Speaker 1 00:00:07 Hello and welcome to the Wonder Baba podcast. My name is Sheena Mitchell, I'm a pharmacist and mom of three. I'm here to chat all about child and family health. I combine healthcare and practical advice to help you on your parenting journey. I really hope you enjoy the show. So this week I decided to do a little episode on flu and that is because the levels are very, very high this year and are likely to continue to rise as the flu season is really only kicking off. Flu will be with us right into the spring. So you know, we're talking about kind of March, April before there's any real ease off. In this episode, I am going to be talking all about the symptoms of flu and their treatment because there's so much going around. I decided not just to talk about kids in this episode, but also adults and pregnant women and women who are breastfeeding. Speaker 1 00:01:04 I'll also talk a little bit about if and when flu is diagnosed and then I will be answering some questions that were put to me on my Instagram stories box over the last 24 hours. So if you wanna get involved in this podcast, I will be popping up a question section there for future episodes. So follow me at Wonder Baba Care and then I will be able to answer your questions directly in the podcast. Okay, so first of all, what is seasonal flu? Well, obviously we know it's been around for years and it comes at this time of year in winter and spring. So it's an acute respiratory infection and it's basically caused by influenza viruses. Illness can vary in severity and sometimes it can lead to hospitalization and death. I ended up in hospital with flu B in 2020. I think it was March, early March just before covid kicked off actually. Speaker 1 00:02:01 And I ended up in hospital for nine days. So I definitely have personal experience on just how rotten you can feel with it and just how seriously we should take it. Luckily most cases are mild to moderate and people will recover within a week at home without needing further medical attention. Kids, the elderly, so over 60 fives, pregnant women, healthcare workers or those with serious medical conditions are most at risk of developing severe cases of flu. There are four main types of flu viruses and they are handily called A, B, C, and D. So really what we need to know about our flu A and B, because flu C is very mild and less frequent, it's not really posing a problem and flu D mostly affects animals. So again, we don't need to worry about that. Flu A is what is circulating most at the moment in Ireland and that always tends to be the way. Speaker 1 00:02:58 So flu A tends to come earlier in the season and flu B comes later in the season. So for example, when I got flu in March, 2020, it was a mutant strain of flu B that I contracted. So the incubation period for flu is one four days, but it's usually around two days after you have contact with someone who is symptomatic. It does spread really rapidly and it spreads through infectious droplets which are transmitted when someone coughs or sneezes. It can be airborne for up to one meter and it also spreads on hands. So lots of hand hygiene will really help to stop the spread and also ensuring kids are, you know, coughing into their elbows and using tissues and using hand gel. So we are kind of back to the basic guidelines of good hand hygiene and cough etiquette that we talked a lot about during the pandemic. Speaker 1 00:03:53 It's always been a good idea, but with flu levels so high now it's really important. I know that the government in HSC are encouraging people now to wear masks and I think that's very important if you're in large gatherings indoors or in very busy crowded places because as I said, the flu virus can be airborne for up to one meter and you know, especially if you're around any vulnerable groups, so any young kids or elderly people, it is the right thing to do to wear a mask really at this stage. Okay, so signs and symptoms with flu generally you get a sudden onset of fever, so a high temperature, so over 38, 39 degrees. Uh, you also get a cough and this cough is usually dry. It's also quite persistent so you might find that even after a couple of weeks when you've recovered with from the flu, you'll still have a lingering dry cough and it can actually go on for quite a while. Speaker 1 00:04:53 It is normal and it will resolve by itself. It just takes a little bit of time. People with flu also suffer from headache and muscle and joint pain. They can also feel really unwell. So in medical terms we call this severe malaise where you just feel rotten can also get a sore throat and runny nose with all the strap A that's going around at the moment. It is no harm to use a little torch or even the torch on your phone to have a little look at your or your child's throat if they are complaining of a sore throat because fever and sore throat can also be a sign of strep A, which requires antibiotics, but that is defined by white bots and patches on the throat and tongue. So it's an easy way to kind of differentiate between a bacterial and viral infection. So with viral infections you have no white spots, you just have a red, raw, irritated throat. Speaker 1 00:05:46 People with flu will also suffer from a runny nose. Okay, that is most of the signs and symptoms of flu. The treatment as I said, there is not with antibiotics. So the flu is a virus obviously sometimes it can develop into severe disease and sometimes after flu you can be more susceptible to developing a strep, a infection. So it is worth understanding that that flu itself is not bacterial, it's viral, but it does put you more at risk of developing a bacterial infection afterwards. So I would urge people to just really try and recover well and build yourself back up as much as you can. And I suppose stay