Pediatric acute respiratory infections

Acute respiratory viral infections (ARVI) in children account for approximately 75% of all childhood illnesses. Upper respiratory tract infections (acute respiratory infection (ARI), acute respiratory diseases (ARD), ARVI) are a group of acute infectious and inflammatory diseases of the upper respiratory tract of various localizations, etiologies and symptoms.

ARIs are the most common infections on the globe. It is impossible to fully account for the true incidence. Almost every person suffers from ARIs several times (from 4-8 to 15 times or more) a year, mainly in the form of mild and subclinical forms. ARIs are especially common in young children. Children in the first months of life rarely get sick, since they are in relative isolation and many of them retain passive immunity for 6-10 months, received from the mother transplacentally in the form of IgG. However, children in the first months of life can also get ARIs, especially if they are in close contact with sick people. The reasons for this may be weak transplacental immunity or its complete absence, prematurity, primary forms of immunodeficiency, etc.

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Epidemiology of ARVI

According to statistics, a child can get sick from 1 to 8 times a year. This is due to the fact that the immunity developed in the child's body against one virus is powerless against another infection. And there are hundreds of viruses that cause ARVI. These are influenza viruses, parainfluenza, adenoviruses, enteroviruses and other microorganisms. And since parents often have to deal with ARVI, they should know as much as possible about this disease, the mechanisms of its development and methods of combating viral infections in childhood.

The highest incidence rate is among children aged 2 to 5 years, which is usually associated with their attendance at child care facilities and a significant increase in the number of contacts. A child attending a kindergarten may have ARVI up to 10-15 times during the first year, 5-7 times during the second year, and 3-5 times per year in subsequent years. The decrease in incidence is explained by the acquisition of specific immunity as a result of ARVI.

Such a high incidence of acute respiratory viral infections in childhood makes this problem one of the most pressing in pediatrics. Repeated illnesses significantly affect the child's development. They lead to a weakening of the body's defenses, contribute to the formation of chronic foci of infection, cause allergies, prevent preventive vaccinations, aggravate the premorbid background and delay the physical and psychomotor development of children. In many cases, frequent acute respiratory viral infections are pathogenetically associated with asthmatic bronchitis, bronchial asthma, chronic pyelonephritis, polyarthritis, chronic diseases of the nasopharynx and many other diseases.

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Causes of ARVI in children

Factors that contribute to the development of ARVI follow the child everywhere. Such reasons include:

• hypothermia, drafts, wet shoes;
• communication with other children sick with acute respiratory viral infections;
• sudden change in weather, off-season (fall-winter, winter-spring);
• decreased body defenses;
• hypovitaminosis, anemia, weakened body;
• decreased physical activity of the child, hypodynamia;
• improper hardening of the body.

All of these are factors that weaken the body and contribute to the unhindered spread of the virus.

The reasons for frequent ARIs in children are the high sensitivity of the child's body at any age, including a newborn baby. Frequent ARIs in a child begin from the moment he enters a nursery, kindergarten or school. Diseases can be repeated in succession. This happens because the immune defense after a viral infection is developed from one type of virus. Penetration of a new virus into the body provokes a new disease, even if a small amount of time has passed since the previous one.

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How long does an acute respiratory viral infection last in a child?

How long can a baby be contagious and how long does an acute respiratory viral infection last in a child?

As a rule, the more time has passed since the first symptoms appeared, the less likely it is that the child is contagious. The period of time when the sick person is able to infect others usually begins with the appearance of the first symptoms of the disease or simultaneously with them. In some cases, the baby may still look "healthy" outwardly, but the disease process may already be underway. This depends on many factors, including the strength of the child's immunity.

The initial moment of the incubation period (when the virus has already penetrated the child's body, but the disease has not yet manifested itself "in all its glory") is considered to be the moment of contact with an already contagious patient. Such a moment can be contact with a sick child in a kindergarten, or an accidentally caught "sneeze" on a trolleybus. The final stage of the incubation period ends with the appearance of the first signs of the disease (when complaints appear).

Laboratory tests can already indicate the presence of the virus in the body during the incubation period.

