How to Raise a Child Without Antibiotics

Child 3


Since this Atlantic article was tweeted by @BradSpellberg you know it’s worth a careful read. It’s the unusual case of a 14-year old boy who, though he had been sick, had never been given an antibiotic. That’s because his parents understood the foundational rule: That antibiotics only work on bacterial-driven infections not viral-driven ones. Thus, for example, when you have the cold or flu antibiotics are not for you.

But this can be hard to follow in practice especially when facing your sick child. The article nicely explains why:

 Take a cold, for example, or bronchitis. Our friends know on one level that these are usually caused by viruses, but after a week or two of yuck and snot they’ve had it — so they call the pediatrician for an antibiotic. The harried doctor knows it’s likely viral but doesn’t want to fight with yet another parent about antibiotics — so out comes a prescription. “Just in case this thing’s bacterial, let’s cover our bases,” the doctor says, and moves on to the next patient. The child takes the antibiotic, and around the same time the cold would run its course anyway, the child gets better. Everyone is happy, right? No harm done. Except there’s lots of harm done.


So to avoid falling into this trap, there’s 5 refrigerator-door rules to know & follow:

  • Antibiotics are unnecessary for colds or bronchitis, even when they last longer than two weeks. Colds and bronchitis often take more than two weeks to resolve, so if there are no signs of pneumonia, then antibiotics can be withheld safely.
  • Green sinus discharge and green sputum does not mean you require antibiotics. Sinus discharge, sputum, and phlegm all turn various colors as the body fights infection, and many studies have shown that green sputum is as likely to be viral as bacterial.
  • Ear and sinus infections don’t always require antibiotics. Medical guidelines for sinus and (hot off the presses) ear infections suggest that patients without red flag symptoms can be observed without antibiotics; your doctor can help ensure this is safe.
  • If your child gets a prescription for antibiotics, ask your doctor to explain why.
  • The diagnosis of pneumonia — a legitimate indication for antibiotics — can not be made without a chest X-ray. Since the symptoms and physical examination can be the same in bronchitis (which is usually caused by a virus) and pneumonia (often bacterial), a chest X-ray is needed to determine if the diagnosis is really pneumonia, and therefore if antibiotics are needed. Don’t accept a prescription for antibiotics for pneumonia without a chest x-ray.

There is, of course, one other factor – luck. As the author points out: “Granted, we have been very lucky. Our son has never been in a major accident, needed surgery, or contracted any major illnesses. He was born healthy, he was breastfed, and he got his vaccines. He’s had his fair share of colds and a particularly scary case of flu, but never, not even once, required antibiotics.”




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