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Respiratory Infections: treat at home, urgent care, or ER?

  • Writer: Alex Kelly
    Alex Kelly
  • 3 days ago
  • 9 min read

Updated: 23 hours ago

I have teamed up with Natalie Wescott, an ER RN, to discuss the top 3 reasons she sees kids in the Emergency Room. We’ll also discuss how to support and treat these issues at home, and when to seek a higher level of care. Natalie brings a very unique perspective, as she is holistic minded but works in the field of modern medicine. This is great, because there is a time and a place for both!


The top 3 reasons Natalie has seen kids in the ER:

  • Respiratory Illnesses

  • Fevers

  • Lacerations



Respiratory Illnesses

A respiratory illness is any condition that affects your child’s ability to breathe comfortably. It can be as simple as a runny nose or as serious as pneumonia.


These illnesses affect the airways, lungs, or both—and they’re incredibly common in childhood. An upper respiratory illness would include symptoms such as sneezing, congestion, sore throat, ear pain, and runny nose. A lower respiratory illness would include coughing, wheezing, and difficulty breathing.


These symptoms are common in respiratory illnesses, but it’s important to know when a child is in respiratory distress.


Respiratory distress is when your child is working too hard to breathe, and their body is not able to oxygenate effectively—this is when things can escalate quickly. A child struggling to breathe can go from stable to critical very quickly. Their smaller airways, higher oxygen needs, and limited reserves mean once they begin to tire, things can unravel fast.


Some common causes of respiratory distress include:

  • Bronchiolitis (lung infection usually caused by virus like RSV, flu, COVID, rhinovirus)

  • Asthma (can be triggered by allergens, cold air, exercise, illness)

  • Croup (swelling of the upper airway, usually caused by viruses)

  • Pneumonia (bacterial lung infection)

    Getting these diagnoses does not mean you have to panic! You just need to on higher alert to watch for signs of distress!



Example of Retractions


Watch your child’s breathing when they are healthy, so you can recognize when it looks abnormal.


How to Treat Respiratory Illnesses at Home


Cough and Congestion:

Our body produces more mucus when sick to help trap pathogens, while coughing and sneezing helps to expel them.


When you take a decongestant, you are drying up the mucus that is designed to trap and expel pathogens. Instead, focus on thinning the mucus so it can easily be expelled. 


Nebulize Saline

You can DIY saline by dissolving ½tsp sea salt in 8oz of purified water.


Set Up Humidifiers

Maintaining humidity in the range of 40-60% can also reduce transmission of pathogens.


STAY HYDRATED, take steam showers, use saline drops or mist in the nose, and REST. These go for fevers as well!


Homeopathy & Tinctures for Congestion


Briar Rose for Respiratory Health

  • Briar Rose is a natural form of medicine called gemmotherapy, and is made from plant buds. It supports a healthy sinus passage, eyes, and throat, therefore useful against: runny nose and congestion, ear aches and infections, sore throat, sinus infections, headaches caused by allergies

    • It can be used as a preventative 2-3x a week, or 2-3x a day when battling active sickness

    • Infants: 5-8 drops; 3-8yrs: 15-20 drops; older kids/adults: 25-50 drops


Chest Rubs

Manual Percussion

If your child has chest congestion, you can try manual percussion. This is done by cupping your hand and clapping the child's back to help loosen mucous and move it to the larger airways to allow it to be more easily coughed up.


Non-Medicated Cough Syrups


Medicated Cough Syrups

It is best to avoid cough suppressants for the same reasons to avoid decongestants. Coughing is how the body removes pathogens, so taking a suppressant can prolong the illness. However, if one becomes necessary due to lack of sleep or unable to eat/drink, Genexa is a good brand.


Cough suppressants are typically not recommended for babies. The FDA advises against OTC cough and cold medicines in infants under 2, while others recommend it against children under 4.


