To get an excused absence due to illness, please:

1. Contact your school’s attendance office to communicate your child’s absence. 
2. Submit a parent note in writing within five school days of your child’s return to campus. The excuse note should include the following:

• Student Name
• Student ID Number
• A written statement giving the dates and reason for absence
• Parent/guardian signature
• Parent phone number

3. If your child is absent for multiple days, contact your school for the attendance petition process.

From Cook Children’s Medical Center: Symptoms to be aware of and action to take

Like many hospitals and children’s hospitals around the country, Cook Children's is experiencing a surge in patients diagnosed with RSV, flu and other respiratory illnesses. The increase impacts our ability to care for patients in a timely manner.

RSV is a common respiratory virus. Some children require hospitalization, but most do not.

It is NOT necessary for your child to take a strep throat, flu or RSV test before returning to school.

RSV and Other Illness Guidelines for Parents

Parents should NOT go to the Urgent Care or Emergency Department for only a flu or COVID test. See your pediatrician, who can test for flu, RSV, strep throat and COVID. Adults can also use at-home tests or tests at a pharmacy.

Call your pediatrician if:

• If your child is experiencing mild respiratory symptoms but is not having difficulty breathing and is well-hydrated.
• If you need to have your child tested for RSV, the flu or COVID-19.

Seek immediate medical care if:

• Persistent fever for more than two or three days. However, any temperature greater than 100.4 in an infant under two months of age is considered a medical emergency.
• You have concerns that your child is dehydrated.
• In dehydrated babies, parents will see fewer wet diapers or a lack of tears. Their flat spot on the head can also appear more sunken.
• Breathing faster than usual or can see the skin between the ribs being sucked in.
• If your child requires frequent use of their albuterol rescue inhaler or is having worsening asthma symptoms.

Prevention:

• Get the flu vaccine and stay up to date on the vaccine schedule from the Centers for Disease Control and Prevention.
• Get the COVID vaccine and approved boosters.
• Teach your children to cough or sneeze into their elbow.
• Use hand sanitizer.
• If sick, wear a mask in public and stay home.

If your child attends a different district, please call your campus to find out what your absentee policy is.

RELATED

• RSV Decreases While Flu Continues to Increase at Cook Children's (checkupnewsroom.com)
• Prepare Now for Flu Season with Vaccine Protection
• Get Immunized for a Healthy School Year (checkupnewsroom.com)
• Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)

This is resulting in longer wait times. Our emergency department is seeing between 400-500 children each day. Our Urgent Cares are seeing 600-700+ children each day.

A high number of our hospital admissions are RSV cases. RSV can range from mild upper respiratory tract infections to severe lower respiratory tract disease, including bronchiolitis or pneumonia. The increase in RSV and influenza A is happening much earlier this year.

From Oct. 2 to Oct. 8, there were 210 positive RSV cases at Cook Children’s, a positivity rate of 24%.

One week later (from Oct. 9 to Oct. 15), there were 288 positive RSV cases, a positivity rate of 29%. During the same time period, there were 47 positive influenza A cases, a 4.7% rate.

RSV cases normally spike much later in the respiratory season, such as in December or January.

RSV is a very common respiratory virus. Some children require hospitalization, but most do not.

Parents should not go to the Urgent Care or Emergency Department for only a flu or a COVID test. See your pediatrician, who can test for flu, RSV, strep throat and COVID. Adults can also use at-home tests or tests at a pharmacy.

Laura Romano, D.O., a hospitalist at Cook Children’s, urges parents to keep their children at home when they are sick to prevent the spread of illness, especially to vulnerable populations. Flu, COVID and rhinovirus are also circulating in our community.

Last year, more people were wearing face masks and children were more likely to stay home while sick. This year, parents are sending their children to daycare and school for the first time following two years of the pandemic, Dr. Romano said. Children who haven’t been previously exposed to respiratory viruses are getting sick.