The incubation period of ARVI in children can last from several hours to 2 weeks. This applies to such pathogens as rhinovirus, influenza virus, parainfluenza, parapertussis, adenovirus, reovirus, and respiratory syncytial virus.

The period during which a child is contagious may begin 1-2 days before the first signs of the disease appear.

How long does ARVI last in a child? If you count from the moment the first symptoms appear, the period of illness can last up to 10 days (on average, a week). At the same time, depending on the type of virus, the child can remain contagious for another 3 weeks after recovery (disappearance of symptoms).

Symptoms of ARVI in children

Regardless of the type of virus that causes ARVI, the classic form of the disease has some common symptoms:

• "general infectious" syndrome (the child has chills, may experience muscle pain, headache, weakness, fever, enlarged submandibular lymph nodes);
• damage to the respiratory system (nasal congestion, runny nose, sore throat, dry cough or cough with sputum);
• damage to mucous membranes (pain and redness in the eye area, lacrimation, conjunctivitis).

The first signs of ARVI in a child are often characterized by a sudden onset with a clearly defined "general infectious" syndrome. In parainfluenza or adenovirus, the first signs are damage to the respiratory organs (throat, nasopharynx), as well as redness and itching of the conjunctiva of the eye.

Of course, it would be easier for both parents and doctors if the course of ARVI in children was always classical. However, a child's body is a very complex system, and its response to the penetration of a particular virus cannot be predicted 100%. Each organism is individual, so the course of ARVI can be erased, asymptomatic, atypical or even extremely severe.

Since it is unlikely that parents will be able to guess and predict the course of the disease, it is necessary to know about the conditions in which you will have to see a doctor as a matter of urgency.

Symptoms of acute respiratory viral infections in children that require urgent medical attention:

• Temperature readings have exceeded 38°C and respond little or not at all to antipyretic medications.
• The child's consciousness is impaired, he is confused, indifferent, and may faint.
• The child complains of a severe headache, as well as the inability to turn his neck or bend forward.
• Spider veins and rashes appear on the skin.
• There is pain in the chest, the child begins to choke, it is difficult for him to breathe.
• Multi-colored sputum (green, brown or pink) appears.
• Swelling appears on the body.
• Cramps appear.

You shouldn't self-medicate, especially if it concerns your child. Also pay attention to other organs and systems of the baby, so as not to miss the beginning of inflammation.

Temperature during acute respiratory viral infection in children

Children are quite sensitive to increases in body temperature: excessively high temperature can cause convulsions in children. For this reason, the temperature should not be allowed to rise above 38-38.5°C.

A temperature of up to 38°C should not be brought down, as there is no need to interfere with the body doing its job – fighting the penetration of the virus. This can provoke the appearance of complications. What should be done:

• don't panic;
• monitor the child’s condition – usually the temperature should stabilize within 3-4 days.

A prolonged acute respiratory viral infection in a child with a temperature that does not go down may indicate the addition of a bacterial infection. It also happens that the temperature readings after a viral infection have dropped, the child seems to be on the mend, but after a few days he feels worse again, and a fever appears. In such a situation, you should not delay calling a doctor.

In the classic course of ARVI, the temperature can last no more than 2-3 days, maximum - five days. During this time, the body must fight the virus, producing its own antibodies to it. Important: do not deliberately bring the temperature down to normal, you can only lower it so that the body continues to fight the infection.

Cough during acute respiratory viral infection in children

Cough during ARVI in children is a fairly common symptom. It is usually present against the background of fever, runny nose and other signs of the disease. At the onset of the disease, a dry cough is observed (without sputum production). Doctors call such a cough unproductive: it is difficult for a child to tolerate, can disturb his sleep, and negatively affect his appetite.

In the classic course of ARVI, after 3-4 days the cough goes into a productive stage - sputum appears. But it should be taken into account that not all children know how to cough it up. For this reason, the child needs help: regularly massage the chest, do light gymnastics, and in case of a coughing fit the baby should be given an upright position.

As a rule, cough during viral infections lasts up to 15-20 days, however, if its duration exceeds three weeks, then chronic cough can be suspected. In such cases, competent consultation of a pediatric pulmonologist and allergist is simply necessary, as well as the appointment of complex therapy.