vigilant, especially in young kids, uh, just to make sure that they're recovering well and that their symptoms are going away after one to two weeks. The best treatment for flu is vaccination. So the children's flu vaccine, the uptake hasn't been amazing, you know, I would've expected it to be much higher. Speaker 1 00:06:49 I think. Um, the HC said around 10% of two to 17 year olds received vaccination for flu. I felt like there was a lot of people because I did a lot of them, but I would strongly recommend getting your children vaccinated for flu if you can. It's a really straightforward nasal flu vaccine and for adults as well. Obviously there are at-risk groups, so the over 60 fives healthcare workers, immunocompromised pregnant women of any age and yeah anyone with chronic medical conditions. But other than that they're the people who will be covered by the HSE to receive their vaccination for free. It's important to be aware that you can actually go into your community pharmacy and get vaccinated privately for 25 euro. I know it's not free and it is a lot of money when you know it's a busy time of year. Money is tight, everything else is so expensive at the moment, but sometimes investing in your health and investing in yourself is worthwhile, especially when flu is circulating so widely. Speaker 1 00:07:54 I always try to <laugh> rationalize these things in my head that if you were treating flu the costs of the medication could easily stack up to 25 euro, nevermind the week or two you'd miss off work, you know, in loss of wages. So yeah, I definitely recommend everyone to take the vaccine if they can. One of the next episodes I'll be releasing will be dispelling the myth that children receiving the flu vaccination are more at risk of contracting strep A, that there's an association between strep A and the flu vaccine. And while I'm not gonna go into that now cuz this is really more about treatment and getting us all through flu season, I just want to highlight that that is misinformation inaccurate and I have lots of supporting data and information from the flu end manufacturer and also from the H P R A in Ireland that dispel that myth. Speaker 1 00:08:49 So just if you see that online, ignore, okay, because treatment relies on symptomatic treatment rather than you know, a cure. As such I decided to work through the different symptoms and medication types and hopefully I will point out some useful info about all of them as we go along. So the first thing uh, we would do is treat a fever or headache muscle, joint pain, sore throat. These can all actually be treated with paracetamol or ibuprofen whether you're an adult or a child. So obviously for adults there's a lot of different products out there which contain paracetamol and ibuprofen. So if it's just that item you need, you have no other symptoms, then you can just select one from your pharmacy. We have them for sale on our website as well for delivery. And then for children obviously you will be giving liquid versions or there are calpol melts and your chewables for older kids, they're all available and just to make sure to read the packaging to make sure it's suitable for your child before use. Speaker 1 00:09:53 So Paracetam Piramal works to reduce fever and resolve pain and ibuprofen will do the same thing. You can use them together if one on its own has not resolved the symptoms within an hour. I have an article about that on my website, I just wouldn't recommend routinely giving both in terms of runny nose and congestion and sinus pain, there is something called pseudoephedrine which is a decongestant so that basically relieves sore painful sinuses and can help to dry up a runny nose. So there are lots of different products on the market and I just wanna make it a bit easier for you to understand. So for and pseudoephedrine combined you can get either supa sinus or pseudo plus that's all they contain, either of those brands do the same thing. And then you can also get a product which has paracetamol, which is your painkiller and fever treatment, pseudo efrin which is your decongestant, and also a drug called diphenhydramine, which is an old style antihistamine and it can also help dry up runny nose but can cause drowsiness. Speaker 1 00:11:02 So that combination of three drugs is what's in benn for flu. So would you, you would use that instead of another Paracetamal containing product. Another cool product, Benn Dew is benn day and night. So it has just the paracetimol and pseudo arine in the daytime tablets so it doesn't make you drowsy. And then the nighttime one contains just paracetamol and diphenhydramine so it will help to resolve your runny irritating nose but it'll also help you sleep a bit and sometimes when you've flu you know you don't sleep great. So it can be very welcome to have a product like that which can help promote good sleep. One last paracetamol containing product which is in combination with other drugs would be iveco. So often people ask for this because it is suitable for use in diabetics who are, you know, kind of tightly controlling their blood sugars. Speaker 1 00:11:55 It contains paracetamol, um, in a kind of weird dose. It contains 325 milligrams per tablet of paracetamol, whereas all of the other products I've mentioned contain 500 milligrams per tablet. With this one Veco you'd be taking one to two tablets three times a day, whereas with the other products it's you know, one to two tablets four times a day. The Elco also contains Bren Ironmine, which is an old style antihistamine which will also help to reduce nasal symptoms and it also contains caffeine which can help the uptake of the paracetamol a little bit and help to get rid of headaches a bit better sometimes. So I suppose they're your main paracetimol products that are on the market and currently available