There are limited treatments for RSV; most are available for premature infants, infants with other lung diseases, infants who are considered immunocompromised, or patients with a congenital heart disease.

What are the symptoms of RSV?

In infants younger than six months, RSV infection may result in symptoms of irritability, poor feeding, lethargy, and/or episodes where they stop breathing with or without fever.

In older infants and young children, a runny nose and decreased appetite may appear one to three days before cough, often followed by sneezing, fever, and sometimes wheezing. RSV, COVID, and the flu can all worsen a child’s asthma and lead to an increase in asthma symptoms such as wheezing, waking up at night coughing, and shortness of breath.

Symptoms in adults are typically consistent with upper respiratory tract infections, including runny nose, sore throat, cough, headache, fatigue, and fever. RSV can be a very serious illness for anyone who is immunocompromised. But for most children, it is a minor upper respiratory infection.

If parents begin to see any RSV symptoms in their child, it is important to keep them well hydrated.

Call your pediatrician if:

• You are concerned that your child might have been exposed to either the flu, RSV, or COVID.
• If your child is experiencing mild respiratory symptoms but is not having difficulty breathing and is well-hydrated.
• If you need to have your child tested for RSV, the flu, or COVID.

Seek immediate medical care if:

• Persistent fever for more than two or three days. However, any temperature greater than 100.4 in an infant under two months of age is considered a medical emergency.
•  Concerns for dehydration.
•  In dehydrated babies, parents will see fewer wet diapers or a lack of tears. Their flat spot can also appear more sunken.
• Breathing faster than usual or can see the skin between the ribs being sucked in.
• If your child is requiring frequent use of their albuterol rescue inhaler or is having worsening asthma symptoms.

Prevention

•  Get the flu vaccine and stay up to date on the vaccine schedule from the Centers for Disease Control and Prevention.
• Get the COVID vaccine.
• Teach your children to cough or sneeze into their elbow.
• Use hand sanitizer.
•  If you’re sick, wear a mask in public and stay home.

Flu cases continue to increase at Cook Children's Health Care System. From March 13 to March 19, there were 275 positive cases of influenza A and zero cases of influenza B.

Positive flu cases have steadily increased every week since mid-January.

For the week of March 6 through March 12, lab data showed that there were 242 positive and 511 negative cases of influenza A. There were zero positive cases of influenza B.

By this time of year, typically cases decline.

“But what we have seen over the last week or two is cases are actually on the rise,” said Pediatrician Alice Phillips, M.D. of Cook Children's Pediatrics Cityview.

There has been more activity during the 2021-2022 flu season compared to 2020-2021. Typically, the flu season starts in November and the spike can be in December or January, Dr. Phillips said.

Why is there a current increase in cases? One potential contributing factor comes from people wearing their masks less frequently and returning to pre-pandemic activities. On Feb. 25, the Centers for Disease Control and Prevention issued new masking guidance for areas of low transmission of COVID-19.  These guidelines can be read here.

With students out of school for spring break, it could potentially stop the spike of cases, but pediatricians will have to wait and see the data when kids return to the classroom, Dr. Phillips said.

What are the symptoms? What should I do?

It’s a good idea to get your child tested if you believe they have the flu, Dr. Phillips said. The symptoms are similar to COVID-19 because both have symptoms of fever, cough and a sore throat. Both illnesses could potentially pose a risk to someone who is immunocompromised.

If you have the flu, you should isolate. You can stop isolating once you’re fever-free for 24 hours without fever-reducing medicine.

Common flu symptoms are:

• Fever or feeling feverish/chills
• Cough
• Sore throat
• Muscle or body aches
• Headaches
• Fatigue (tiredness)
• Vomiting and diarrhea are more common in children than adults

When should we go to the doctor?

“I think anytime a parent has a concern about their child, they should call their provider because if you're worried, your instincts as a parent are very strong,” Dr. Phillips said.

