Food is an important part of any holiday celebration and cooking with your kids can help nurture their ethnic identity, heritage and culture. Here are some food safety tips to help keep holiday cooking fun and healthy: www.healthychildren.org/English/healthy-living/nutrition/Pages/Holiday-Food-Safety-Tips.aspx?_gl=... ... See MoreSee Less

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Indeed, worst shoes for kids!!!!
For multiple reasons…..
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Cough - when to be concerned ... See MoreSee Less

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Cough - when to be concerned ... See MoreSee Less

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SCIENCE EXPLAINS WHY FRIGHT IS FUN

Health experts discuss the biological reasons why human beings get enjoyment from being scared in settings like horror movies and haunted houses. Fright can stimulate the same centers of the brain as happiness and pleasure, and it's enjoyable because there is no real threat of harm. Fear also triggers the release of stress hormones and neurotransmitters that induce a "fight, flight or freeze" response, an evolutionary development that helped early humans avoid danger. Full Story: ABC News (10/31)
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SCIENCE EXPLAINS WHY FRIGHT IS FUN

Health experts discuss the biological reasons why human beings get enjoyment from being scared in settings like horror movies and haunted houses. Fright can stimulate the same centers of the brain as happiness and pleasure, and it's enjoyable because there is no real threat of harm. Fear also triggers the release of stress hormones and neurotransmitters that induce a "fight, flight or freeze" response, an evolutionary development that helped early humans avoid danger. Full Story: ABC News (10/31)
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WHY FOOD ALLERGIES ARE ON THE RISE?

We are over-protecting our kids. That practice was tragically exacerbated by the American Academy of Pediatrics, which, alarmed by rising food allergies, advised parents in 2000 to avoid exposing kids to peanuts or peanut products until age 3. That’s way too late to avoid most food allergies through exposure.

Contrary to advice a couple of decades ago, parents would do well to introduce their tots to peanut butter — though perhaps not by the pallet load.
“That led to this whole epidemic of people not feeding their kids the allergens early, which then probably contributed to the increase in allergies, because you’re not giving the immune system a chance to train when it’s best suited to learn,” (Center for Food Allergy and Asthma Research)

Those guidelines are now reversed. The National Institute of Allergy and Infectious Diseases recommended in 2017 that children be exposed to peanuts as early as 4 months — particularly if they have eczema. The new advice was based on a landmark study out of the United Kingdom that found that early exposure led to a massive drop in the incidence of allergies.

“If you can get anywhere close to an 81 percent decrease that we saw in the original study, we’re talking about saving thousands and thousands of kids from peanut allergies,” Anthony S. Fauci, then the institute’s director, said
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CHILDHOOD LONG COVID SYMPTOMS IS A SIGNIFICANT CONCERN

Recent research suggests that about 16% of pediatric COVID-19 patients end up with long COVID symptoms, which often interfere with their schoolwork and activities. Specialist Dr. Katherine Clouser says the pediatric long COVID clinic where she works is partnering with school nurses and teachers to identify signs of the condition in children, and clinicians are treating it with different combinations of methods, including talk therapy, intensive rehabilitation and antivirals, depending on individual symptoms.
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Scent dogs may be a cheaper, faster and more effective way to detect COVID-19

A review in the Journal of Osteopathic Medicine found that scent dogs detected COVID-19 in symptomatic, presymptomatic and asymptomatic patients faster and with better sensitivity than current RT-PCR or antigen tests. "We believe that scent dogs deserve their place as a serious diagnostic methodology that could be particularly useful during pandemics, potentially as part of rapid health screenings in public spaces," the researchers said. Full Story: News Medical (7/17)
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Scent dogs may be a cheaper, faster and more effective way to detect COVID-19

A review in the Journal of Osteopathic Medicine found that scent dogs detected COVID-19 in symptomatic, presymptomatic and asymptomatic patients faster and with better sensitivity than current RT-PCR or antigen tests. "We believe that scent dogs deserve their place as a serious diagnostic methodology that could be particularly useful during pandemics, potentially as part of rapid health screenings in public spaces," the researchers said. Full Story: News Medical (7/17)
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Study Finds Social Media Impact On Children & College's Want To Create Gambling Addicts ... See MoreSee Less