for the treatment of flu-like symptoms. I'm putting emphasis there on the fact that they're available because there are a lot of things that you know, as we've heard in the media are coming in and outta stock. A lot of the Benn cough bottles aren't currently available but there are cough bottles out there and I'll talk about them in a minute. Speaker 1 00:12:59 So if you choose to go with an ibuprofen based combination product instead of a paracetamol based one, then you could use something that has ibuprofen and pseudoephedrine. Again, the pseudo arine is are decongestant, so products which contain this combination and are available at the moment or neurophin, cold and flu, neurophin sinus and pain, they're actually the same thing. Those two products, they both contain the same levels of the same ingredients. So yeah, make it out what you will. Um, and also BR pro cold and flu, so again that contains the same ingredients as the near cold and flu and the neurophin sinus and pain. So if your symptoms are really severe you're gonna choose a combination product. So either a paracetamol based one or an ibuprofen based one. If you don't get relief from from taking that combination product, you can either add in plain paracetamol or plain ibuprofen depending on which one you're already taking. That's the best way to relieve the symptoms of a headache. Runny nose fever and sore throat, that kind of thing. Speaker 1 00:14:10 For children you are a bit more restricted but in generally you're giving paracetamol based product if they have fever and headache you can give neurophin instead of that and if absolutely necessary you can give both kind of alternate between the two of them, use them together. It's important to keep hydrated so ensuring your child is having lots of fluids and you can give boiled cooled seven up. I will say for children there is a decongestant available so it'ss sudafed suspension, it is only suitable for children age six years and up but it can be very, very helpful if they have a lot of nasal symptoms because they can get very irritated by that. I also recommend the use of nasal sprays, so saline, nasal sprays and steam. You can even use Elvis oil and snuffle babe oil. I actually have an episode all on blocked and stuffy noses. So if you flick back through the podcast episodes you will see that and I talk in detail there about the best way to resolve nasal congestion in kids. Speaker 1 00:15:16 So if you are an adult and you have a headache but you for whatever reason don't wanna take a combination product or you don't want to take an oral decongestant, you can also use the nasal saline sprays and, and you can also try the trove range of decongestant nasal sprays. Um, there's a few other on the market as well so that's definitely worth a shot. I can really relieve sinus symptoms quite quickly. And then for women who are pregnant, I don't want you to feel left out so you can also use a nasal spray, you can use the ster mar sa saline nasal spray and you can use a product called a Vogel Sign U Force. So sign U force is actually suitable for kids over two and it's suitable in pregnancy with pregnancy. I'll give more information about that in a minute, but the general advice is to use as little medication as possible really. Speaker 1 00:16:16 So you know, you limit your use of any products, whether they be herbal, natural, homeopathic, essential oils or paracetamol based products. With any of these it is always best to use the lowest dose for the shortest duration of time that is needed to resolve your symptoms. Okay, so for pregnancy in terms of pain and fever and all of that kind of thing, you can use paracetamol as I said there at the lowest dose needed. You can't use ibuprofen, this is especially important in the first and third trimester, but you know, during pregnancy obviously you've got paracetamol at your disposal for short-term use and you've got sinus force nasal spray, you've got all the stereo mar nasal sprays, you can use steam inhalation and hopefully those treatments combined will alleviate your symptoms of fever, pain and congestion. The reason that paracetamol isn't recommended for long-term use is because it's actually linked to a ADHD and other problems in neurodevelopment, um, in unborn babies. Speaker 1 00:17:26 So it's something just a flag. Don't be afraid to take it because these risks aren't there for kind of short-term use and actually the damage, um, a maternal fever could do is a risk far greater than using some short-term paracetamol. So absolutely take what you need but if it's long-term uh, pain relief or something, you're better talk to to your doctor than to continue to just take paracetamol for breastfeeding. Um, moms out there you can take paracetamol and ibuprofen, no problem. I would avoid generally the use of pseudoephedrine containing products because they can cause a reduction in breast milk supply and this is actually not due to kind of decreased breast blood flow, but the thoughts is that it's actually due to decreasing prolactin concentrations. So yeah, unless you have an Uber great supply of breast milk, then I would avoid the combo products and, and the Plains Rine products like p Sudafed. Speaker 1 00:18:30 Sometimes it can be useful if your nasal problems are very severe to use an antihistamine. I find this helps kids and adults alike. It is suitable in breastfeeding to use a non-sedating antihistamine, uh, one which contains Lorraine or cetirizine is probably best. Um, again, just use it as needed. Um, for children there are antihistamine suspensions like zertec liquid and the one thing I'd say is they're not kind of really strongly licensed or marketed towards nasal congestion associated with viral infection. So you know, I suppose look it's something that might be worth trying once and