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Vomiting in a child with ARVI

Vomiting in a child with ARVI may occur simultaneously with the appearance of a high temperature and cough. The sputum, which is difficult to remove, is thick and viscous, irritates the respiratory organs and provokes attacks of painful coughing in the child. The gag reflex is triggered as a result of the transition of the excitatory signal from the cough centers to the vomiting centers. In some cases, vomiting may occur due to the accumulation of a large amount of mucous secretions in the nasopharynx, but in this case, vomiting occurs without coughing. Most often, vomiting against the background of coughing is not profuse, and does not bring visible relief to the child.

It is important to distinguish when vomiting is associated with the simultaneous stimulation of the cough and gag reflex, and when vomiting may be a sign of poisoning or gastrointestinal disease. Therefore, it is imperative to show the child to a doctor, otherwise this may provoke the appearance of unwanted and sometimes severe complications.

Rash with acute respiratory viral infection in a child

If a rash appears during an acute respiratory viral infection in a child, this is a direct reason to see a doctor. There are several possible causes of rashes during illness:

• intolerance to any of the medications taken by the baby;
• allergic reaction to foods that parents usually give to a sick child (raspberries, oranges, lemons, garlic, ginger, etc.);
• high temperature, which contributes to increased vascular permeability - in such cases, the rash resembles various-sized hemorrhages on the skin.

There are also more serious reasons for the rash. For example, the addition of meningococcal infection: such a rash is usually accompanied by hyperthermia and vomiting. In any case, when a rash is detected on the child's body, all measures should be taken to deliver the baby to the infectious diseases department as soon as possible. You can simply call an ambulance and describe the symptoms of the disease. In this case, you cannot delay.

A child has a stomach ache due to acute respiratory viral infection

Quite often, parents face a situation when a child has a stomach ache due to ARVI. The pain is most often colicky and localized in the projection area of the large intestine. Doctors can explain this symptom by a combined reaction of the lymphatic system of the intestine and appendix. For the same reason, ARVI can be complicated by an attack of acute appendicitis. In such a situation, the most competent action of parents may be to call a doctor at home, and if the pain in the abdomen increases, then you will have to call an ambulance.

A large number of acute respiratory viral infections can be accompanied by diarrhea along with abdominal pain. Diarrhea with acute respiratory viral infections in a child is caused by cramping spasms in the intestines – the child’s body’s reaction to the disease. However, most often diarrhea and abdominal pain are provoked by medications that the child is forced to take. For example, if the child is prescribed antibiotics or antiviral drugs, this can gradually lead to a disruption of the intestinal microflora, or manifest itself as a hypersensitivity reaction of the digestive system to certain types of drugs. In either case, a doctor’s consultation is mandatory.

Conjunctivitis with ARVI in a child

Unfortunately, conjunctivitis with ARVI in a child occurs in almost all cases of the disease, especially when attacked by an adenovirus infection. Signs of conjunctivitis become noticeable immediately. At first, the viral infection that caused ARVI affects one eye, but after 1-2 days the other eye is affected. Both eyes of the child become red, itch, there is a feeling of "sand" in the eyes. The baby squints, rubs his eyelids, cries constantly. The eyes may become covered with crusts, and light discharge may accumulate in the corners.

This type of conjunctivitis gradually goes away on its own as the child recovers from the acute respiratory viral infection. However, special children's medicines - antiviral eye ointment or drops, which can be easily purchased at pharmacies - can help alleviate the child's condition and eliminate itching and discharge from the eyes faster.

True, in some cases, conjunctivitis can also be the result of an allergic reaction in a child. In this condition, the child not only experiences tearing and redness of the eyes, but also swells the lower eyelids. It is typical that both eyes are affected at the same time with an allergy. If this happens, an urgent consultation with a doctor is necessary, identification and elimination of contact with a potential allergen, prescription of antihistamine eye drops and medications.

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Features of the course of acute respiratory viral infections in children

Children of different ages may react differently to the appearance of signs of acute respiratory viral infection.

