A Pediatrician on Why Some Kids Are Always Sick

Hi, friends! So, who at your house is sniffling and coughing again? Cold season is here, and some kids just seem to get hit harder than others. Today we're talking about that, and a lot more, with Aaron Pfister, a pediatrician in Germany who is also on Instagram as @deinkinderdoc.

Dear Aaron, it's fall and lots of kids are sick again. What's going around right now?

Fall is typically the season for respiratory infections: colds, RSV, parainfluenza, rhinoviruses, and every now and then the first flu cases. Stomach bugs like norovirus and rotavirus are also making the rounds in daycares right now.

This is my youngest's first daycare winter. Last year, though, he was with an in-home daycare provider. Can I hope he already got some immune system training?

Definitely a little! Kids who have been in a smaller group usually have already met a few viruses. But that doesn't mean the winter will be totally quiet. Daycare is simply a new “virus world.”

Some kids feel like they're constantly sick and others almost never are. Why such a big difference?

There are several reasons. Some kids have already built up lots of defenses through siblings or earlier child care. Others just have bad luck with who they're around, or pick up new viruses faster. The immune system needs a few years of training, and the first two or three years in daycare are often especially “athletic” for it. And 12 infections a year is completely normal!

What are your top 3 tips for protecting against infection?

1. A balanced diet with lots of fruits and vegetables. 2. Airing out rooms and getting lots of fresh air. 3. Enough sleep and time moving around outdoors. That's what strengthens the immune system best.

As a pediatrician, do you recommend supplements for fall and winter?

Vitamin D actually makes sense. We recommend it for all kids (and adults) during the dark months. Anything else only after talking with your doctor, and only if there's a real deficiency. Colorful pills or “immune shots” are unnecessary.

With my teenager, I end up arguing about heavy jackets and hats. How much protection does the right clothing actually give us on cold days?

Cold doesn't make you sick directly, but it makes infections more likely: cold mucous membranes get less blood flow, which makes it easier for viruses. So a hat isn't a magic bullet, but it's useful, especially when it's wet and windy.

And when it does get us: which home remedies do you like to recommend so everyone gets back on their feet quickly?

Lots of fluids (water or tea is best), fresh air, saline nasal spray, and loving care. And sooooo much patience.

One last question: when can a sniffly kid go back to daycare, and when not?

If your child is fever-free, feels good, and is playing actively, they can usually go back. With fever, a bad cough, vomiting, or diarrhea, stay home. The rule of thumb: if you'd hand your child, just as they are right now, to another parent for a playdate without feeling guilty, then they're fit for daycare.

By the way, you'll find lots of tips and answers to common parenting questions in my “Kind krank” (“Sick Kid”) course. It covers everything parents should know when your child suddenly has a fever, a cough, or just isn't feeling well.