How much pain is normal?
A child’s immune system learns to recognize viruses only when it encounters them, and there are hundreds of respiratory viruses. Therefore, in the first year or two in a team, children get sick especially often, and by school the number of episodes noticeably decreases. The guideline for a preschooler is up to 6-8 episodes of ARVI per year, for a schoolchild - 3-5. It is not the number of days with a runny nose that needs to be counted, but rather the episodes: a lingering cough after a viral infection can last for several weeks and does not mean a new illness.
- Up to a year - usually fewer episodes if the child is not in a group
- 1–5 years – up to 6–8 ARVI per year
- First year of kindergarten - possibly up to 10–12
- Schoolchildren - 3–5 episodes
- Residual cough and runny nose for up to 2–3 weeks is normal
Why does a child get sick more often than his peers?
Most often, it is not a breakdown of the immune system, but the number of contacts and the conditions under which the mucous membrane of the respiratory tract is less protected. Dry air, tobacco smoke and chronic inflammation in the nasopharynx reduce the functioning of the ciliated epithelium, and it is easier for the virus to gain a foothold. Separately, it is worth asking whether each episode was really a new infection: sometimes allergic rhinitis or untreated sinusitis is mistaken for frequent ARVI.
- Kindergarten, school, older brothers and sisters
- Passive smoking in the family
- Dry and hot indoor air
- Adenoids and chronic tonsillitis
- Iron deficiency, vitamin D deficiency, malnutrition
- Allergic rhinitis, which is confused with a cold
When to think about immunodeficiency
Primary immunodeficiencies are rare, and the main thing for them is not the number of colds, but their severity and unusualness. Infections that require intravenous antibiotics, recur in the same location, are caused by rare pathogens, or are accompanied by growth retardation are of concern. A secondary decrease in protection is possible with long-term use of hormones, severe chronic diseases and severe nutritional deficiency. In these cases, the pediatrician refers to an immunologist.
- Repeated pneumonia and purulent otitis
- Deep abscesses of the skin and soft tissues
- Poor weight and height gain
- Long-term thrush and persistent diarrhea
- Severe reactions to live vaccines
- Family history
What examinations are needed
The list of tests should be short and meaningful. They start with a general blood test with a leukocyte formula: it shows signs of inflammation, anemia and changes in the number of leukocytes. Next, they check iron stores and vitamin D levels, since their deficiency is common and has a real impact on well-being. An examination by an ENT doctor reveals adenoids and foci of chronic inflammation. Immunoglobulin levels are examined only when there are alarming signs. Extensive “immunograms” without indications are not needed - they are expensive and rarely change tactics.
- General clinical blood test with formula
- Ferritin and iron metabolism indicators
- Vitamin D (25-OH)
- Examination by an otorhinolaryngologist, assessment of adenoids
- Immunoglobulins A, G, M for alarming signs
- X-ray or other studies as indicated
What really helps
There are no proven “pills for immunity”: immunomodulators, dietary supplements and herbal preparations do not reduce the number of acute respiratory viral infections, but create a false sense of protection. Another thing that works is eliminating specific causes and vaccination. Annual flu vaccination, vaccination against pneumococcus and other infections according to the calendar reduce the risk of severe episodes. Habits are important: hand washing, ventilation, air humidity, stopping smoking in the house. And be sure to have good nutrition and adequate sleep, and not limit your walks.
- Vaccination according to the calendar and annually against influenza
- Complete cessation of smoking indoors
- Air ventilation and humidification
- Hand washing, separate towels and utensils
- Treatment of adenoids and correction of deficiencies as prescribed by a doctor
- Regular walks, sleep according to age, varied diet
- Do not take antibiotics for a common viral infection