She said also it could be good to bring them to the doctor if:

• They’ve had a high fever that you can’t control
• Showing signs of dehydration, such as dry mouth, no tears in their eyes
• If your kid looks sick and you want them checked

Typically, a child can recover at home. You can call and get guidance over the phone if they’re keeping fluids down, and they’re resting and can control the fever.

Remember, it is not too late to get your flu shot. This serves as your best defense against the flu when combined with good handwashing.

Wheeeeeeeeee---oooohhhhhh.

I don't know how else to start this respectful and loving post for our immune system other than with a joyful and exhausted noise.

Your kids are so sick (so often) right now that I lately find myself reassuring parents all day about what's normal and what isn't when it comes to how much sickness is "too much sickness".

I have the biggest crush on our immune system. It is absolutely amazing to behold the genius of its design, when you really think about it.

It is truly a "system". A whole team of different types of cells and organs that are pretty stellar at spotting different kinds of enemies and neutralizing them quickly. The immune system is armed and ready in your skin, your mouth, your gut, your bones, your blood - pretty much all your organs.

(My fave is the B lymphocyte. That little guy makes antibodies - our memories of infections or vaccines in the past that help us to quickly remember and kick microbial butt in the future.)

1) You are teeming - I mean TEEMING with microorganisms. Every centimeter of your body (some crevices more than others) and insides is absolutely SATURATED with fungus, bacteria, and viruses. Your skin, your mouth, your guts, your groin, your nostrils. Your immune system is working constantly to keep trillions of bad boys in check, all at the same time. I read somewhere that the average adult has 2-6 POUNDS of bacteria living in and on them.

2) Your kid's pacifier? Covered in a few trillion microbes. Let that sink in. So when you ask me if those three vaccines are "too many shots at once"? I'm gonna stare at your kid's pacifier and give you a little lecture about how beautifully our immune systems can handle a few trillion antigens at once (and those 7 antigens in the shots ain't no biggie).

3) If newborns had mature immune systems, they would basically attack their mother's cells as being foreign. For this and other reasons, they're born with a muted immune system that rapidly starts to develop over the first few weeks of life. This is why we have to be so careful with them. Mama actually gives baby certain forms of passive immunity for awhile to cover the gaps while baby's immune system starts to develop. This is also why we have to wait a few months for the first batch of vaccines - the antigens just may not be remembered very well if we give them too early.

4) Children in daycare (yes, even one or two days a week, or that in-home daycare with two other kids, or that church daycare they're only in for 2 hours on Sundays) get sick pretty often.

This is especially true if the kiddos that have gotten good at crawling, walking, and picking things up - they grab their friends' toys and chew on them often. They don't cover coughs or sneezes.

It's called "the daycare drip" for a reason.

It is not uncommon for children in childcare to have a runny nose pretty much constantly for months and months. When I first became a community pediatrician, I was sick for 8 months straight.

I call it "ocean waves" of weekly drippy nose and varying degrees of coughing. And they're often picking up more than one virus at a time. Each virus lasts 7-10 days. And they often overlap.

5) MANY of the symptoms of sickness can be caused by the immune system, and not the germ!

- Fever? Thank your immune system for this helper! Read my love letter to fever here (and tips on when to worry). 

- Runny nose? The body makes sticky mucus to keep the germ more controllable and in the nose, so it can't go down to the lungs.

- Congestion? The body sends lots of blood to the area you breathed in the germ, so that the immune system can start the fight there.

- Body aches? Quit running around. You need to rest so your body can fight. And sometimes your body needs to make you slow down.

- Vomiting? Your body perceived a new threat in the stomach, and is trying to get it OUT!

6) Coughing is how we keep the snot from getting into our lungs. It cleans things up for us so we can get it up, swallow it, and poop it out. It is our friend. We want to see a child in the office if their cough has gone unchanged or worsened after 10-14 days, is making them vomit often, makes them wheeze, or if they seem to be struggling to breathe sometimes. Or if you're just plain ole worried.

