Pediatric Hematology, Oncology and Bone Marrow Transplant
Winter Tips for Our Pediatric Oncology Patients

Pediatric Hematology, Oncology and Bone Marrow Transplant

Winter Tips for Our Pediatric Oncology Patients

Kristin Casey, RN, MS, CPNP, CPON, provided the following information to help families stay healthy this winter.

Cold and flu season is in full swing across the country and we all want to do our best to prevent the spread of these unwanted germs.

Here are some general tips to help keep kids healthy this winter. No matter how much of a bubble we want our children to be in to protect them, remember to try and have fun as well. It is nearly impossible to prevent the spread of all germs. With common sense and practicing good germ control you can help your child ge through these tough winter months.

Always report fever of 100.4 or higher, frequent cough, chills, or other symptoms to your child’s doctor or nurse practitioner right away.

Flu Vaccine

Most children actively being treated for cancer may receive the flu vaccine. Please check with your child’s doctor or nurse practitioner to see if this is recommended for your child. Children receiving chemotherapy should receive the injection form of the vaccine.

We encourage other family members of children undergoing cancer treatments to receive the flu vaccine as well through your own medical providers.

Wash Your Hands

You’ve heard it many times but that’s because it is so important! Frequent hand washing is one of the very best ways to prevent the spread of germs and viruses. Teach your children to always wash their hands before eating, after using the bathroom, after coughing, sneezing or using a tissue.

Proper hand washing consists of using warm soap and water and lather it for as long as it takes to sing the tune “Happy Birthday” twice through. Then rinse and dry hands thoroughly.

Hand sanitizers are great as well and we recommend using those throughout the day.

Cough or Sneeze Into Your Elbow

Coughing or sneezing directly into your hands can spread germs faster unless they are able to immediately wash hands afterwards. Teach kids to cough or sneeze into the bend of their elbow if there is not a tissue available. Remind them to wash their hands if using a tissue to prevent spread of germs.

Keep Hydrated

We advise all of our patients on chemotherapy and many even after treatment to stay well hydrated. This is especially important during the winter months. Cold weather and indoor heating can cause mucous membranes to dry out and make them more susceptible to germs.

Drinking plenty of water will help support a healthier immune system. Remember to use moisturizers to lips and skin as well to keep them from cracking and help them stay moisturized. 

Eat Healthy

There are no magic foods to eat that will keep all germs away but maintaining a well balanced diet is the most effective way to help keep kids healthy from viruses. Junk food has little nutritional value and will not help support or build a healthier immune system.

Children undergoing chemotherapy and/or steroids may have taste changes and request different foods. Continue to offer healthy choices and talk to your doctor or nurse practitioner if you are concerned about your child’s nutrition.


Just because the weather may prevent outdoor activity does not mean your children should stay on the couch watching TV or playing video games all day. Exercise is very important to keep your child strong. Depending on where your child is in treatment and how they are doing, there are many activities to keep kids moving during the winter months. Find a place to walk or play indoors, stationary bike, use a Wii exercise game, play a game indoors ("Duck Duck Goose"), tag, or indoor sport of some kind. If weather permits, kids with cancer can still play outside in the winter - just remember to bundle them appropriately!

Clean and Disinfect Toys and Surfaces

If your child is ill or another member of the household is ill, remember to wipe down surfaces and disinfect toys or other items the ill person was in contact with. Ill household members do not need to be isolated from the child with cancer, but we advise good germ protection - such as good hand washing, not sharing utensils, avoid kissing on lips, etc. If non-family members such as relatives or friends wish to visit, just make sure they are not actively ill themselves or recently exposed to an ill contact.

Cough and Cold Remedies

We do not advise the use of bedside vaporizers or humidifiers based on the fact that they are very difficult to clean and could potentially be a source of germs itself. If your child does become ill with respiratory or cold symptoms, please call your doctor or nurse practitioner to discuss individual recommendations based on your child’s symptoms.

The American Academy of Pediatrics does not recommend giving over-the-counter cough or cold remedies to children under the age of six. There is no conclusive data to support that these medications provide symptom relief for this patient population and in many circumstances has led to fatal overdosing.

For children over the age of 6, if parents choose to administer over-the-counter cold remedies, it is recommended to choose a product with a single ingredient and follow package instructions for dosing very carefully to make sure your child is not receiving too much of the medication.

Remember to always check to make sure the product does not contain acetaminophen or ibuprofen. No ibuprofen should be given to patients receiving chemotherapy. If Tylenol is used for comfort, please remember to check your child’s temperature before each dose. Always call if the temperature is 100.4 or higher.

Ingestion of warm fluids such as warm apple juice, chicken soup (be careful to make sure it is warm, not hot or steaming) has been helpful to soothe sore throats or irritated respiratory mucosa.

There is also thought that honey – 1 teaspoon in children over the age of one year - may help an irritated cough for some children.

Nasal saline rinses may be helpful to keep nasal mucosa moist and decrease congestion - make sure to talk to your child’s doctor or nurse practitioner to see if this is appropriate for your child.

Stay warm, stay safe and have some fun this winter!