Homeopathic & Tincture Treatments


Herbal Cough Support

Common Thyme: Research has shown that thyme helps with lung spasms. In this case best taken in the form of a tea or tincture

  • Thyme whole leaf

  • Thyme tea 1

  • Thyme tea 2

  • Thyme tincture: Herb Pharm

  • Wild Cherry Bark: Wild cherry bark helps open up the lower respiratory system, and move mucus up while drying it out. It has calming and :nervine properties, which can help ease coughing spells, especially at night. It is also cooling to sore and inflamed tissues in the sinuses and throat. You can take this as a tea, tincture, or make your own cherry bark syrup. 

  • Mullein: Mullein leaf tea or syrup can help relieve inflammation and coughing spells by helping move stuck congestion. This is a great herb for lung issues, specifically.

  • Onion Method for Coughs: 

    • Slicing up an onion and placing it next to your bed while sleeping can be a powerful decongestant by opening up nasal passages and making it easier to breathe.

    • Slice up an onion, place in a plastic bag, put feet in plastic bag, and cover with a sock overnight. The feet are reflex’s for the chest, head, and abdomen, so this is especially helpful for coughing, congestion, and head colds.


Croupy Cough

Spongia Tosta is a remedy for dry mucous membranes of the mouth, nose, throat, and larynx, dry coughs, swollen or inflamed glands, and certain types of respiratory and cardiac problems. This dissolvable supplement can help relieve the dry, barking cough that comes with Croup. 


COLD AIR

Cold air can help relieve croup-related breathing issues almost immediately. If the weather is cold enough outside you can take your child outside for some fresh, cold air for about 10-20 minutes. Another option is sticking your child’s head in the freezer, and letting them breathe in the cold air for 1-2 minutes. 


STEAM SHOWERS

Breathing in moist air is another way to relieve symptoms almost immediately. Head into the bathroom, shut the door, and turn on the shower as hot as it can go. Once the room is nice and moist, bring your child in to breathe in the moist air for 10 minutes. You can also use a humidifier in your child’s room while they sleep. 


Hydration

Hydration is so important when sick, especially if experiencing fever, vomiting, or diarrhea. Add in electrolytes as needed. If having extended vomiting or diarrhea without adequate re-hydration, call your pediatrician. You want to avoid severe dehydration.


Rest

Your body heals when it sleeps, so if you follow a strict sleep schedule don’t hesitate to throw it out. Let your kiddo nap longer than usual, go to bed earlier if needed, sleep in, etc. Resting allows the body to focus all its energy on healing, cleansing toxins, and immune support. If a fever or cough is keeping your child up at night, that would be a time where you could consider medication if you feel that their body needs to rest and reset.


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How can we support optimal immune function?

  1. Eat whole, real foods 

  2. Prioritize vitamin C, vitamin D, zinc, and magnesium 

  3. Get plenty of restorative sleep

  4. Drink lots of water 

  5. Daily sunshine exposure

  6. Manage stress

  7. Limit toxins 


There are many minerals and vitamins necessary for immunity support. Some of the top are:

  • Vitamin C

  • Vitamin D

  • Zinc

  • Magnesium


This is not medical advice. The following doses are based on the general NIH and CDC daily recommendations. Many children will meet these recommendations through diet. It is always best to consult with your trusted provider on what may or may not be a beneficial supplement for your child.


Vitamin C

Vitamin C helps the body produce immune cells, specifically T cells. It also encourages healthy cells to stay alive and active. Vitamin C is also essential for the growth and repair of tissue throughout the body. It helps heal wounds and fight free radicals in the body to prevent cancers and heart disease. There is evidence showing that Vitamin C may help decrease the length and severity of cold symptoms, making it a great supplement for the winter months.


NIH recommendations:

  • 0-6mo: 40mg daily

  • 7-12mo: 50mg daily

  • 1-3yr: 15mg daily

  • 4-8yr: 25mg daily

  • 9-13yr: 45mg daily

  • 14-18yr male: 75mg

  • 14-18yr female: 65 mg

*infants typically need higher vitamin C because their bodies are still developing and they have a higher need for growth support, immune function, and collagen production


Vitamin D

Vitamin D is vital for the immune system because it helps regulate both the innate and adaptive immune systems. It helps build immunity and fight infection by regulating immune cells, which are what prompt antiviral responses. Vitamin D deficiencies have been linked to increased autoimmune diseases along with susceptibility to infection. It is estimated that up to 90% of the US population has insufficient vitamin D levels. 