7) So when is a kid “sick too often”? Well, honestly it's not a simple answer that i can summarize in a paragraph - sometimes, doctors just have a feeling. In general, I start to worry about immune system dysfunction or deficiency when a child has many invasive bacterial infections each year - like pneumonias, bone infections, or ear and sinus infections that are severe and numerous. Children that are hospitalized more than once in a year for a troublesome infection tend to worry me. Kids who need to be on many antibiotics throughout the first few years of life (think monthly for more than a year) make me scratch my head sometimes, too. Often these children aren’t growing well or thriving.

8 ) "So can I 'boost' my kid's immune system with this amazing supplement I found online?" Okay, you guys (and a few corporations making millions off of the worry of parents) are gonna hate me for this - but there is no magical "booster" for the immune system other than vaccines. We need good sleep, a decent diet, and exercise to keep our immune system balanced.

You actually DON'T WANT an over-reactive immune system - that only leads to different kinds of trouble.

So if your kid's a picky eater, pop a multivitamin in them daily or every other day to fill in the gaps, assure they're getting good sleep, keep stress low, wash those hands, get your vaccines, and enjoy some time outside running around in the fresh air and sunlight.

Hope this helps you understand why I totally nerd out over the immune system sometimes.

Talk with your doctor if you think your kiddo is getting sick too often. It's honestly a conversation that will help you feel better as your doc knows your child best.

Now if you'll excuse me I need to lay face-down on my yoga mat.

-Hugs! Dr. Diane

There’s been a ton of surprises related to the COVID pandemic and skipping flu season last year was another one I never saw coming.

Masks and social distancing definitely played a role but the absolute lack of cases was still shocking.

So, will we get lucky again this year?

I doubt it.

And here’s 3 reasons why:

1. Social distancing and masking are going away or gone. And we all want to get to that place…but it does mean we’re likely to have flu cases spread among classmates and families.
2. Skipping a flu season last year may make individuals more vulnerable to flu this year. Our bodies haven’t seen flu for almost two years. And just like our other colds went wild in kids this fall, flu could do the same this winter.
3. A mild or absent flu season last year may make people more likely to skip their flu shot this year. “Do we really need one after last year?” is a common question I have been asked.

What can you do to protect your child and their friends?

Get them their flu shot. Now’s not the time to get cute. Just do it.

Start to work with your child on hand-washing and covering their coughs. We need to protect ourselves and others.

Keep your child home if they are sick. If something seems to be brewing, give it a day to develop at home.

“When will this cough ever go away?”

These and similar questions have been the topic of the last month at my practice.

And while I know parents are annoyed and I’m annoyed and the kids are annoyed - everyone’s annoyed - most of the time we don’t need to be concerned.

Here’s why I think kids have been sick A LOT for the last few months:

1. Cold and upper respiratory virus season were delayed due to masks and social distancing-which are starting to go away.
2. A season of terrible weather changes from hot to cool, dry to wet and everything in between and back again.
3. A wicked allergy season which tons of mountain cedar, pollen, grass, mold, etc. (Thanks to all the rain.)
4. The beginning of summer illness season with lots of fevers and rashes and insect bites and swimmer’s ear.

We see all four of these things every year, but we usually see them spread out over six months instead of crammed into two.

So what do we do?

Try to keep calm. Several mild illnesses don’t necessarily mean something bad is happening-it’s usually just bad luck.

Talk with your doctor. If you’re worried something else is going on, ask your doctor.

Consider testing if in addition to several mild illnesses, you have some severe illness or mild illness that doesn’t respond to typical treatments.

And while I’m confident that we’ll get through it together, I need your help.

Ruling out COVID-19 for kids with symptoms (some mild, some more severe) has become the biggest reason for kids visiting our office. We’ve already seen kids getting sick as they go back to school and that makes me nervous about what the upcoming flu season is going to look like.