seeing if it helps and if it doesn't, just give up on that idea and go back to the steam and other products. Okay, so for coughs with flu the cough tends to be a dry cough. Obviously it can develop into a secondary bacterial chest cough for a cough that isn't going away. Speaker 1 00:19:33 After kind of two to three weeks you probably do need to see your GP and check out my episodes on the treatment of coughs in children, which was relatively recent. There's a lot of other types of cough out there at the moment with RSV levels still really high. We know that that causes a cough that significantly worsens on day three to five and can cause difficulty breathing. So with flu you're watching out for all of the same things and just alleviating symptoms where you can. So Bronco stop junior is quite a good general cough bottle for kids over one. It just soos their throat. Steam again is great. I really love the meina humidifier for nighttime for any of these kind of viral infections. It just helps to calm the airways and to help keep the mucus running from nasal drip at night so that it doesn't end up clogging and causing a secondary infection. Speaker 1 00:20:29 For adults. A dry cough really as well, you know there is Bronco stop um, and you can use that but even a bit of honey and lemon in hot water can be really, really beneficial. Honey helps to coat the throat if the throat is irritated and lemon helps to break down and thin out mucus if there's any coming from a nasal postnasal drip. So sometimes the basic things are the best. If your cough gets chesty, the best cough bottle for a chesty cough is culex or visco X. These help to thin down mucus which prevents a clogging within the lungs and causing infection. Do remember that it is normal for a cough to persist after flu for a number of weeks and so long as it's not a new cough or not getting worse then it's okay just to treat it you know regularly. Um, I know after I had flu I found the broncho off pastels really, really good, just have in my pocket because the cough was irritating and dry and it just helped to reduce the irritation a little bit and soothe my throat. Speaker 1 00:21:38 So for diagnosis of flu really you're just looking out for the symptoms as described above or as V usually only affects kind of children under two and you know it's a different kind of a cough that almost, you know, you can hear the inflammation in the lungs because it's, it's a lower respiratory infection so it is quite different to flu with things like scarlet fever which is also circulating at the moment. You can kind of tell flu apart from that because it isn't localized, you feel crappy everywhere, whereas with strep A in your throat or scarlet fever, it's quite localized to the throat area and you get headaches and a bit of a temperature but with flu you get much more widespread muscle and joint pain. And one last thing just before I go into the listener questions diagnosis. So obviously you won't be officially diagnosed unless you end up attending a GP or hospital and even at that your GP may not swab you because it's so hard to get GP appointments at the moment. Speaker 1 00:22:40 I got in a new product which I think is fab just for reassurance to help you navigate your way to try and figure out what illness you're dealing with in terms of flu covid or sb. So they're called flu care uh, combo tests and I have them in my link in my bio on Instagram at Wonder Baba Care and you can find them by searching Flora Care on the Wonder Baba dot i e website. I'll pull a link in the show notes but the spelling is f L UO R E C A or E and they're haunty because it is one nasal swab that tests for three things. It can tell you whether you have flu A or flu B, which I think is really cool. I put up a picture um, on Instagram yesterday of uh, test results that a patient sent me back showing that they did have flua and it was really cool just to see it work. Speaker 1 00:23:35 I think that's useful because it gives you the bit, you know, a bit of reassurance that unless your symptoms become unmanageable at home, you know, you're kind of reassured knowing that you don't need an antibiotic unless it's persisting beyond a couple of weeks or you might need to be assessed at that point. But generally with flu it does resolve itself with time and the treatment is just symptomatic treatment so you can continue to do that at home. Okay, so I did cover a lot of the questions in the podcast already so I'm just gonna have a little look here now to make sure that I haven't missed anything. So someone was asking could you cover being sick with breastfeeding and how to medicate and to be able to stay feeding. So you know with breastfeeding, keeping hydrated yourself is really important. It's also really important to highlight that by continuing to breastfeed when you're sick, even though sometimes you really don't feel like it and you are just exhausted. Speaker 1 00:24:31 But get into bed, get into bed with the baby if you can or have someone bring them to and from you because you know all of those antibodies that you're making are being passed onto your baby and offering them protection. In terms of medication you can when you're breastfeeding, take paracetamol or ibuprofen if needed. As I said, pseudo efrin it's probably okay if you have a really high supply of milk, but if you are struggling with milk supplier in the early early days at all, I would avoid it. Um, and just use something like the sign you for a nasal spray to relieve symptoms of congestion. Okay, so what's best for nighttime coughing? So nighttime coughing is really tricky and I definitely recommend having a glass of water beside your bed and even something like the broncho stop pastels, if you start into a coughing, you know, fit in the middle of the night, I really like