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The most important virus you’ve never heard of ... See MoreSee Less

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The most important virus you’ve never heard of ... See MoreSee Less

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BIG RESPIRATORY PLAYER THIS SEASON:
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I WANT TO HEAR YOUR OPINION, please comment
BIPARTISAN BILL WOULD BAN CHILDEN UNDER 13 FROM SOCIAL MEDIA USE
NBC News (4/26) reports that on Wednesday, a bipartisan group of senators introduced the Protecting Kids on Social Media Act, which “aims to protect children from any harmful effects posed by using social media.” The new legislation “would set a minimum age of 13 to use social media apps, such as Instagram, Facebook and TikTok, and would require parental consent for 13 to 17-year-olds.” NBC adds that “studies in recent years have suggested that social media has been linked to a rise in mental health disorders in teens and depression in adults.”
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I WANT TO HEAR YOUR OPINION, please comment
BIPARTISAN BILL WOULD BAN CHILDEN UNDER 13 FROM SOCIAL MEDIA USE
NBC News (4/26) reports that on Wednesday, a bipartisan group of senators introduced the Protecting Kids on Social Media Act, which “aims to protect children from any harmful effects posed by using social media.” The new legislation “would set a minimum age of 13 to use social media apps, such as Instagram, Facebook and TikTok, and would require parental consent for 13 to 17-year-olds.” NBC adds that “studies in recent years have suggested that social media has been linked to a rise in mental health disorders in teens and depression in adults.”
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EAT FOODS WITH VITAMIN C FOR OVERALL HEALTH
Vitamin C, or asorbic acid, is an essential nutrient that you need to acquire through your diet, says registered dietitian Devon Peart, adding that adequate intake of this antioxidant helps protect against cell damage, promotes healing, and supports eye and skin health. Eating one orange daily likely will supply the recommended amount of vitamin C, Peart says. Full Story: Cleveland Clinic (4/5)
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EAT FOODS WITH VITAMIN C FOR OVERALL HEALTH
Vitamin C, or asorbic acid, is an essential nutrient that you need to acquire through your diet, says registered dietitian Devon Peart, adding that adequate intake of this antioxidant helps protect against cell damage, promotes healing, and supports eye and skin health. Eating one orange daily likely will supply the recommended amount of vitamin C, Peart says. Full Story: Cleveland Clinic (4/5)
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DIET RICH IN MAGNESIUM LINKED TO BRAIN HEALTH
A study involving 6,001 cognitively healthy adults found an association between a diet high in magnesium and brain health. The research, published in the European Journal of Nutrition, showed that over a 16-month period higher consumption of magnesium-rich foods, including leafy greens, legumes, nuts, seeds and whole grains, was linked to larger brain volumes and possibly better brain health. Full Story: Medscape
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DIET RICH IN MAGNESIUM LINKED TO BRAIN HEALTH
A study involving 6,001 cognitively healthy adults found an association between a diet high in magnesium and brain health. The research, published in the European Journal of Nutrition, showed that over a 16-month period higher consumption of magnesium-rich foods, including leafy greens, legumes, nuts, seeds and whole grains, was linked to larger brain volumes and possibly better brain health. Full Story: Medscape
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WALNUTS ARE HELPFUL IN NEGATING EFFECTS OF STRESS AND SUPPORTING MOOD

In a separate study, using advanced mathematical techniques, researchers found when a small handful (~1/oz.) of walnuts was added into the daily diet of children, adolescents and adults who don't currently eat nuts, it improved intake of plant-based protein foods, along with higher intakes of nutrients to encourage, such as unsaturated fats, versus nutrients to limit like saturated fats and increased intake of under-consumed nutrients like fiber and potassium for some groups, as well as folate and magnesium.
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WALNUTS ARE HELPFUL IN NEGATING EFFECTS OF STRESS AND SUPPORTING MOOD