Because the symptoms of flu overlap with COVID-19 so much, it’s going to be difficult to tell whether flu or COVID-19 is causing your child’s flu-like illness. And, there’s no guarantee that a child can’t get both at the same time.

So with the flu season nearing, you probably have a lot of questions that need to be answered about this possibility:

• Does every child with flu-like illness need to be tested for both?
  • Probably.
• Does getting COVID-19 and the flu at the same time mean your child will be more at risk for severe illness?
  • Probably.
• Will we have enough COVID-19 testing available to continue avoiding unnecessary quarantines?
  • I hope so, but every time we test a child for COVID-19 because they have flu-like illness, we have fewer tests available.

Here are some things you can do to help your child and yourself (and me):

1. Get your child their flu shot. ASAP. The effectiveness of the flu shot does vary from year to year. It’s not perfect. But, it’s the best we have. And even decreasing the amount of flu by 60% this year will change the lives of those children: Avoiding not one but two tests. Avoiding the worrying during the waiting time and wondering if your child has flu, COVID-19 or something else.
    
2. Start practicing hand washing. Children need to be taught to wash their hands adequately and often.
    
3. Wear your mask, even in situations where you think it might not be necessary. It will not only protect against COVID-19, it will protect against the flu as well. We, as a health care provider and a society, cannot afford to have a terrible flu season this year.
    
4. Keep yourself and your child home if you are sick. This is important…every…single…year. But it is especially important this year. Don’t be the family that knocks over the first domino. Even if you aren’t seen by a doctor, waiting a day can be helpful to see if your simple symptoms progress or go away.

Let’s all do our part.

We can do this!

One of the first things I like to know when ascertaining the seriousness of a child’s condition is whether the child is playing, smiling eating or drinking. If a complaint is brought up regularly, interferes with play or a child really cries, parents should consult a physician.

High Fever

New parents might find the recommendations for when to seek treatment for a fever daunting, but it gets easier with time.

For infants 3 months and younger, any fever is serious and parents should see a physician’s help immediately.

For children older than 3 months, a high fever combined with symptoms such as lethargy, changes in fluid and/or difficulty breathing require prompt medical attention.

Children who are 3 months or older with fevers of 102 degrees Fahrenheit or higher that don’t respond to fever-reducing medicine should see a doctor.

Fevers up to 101 can often by managed with fever-reducing medicine, fluids and rest. However, if your child also has a harsh cough – which may indicate croup – you need to consult a doctor.

Stomach Hurts

If your child has a stomachache, there are three red flags that may warn parents of a serious illness such as appendicitis:

1. Your child has a tummy ache and a fever.
2. Your child can point with one finger to where it hurts.
3. Your child has been vomiting.

Children don’t need to have all three symptoms for parents to seek help because any one of these symptoms can indicate that appendicitis might be a possible diagnosis. Parents should also not wait too long. If symptoms worsen in six to eight hours, consult a doctor.

My Head Hurts

Headaches and even migraines can occur in children as young as 3 years of age. Parents can give their child a nonsteroidal anti-inflammatory medicine, such as ibuprofen, or eliminate headache pain caused by hunger, fatigue or dehydration with food, rest or fluids.

Talk to your pediatrician about his or her treatment recommendations, particularly if you’ve never treated your child’s headache before.

If headaches occur at the same time each day, parents should consult their pediatrician. Headaches can occur with the flu or fever, but we become concerned if a headache is serious enough to make a child cry, interferes with play or is so bad the child is vomiting.

Related Topics:

• Let's Learn About Fevers
• Is It Strep Throat or the Flu?
• Let's Learn About the Flu
• Probiotics for Tummy Bugs: Do They Help Your Chlid?
• My Child Poops Every Day. How Can They Be Constipated?
• Is Over-The-Counter Medication Causing Your Child's Headaches?
• When It Comes To Your Kids, It's Never Just a Virus

Kids are gross.

