Hey there, and welcome to the show! Today we’re talking about how to dodge the flu, colds, RSV, and all of those things that tend to fall on young children, especially as we head indoors more and are around people in close quarters during the fall and winter seasons.
I have an amazing guest today. His name is Dr. Joel Warsh, and he’s the author of a brand new parenting book called Parenting at Your Child’s Pace. He is an integrative and holistic pediatrician practicing in the Los Angeles area, and he’s going to help you understand what you can do as your child begins child care, or possibly enters pre-K this fall. He’ll also help you recognize when they’re getting sick, what symptoms to look for, when to go to the doctor, and how to help them, and maybe even prevent some of the illnesses that come around. I think you’re really going to glean a lot from this episode. So let’s get started!
In the first three years, children grow and learn faster than at any other time in their lives. It’s an amazing transformation. And guess what? Parents do too. I’m Ann McKittrick, the mom of three kids who has helped hundreds of parents in my 30-plus years in early childhood education. The key to success is understanding not only your child’s development but your own growth as a parent too. Finding strategies so you can all flourish together. Welcome to Parenting in the First Three Years.
Hey, Dr. Warsh, thank you so much for joining me on the podcast. It’s nice to have you.
Thanks for having me on. I’m excited to chat.
Why don’t you start out by telling us a little about your family and your own children, and then we’ll get into your work, your book, and all of those things.
Sure. I’m in Los Angeles, and I have two awesome kids. One is almost five, and the other is almost five months old. So, I’m a dad of two and a pediatrician. I focus on integrative medicine. I completed all the regular medical training, but I try to balance the best of both worlds and incorporate natural remedies whenever it makes sense. That’s what I’ve been doing lately.
Yeah, that’s great. So tell us quickly, why do people call you Dr. Gator?
Dr. Gator, well, my wife’s last name is Intelligator, and people thought it was funny and started calling me Dr. Gator. Everyone thinks it’s a Florida thing, but it’s not. I grew up in Toronto. Nothing against Florida, but it’s a wife thing.
That’s so funny. Intelligator is a very interesting name, but I love that it caught on for you. So, we’re talking today, and at the time of this recording, it’s mid-August. In our community, everyone started school this week, actually yesterday. Kids are coming together, and typically we see a lot of bugs that pop up during the fall and winter seasons. So, we’re going to talk about what we can do to dodge the flu this season and your recommendations for parents of really young children. Does that sound good?
Great.
So, as we start, what can parents do now to try to avoid the flu in a month or two when it really begins to pick up?
You know, that’s a great point. As we get into the school year, fall, and winter, it’s called the cold and flu season for a reason. For whatever reason, viruses, coughs, colds, and runny noses start to ramp up, probably because kids are around each other more, and we’re inside more. These things are contagious, and when you’re around other kids who have it, you pass it on. A lot of times, you don’t even know you’re sick, so you pass it on to other kids, or maybe you go back around other kids too soon and are still contagious. There’s no magic or miracle to never getting sick.
I think we should have realistic expectations. My goal as a pediatrician and as parents is not to prevent our kids from ever getting sick, because that’s not realistic. If you’re sending them to school, they’re going to catch things now and again. On average, kids get about three to five viral illnesses a year. So, I think having those expectations is reasonable.
But at the same time, I think our job is to set our kids up for success, help them be as resilient as possible, minimize their exposures, and minimize their risk. Also, help them have a resilient body so if they do get exposed to anything, either they don’t catch it or have minimal symptoms. Of course, we want to avoid serious symptoms like going to the hospital or getting really sick, like bad pneumonia.
To me, that’s where I start with parents: discussing this. It doesn’t matter how health-conscious you are, you can be in the middle of the mountains, living by yourself, having your own organic farm, and you’re still going to catch colds now and again. And I think that’s a good thing too. You want to catch things. You want to get viruses so your body builds immunity and your immune system works. But you just don’t want to get very sick, right? That’s what our goal is. We don’t want to be sick all the time, but having a cold every now and again is good for your body as long as you can fight it off because it helps build your immune system, and you grow stronger as you get older.
So, to me, the big things we can do now are, as we talked about, building that resilience, building that foundation for health, and putting their bodies in the best place so that their immune system is functioning optimally. The foundations of health, I call them the seeds of health, are stress, environment and toxins, exercise, diet, and sleep. If we focus on those basics, that’s going to get us a long way. Most people are not focusing on those things these days. We’re kind of doing the opposite: older kids are not sleeping, they’re on their phones all day, and they’re stressed out.
There’s a ton of research from 50 years ago where they were looking into what your risks are for a virus, and they were putting viruses in people’s noses. I don’t know who was volunteering for these studies, but they were doing it. We know you have a much higher risk of getting sick with a virus stuck in your nose if you’re stressed or haven’t slept. Most people intuitively know that because you can go back in your own life and see that right after a stressful period, you got sick. That’s pretty common, I think.