In a separate study, using advanced mathematical techniques, researchers found when a small handful (~1/oz.) of walnuts was added into the daily diet of children, adolescents and adults who don't currently eat nuts, it improved intake of plant-based protein foods, along with higher intakes of nutrients to encourage, such as unsaturated fats, versus nutrients to limit like saturated fats and increased intake of under-consumed nutrients like fiber and potassium for some groups, as well as folate and magnesium.
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HOW TO LESSEN EFFECTS OF THE TIME CHANGE
Disrupted sleep rhythms due to the twice-yearly time change can throw off a person's rest patterns for days, leading to accumulated sleep loss, which studies have shown may inrease the risk of stroke, heart attack, high blood pressure, accident, injury and mental health issues. To lessen the effects of the change, exercise regularly, get seven to nine hours of rest a night, go to bed earlier the week before, try an earlier wake time with exposure to bright light, do relaxing activities the evening before, eat a protein-heavy breakfast, and limit caffeine and alcohol.
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HOW TO LESSEN EFFECTS OF THE TIME CHANGE
Disrupted sleep rhythms due to the twice-yearly time change can throw off a person's rest patterns for days, leading to accumulated sleep loss, which studies have shown may inrease the risk of stroke, heart attack, high blood pressure, accident, injury and mental health issues. To lessen the effects of the change, exercise regularly, get seven to nine hours of rest a night, go to bed earlier the week before, try an earlier wake time with exposure to bright light, do relaxing activities the evening before, eat a protein-heavy breakfast, and limit caffeine and alcohol.
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POSITIVE PARENTING ... See MoreSee Less

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POSITIVE PARENTING ... See MoreSee Less

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INVOLVING KIDS IN MEAL PALANNING AND PREP TEACHES HEALTHFUL LESSONS
Planning ahead and making time to involve the whole family in meal planning and preparation teaches children about healthful eating, encourages them to try new foods, and with older children, can serve as a lesson in budgeting, says registered dietitian Danielle Townsend. "The adults in children's lives are the main role models when it comes to learning about healthy eating," Townsend says, offering tips for involving kids in food prep and recipes to try.
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INVOLVING KIDS IN MEAL PALANNING AND PREP TEACHES HEALTHFUL LESSONS
Planning ahead and making time to involve the whole family in meal planning and preparation teaches children about healthful eating, encourages them to try new foods, and with older children, can serve as a lesson in budgeting, says registered dietitian Danielle Townsend. "The adults in children's lives are the main role models when it comes to learning about healthy eating," Townsend says, offering tips for involving kids in food prep and recipes to try.
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ABOUT 40% OF PARENTS TO QUICK TO GIVE CHILDREN FEVER REDUCING MEDICATION
HealthDay (2/20) reports the study has found that about 40% of parents reach for fever-reducing medicines too quickly.” This poll “surveyed nearly 1,400 parents of children aged 12 and under” and found that “even though parents recognize the benefits of a low-grade fever for fighting off infection, about one-third would still give their child fever-reducing medication at temperatures below 100.4.” Half of parents “would do so at a temperature between 100.4 and 101.9, while about one-quarter of parents would give another dose later to help prevent a fever from returning.
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COVID-19 TIED TO GREATER RISK OF DIABETES
(2/14) reports people who have had COVID-19 “have a higher risk of developing diabetes, and that link seems to have persisted into the Omicron era, a new study” published in JAMA Network Open found. The researchers found COVID-19 “increased the odds of a new diabetes diagnosis by an average of about 58%.”
Medscape (2/14, Subscription Publication) reports the study also found:
“vaccination against SARS-CoV-2 appears to diminish” the likelihood of “diabetes following COVID-19 infection.”
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COVID-19 TIED TO GREATER RISK OF DIABETES
(2/14) reports people who have had COVID-19 “have a higher risk of developing diabetes, and that link seems to have persisted into the Omicron era, a new study” published in JAMA Network Open found. The researchers found COVID-19 “increased the odds of a new diabetes diagnosis by an average of about 58%.”
Medscape (2/14, Subscription Publication) reports the study also found:
“vaccination against SARS-CoV-2 appears to diminish” the likelihood of “diabetes following COVID-19 infection.”
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POOR SLEEP CAN REDUCE LIFE EXPECTANCY BY 15%

Did you know that sleeping less than 5 hours a night on average reduces life expectancy by 15%? For someone with a standard life expectancy of 78 years, that's almost 12 years off your life.