• ARI in a breastfed baby may manifest itself with such symptoms as restlessness, poor sleep, loss of appetite; bowel disorder, excessive tearfulness and capriciousness. Such changes in the behavior of a breastfed baby should arouse suspicion in the mother, since the baby cannot explain his state of health in words.
• An acute respiratory viral infection in a one-month-old child may occur with difficulty breathing through the nose, since the baby does not yet know how to breathe through the mouth. How to suspect that the child has a stuffy nose? The baby becomes restless when sucking, often refuses to eat and pushes away the breast or bottle. In such cases, it is imperative to clear the baby's nasal passages.
• ARI in a 2-month-old child can typically manifest itself as shortness of breath with prolonged wheezing - this symptom is often called asthmatic syndrome. In this case, symptoms of intoxication are expressed: grayness or cyanosis of the skin, lethargy, apathy, elevated temperature.
• ARI in a 3-month-old child often occurs with damage to the respiratory organs, which, if unskilled assistance is provided, can be complicated by bronchitis or pneumonia. Therefore, it is very important to pay attention to the difficulty of swallowing and nasal breathing of the child, regularly measure the temperature. It is highly undesirable to stop breastfeeding during this period, since mother's milk in this case will be the best medicine for the baby.
• ARI in a 4-month-old child is accompanied by damage to the mucous membrane of the nasopharynx and bronchi, which manifests itself in the form of a runny nose and cough. An increase in the submandibular or parotid lymph nodes, spleen can be observed. Conjunctivitis, keratoconjunctivitis, which is expressed in redness of the eyes and continuous lacrimation, often develops.
• ARI in children under one year old can be complicated by croup - a condition when the larynx becomes inflamed and swells, namely the area that is located directly under the vocal cords. This condition is explained by the fact that in small children this area contains a large amount of loose fiber, which easily swells. At the same time, the laryngeal lumen is not large enough. Croup most often develops at night, so parents should pay attention to a suddenly beginning "barking" cough, heavy breathing, attacks of suffocation, anxiety, cyanosis of the lips in the child. If such signs are observed, it is necessary to urgently call an ambulance.
• ARI in a child at 6 months is a period when the baby has already been introduced or is being introduced to complementary foods. Often at the age of six months, a viral infection is accompanied, in addition to damage to the respiratory system, by the involvement of the digestive system in the process. This can manifest itself in signs of acute gastritis or enteritis: abdominal pain, bowel disorder.
• A 1-year-old child may have ARVI from 1 to 8 times a year, depending on the immune system. Starting from this age, it is very important to begin hardening procedures and strengthen the baby's immune defense so that his body can resist numerous viruses and bacteria. It is especially important to protect the baby in the autumn-winter and winter-spring periods.
• ARI in a 2-year-old child is often accompanied by laryngitis (inflammation of the larynx), tracheitis (inflammation of the trachea - the respiratory tube), or a combination of these diseases. Signs of such damage are a hoarse voice, a dry, obsessive cough. Of course, a 2-year-old child cannot yet express his complaints coherently. Therefore, parents should carefully monitor the child's condition. If breathing becomes difficult, intercostal spaces become sunken, or the wings of the nose swell, it is necessary to urgently call an ambulance.
• ARI in a 3-year-old child usually begins with a rise in temperature towards evening. Headache appears, the child feels apathetic, tired, sluggish. Most often, the disease appears during the epidemic season, so diagnosis is not difficult. The severity of the condition determines the child's well-being.

If you notice any unusual or suspicious symptoms in your child, be sure to call an ambulance. Don't be afraid to bother the doctor once again: the most important thing is your baby's health.

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Recurrent acute respiratory viral infection in a child

A repeated ARI in a child is not uncommon, as children are usually very susceptible to viral infections. Babies are prone to infection with the virus from the first weeks of life, but in the first three months they do not get sick as often as at an older age. The tendency to the disease is especially evident at the age of six months to three years, then the susceptibility decreases somewhat, although this may also depend on the individual immunity of the body.

Why do recurrent ARVIs occur? The fact is that immunity is specific to certain types and even types of viral infections. Such immunity is not stable and long-lasting. And in combination with a large number of virus varieties, it creates a high percentage of the probability of recurrent diseases.