Right, yeah. So, with a little kid—we’re talking zero to three years old here—that would look like really focusing on diet and sleep, would you say? And stress, I guess?
I mean, stress too. I think a lot of it for younger kids is our own stress, not putting stress on our kids. Certainly, some stress, but for sure making sure they sleep and are moving as they get older. Maybe not for a baby, but certainly for a toddler, moving around during the day is important instead of being in front of a screen. Diet and toxins are big ones. We need to focus back on what we’re feeding our kids and what they’re being exposed to. If their body is dealing with a lot of toxins, it’s logical to think they won’t deal with a virus as well because their body has to handle multiple things. The more their body can be available to fight off infection, the less likely they are to get very sick.
Okay. So just real quick, how would you define a toxin for a two-year-old? What would that be?
I think any chemical not meant to be in the body that causes harm, especially as the dosage gets higher. Heavy metals, chemicals created by companies that are newer and weren’t meant to be ingested or touched. To me, that’s what I’m thinking about when it comes to chemicals. There are all kinds of chemicals out there, and we can’t deal with everything, but we can manage what we can. There’s a lot we can do. We can’t change the air out there, right? I guess you can go fight in Congress, but that’s not what most people do. You can think about your own home, have more plants, get an air filter, and although you can’t change the water in your city, you can get a water filter. These are little things to decrease the chemicals your children are exposed to. Every little bit matters. If you minimize sugar, remove dyes and preservatives, cook more, it adds up. It doesn’t mean one piece of cake will be the difference between getting sick or not, but if you eat unhealthily for a week and then go to school, the body is already inflamed and dealing with unhealthy food, and then when exposed to a virus, the body can’t handle it well. I think that’s what happens to many kids. Their bodies are so stressed out by inflammation that they can’t fight off viruses easily.
Yeah, yeah. As we talk about dodging the flu, I’m wondering, for a parent whose child gets a runny nose, how do they know when to rely on a natural approach versus going to the doctor and getting medicine? How does a person know what to do?
That’s a great question, and I definitely try to cover that in the book because it’s a big question on parents’ minds. If you’re ever really worried, you can always go to the doctor. It’s never wrong to get checked if you’re worried. But, especially as your children get older and you understand what to worry about versus not, minor symptoms like a cough or cold don’t usually require a trip to the doctor. You can usually manage that at home, and that’s a good time for natural remedies.
There are viruses and bacteria; bacterial infections need antibiotics, but viruses don’t. The vast majority of the time, when your child is sick, it’s a virus. So, it’s almost always a virus when kids get sick. If it gets worse, persists, or goes outside normal symptoms, get checked. Severe symptoms like trouble breathing, fevers lasting many days or above 105, extreme pain, lethargy, or dehydration are reasons to get checked. But if it’s just a runny nose, a little cough, or minor sickness, rest, drink fluids, and take it easy. That’s what you need to do to help them get better. You can go to the doctor if you want, but they won’t usually do anything in the first few days. That’s a great time for natural remedies.
There’s good evidence for many natural remedies for minor coughs, colds, and viruses, like vitamin D, vitamin C, elderberry, zinc, and honey for kids older than one. These aren’t magic, but they can help shorten the illness a bit, support the immune system, and have minimal risks. Then, if it gets worse, go to the doctor and consider medicine.
Right, yeah. Is there a natural remedy that helps with fever?
For fever, the most common things are warm baths or magnesium Epsom salt soaks. Some people use homeopathics if they like them. But generally, unless the fever is really high, you want to leave it alone. A fever is a good thing; it’s your body fighting off an infection. Unless the child is miserable, you want to let the fever run its course. It helps mobilize the immune system. We’re very afraid of fevers, but fever is good as long as it’s not a newborn. Once a child is older, you can leave it alone and let it do its thing. If it gets really high or lasts many days, then yes, get it checked. But otherwise, fever is expected with a virus and helps fight it off.
You know, in my career as an early childhood educator, I started in the infant room. I remember that first year I caught every bug that walked in the door. After that, and this was many years ago, I built up great immunity, and now, knock on wood, I hardly ever get sick. I can’t even remember the last time I had a cold. I know there’s a lot of truth to this whole building up your immunity. Is that just kind of a given when a child begins child care? Because I saw it with children too. When they first started, they would catch everything, but after a while, they wouldn’t. What do you say about that?
Honestly, the answer is yes. If you send your child to daycare or preschool, they’re going to get sick a lot. That’s part of the deal because there are a bunch of kids, and they always have something, touching toys, slobbering, and sharing. They’re going to get sick a bunch. The issue with daycare is that kids are probably getting sick too much. Because both parents are working, they need daycare for someone to watch their child. It’s hard to take a week or two off after a cold to let the child get 100% better before sending them back. But that’s not what happens. Rules say 24 hours without a fever, or they’re getting better, so they go back. Parents need daycare, and that’s an issue with our system.