Truth is, when you aren't getting high-quality sleep consistently, you don't just feel groggy - you're also setting yourself up for less time on this planet. Research has shown that a lack of high-quality sleep can lead to higher stress, a bad mood, and significantly lower energy and vitality.
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POOR SLEEP CAN REDUCE LIFE EXPECTANCY BY 15%

Did you know that sleeping less than 5 hours a night on average reduces life expectancy by 15%? For someone with a standard life expectancy of 78 years, that's almost 12 years off your life.

Truth is, when you aren't getting high-quality sleep consistently, you don't just feel groggy - you're also setting yourself up for less time on this planet. Research has shown that a lack of high-quality sleep can lead to higher stress, a bad mood, and significantly lower energy and vitality.
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STUDY LINKS DIETARY ZINC TO MIGRAINES
A study involving 11,088 American adults found those whose diet included 15.8 milligrams or more of zinc daily had a lower risk of migraines, compared with those who consumed 5.9 mg or less each day. The findings, published in the journal Headache, suggest that "zinc is an important nutrient that influences migraine," researchers wrote.
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STUDY LINKS DIETARY ZINC TO MIGRAINES
A study involving 11,088 American adults found those whose diet included 15.8 milligrams or more of zinc daily had a lower risk of migraines, compared with those who consumed 5.9 mg or less each day. The findings, published in the journal Headache, suggest that "zinc is an important nutrient that influences migraine," researchers wrote.
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KIWI CONSUMPTION LINKED TO IMPROVED CONSTIPATION
Eating two kiwis daily followed by a four-week washout period was associated with an increase in complete spontaneous bowel movements and improved gastrointestinal symptoms among people with constipation, according to research published in The American Journal of Gastroenterology. Researchers noted specific improvements in indigestion, stool consistency, abdominal pain and constipation.
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KIWI CONSUMPTION LINKED TO IMPROVED CONSTIPATION
Eating two kiwis daily followed by a four-week washout period was associated with an increase in complete spontaneous bowel movements and improved gastrointestinal symptoms among people with constipation, according to research published in The American Journal of Gastroenterology. Researchers noted specific improvements in indigestion, stool consistency, abdominal pain and constipation.
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EXPERTS WARN LATEST OMICRON SUBVARIANTAS SHOW GREATED IMMUNE ESCAPE WILL LIKELY LEAD TO RISING CASES

COVID-19 Hospitalizations Rise Following Thanksgiving Holiday
The Washington Post (12/4) reports a post-Thanksgiving uptick in patients with COVID-19 “at U.S. hospitals is arriving even as health systems contend with waves of feverish, coughing people stricken with RSV and influenza infections.” COVID-19 hospitalizations last week “reached their highest level in three months, with more than 35,000 patients being treated, according to Washington Post data tracking.” Public health authorities “are concerned that the increase in the number of” patients with COVID-19 “will worsen the strain on hospitals already under pressure from the effects of” influenza and RSV. Experts “warn that holiday gatherings are a prime time for the coronavirus to spread as millions of Americans travel and get together.” The increase “in hospitalizations probably reflects a combination of patients who were infected before the Thanksgiving holiday rush and those exposed during Thanksgiving week, health experts said.”
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EXPERTS WARN LATEST OMICRON SUBVARIANTAS SHOW GREATED IMMUNE ESCAPE WILL LIKELY LEAD TO RISING CASES

