Why Aren't My Kids Getting Better?

Question of the Week

Although frustrating, this is a common scenario in Pediatrics, especially if parents are expecting immediate results. Why does it happen?

The Tincture of Time

For example, kids with the common cold are often sick for a few weeks. They often worsen over 3-5 days and then gradually get better over the next week or two. If you saw your Pediatrician on the first or second day of the illness, you shouldn't usually expect your child to be better in just a few days, even if he did get an antibiotic (which don't work for viral infections).

The same goes for stomach viruses. Although vomiting with these infections usually only lasts a day or two, the diarrhea might linger for several weeks.

Remember that there are many true '24 hour viruses'. Most take a week or two to go away.

Non Compliance

Older kids and teens are often given the responsibility of taking their medications on their own, so it can be hard to tell if they are using them or not. One easy way is to just think about how often you have gotten refills. If you were given a one month supply, you haven't gotten a refill in several months and your child still has a lot of medicine left, then he likely isn't using it.

Food & Drug Interactions

Another reason for your child to not get better is that the medicine he is taking is interacting with something else, such as a food, drink or other medication. Be sure to read the package insert to see if there are any food or drug interactions for the medicine your child is taking. Be sure to keep in mind that OTC medications and natural therapies can also sometimes interfere with your child's medications.

Medication Side Effects

If your child worsens after starting a new medication, you should always consider that he may be having a side effect of the medications he is taking.

One common scenario occurs in kids who have a simple cold and then get fussy and are up all night. Most parents first thought is that their child has an ear infection, and while that often does occur, it could also be that the cold medicine that you gave your child before bed is making him irritable and have insomnia.

Reading the package insert can help you to see what common side effects of the medication are. Be careful, because these will often include very rare side effects. Instead of looking at every side effect listed, concentrate on the common ones, especially those that occur more commonly than placebo.

Question of the Week

Undertreatment

Although we hear about kids being overtreated and overdiagnosed more, like for ADHD, undertreatment is also a big problem. This is especially true for chronic conditions like allergies and asthma.If you have a child with asthma and he is coughing every night and has an attack each week, and he is just using a bronchodilator, like albuterol, then he is being undertreated. He needs more aggressive treatment with an inhaled steroid to get his symptoms under control.

The Wrong Diagnosis

Lastly, you should also consider that your child was diagnosed with the wrong thing. If she has had a cough and runny nose for 2 months and 4 round of antibiotics haven't helped, then maybe it is just allergies.

This doesn't always mean that your Pediatrician made a mistake. Sometimes it can be difficult to sort out what is causing common symptoms and your doctor will just start treatment for the most common thing that causes those symptoms. If that doesn't work, then he or she might try something else.

What to Do

To help prevent many of the situations discusses in this article, it can help to ask your doctor what you should expect from your child's illness.

Ask questions like:

• When should he get better?
• What signs should I look for that may mean he is getting worse or has another more serious condition? And then what should I do?
• What is this medicine supposed to do? What are it's main side effects?
• When should I come back if he is not getting better?

And if your child continues to get worse or isn't getting better and you are not comfortable with what your Pediatrician is doing, then consider getting a second opinion from a specialist.