You can’t stop them from getting sick. Focus on what you can: help their body be resilient so when they catch a cold, they don’t get very sick. It’s a reality, and no two-year-old will cover their mouth when they cough. You can tell them to cough into their elbow, but… yeah.
Okay, so another question I have about dodging the flu this season is how can parents differentiate between a cold, the flu, and RSV? What are the signs?
First, from a pediatric perspective, it doesn’t matter that much unless symptoms are more severe, which one they have. If you’re around someone very vulnerable, it might matter. If you have a young baby or someone with an immune condition, the flu or RSV could have more severe consequences, so it’s good to know. Other than that, the flu or RSV is usually a minor viral illness—cough, cold, runny nose. You won’t necessarily know the difference unless you test for it. In general, the rule is don’t test unless it’s going to change what you’ll do. There are no medications for most of these, so it doesn’t make a difference unless symptoms are severe.
But, some symptoms can differentiate. RSV tends to cause more coughing and trouble breathing. If a young child gets very sick and goes to the hospital for breathing trouble, RSV is common. Not common to end up in the hospital, but it can happen. Flu often has higher fevers, sore throats, and stomach symptoms like vomiting or aches. Cold and runny nose can have minor coughs and maybe a lower-grade fever. But there are many viruses, so sometimes it’s hard to tell.
Yeah, I remember my kids used to get strep a lot, and I got to where I could smell it. I knew if it was strep or just a sore throat, I would just say, “Come here, let me smell you,” and I would know if we needed to go to the doctor for medicine.
Yeah, because sometimes you can see pus in the back of the throat, and a really attuned mom just knows.
Yeah, and that comes with time, observing your children, watching patterns, and knowing what to do. That’s good. Are there any trends or predictions from doctors about this year?
I haven’t seen a ton of predictions this year. It feels like we’re up in the air about how it’s going to go. After COVID, we thought we’d see higher cases because kids hadn’t been exposed in a while. Now, a few years later, I’d guess we’re back to normal numbers, so not higher but within reason. I haven’t heard any big concerns about flu or RSV this year. Even coronavirus, people are concerned because of the past few years, but it’s important to remember that coronavirus isn’t new. That version was new, but coronaviruses are usually responsible for 40% of colds in kids. Testing positive for coronavirus doesn’t mean much. Usually, it’s a minor cold. So we’ll see how it goes. If I had to guess, it’s going to be a fairly normal winter. Everything will go higher than now, but within reason.
One more question before we wrap up. I hear people talking about not going outside because they don’t want their kids to get sick. What do you say about that?
I think that’s a very bad idea. The opposite should be true. Sunlight, vitamin D, is very helpful for the immune system. We need to be moving, get outside, and be in nature. Over-sanitizing leads to higher levels of chronic disease in kids. We shouldn’t keep kids away from all viruses because then when exposed to something, the immune system isn’t ready to handle it. We need to expose our kids to reality. That means being around people. Be cautious, but let kids be kids, let them go outside, and let them play. They’ll get sick at some point, so don’t deprive them. And, you’re less likely to get sick outside. If your kids play outside, the risk is lower. There’s more air, and the sunlight kills many viruses. In general, kids get sick more in winter because viruses spread more indoors. So, be more cautious inside, but don’t be too cautious outside.
So as we approach the colder months, it’s still good to go outside even when it’s cold, right?
Always, as much as you can. Sunlight is useful, even in cold locations. I grew up in Toronto, so I know it gets cold. But any sunlight you can get is good for you. In colder places, it’s harder to get sunlight, but every little bit helps.
Great, thank you so much. This is really helpful for parents who dread flu season. What’s one word of encouragement you have for parents of young children, zero to three years old?
One of the big things I talk about in the book, Parenting at Your Child’s Pace, is that you got this, we got this, we can do it. We don’t trust our parenting instincts enough these days. Parents have been doing this for a long time, and we have more information and technology now, so it can seem scary, but we can do this. If you trust your gut, you figure it out as you go. So, I want to give parents back that feeling that they can do this because we really can.
Yeah, kind of empowered to do what you already know how to do. I love your book, Parenting at Your Child’s Pace, and I’m going to start giving it to everyone I know who’s pregnant because it’s got such great information and down-to-earth advice. I’ll put a link for your book in the podcast notes. Is there anything else you want to say about the book?
No, I’m so thankful for everyone who’s gotten the book. It was a number one new release in parenting, child health, baby and toddler health, pediatrics, and parenting. It’s exciting to see that people are interested, and I hope it’s helpful for anyone who is pregnant or has young children so they can set their kids up for success.
Great, thank you so much, and congratulations. Thanks for being here.
Thank you for having me on.
Okay, bye-bye.