COVID-19 Hospitalizations Rise Following Thanksgiving Holiday
The Washington Post (12/4) reports a post-Thanksgiving uptick in patients with COVID-19 “at U.S. hospitals is arriving even as health systems contend with waves of feverish, coughing people stricken with RSV and influenza infections.” COVID-19 hospitalizations last week “reached their highest level in three months, with more than 35,000 patients being treated, according to Washington Post data tracking.” Public health authorities “are concerned that the increase in the number of” patients with COVID-19 “will worsen the strain on hospitals already under pressure from the effects of” influenza and RSV. Experts “warn that holiday gatherings are a prime time for the coronavirus to spread as millions of Americans travel and get together.” The increase “in hospitalizations probably reflects a combination of patients who were infected before the Thanksgiving holiday rush and those exposed during Thanksgiving week, health experts said.”
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STUDY SUGGESTS EARLY PENUT INTRODUCTION FOR ALL INFANTS
Early introduction of peanuts to all infants, regardless of risk category and ethnicity, may reduce the incidence of peanut allergy by 88%, as opposed to introducing peanuts only to those with risk factors like severe eczema, according to research presented at the American College of Asthma & Immunology Annual Scientific Meeting. Introduction before 6 months of age is optimal with "all infants in the general population...encouraged to consume peanut products once they have reached 4 months of age," according to researcher Dr. Gideon Lack.
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STUDY SUGGESTS EARLY PENUT INTRODUCTION FOR ALL INFANTS
Early introduction of peanuts to all infants, regardless of risk category and ethnicity, may reduce the incidence of peanut allergy by 88%, as opposed to introducing peanuts only to those with risk factors like severe eczema, according to research presented at the American College of Asthma & Immunology Annual Scientific Meeting. Introduction before 6 months of age is optimal with "all infants in the general population...encouraged to consume peanut products once they have reached 4 months of age," according to researcher Dr. Gideon Lack.
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PFIZER TO SEEK FDA APPROVAL FOR MATERNAL RSV VACCINE
Pfizer plans to submit its maternal respiratory syncytial virus vaccine for FDA approval by the end of this year, citing trial results that showed it to be more than 80% effective at preventing serious RSV illness and reducing the need for medical care in a baby's first months of life. The vaccine is given to pregnant people, whose bodies create antibodies that cross the placenta and provide protection for infants after they are born.
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PFIZER TO SEEK FDA APPROVAL FOR MATERNAL RSV VACCINE
Pfizer plans to submit its maternal respiratory syncytial virus vaccine for FDA approval by the end of this year, citing trial results that showed it to be more than 80% effective at preventing serious RSV illness and reducing the need for medical care in a baby's first months of life. The vaccine is given to pregnant people, whose bodies create antibodies that cross the placenta and provide protection for infants after they are born.
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PFIZER TO SEEK FDA APPROVAL FOR MATERNAL RSV VACCINE
Pfizer plans to submit its maternal respiratory syncytial virus vaccine for FDA approval by the end of this year, citing trial results that showed it to be more than 80% effective at preventing serious RSV illness and reducing the need for medical care in a baby's first months of life. The vaccine is given to pregnant people, whose bodies create antibodies that cross the placenta and provide protection for infants after they are born.
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RSV: WHEN IT'S MORE THAN JUST A COLD
By: Andrea Jones, MD, FAAP

Almost all children get RSV at least once before they are 2 years old. For most healthy children, RSV is like a cold. But, some children get very sick with RSV.

What is RSV?
RSV (or respiratory syncytial virus) is one of the many viruses that cause respiratory illness―illnesses of the nose, throat, and lungs. This virus occurs in the late fall through early spring months, but can vary in different parts of the country.

With mask-wearing and physical distancing for COVID-19, there were fewer cases of RSV in 2020. However, once safety measures relaxed with the arrival of COVID-19 vaccines, a rise in RSV cases began in spring 2021. The spread of RSV and other seasonal respiratory illnesses like influenza (flu) has also started earlier than usual this year.
RSV symptoms in babies
Typically, RSV causes a cold, which may be followed by bronchiolitis or pneumonia. Symptoms generally last an average of 5-7 days.

Cold: Upper Respiratory Tract Infection
Bronchiolitis: Lower Respiratory Tract Infection
Cold symptoms may include:

Fever (temperature of 100.4 or higher)

Cough (dry or wet sounding)

Congestion

Runny nose

Sneezing

Fussiness

Poor feeding

Symptoms may include cold symptoms, plus:

Fast breathing

Flaring of the nostrils

Head bobbing with breathing

Rhythmic grunting during breathing

Belly breathing, tugging between the ribs and/or the lower neck (see video, below)

Wheezing

How hard is your baby breathing? What to look for.
Chest wall retractions happen when a baby must use muscles between the ribs or in the neck to breathe. It is a sign that your baby is having to work harder than normal to breathe.