Germs and kids are doubly gross.

As parents, we know this is true, especially during this time of year. The illness visits are piling up in my office and throughout the Cook Children's system. The days off school are starting. Missed workdays are causing stress.

We all hate this part of winter.

In my office, we're seeing lots of barky coughs from croup. We've also seen a ton of kids with sore throats from strep and viruses. Lots of fever from ear infections and flu season is just around the corner.

So what do you do? How do you survive the winter and keep your child healthy?

There's no magic vitamin. There's no magical food. There's no magical anything.

But here's something you can do: teach them not to be (as) gross.

1. Kids, stop licking and chewing stuff: Not the table, not your clothes, not your friends. There is nothing you can lick except your food, and really, you should chew it.
2. Kids, wash your hands. Several times a day. Wash them after you eat. Wash them after you go to the bathroom. Wash them just because you need to wash your hands. Get those germs off.
3. Kids, cough into the crook of your elbow. Don't cough on your classmates or your teacher (this isn't going to get you out of a test). Don't cough into your hands because then you will be spreading germs around the next time you touch someone or hand something to a classmate or sibling. 
4. Kids quit sucking your snot back up into your nose. You're driving us all crazy and making us all nauseous. It's disgusting. Really. And it's also bad for you. Get that crud out of your nose and out of your body.
5. Kids, stay home from school if you're sick. If you have a fever, it's not allergies, and no, you can't take Motrin on your way into school to make it through the day. (Ok, kids. This one was more for your parents.)

I'm sure there's more. What other lessons should we teach our kids so they won't be as gross this winter?

Stay well,

Doc Smitty

Some estimate that children will have 8-12 upper respiratory infections (coughs and colds) per year. Because many of those will be clustered in the winter and viral respiratory infections can last 1-2 weeks, it’s possible your child might seem to be sick “all winter long.”

Anytime a child seems to be sick off and on for months at a time, people will search for answers. Anytime people search for answers, they will start to make connections where connections don’t really exist…

So, now it’s time for: Winter Weather Health Myths

Myth No. 1 - Feed a cold and starve a fever.

I don’t care if you decide to feed a cold. If a child is hungry and not vomiting, let them eat but starving a fever doesn’t make sense. Besides, the major thing is that you need to monitor a child’s drinking when they are sick more than their eating. Dehydration is frequently what causes a child with a cold or flu to get sicker and require medical attention. You should encourage (“force”) your child to drink small, frequent sips of whatever fluid they will drink. Pedialyte or Gatorade are good options but milk is fine too (yes, even with fever).

Myth No. 2 – It’s been too cold for my child to exercise.

Maybe, for like two weeks in late January, it’s too cold for your child to exercise OUTSIDE. Otherwise, buy you and your child a sweatshirt and go for a walk. During those two weeks, you can walk circles around the house together or just do some lunges or something. Even 10 minutes a day is better than zero.

Myth No. 3 – Going outside to the cold (wet head or not) will make your child sick.

Cold weather and getting cold doesn’t actually make you sick. Getting sick is the result of being exposed to an infection that makes you sick not by getting cold. We think that viruses tend to increase in activity during winter due to the fact that people are more likely to be crowded inside.

Myth No. 4 – Taking Vitamin C (or a multivitamin or Zinc or essential oils) will protect your child from colds and flu.

The supplement industry has become big business for both adults and children as people look for anything to prevent illness. Unfortunately, study after study show that they simply don’t work. Essential oils are one of the latest to promote the ability to “boost” the immune system but studies are still lacking to show benefit in children. For now, our best bets are simple things like washing hands, covering coughs and getting the flu vaccine (I know it’s not perfect but at least it’s something).

Myth No. 5 – If you don’t like the weather in Texas, wait 5 minutes.