Dosing recommendations vary from doctor to doctor and institution to institution. Some believe the lower end doses are fine, while others believe in higher doses. This is why I always recommend finding a provider you know and trust, to help navigate what is best for your unique situation.

  • CDC minimum vitamin D dosage:  Newborn-12 mo: 400 IU daily, 1yr-adult: 600 IU daily

  • CHOP maximum vitamin D dosage:  Newborn-12 mo: 1500 IU daily, 1-8yr: 3,000 IU daily, 9yr and older: 4,000 IU daily


Zinc

Zinc is an essential mineral that plays an important role in the immune system, cell growth, wound healing, managing blood sugar levels, metabolism, and the sense of taste and smell. If taking via supplement, it is recommended to take with food as it can upset the stomach.


CDC Dosage Recommendations

0-6mo - 2mg

7-12mo - 3mg

1-3yr - 3mg

4-8yr - 5mg

14-18yr - 11mg male, 9mg female

19+yr - 11mg male, 8mg female


Magnesium

Magnesium is an essential mineral that plays a key role in hundreds of bodily functions, yet it’s estimated that up to 60% of the population is deficient. A few of its most important functions include:

  • Muscle relaxation

  • Stress management

  • Nerve function, 

  • Blood sugar regulation 

  • Energy production

  • Activates Vitamin D and supports bone health

If going to take as a single form, choose magnesium glycinate. Many magnesium supplements include a blend in order to receive the benefits of each. Read more about the different forms of magnesium, and specific recommendations here.


Other Immunity Support Options

Probiotics

Probiotics are live microorganisms (live bacteria) that support your gut and immune system. Our bodies are FULL of bacteria both good and bad. Probiotics help to balance the microbiome with “good” bacteria. By increasing good bacteria, our body can more effectively fight against harmful bacteria, restore gut balance, and reduce inflammation.

The best way to increase probiotic intake is through foods. Fermented foods that are high in probiotics include yogurt, kefir, sauerkraut, kimchi, kombucha, miso, and fermented vegetables. 

If choosing to supplement, probiotic dosing is a little different than normal vitamins. If an age range isn’t specified, a good rule of thumb is to use 1/4 the recommended adult dosage for children up to 6 years; half for children 6-12 years, and the full dose for 13 years and up. 


Thieves

Thieves is an oil blend typically consisting of clove, lemon, cinnamon, eucalyptus, and rosemary. It’s an oil inspired by the legend of four 15th century French thieves who would steal from the dead. They formulated the blend to protect against sickness when they stole from plague victims.


Rub on bottoms of feet during cold/flu season or if feeling sick (dilute with coconut oil if using on children) I like YL thieves, and Plant Therapy germ fighter


John Hopkins Medical does not recommend the use of essential oils under 3 months.

Their dilution guidelines are:

  • 3mo-24mo: 0.25% to 0.5%

  • 2-6yr: 1% to 2%

  • 6-15yr: 1.5% to 3%

  • Over 15yr: 2.5% to 5%


Elderberry

Elderberries are believed to boost the immune system due to their high levels of antioxidants and anti-inflammatory properties. They contain polyphenols which can help prevent cell damage. They also contain Vitamin C which can help prevent illness and support the immune system. Many people are comfortable giving their babies elderly syrup as long as it doesn’t contain honey. But there isn’t enough research to deem it officially safe for children under 5. Many integrative pediatricians recommend waiting until at least 10 months. 


Garlic Honey or Mullein

Garlic contains antibacterial properties and contains allicin which helps stimulate the immune system. Honey is filled with antioxidants like flavonoids and polyphenols, which help fight against inflammation. Honey is also antibacterial, antiviral, and antifungal. *Honey is not recommended for children under 12 months. 


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