Watch your child's rib cage as they inhale. If you see it "caving in" and forming an upside-down "V" shape under the neck, then they are working too hard.

Is your baby or young child at a greater risk of this respiratory illness?
Those infants with a higher risk for severe RSV infection include:

12 weeks old or younger at the start of RSV season

Premature or low birth weight infants (especially those born before 29 weeks gestation)

Chronic lung disease of prematurity

Babies with certain types of heart defects

Those with weak immune systems due to illness or treatments

Additional risk factors for severe RSV infections include low birth weight, having siblings, a mother's smoking during pregnancy, exposure to secondhand smoke in the home, history of allergies and eczema, not breastfeeding, and being around children in a child care setting or living in crowded living conditions.

When should you call the doctor?
RSV symptoms are typically at their worst on days 3 through 5 of illness. Fortunately, almost all children recover from an RSV infection on their own.

Call your pediatrician right away if your child has any:
Symptoms of bronchiolitis (listed above)

Symptoms of dehydration (fewer than 1 wet diaper every 8 hours)

Pauses or difficulty breathing

Gray or blue color to tongue, lips or skin

Significantly decreased activity and alertness

Some children with RSV may be at increased risk of developing a bacterial infection, such as an ear infection. Call your doctor if your child has:

Symptoms that worsen or do not start to improve after 7 days

A fever (with a rectal temperature of 100.4°F or higher) and they are younger than 3 months of age (12 weeks).

A fever that rises above 104°F repeatedly for a child of any age.

Poor sleep or fussiness, chest pain, ear tugging or ear drainage

How do doctors diagnose RSV?
Pediatricians diagnose children with a cold or bronchiolitis by asking about their symptoms and by doing a physical exam. Your pediatrician may do a nasal swab test to determine if your child has RSV or another virus. A chest x-ray and/or oxygen saturation test may also be done to check for lung congestion. Because most children recover without difficulty and because there is no treatment for RSV, these tests usually are not necessary.

Is RSV contagious?
Yes. RSV spreads just like a common-cold virus―from one person to another. It enters the body through the nose or eyes or, usually from:

Direct person-to-person contact with saliva, mucus, or nasal discharge.

Unclean hands (RSV can survive 30 minutes or more on unwashed hands).

Unclean objects or surfaces (RSV can survive up to 6 hours on surfaces, toys, keyboards, door knobs, etc).

Symptoms can appear 2 to 8 days after contact with RSV. According to the U.S. Centers for Disease Control and Prevention (CDC), people infected with RSV are usually contagious for 3 to 8 days. However, some infants and people with weakened immune systems can be contagious for as long as four weeks―even if they are not showing symptoms.

Keep in mind, children and adults can get RSV multiple times–even during a single season. Often, however, repeat infections are less severe than the first one.

What can you do to help your child feel better?
There is no cure for RSV and medications, like steroids and antibiotics, do not help with RSV.

To help your child feel more comfortable, begin by doing what you would for any bad cold:
Nasal saline with gentle suctioning to allow easier breathing and feeding.

Cool-mist humidifier to help break up mucus and allow easier breathing.

Fluids and frequent feedings. Make sure your child is staying hydrated. Infants with a common cold may feed more slowly or not feel like eating, because they are having trouble breathing. Try to section baby's nose before attempting to breast or bottle-feed. Supplementation with water or formula is unnecessary for breastfed babies. If difficult for the baby to feed at the breast, expressing breastmilk into a cup or bottle may be an option.

Acetaminophen or ibuprofen (if older than 6 months) to help with low-grade fevers. Always avoid aspirin and cough and cold medications.

Only 3% of children with RSV will require a hospital stay. Those children may need oxygen to help with breathing or an (intravenous) IV line for fluids. Most of these children can go home after 2 or 3 days. Rarely, a child may need care in a pediatric intensive care unit (PICU).

How can you protect your children from RSV?
Wash your hands! Just as you would to prevent germs at any time, use soap and water and scrub for at least 20 seconds. Remind children to practice good hand hygiene all through the year.