A child may develop ARVI as a single case or as a result of a mass epidemic, which often happens in a group of children. That is why the child's morbidity usually increases with the beginning of attending kindergarten or other preschool or school institutions.

Complications of acute respiratory viral infections in children

According to statistics, at least 15% of all acute respiratory viral infections in childhood leave behind complications for other organs and systems of the body. For this reason, it is important to remember that in children, acute respiratory viral infections can occur with a high temperature for no more than five days. A longer increase in temperature above 38°C may indicate the appearance of complications or the addition of another disease. Sometimes the temperature seems to decrease, but after 1-3 days it rises again: symptoms of intoxication appear, such as tearfulness, pallor, lethargy, increased sweating. The child refuses to eat and drink, becomes indifferent to what is happening. What are the complications of acute respiratory viral infections in children?

• A cough after an acute respiratory viral infection in a child may in some cases mean that the disease is progressing to bronchitis or even pneumonia – the viral infection gradually moves down the respiratory tract. At first, there may be a clinical picture of laryngitis (dry cough, hoarse voice), then tracheitis (painful cough, voice functions are restored), and subsequently bronchitis. The main symptom of bronchitis is a cough. At first, it is dry and rough, and gradually sputum begins to form and cough up. Difficulty breathing joins in, the temperature rises again, increased sweating, fatigue. If the child has frequent and heavy breathing (sometimes the baby seems to "groan"), then bronchiolitis or pneumonia can be suspected. A doctor's consultation is mandatory.
• A rash in a child after an acute respiratory viral infection can be the result of several reasons. For example, it can be the addition of diseases such as rubella, measles, herpes (roseola infantum), enterovirus infection, scarlet fever, etc. Or it can be an allergic reaction to drugs, for example, antibiotics. The exact cause of the rash should be determined by a doctor.
• Arthritis after ARVI in children can appear after a protracted illness. This arthritis is called "reactive". Symptoms of reactive arthritis can appear several days or even weeks after recovery. Usually there is pain in the joint (usually in the morning). This can be the hip joint, knee, ankle, etc. The child has difficulty getting out of bed, limps when walking, complains of severe pain. A pediatric rheumatologist can diagnose the disease and begin treatment based on an examination and the results of some tests.

Also complications of ARVI can be sinusitis (an inflammatory process in the paranasal sinuses) or otitis media. Such diseases can be suspected by constant nasal congestion against the background of headache, or by shooting pain in the ear along with hearing loss and a feeling of congestion.

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Diagnosis of acute respiratory viral infections in children

The main task of the tests conducted to diagnose ARVI in children is to determine the type of pathogen. Depending on this, a further treatment plan will be prescribed.

The most common tests for acute respiratory viral infections in children are a complete blood count, a complete urine test, and immunological tests to detect antibodies to the viral infection.

What indicators usually indicate ARVI?

Complete blood count:

• red blood cells - normal or increased due to fluid deficiency in the body;
• hematocrit – normal or increased (with fever);
• leukocytes - lower limit of normal or decreased, which indicates a viral etiology of the disease;
• leukocyte formula - predominance of lymphocytes, slight increase in monocytes;
• eosinophils - decreased quantity or complete disappearance;
• neutrophils - decreased quantity;
• ESR increases in children with acute respiratory viral infections, but this indicator is not specific for viral infections.

General urine analysis:

• the changes are not specific, sometimes there is a small amount of protein in the urine, which disappears after recovery;
• possible, but not at all necessary, is slight microhematuria.

In rare cases, ketone bodies can be found in the blood or urine – acetone and acetoacetic acid – chemical complexes that are formed in the liver during the digestion of food that has entered the digestive tract. Acetone in ARVI in children can appear in various concentrations, and since this substance is initially toxic, its presence in large quantities can cause signs of poisoning in a child (in particular, vomiting, as well as the smell of acetone from the mouth or from urinary excrement). Only a medical specialist should determine and treat acetone in the blood or urine.

Immunology is an analysis of immunoglobulins M (isolated already at the initial stages of the disease). This analysis is taken twice - at the first symptoms of ARVI and a week later. This study allows you to accurately identify the pathogen. However, the immunological method is not always used, but only in severe and protracted cases of the disease.

