Five Things I Like About Lice

Lice have few friends in this world.  While I would not count myself among them, I do appreciate that lice have several endearing characteristics.  Here are five things that I, as a pediatrician, like about lice.

  1. Lice can’t fly

Lice can only crawl. They cannot fly or jump. This means they can only travel from one person to another by crawling directly from head to head. This is a very good characteristic.  You cannot get lice from another person unless you put your head close to theirs.  That is why preschool children are most likely to get lice.  While older people usually respect others’ personal space, preschoolers are often on top of each other, rolling and tumbling. It is also why caregivers of young children often get lice.

  1. Lice don’t carry any diseases

Fleas carry plague, ticks carry Lyme disease, and mosquitoes carry malaria and all sorts of bad things.  Lice carry no diseases.  This is very good.  While lice are highly distasteful and itchy, they will not make you sick.

  1. Lice can only live on a human head

I love this quality of lice.  Bedbugs can live for months on a surface without feeding on a person.  Lice, on the other hand, die after 1-2 days of falling off a human head.  They do not lurk on bed sheets, hats or hairbrushes.  It is usually recommended to wash sheets and hats that were in contact with an affected person within the past few days. But the risk of spread from objects is very small.  This means that there is no reason to use chemicals in the home to stop the spread of lice. That’s good!

  1. Lice are relatively easy to kill

Anyone who has tried to eradicate bedbugs knows that it is very, very hard.    Bedbugs hide in miniscule crevices in beds, luggage, you name it.  Lice pose no such challenge. They live in only one place and are often susceptible to over the counter medication.  When this does not work, there are several prescription medications that will kill them.  While repeat treatments may be needed, and nit combing is labor intensive, it is nothing compared to the heating of a room to 120 degrees for two hours required to kill bedbugs.

  1. Pets don’t get lice

Cats and dogs do not get lice. Only people get lice.  An affected child can hug their pet and rub heads all they want, the pet won’t get lice.

Next time that your child gets lice, remember all these good qualities.  Take a deep breath and treat your child’s head.  It could be a whole lot worse!

When is a Cough more than a Cold?

Most children get several viral upper respiratory infections, or colds, in the winter season. Young children in childcare can appear to have one continuous cold for months, as one virus overlaps with another with no recovery in between.

Sometimes, however, colds can develop into more significant conditions. When should a child be brought to the doctor?  Here are some tips to help parents make that decision.


Fever is a nonspecific sign that your child is fighting an infection, whether it is a common virus or more serious condition.  Thanks to vaccines, fevers today are rarely due to serious infections.

High body temperature is not dangerous, and is part of how our bodies fight off infections. Even fevers as high as 104-105 do not hurt the body or cause brain damage, and are not a reason alone to go the hospital.  However, when children have high fevers, they look and feel terrible. It can be frightening.

Doctors recommend treating fevers of 101 or above so the child feels better.  It is ok, though not necessary, to treat lower fevers if treatment is helpful.

Pediatricians want to see children who have had a fever for more than three days.  Any fever with pain, whether in the throat, ear, head or elsewhere, should be evaluated by a doctor.


It can be hard for children, particularly babies, to breath through congested noses. This is a mechanical problem, which improves somewhat with nasal saline drops, suctioning, and humidifiers.

Sometimes, however, colds can progress down into the lungs.

After a few days, a cough may get worse instead of better.  Children and babies may show signs of labored breathing, such as breathing fast, using their stomach muscles or sucking in around the ribs or clavicle with each breath.  

Whenever there is a concern for difficulty breathing, it is important to contact your pediatrician, even in the middle of the night.


When children feel sick they often refuse to eat. Babies with congested noses struggle to feed, and older children may need a lot of encouragement.  While it is ok to skip solids for a couple of days, it is important that sick children drink fluids.

Fluids with electrolytes and calories are better than water. Milk and formula are fine, while clear fluids, such as electrolyte solutions, may be easier for children to keep down.  Older children often are happy to eat popsicles and juices that may not be part of their regular diet.

Minimal fluid intake can lead to dehydration, usually after a few days. Signs include decreasing urine output, dry lips or gums and absence of tears. Children with signs of dehydration need to be been by a doctor.

General Appearance

Children with viral infections look and feel lousy.  They are less active, fussy and don’t eat or sleep well. However, once the fever is reduced, they generally feel well enough to engage in reduced age-appropriate behaviors, such as sitting up, communicating and drinking. Children with very atypical behavior, such as marked weakness or irritability, particularly when without fever, need to be promptly evaluated by a physician.

Prolonged congestion

Sometimes the congestion just won’t go away.  If significant nasal congestion continues more than ten-fourteen days, children should be seen to make sure they have not developed a sinus infection.

Having a sick child at home is never easy. Thankfully, most childhood illnesses today resolve with time. Monitor your child, and contact your pediatrician for any of the concerns above so we can provide the care they need.