Other things that can help prevent RSV
Vaccinate. Keep your children up to date on their immunizations and get the whole family annual flu shots. Getting vaccinated with Tdap―to protect against whooping cough is especially important for adults who are around infant—new parents, grandparents, babysitters, nannies, etc. Your child should also be immunized against COVID-19.

Limit your baby's exposure to crowds, other children, and anyone with colds. Keep them home from school or child care when they are sick and teach them to cover their coughs and sneezes.

Go germ-free. Disinfect objects and surfaces in your home regularly and avoid exposing your child to smoke from tobacco or other substances.

Feed your baby breastmilk. It has unique antibodies to prevent and fight infections.

Injections for high-risk infants
There is a monoclonal antibody treatment that may reduce the risk of severe RSV infection in some high-risk infants. Your pediatrician will let you know if your baby is a candidate.

Hope on the horizon
Medicine is always advancing! Scientists are currently studying vaccines to prevent and medications to treat RSV. We may have more options in the future. In the meantime, rest assured that most children recover well from RSV and grow to be healthy adults.

More information
COVID-19 & Other Respiratory Illnesses: How Are They Different?
Treating Bronchiolitis in Infants
HealthyChildren.org Parent Webinar on RSV
RSV in Infants and Young Children (CDC)
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RSV: WHEN IT'S MORE THAN JUST A COLD
By: Andrea Jones, MD, FAAP

Almost all children get RSV at least once before they are 2 years old. For most healthy children, RSV is like a cold. But, some children get very sick with RSV.

What is RSV?
RSV (or respiratory syncytial virus) is one of the many viruses that cause respiratory illness―illnesses of the nose, throat, and lungs. This virus occurs in the late fall through early spring months, but can vary in different parts of the country.

With mask-wearing and physical distancing for COVID-19, there were fewer cases of RSV in 2020. However, once safety measures relaxed with the arrival of COVID-19 vaccines, a rise in RSV cases began in spring 2021. The spread of RSV and other seasonal respiratory illnesses like influenza (flu) has also started earlier than usual this year.
RSV symptoms in babies
Typically, RSV causes a cold, which may be followed by bronchiolitis or pneumonia. Symptoms generally last an average of 5-7 days.

Cold: Upper Respiratory Tract Infection
Bronchiolitis: Lower Respiratory Tract Infection
Cold symptoms may include:

Fever (temperature of 100.4 or higher)

Cough (dry or wet sounding)

Congestion

Runny nose

Sneezing

Fussiness

Poor feeding

Symptoms may include cold symptoms, plus:

Fast breathing

Flaring of the nostrils

Head bobbing with breathing

Rhythmic grunting during breathing

Belly breathing, tugging between the ribs and/or the lower neck (see video, below)

Wheezing

How hard is your baby breathing? What to look for.
Chest wall retractions happen when a baby must use muscles between the ribs or in the neck to breathe. It is a sign that your baby is having to work harder than normal to breathe.

Watch your child's rib cage as they inhale. If you see it "caving in" and forming an upside-down "V" shape under the neck, then they are working too hard.

Is your baby or young child at a greater risk of this respiratory illness?
Those infants with a higher risk for severe RSV infection include:

12 weeks old or younger at the start of RSV season

Premature or low birth weight infants (especially those born before 29 weeks gestation)

Chronic lung disease of prematurity

Babies with certain types of heart defects

Those with weak immune systems due to illness or treatments

Additional risk factors for severe RSV infections include low birth weight, having siblings, a mother's smoking during pregnancy, exposure to secondhand smoke in the home, history of allergies and eczema, not breastfeeding, and being around children in a child care setting or living in crowded living conditions.

When should you call the doctor?
RSV symptoms are typically at their worst on days 3 through 5 of illness. Fortunately, almost all children recover from an RSV infection on their own.

Call your pediatrician right away if your child has any:
Symptoms of bronchiolitis (listed above)

Symptoms of dehydration (fewer than 1 wet diaper every 8 hours)

Pauses or difficulty breathing

Gray or blue color to tongue, lips or skin

Significantly decreased activity and alertness

Some children with RSV may be at increased risk of developing a bacterial infection, such as an ear infection. Call your doctor if your child has:

Symptoms that worsen or do not start to improve after 7 days

A fever (with a rectal temperature of 100.4°F or higher) and they are younger than 3 months of age (12 weeks).

