Ask the Doc: Viruses

viruses viruses

Approved by the What’s Up Moms Medical Advisory Board

It feels like my kid keeps getting sick. Is there something wrong with her immune system?”

It’s not just something I hear in winter. Year-round, I get versions of this question, usually asked by bleary-eyed, exhausted parents who can’t believe that again they’re back at the doctor’s office with a sick child. It can be especially brutal if you have a child who is experiencing their first year in preschool/daycare. Each illness may come on the heels of a previous one, and it can be hard to know when one infection ends and another begins. This can be particularly true for households with multiple young kids.

These days I get to experience both sides of the doctor-parent dynamic, since my almost-3-year-old twins are in preschool and my 16-month-old has managed to catch every last bug they brought home. Let’s just say they are MUCH more adept at sharing their germs than they are at sharing their toys.

So what IS normal?

  • The average child gets 6-8 respiratory viruses per year and 1-3 gastrointestinal viruses each year. Those just starting daycare or preschool get sick even more than that (up to 12 times/year), and each illness can last 10-14 days until full resolution. Throw in a handful of child-specific viruses (like Hand Foot & Mouth virus, which most parents have never heard of until an outbreak at preschool spreads like wildfire), and if you feel like your child is sick half the time, well, you’re kinda right.
  • There are more than 200 types of viruses that cause the common cold, and once you fight off a virus, immunity to it can be lifelong or just last a few years. So while it isn’t really possible to become completely immune to the common cold, over time a person develops stronger resistance to more and more of the viruses that are out there circulating. (So the good news is after a school year or two, everyone in the family typically builds up better immunity and gets sick far less frequently!)
  • Often, the most contagious period is just before a child actually has symptoms, so there’s no way to completely avoid exposure. Trips to the museum, the park, and even the grocery store can all be sources of exposure.

When should I be concerned that it’s something more than a cold?

First off, any time you’re worried, talk to your pediatrician. As I said, I’ve literally fielded the above question hundreds of times, and while most of the time the answer is “it’s normal and this will pass,” sometimes we do uncover underlying medical issues such as asthma, environmental allergies, reflux, cough-variant tic disorders and (rarely) immune or heart disorders.

Things to look out for:

  • Failure to grow and gain weight in infancy (losing weight during a cold is typical, and if a child bounces back afterwards and appetite improves, no need to worry)
  • Any cough that is accompanied by wheezing/difficulty breathing or one that isn’t improving after 2-3 weeks
  • Persistent or recurrent fevers
  • Recurrent bacterial infections, such as pneumonia or sinusitis
  • Frequent ear infections (If a child has had 4 or more ear infections in a year or 3 or more in 6 months, talk to your pediatrician about seeing an Ear Nose and Throat specialist.)
  • Rare or unusual infections (repeated fungal infections, repeated skin boils)

The good news is that most children develop their long-term immunity during those early years, one virus at a time. Studies have shown that when children start preschool, those who have been to daycare prior get sick far less often than their peers who never went to daycare. The same is true for kindergarteners who have been to preschool vs those who haven’t.

So think of it this way: each time your child gets sick, it’s (hopefully) one less virus for them to deal with down the road. When I’m up at night with a coughing/sniffling child, I like to remind myself that they’re building their immunity for the future. Makes the sleepless nights pass by just a little more easily.

Dr. Hovav is a board-certified Pediatrician in CA and Fellow of the American Academy of Pediatrics. She lives in Sherman Oaks with her husband and three young children, boy/girl twins and their wanna-be-a-triplet little brother. She can be found caring for patients in Studio City at Beverly Hills Pediatrics -The Valley.