Since Starting Daycare, She Has Had One Cold After Another

"Since starting daycare my child has had one cold after another. They get better and catch another, and just as they seem to be getting better they catch another."

Almost always, one more thing comes attached to this. "And through all of it they barely eat."

Parents speak of these two separately, but I hear them as one story.

Frequent colds at that age are not because the body is weak

From the day a child goes to daycare, the number of people they meet multiplies several times over. The viruses that cause colds come in a great many kinds, and the child has not yet met most of them.

Immunity remembers only what it has met before. For a virus met for the first time there is no prepared response, so the child learns by being ill. The Korean Pediatric Society summarizes that a child has 6 to 10 colds in a year. Compared with an adult's 2 to 4 it looks like a lot, but at that age that is ordinary. It is more frequent still if the child is in group care or has siblings.

The number of times a child is ill does not by itself mean immunity is weak. Rather, what is learned in that period reduces the share to be carried later. Of course there are differences from child to child in how quickly or slowly recovery comes, and that difference is what I look at.

Losing appetite while ill is something the body has ordered

This is the part parents are most surprised by.

When the body fights an infection, inflammatory signaling substances are released. Those substances do not only catch the pathogen; they also act on the place in the brain that handles appetite and hold down the wish to eat. Running a fever, feeling drained, and wanting to lie down are the work of the same signals.

That is, the child is not refusing to eat; the body has decided that now is not the time to eat. It is a state in which the strength that would go to digestion has been turned elsewhere for a while.

So forcing food during this period usually does not go well. The child brings it back up or resists eating more, and eating is left as an unpleasant thing for the child.

The problem lies in recovery arriving late

Not eating while ill passes in a few days on its own. The place I actually work on is what comes after.

There are children whose appetite does not return even after the fever has come down and the cough has quieted. If they catch another cold in the meantime, the amount they eat is pressed down again before it has recovered, and when this overlaps a few times, the period of not eating grows longer than the period of being ill.

Then the strength to recover by eating well decreases, and because recovery is late, the next cold is suffered longer. The state parents feel as "one cold after another" is made here.

So what I look at

Rather than the side of preventing colds, I look first at the speed of returning to normal after being ill.

Whether a state of not being hungry at mealtimes continues, whether the child feels unusually heavy for a long time after eating, whether the belly is always out as if full — these are what I ask about. Hunger is a signal that rises as the stomach empties, so if the speed at which the stomach empties is lagging, hunger itself does not rise easily.

The medicine used for a child is not an adult's reduced down. Children tend to respond to medicine quickly and to recover quickly as well, and I take that into account when preparing it. I have set this story out separately in May children take herbal medicine.

Things you might try at home

While the child is ill, you do not have to make the amount eaten a goal. Water and sleep come first.

After the fever comes down, rather than trying to feed one large meal, it is better to start with small amounts often, with warm and soft things first. There is less burden when the stomach begins to move again.

And leaving eating as an enjoyable thing for the child is a gain over the long run. One spoonful the child reached for on their own lasts longer afterward than one meal fed by force.

When to see a doctor first

If the child is short of breath, cannot swallow even water, if urine has clearly decreased, if fever continues for several days, or if the child is drained and hard to wake — pediatric care comes first. The same goes for when weight is dropping.

This piece is about what to look at in the space between, when a child does not return to normal well even after the illness has passed.

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Sources

• A summary that a child has 6 to 10 colds in a year — Korean Pediatric Society
• A review summarizing the response in which inflammatory signaling substances act on the brain to suppress appetite and cause lethargy — Immunology and Allergy Clinics of North America, 2009

Written by Dr. Heo Ji-young (Ph.D. in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)