What are frequent infections?

Some children seem to always have the sniffles. They get one cold after another. Many parents wonder, "Isn't my child having too many colds?" Children start to get colds after about 6 months of age. Babies, toddlers, and preschoolers get about 7 or 8 colds a year. During the school-age years they average 5 or 6 colds a year. Teens finally reach an adult level of about 4 colds a year.

In addition to colds, children can have diarrheal illnesses (with or without vomiting) 2 or 3 times per year. Some children tend to get high fevers with most of their colds or they have sensitive gastrointestinal (GI) tracts and develop diarrhea with most of their colds. This worries many parents.

What is the cause?

The main reason your child is getting all these infections is that he or she is being exposed to new viruses. There are at least 200 different cold viruses. Your child's body will build up defenses (immunity) against these viruses when he or she is exposed to them. But this takes time. It takes many years to build up immunity to cold viruses. Your child will be exposed more if he or she attends day care, play group, a church nursery, or a preschool. Older brothers and sisters may bring home a virus from school. Colds are more common in large families. The rate of colds triples in the winter when people spend more time crowded together indoors breathing recirculated air. Smoking in the home increases your child's susceptibility to colds, coughs, ear infections, sinus infections, croup, wheezing, and asthma.

If your child is over age 3 years, sneezes a lot, has a clear nasal discharge that lasts over a month, doesn't have a fever, your child may have an allergy. This is true especially if these symptoms occur during pollen season, your child probably has a nasal allergy (hay fever). Allergies are much easier to treat than frequent colds because medicines can help control symptoms.

What doesn't cause frequent infections?

Colds are not caused by poor diet or lack of vitamins. They are not caused by bad weather, air conditioners, or wet feet.

Many parents are worried that their child has some serious underlying disease because they get a lot of colds. A child with an immune system disease doesn't get any more colds than the average child. The difference is that a child with an immune problem will have trouble recovering from illness. They also will have 2 or more bouts per year of serious infections such as pneumonia, sinus infections, draining lymph nodes, or boils. In addition, a child with a serious disease does not gain weight very well or look well between infections. Tell your health care provider if your family is worried about a particular problem. Also, if your child gets a lot of ear infections, it doesn't mean that your child has a serious health problem. They mean only that the tubes in the ear aren't draining properly.

Some parents worry that they have in some way neglected their child or done something wrong to cause frequent colds. Having all these colds is an unavoidable part of growing up. Colds are one infection which can't be prevented. They cannot be avoided and help build up your child's immune system.

How can I take care of my child?

• Look at your child's general health.

  If your child is vigorous and gaining weight, you don't have to worry about his or her health. Your child is no sicker than the average child of her age. Children get over colds by themselves. Although you can reduce the symptoms, you can't shorten the course of each cold. Your child will muddle through like every other child. The long-term outlook is good. The number of colds will decrease over the years as your child's body builds up a good antibody supply to the various viruses.

• Send your child back to school as soon as possible.

  The main requirement for returning your child to day care or school is that the fever is gone and the symptoms are not excessively noisy or distracting to classmates. It doesn't make sense to keep a child home until you are sure he will not spread any germs. This could take 2 or 3 weeks.

  Also, as long as your child's fever is gone, there is no reason he or she cannot attend parties, play with friends after school, and go on field trips. Gym and team sports may need to be postponed for a few days.

• Try not to miss work.

  When both parents work, these repeated colds are extremely inconvenient and costly. Since colds are not serious, you can usually leave your child with a baby sitter if needed. If your child goes to day care or preschool, he or she can go back once the fever is gone. There is no reason to prolong the recovery at home if you need to return to work. Going back to day care or school won't make the cold worse or expose other children more than they are already exposed. In addition, you don't need to take your child out of preschool or day care permanently because of these repeated illnesses. Consider switching to a small home-based day care if your child is less than 2 years old. Also find another day care if someone on the day care staff smokes on-site.
   

There are no instant cures for recurrent colds and other viral illnesses. Antibiotics are not helpful unless your child develops complications such as an ear infection, sinus infection, or pneumonia. Having your child's tonsils removed is not helpful because colds are not caused by bad tonsils. Again, the best time to have these infections and develop immunity is during childhood.