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Treatment of acute respiratory viral infections in children

Children with mild to moderate forms of ARVI can be treated at home. They are hospitalized only in the following cases:

• in severe forms of the disease, or in the presence of complications (pneumonia, croup, etc.);
• for children under 1 year of age, or from 1 to 3 years of age;
• under unsatisfactory epidemiological and material-domestic conditions.

The standard treatment for ARVI in children involves, first of all, removing intoxication from the body. This involves drinking a large amount of warm drinks, taking multivitamins, and in more severe cases, intravenous glucose and blood substitutes. At high temperatures, antipyretic drugs can be used in the form of tablets or rectal suppositories, and in severe cases, in the form of intramuscular injections.

During the fever period, the child is prescribed bed rest. In the absence of complications, antibiotics and sulfonamides are usually not used, but in some cases they are still prescribed to small children, since it is very difficult to recognize a complication in an infant.

The treatment protocol for acute respiratory viral infections in children with complications includes the use of bronchodilators (for pneumonia or bronchitis). Antibiotics are used with caution, taking into account the child's allergic tendency. In case of laryngeal stenosis, sedatives and antispasmodics are used, and in severe cases, hydrocortisone injections are administered.

Modern treatment of ARVI in children involves prescribing drugs aimed at eliminating the main symptoms of the disease. What are these drugs:

• antitussives in the form of syrups, chewable or regular tablets;
• warming creams or balms based on natural ingredients that are rubbed into the skin of the chest;
• other warming procedures (mustard plasters or compresses) as indicated;
• vitamin preparations to strengthen the immune system.

We will talk in more detail about medications for ARVI below.

Medicines for the treatment of acute respiratory viral infections in children

All antivirus tools are divided into 4 categories:

• homeopathic antiviral agents;
• purely antiviral medications;
• interferons and interferon stimulators;
• immune stimulating agents.

Let's consider each of these categories separately.

1. Homeopathy for ARVI in children. The most frequently prescribed suppositories from this category of medicines are Viburcol, Oscillococcinum and Aflubin, slightly less common are EDAS-103 (903) or Gripp-Heel. Homeopathic specialists claim that the listed homeopathic remedies stimulate the protective function of the child's body, and this is often true, although the pharmacodynamics of these drugs has been practically not studied. As a rule, homeopathic remedies have an effect already at the first doses of the drug.
2. Specific antiviral agents. In pediatrics, antiviral agents such as Arbidol, Rimantadine, Ribavirin and Tamiflu (in some cases also Acyclovir, according to indications) are most often used. The listed drugs inhibit the virus from entering cellular structures, block the virus from multiplying, but have a different spectrum of activity and are not intended for all children's age groups.
3. Interferon preparations and their stimulants are perhaps the most popular group of antiviral agents. For example, Viferon for ARVI in children suppresses the development of the virus and destroys it in 1-3 days. Interferons are able to rid the body of a viral infection, both during the incubation period and from any period of the disease. In addition to the injection of interferons, the most interesting are Viferon suppositories, Kipferon suppositories and Grippferon nasal drops. Perhaps the only contraindication to the use of the listed drugs may be an allergic tendency of the baby's body to the ingredients of the drugs, especially to the components of suppositories - cocoa butter or confectionery fat. By the way, medications that activate the production of interferons (Amiksin, Neovir, Cycloferon) are recommended to be used only for prevention, but not for the treatment of ARVI, due to the slow action of such drugs.
4. Immunostimulating drugs - Isoprinosine, Riboxin, Immunal, Imudon, Methyluracil, Bronchomunal, IRS-19, Ribomunil, etc. One of the most popular listed medications, Isoprinosine for ARVI in children is used more as a preventive measure, however, like other immunostimulants. The reason is that the effectiveness of the immunostimulants is observed only after 14-20 days from the start of immunostimulating treatment. These drugs can also be used to restore the body after recovery.

As is known, antibiotics are not prescribed for ARVI in children with the classic course of the disease, since they have nothing to do with the viral infection. Antibiotic therapy is used only in the case of complications, or if they are suspected: most often, drugs-derivatives of ampicillin are prescribed.

