedy: Tea With Lemon and Honey
The same theory for chicken soup holds true for a cup of hot tea: Heat increases blood flow, which may speed healing, says Bottino. More importantly, since mucus production can make you dehydrated, drinking lots of fluids -- especially clear ones like tea -- is key.

Besides sweetening the drink, honey may help curb your child's hacking. According to a study in the journal Pediatrics; Adolescent Medicine, 2 teaspoons of the sticky stuff before bed helped reduce coughs. Although you should never give honey to kids younger than 2 years of age, it may be a tool in addition to OTC meds to calm a cough.

Tea's also high in immune-boosting antioxidants, and a 2009 study in the Proceedings of the National Academy of Sciences found that blood cells in tea drinkers responded five times faster to bacteria and virus infections than their coffee-sipping counterparts. Is your child not a fan of English breakfast tea or Earl Grey? Brew a mug of hot water with lemon and honey instead.

Mom's Remedy: Bed Rest
It's no wonder that you feel wiped out when you're sick. That's your body's way of telling you that you need to log more z's for your immune system. According to a 2009 study in the Archives of Internal Medicine, people who logged less than seven hours of sleep a night were nearly three times as likely to catch a cold than those who got eight or more hours.

“Sleep is the most important thing you can do to fight off an infection," says Bottino. During shut-eye, he says, your body literally renews itself. To help your child snooze soundly, get symptoms like coughing under control first; a humidifier and over-the-counter medications can help him or her nod off quickly. Also place a box of soft facial tissues on your child's bedside table -- that way, relief will be within reach whenever he needs it and he won't have to disrupt his sleep too much during the night.

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Allergy-Proof Your Workout

There are already countless excuses for skipping your workout -- don’t let your allergies be one of them. If you’re one of the 40 million Americans who suffer from sniffles, sneezes, wheezes and watery eyes every spring or fall, you know that these symptoms can make exercising outside difficult. But with a few smart moves, you can breathe easy while staying fit.

1. Time it right.
Plants release their pollen early in the morning, right after dawn, according to the Asthma and Allergy Foundation of American. As the wind shifts, the count rises and reaches its peak around mid-day in cities and urban areas. To avoid an allergy attack, schedule workouts in the very early morning or later in the evening. Or head outdoors right after it rains, which temporarily washes away the pollen.

2. Check the pollen count.
If the pollen counts are particularly high, you may want to take your workout inside. Check the levels in your area on the National Allergy Bureau’s website. Hit the gym, set up your own mini boot camp or do a workout DVD.

3. Treat it early.
The best time to take your allergy medication isn't when you start to sneeze -- it's beforehand. Those meds are most effective when they're already in your system, say the experts. 

4. Shield your eyes.
To keep irritants from getting in your eyes during a workout, slip on a pair of wraparound shades before your walk, run or bike ride. Wearing a hat can also keep pollen from clinging onto your hair all day long, which can worsen your symptoms.

5. Shower off.
As soon as you get done with your workout, hop in the shower to rinse away that pollen and toss your clothes straight in the wash. To avoid tracking those allergens throughout your home, keep a clothing and sneaker bin in your home's mudroom or entryway.

6. Keep moving.
Don't be tempted to skip your sweat session on account of those sniffles: According to a study published in the Asian Pacific Journal of Allergy and Immunology, exercising for half an hour can reduce your allergy symptoms by as much as 70 percent. The researchers explain that moderate physical activity may counteract nasal inflammation. That's motivation enough to lace up those sneakers!

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