Did you know that over $US 3 Billion is spent on over the counter medicines for the common cold each year? How effective do you find cold medicines? Of course they relieve fever and pain for a short time but your body may still need help to fight the virus and recover. That is where Natural Therapists can help. Instead of “soldiering on”, meanwhile spreading your illness into the wider community we can support your immune system and allow it to help you to get better eg. to do its job. Many of your children may be starting to pick up the typical illnesses that come with colder weather like coughs and colds. Cough is the body’s protective reflex to dislodge mucus or a foreign body. It depends on the cause of the cough whether its a virus, infection, allergy, post nasal drip or asthma as to what the treatment will be.
Today we will be looking at how to help upper respiratory tract infections (URTI’s) which include strep throat, tonsillitis, sinusitis, croup and ear infections. This blog is written with children in mind but adults can also find the information useful. Next week I will look at lower respiratory infections like coughs, bronchitis, pneumonia, RSV, post-viral cough, whooping cough and asthma. I will also be touching on allergic rhinitis also known as hay fever as treatment is very similar to asthma.
Most URTI’s are caused by viruses and resolve by themselves while our treatment is aimed at shortening the length of the illness by stimulating and supporting the immune system as well as relieving the symptoms with herbs and vitamins/minerals. We may use herbs like Echinacea, Elder, Liquorice, Thyme and Peppermint in a base especially formulated for kids (so it tastes good!). URTI’s caused by bacterial infections can be more stubborn and more painful and can become serious. We may add stronger antimicrobial herbs to the mix including Goldenseal, Propolis, Myrrh or Oregano while still bearing in mind the taste is not too bitter. These sorts of herbs I may use in a strep throat or tonsilitis mix together with a topical salve on the throat. I also have a sugar-like liquid I use in my children’s herb mixes called glycerol which is not absorbed but helps to mask the taste of the more bitter herbs. It also helps the herbs to stick to the tonsils and throat. It is useful for parents if I can give clear guidelines as to how soon you want to see improvements and at what stage you need to see the GP for antibiotics.
Children are more likely to contract the flu than adults with a 20-50% chance during flu season compared to 10-30% in adults. And children are more likely to be hospitalised with complications especially those kids at high risk with chronic health conditions. Herbally we want to support the immune system using antiviral and antibacterial herbs while also helping ease symptoms. Elderberry syrup has a long history of use and has been shown in trials to be effective against the flu virus, Streptococcus pyrogenes, group C and G Streptococci and demonstrated immune stimulating effects in animal & human studies. Giving extra Vitamin C, D and Zinc are proven to be useful. Keeping your child well hydrated with fluids and electrolytes goes without saying: ‘keep up the fluids’ is a common doctor’s refrain. We need to monitor children for signs of deterioration especially when symptoms return after a child feels better, a good sign of a secondary bacterial infection.
Is a viral infection causing inflammation of the larynx, trachea and subglottic airway. 1-5% of children will be hospitalised but less than 3% will require intervention. It is the second most common cause of respiratory distress in the first year of life and often occurs between 6 months and 3 years of age. You will know it by its characteristic dry barking seal-like cough which follows 1-3 days of non specific symptoms like runny nose, cough and/or fever. The cough is usually worse at night and for going out into cold air and it can progress very fast into difficulty breathing: make sure you CALL AN AMBULANCE if this happens as cold air can exacerbate the swelling of the airway and you cannot resuscitate a child in the back of a car. In hospital the use of steroids have reduced the need for intubation (tube down the throat) by 80%. The standard treatment for croup since the early 1900’s has been humidification but this is not recommended anymore because a meta-analysis (a series of clinical studies are looked at and a average result is extrapolated) showed it was not effective. Unfortunately the analysis in question looked at trials that had poor design with short treatment duration ( 20-60 minutes compared the overnight treatment with a humidifier which is usual). We still recommend it as the humidified air does seem to help the inflammation and breathing. If you are managing croup at home take your child into the bathroom and fill the room with steam and stay in there until they are breathing easier. You can use a humidifier in the bedroom overnight with antimicrobial herbs like eucalyptus, lemon myrtle & oregano and muscle relaxant oils like lavender. For safety it may be better to sleep in the room with your child but make sure you ventilate the room well during the day to stop the growth of mould. Sipping warm thyme and liquorice tea with manuka honey can help and a herbal remedy made up by your herbalist can also help. Rubbing a good natural topical liniment into the chest (we have a great one at the clinic) which may include eucalyptus, peppermint and lavender can be useful too. Rest and keep warm, keep yourself and your child calm as crying just makes the symptoms worse. So stay in bed, snuggle, read books, watch movies, do jigsaws and cuddle is the best medicine. Remember if there is real difficulty breathing or shortness of breath, the lips become blue or there is lots of distress or lethargy then take your child to emergency or call an ambulance.