using a humidifier at night that helps to reduce coughing episodes because it keeps the air moist and stops your airways from drying out, which sometimes can irritate a dry cough that's associated with flu. Speaker 1 00:25:36 So it's the Medi Santa humidifier that I recommend, it's available on Wonder Baba, ie. You can also add a bit of Albus oil to that or if you want a gentler blend for you know, kind of young children but over three months you can use the snuffle baby oil. Someone's just asked what the best thermometer to use it is and with that it depends on the age of of your baby. So I do have, I think God it's only been since March I've been doing this podcast and I can't actually remember if I've done one or if it was an article I wrote, but in any case I definitely have an article on thermometer use and I think a podcast, but I'd have to check for young babies Your're best to use a digital thermometer under their arm. And then for older children you can use an ear thermometer. Speaker 1 00:26:23 I personally love the bra thermoscan ear thermometer. I find it really easy to use and I like that I can check their temperature when they're asleep. For adults you can also use the earth thermometer and that is probably the best one to use. So one thing worth saying is that you know, you get the infrared for a forehead thermometers and they are really, really handy and have been such a good screening tool during covid. I still have one and I still use it regularly, but I just want to point out a couple of things on that. When you're using a forehead thermometer infrared, you need to hold it the correct distance from the forehead to get a reliable reading every time. You also need to be in a room that there is no draft in, so that can be quite tricky. There are other variables that can affect it, so it's fine as a screening tool, it's handy at night if you wanna check, you know, your your baby or someone who needs their temperature checked at night. Speaker 1 00:27:17 But um, in general I would probably recommend the brawl thermo scan. Um, someone asking about temperature and how high is too high. So for this question it really depends on age and also whether the temperature is responding to medication. So if your child is under three months, a temperature over 38 degrees is too high, so that's a GP call or a doctor call also. Then if your child is kind of under six to 12 months, if it's going over 39 you probably want to be checking in with your doctor in that case. Also for adults or older kids, if the temperature goes over 39, you know it is quite high but if it comes down with paracetamol and or ibuprofen and sometimes you may need to use both, just obviously trying one first and seeing if it does it on its own is ideal. But if it comes down that's okay. Speaker 1 00:28:12 You can just continue to treat it like that and hopefully it'll resolve within a couple of days. Obviously if your child or any adult is having other symptoms you know that would kind of flag warning for you like drowsiness, lack of response, dehydration, then you're gonna see the gp. But if it's just temperature alone and it's coming down with medication, that's okay. Someone has asked about earache in kids and I just want to refer you to a podcast episode that I did relatively recently again, which was on ear infections in children because that's fully covered there. One person is asking about calpol, so their baby is two months old around Christmas time and can they give calpol then The answer is no. So for a baby under three months, if they need paracetamol treatment then they actually need to see a GP because you know you're giving paracetamol because of a fever and for any baby under three months of age, if their fever is over 38 degrees you need to bring them to the GP anyway or to the doctor. Speaker 1 00:29:12 Obviously on the bottle of calpol it does say from uh, eight weeks, but it's only licensed between eight and 12 weeks for a post vaccination fever. And that kind of came about due to the introduction of the men B vaccination, which is given at eight weeks and is very likely to cause a fever. So they give paracetamol in that case because they know the cause of the illness. But for any other fever in a child under three months, really you do need to be seeking medical attention and not treating at home a paracetamol. I hope that is all clear, but if there's anything else you want to know, of course just reach out, send me a message on Insta and I will try and get back to you. Obviously it's a busy period, but I suppose I've always taken it on as my role to try and help people when healthcare isn't accessible and I think at the moment that is a really big issue and you'll all know that I'm campaigning our government at the moment to try and resolve that by allowing pharmacists who provide an expanded role of healthcare within our communities. Speaker 1 00:30:14 So thank you all for supporting this podcast. If you can give it a little review that does wonders for the rankings. So I would love that if you can, you can review it on Spotify or on Apple Podcasts and even just, yeah, tell your friends and share this episode. There's a lot of flu going around at the moment and hopefully this has made the range of products a lot easier to understand because there's, while there's lots of different names of products, a lot of them contain the same ingredients. So just have a listen back to that section where I discussed the ingredients that you need and you can work then within the supply chain because sometimes the product that you're used to mightn't be available, but actually there could be a product that's identical, which is very likely an Irish pharmacy. So you know, you don't need to panic and there are alternative products out there. Thank you so much for listening. Bye.