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Nutrition for children with acute respiratory viral infections

Nutrition for children with ARVI is approximately the same as for a common cold. The main condition is that the baby should be offered food only if there is an appetite. Do not force-feed the child.

You also can't give your child harmful products: chips, soda. It is recommended to drink plenty of warm drinks and easily digestible food rich in vitamins, such as vegetables, fruits, berry puree and jelly.

It is recommended to offer small children apple compote without sugar, dried fruit decoctions. If there is no allergy to berries, you can prepare fruit drinks or berry kissels, or simply give warm mineral water without gas.

As a drink for children aged 3-4 years, you can use apricots, cherry plums, pears (if there is no allergy) to make compotes. You can offer weak green tea - it contains antioxidants that help remove toxins from the body.

It is advisable to avoid decoctions and infusions of strawberries, currants - such berries are more allergenic. Replace them with bananas, grapes or kiwi.

The diet for ARVI in children should contain easily digestible and healthy foods:

• It is advisable to puree and chop the ingredients for preparing meals; the food should be light and soft;
• during illness, try to avoid store-bought baby food; it is better to prepare porridge, puree, and pureed soups yourself from fresh ingredients;
• During the recovery stage, it is important to enrich your diet with proteins, so use white meat, minced meat or boiled egg white as food additives;
• children aged 3-4 years can be offered lean fish, such as pike perch, cod, etc.;
• don't forget about fermented milk products - they will maintain the balance of microflora in the intestines. Fresh kefir, natural yogurt, low-fat cottage cheese, acidophilus mixture are suitable. You can add a spoonful of honey to such products (if there is no allergy);
• As your child recovers, return to normal nutrition, but do it gradually so as not to overload the body.

Be smart when choosing food for your child with ARVI: food should be nutritious, fortified with vitamins, varied, but at the same time, overeating and eating unhealthy foods should not be allowed.

Prevention of acute respiratory viral infections in children

Prevention of ARVI in children is aimed mainly at increasing resistance and strengthening the child's body's immunity. What activities have a preventive focus:

• hardening (outdoor games, air baths, cool showers, walking on the grass without shoes, a night's rest in a cool room, swimming in pools and open water);
• stabilization of digestive processes (eating vegetables and fruits, following a diet and drinking regimen, supporting intestinal microflora);
• regulation of stool, normalization of nutrition;
• ensuring adequate sleep (resting without a full stomach, ventilated air in the room, sufficient amount of sleep).

Preventive measures should be carried out systematically, without forcing the child, but by explaining to him the need for this or that procedure to maintain health.

If necessary and the immune system is in poor condition, it is sometimes necessary to resort to the use of drugs that stimulate immune defense.

Medicines for the prevention of acute respiratory viral infections in children

The special multivitamin complex Vetoron has immunomodulatory, anti-inflammatory and adaptogenic properties. It is prescribed orally from the age of 5, 3-4 drops, and from the age of 7 - 5-7 drops per day, or in capsules from the age of 6 from 5 to 80 mg once a day.

It is recommended to take ascorbic acid, retinol and B vitamins in a dose according to age. The best proportion of the above vitamins is presented in the preparations "Undevit", "Complevit", "Geksavit". The dragees are taken 2 to 3 times a day for a month. In the autumn-winter period, it is useful to give the child rosehip syrup in the amount of 1 teaspoon per day.

Recently, adaptogens, which stimulate the body to resist infection, have become very popular. We offer you the schemes for taking the most popular drugs in this category:

• Immunal – taken orally from 1 to 3 years old – 5-10 drops, from 7 years old – 10-15 drops three times a day;
• Dr. Theiss drops – orally from one year of age, 10-20 drops three times a day;
• Hexal drops – orally 6 drops twice a day from the age of 12;
• Tincture of Aralia – from 1 to 2 drops/year of life, once a day half an hour before meals, for 14-20 days.

As emergency preventive measures, you can take medications based on medicinal plants (chamomile flowers, sage, calendula, Kalanchoe, garlic or onion), or local immunocorrective agents (Immudon, IRS-19).

ARIs in children tend to relapse, so it is necessary to find your own recipe for prevention that will allow you to forget about the disease for many years.