A fever that rises above 104°F repeatedly for a child of any age.

Poor sleep or fussiness, chest pain, ear tugging or ear drainage

How do doctors diagnose RSV?
Pediatricians diagnose children with a cold or bronchiolitis by asking about their symptoms and by doing a physical exam. Your pediatrician may do a nasal swab test to determine if your child has RSV or another virus. A chest x-ray and/or oxygen saturation test may also be done to check for lung congestion. Because most children recover without difficulty and because there is no treatment for RSV, these tests usually are not necessary.

Is RSV contagious?
Yes. RSV spreads just like a common-cold virus―from one person to another. It enters the body through the nose or eyes or, usually from:

Direct person-to-person contact with saliva, mucus, or nasal discharge.

Unclean hands (RSV can survive 30 minutes or more on unwashed hands).

Unclean objects or surfaces (RSV can survive up to 6 hours on surfaces, toys, keyboards, door knobs, etc).

Symptoms can appear 2 to 8 days after contact with RSV. According to the U.S. Centers for Disease Control and Prevention (CDC), people infected with RSV are usually contagious for 3 to 8 days. However, some infants and people with weakened immune systems can be contagious for as long as four weeks―even if they are not showing symptoms.

Keep in mind, children and adults can get RSV multiple times–even during a single season. Often, however, repeat infections are less severe than the first one.

What can you do to help your child feel better?
There is no cure for RSV and medications, like steroids and antibiotics, do not help with RSV.

To help your child feel more comfortable, begin by doing what you would for any bad cold:
Nasal saline with gentle suctioning to allow easier breathing and feeding.

Cool-mist humidifier to help break up mucus and allow easier breathing.

Fluids and frequent feedings. Make sure your child is staying hydrated. Infants with a common cold may feed more slowly or not feel like eating, because they are having trouble breathing. Try to section baby's nose before attempting to breast or bottle-feed. Supplementation with water or formula is unnecessary for breastfed babies. If difficult for the baby to feed at the breast, expressing breastmilk into a cup or bottle may be an option.

Acetaminophen or ibuprofen (if older than 6 months) to help with low-grade fevers. Always avoid aspirin and cough and cold medications.

Only 3% of children with RSV will require a hospital stay. Those children may need oxygen to help with breathing or an (intravenous) IV line for fluids. Most of these children can go home after 2 or 3 days. Rarely, a child may need care in a pediatric intensive care unit (PICU).

How can you protect your children from RSV?
Wash your hands! Just as you would to prevent germs at any time, use soap and water and scrub for at least 20 seconds. Remind children to practice good hand hygiene all through the year.

Other things that can help prevent RSV
Vaccinate. Keep your children up to date on their immunizations and get the whole family annual flu shots. Getting vaccinated with Tdap―to protect against whooping cough is especially important for adults who are around infant—new parents, grandparents, babysitters, nannies, etc. Your child should also be immunized against COVID-19.

Limit your baby's exposure to crowds, other children, and anyone with colds. Keep them home from school or child care when they are sick and teach them to cover their coughs and sneezes.

Go germ-free. Disinfect objects and surfaces in your home regularly and avoid exposing your child to smoke from tobacco or other substances.

Feed your baby breastmilk. It has unique antibodies to prevent and fight infections.

Injections for high-risk infants
There is a monoclonal antibody treatment that may reduce the risk of severe RSV infection in some high-risk infants. Your pediatrician will let you know if your baby is a candidate.

Hope on the horizon
Medicine is always advancing! Scientists are currently studying vaccines to prevent and medications to treat RSV. We may have more options in the future. In the meantime, rest assured that most children recover well from RSV and grow to be healthy adults.

More information
COVID-19 & Other Respiratory Illnesses: How Are They Different?
Treating Bronchiolitis in Infants
HealthyChildren.org Parent Webinar on RSV
RSV in Infants and Young Children (CDC)
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