EAR INFECTIONS (OTITIS MEDIA)
In the USA 93% of children will have experienced an ear infection by the age of 7. It usually precedes an URTI and can present acutely, acutely with fluid or a chronic fluid filled ear commonly called “glue ear” which can last 12 weeks or longer. It can be hard to diagnose and younger children may have fever, irritability, ear pulling or rubbing. Even though the ear may feel really itchy due to the inflammation and fluid DO NOT scratch with an ear bud as this can lead to perforation of the ear drum.
Some facts about antibiotics and ear infections:
78-81% of cases resolve themselves without antibiotics
Only 6% less children had reduced ear pain after antibiotics compared to placebo (this means for every 16 children only 1 will be helped by antibiotics)
Antibiotics have been shown to help children under 2 with ear infections in both ears
Increasingly we are finding bacteria resistant antibiotics so a watch and wait approach is favoured
Giving analgesics for the pain can be a good idea if necessary.
A Herbal Ear Oil containing Calendula, St.John’s Wort, Mullein, Garlic and Lavender was shown in a clinical trial to have the following results.
4 TREATMENT REGIMES WERE COMPARED
• Herbal ear oil alone, 5 drops in affected ears 3 x a day(group A)
• Herbal ear oil + oral amoxicillin (antibiotic) 80 mg/kg/d (group B)
• Topical anaesthetic alone (group C)
• Topical anaesthetic + topical amoxicillin, 5 drops 3 x a day(group D)
• Herbal oil group (A) had less ear pain by day 2 & 3 than group C
• Substantial reduction in pain within 30 minutes of treatment in all 4 groups
• All patients symptoms resolved within 3 days
• Antibiotic treatment alongside herbal oil did not improve outcome compared to
herbal oil alone
(Sarrell, Cohen, & Kahan 2003)
So we can see that herbal ear oil on its own worked and it made no difference if antibiotics were used. Taking a concurrent herbal tonic can help to support immunity and reduce mucus and inflammation.
A couple of things to consider: if there have been 3 or more ear infections in 6 months then you need to consider environmental (smoke, dust, mould) and dietary allergens or irritants as well as immune function. When fluid remains trapped in the inner ear after an infection has resolved it can lead to reinfection and hearing loss which can impact social and language development and learning. Chronic ear infections can have long term implications including permanent hearing loss and need to be treated seriously. More rarely occurring a suppurative ear infection is when the ear drum has burst and pus filled fluid fills the middle ear and can lead to serious complications including facial paralysis, brain abscess and permanent hearing loss. Antibiotics may not protect against this and it needs to be managed with the help of an ENT specialist. If you are not happy with your doctors treatment of your child’s chronic ear infections then get a second opinion.
Remember we can work with your doctor in a supportive way, a Natural Therapists approach will address herbal treatment, nutritional management, dietary inadequacies and potential allergens.
So if you are worried that your child needs immune support and you want to get off the antibiotic roundabout this winter then come in and make an appointment today!
Naturopath & Director
PS stay tuned next week for our blog on coughs and lower respiratory tract infections!
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