A Parent's Guide to Chicken Pox

by Nicki Bradley | More from this Blogger

09 May 2006 08:03 AM

It's that time of year again! Although the recent increase in those receiving the chicken pox vaccine has slowed the occurrences in schools, they still persist. My own family is current knee deep on pox. I know the toll it can take on us parents! We are usually far more affected than our little sweeties! Here's the low-down on the chicken pox and some tips for making it through with your sanity intact.

Contagiousness & Incubation: Chicken pox is most contagious a few days before the spots appear and for the first two days of rash. The contagiousness wanes after that and as soon as all the pox are scabbed over, the child is no longer contagious. The incubation period is from day 14-21 after exposure. Some very few children have been known to get chicken pox a few days earlier, however.

The Vaccine: The chicken pox vaccine is now required in many schools and childcare facilities. However, not all doctors agree that it is necessary or preferred. Talk with your doctor about his concerns and yours and make an informed decision together. Almost all states allow a parent to opt out of a vaccine by simply signing a waiver but you will have to ask for it. If you do opt for the vaccine, be aware that it does not provide 100% immunity to the chicken pox. Many of the cases going through the schools currently involve vaccinated children. It is believed that most kids who are vaccinated will get a milder case of the pox, if they are not immune through vaccination. Some, however, will get a full blown case. A child who is vaccinated and still gets the chicken pox is still contagious!

Symptoms: Often chicken pox begins with flu-like symptoms: mild fever, tummy ache, a runny nose, slight cough. A day or two later, the rash starts. The chicken pox rash goes through several stages. It first appears as a small red dot, barely even raised, like a precursor to a pimple. It then form as fluid-filled blister surrounded by pink or red skin that is often referred to as "dew drop on a rose petal". Then the blister grows and bursts and the fluid crusts over, forming a scab. The rash comes out in "bunches", often starting on the scalp, chest or back and progressing onto the face, arms and legs. Rarely will there be pox on the soles or palms but it isn't unusual for pox to form in the throat, mouth, ears, nose or eyes. After 3-4 days, new spots will stop forming and the disease is basically over.

Risks: Chicken pox is still a mostly-benign childhood illness. Women should know their immunity status before becoming pregnant as getting chicken pox while pregnant has about a 1-2% possibility of severely harming or killing the fetus. Also, as we age, the disease becomes more severe. People over the age of 13 may suffer a longer and more uncomfortable illness with more pronounced flu-like symptoms than those in early childhood. Those with skin problems, such a eczema, may experience 2-3x as many spots as is typical. And those with immune deficiencies, such as those on chemotherapy, people taking long term oral steroids, and those with HIV are much more likely to experience complications from chicken pox. For your average, healthy child, the biggest complications tend to be localized bacterial infections due to scratching so keep hands clean, fingernails cut short and encourage your child not to pick or scratch.

Comfort measures for the child: There are three common complaints from children who have the chicken pox.

The first is, of course, the itching. Suggestions for dealing with itching are:

• Alternate between oatmeal baths and baking soda baths. Keep the tub full, for older children, to allow them to jump in and out as needed all day.
• Use calamine lotion, as needed, at room temperature. Be sure not to use Caladryl or a lotion with an antihistamine included. Also Aveeno anti-itch cream works very well but should be limited to just 4 times per day, as the directions indicate.
• A hot water bottle on spots often relieves the itching.
• Instruct children to rub with an open palm instead of itching with fingernails. But, just in case make sure nails are cut short and wash hands many times a day.
• Some children enjoy wearing mittens or socks on their hands to prevent itching.
• Wear long clothing. Nothing makes a kit want to scratch more than seeing all the spots.
• Keep busy. Taking your child's mind off the itchies will keep them at bay.

The second most common complaint is temperature regulation. When a child has chicken pox, they often also have a low grade fever which might make your child feel unusually warm, have the chills or fluctuate in between both extremes. Add to this the fact that the skin around the pox are comforted by warmth and cold on the skin can be extremely uncomfortable BUT ambient temperature tends to be the opposite with a cool environment much more comforting to a child than a warm one and this was, by far, the most challenging part of coping with the pox for both our child and for us parents!

• Keep the A/C on. If that isn't possible, keep the temperature down with a fan (even in the winter), ceiling fan, etc.
• Fresh air will help a lot. If it is cool outside, enjoy the outdoors as much as your child feels up to, confining him or her to your own yard of course.
• Ditch the sheets and blankets. If you don't, your child probably will while sleeping.
• When it comes to treating the spots, think warm. Use warm water, warm lotion, and warm water bottles on the spots directly. Using anything cold on the spots will probably send your child over the edge! Even though they are more comfortable in a cold room, they will NOT be comforted by ice, cold packs, cool baths, or even lotion. You may have to put your lotion in a warm water soak to increase the temperature a bit above room temp before applying it.

The last area of discomfort is often the sore throat that accompanies chicken pox. If your child has pox in their mouth or throat, it will be even worse. It is important to keep your child hydrated during the illness.

• Offer cold drinks such as smoothies, yogurt drinks or milkshakes. Some children find these comforting and enjoyable. If your child has pox in his or her mouth, they may be intolerable, however.
• Think: soft foods! Soups, broth, ice cream, applesauce. Anything that is easy on the throat is a good idea.
• Chicken pox often causes a drastic decrease in appetite. This is just fine; follow your child's lead. Don't push food. Just focus on hydration. Ice water is a great beverage but if your child has pox in the mouth or throat, room temperature water with a straw might be highly appreciated.
• If your child won't drink water, try electrolyte fluids such as Pedialyte. They can be served room temperature or refrigerated. If your child can handle cold, try electrolytic popsicles. You can buy these or make them at home with Pedialyte fluid.

Tips to keep parents sane:

• Sleep when your child sleeps. We learned that our non-napping child suddenly was taking naps during the disease even though he seemed otherwise completely fine and full energy all day long. We also quickly learned that he was only uncomfortable at night. This made for short, sleep-deprived nights for us. We should have slept during these daytime naps to rejuvenate and prepare for the next night!
• Clear your calendar. Trying to figure out how to keep commitments when your child is contagious is a lose-lose proposition. Try to clear your calendar so you can do nothing but hang out with your kid.
• Take pictures! You may need them for medical proof since many doctors won't allow a contagious child into the office anymore. Regardless, you will want them as mementos for your child's scrapbook!
• Overindulge. It's a week out of both of your lives. Overindulge your child and yourself. Buy your child a few new toys you can both enjoy together - an art kit, a puzzle, a video game, etc. Make it fun. Stock up on your favorite snacks and put your regular household responsibilities on the back burner for the week.

Learn more about Nicki Bradley

I live in the suburbs of Detroit and I'm happily re-married with six children (3 his, 2 mine, 1 ours) ranging in age from 3.5 to 12.

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