While not technically a myth, because weather can change fast in Texas. Good evidence is the last week. But, we’re not alone. Most of the United States believes that the phrase “If you don’t like the weather in ____, wait 5 minutes” applies to their state. A Google search ranking for this phrase puts Texas at number 8 on the states where this phrase was searched for (behind Massachusetts, New York, Georgia, Pennsylvania, Maine, South Carolina and North Carolina).

Don’t buy into the winter weather myths. Here are some tips for preventing winter weather health issues:

• Help your child eat healthy and get good sleep.
• Get your child up and active in some way every day.
• Teach your child to wash their hand and cover their coughs.
• Get your child a flu shot (it’s still not too late).

For parents, this statistic may be a little worrisome. Eight minutes may be fine for grownups, but is it enough time for a pediatrician to spend with a patient and family? From the physician's chair, the answer is yes and no.

"I'm not sure there is a time limit," says Frank McGehee, M.D., a pediatrician at Cook Children's Sixth Avenue office in Fort Worth, Texas. "We will stay with the child as long as necessary, depending on the reason for their visit. Otherwise, most of our checkups are scheduled for 15 minutes.”

Dr. McGehee shares the office with Vanessa Charette, M.D. The two could be considered authorities on the topic of patients and time. That's because in a recent Cook Children's survey, 98 percent of patient families said they felt both doctors spent enough time with their children.

In a world where doctor visits often feel like being put on the clock, this is a valued achievement.

"The benefit of having a pediatrician who a child sees over time is they get to know you," says Dr. Charette. "I may spend two minutes with a child who has a rash because I know them and I know they are a healthy kid, but I may spend 30 minutes with the same child if they are very sick or are having behavioral issues."

One exam that will always take a good amount of time is a well-baby or well-child visit.

"These visits will usually take longer because they're focused on preventive care," says Dr. Charette.

Parents can expect their pediatrician to address how their child is growing, if their development and behavior is normal as well as issues concerning general safety, such as car seats, drowning prevention and the importance of wearing a helmet when riding a bike.

One of the most important things parents can do to make any visit more effective is to ask questions, even if it's not an immediate concern.

"We always ask parents if they have any questions," says Dr. McGehee. "We want to make sure the patient gets what they need."

If you want to make the most of your time, there are three more things you should do:

• Be on time
• Pay attention
• Be present

"Sometimes if you're scared, it's hard to do," says Dr. McGehee. "If you've been up all night with a sick child, listening can be a challenge, but you need to understand what your pediatrician is telling you."

Whether your visit is two minutes or 45 minutes, asking questions and understanding the answers are the best things parents can do to make the most of time spent with their pediatrician.

This week presented an excellent opportunity for me to return the favor.

Our family chose to cancel our usual family Christmas. Not because the kids were bad and we’re not rewarding them. Not because we were frustrated with how commercialized it has become and are taking a stand. 

Actually, the rest of our extended family all got together and opened presents on the Sunday before Christmas as usual. We just didn’t go this year.

So, why didn’t we participate?

Flu.

Since I have been a practicing pediatrician, I have somehow avoided bringing the flu home. Whether it was luck or blessing or whatever you want to call it, we have been spared, until this year. My two boys have the flu.

So why didn’t we go?

Believe me, skipping the excitement and fun of watching our kids with their cousins is heartbreaking. This is the first year that all of our kids seem to know something is different about this time of year and Christmas at my grandmothers is always one of the highlights.

But, taking a risk with the rest of our family is not worth it and it should not be for you either. If your child is sick, find some other way to celebrate that doesn’t put others at risk. 

Think about those people who are most at risk from complications of the flu: children under 5 years (especially under 2, all the new babies out there), adults over 65 years (grandma and grandpa), pregnant women (your cousin’s first baby) and people with chronic medical conditions. These are just the types of people who it’s hard to stay away from at Christmastime.

We will make the best of today and pray that we are all better come Christmas Day. You should do the same.

About the author

Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . View more from The Doc Smitty at his Facebook page. He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.