{SQT} How to Manage Illness in a Large Family

Posting this one day early just in case it helps others in the thick of their own illnesses . . .


We are experiencing a terrible illness season in our country and, in particular in our city, lately. With so many families around us succumbing to terrible illnesses--and with our family being almost two weeks' homebound so far due to influenza and an intestinal illness simultaneously savaging all of us--I am inspired to share some tips and tricks I've learned over the years, as managing a large family through illness (and with the added complication of a sometimes-traveling husband) is different than managing a smaller family through it.

I think I earned my "General's Stripes" during what was probably our worst illness: I was four weeks postpartum with our sixth child, I was still pumping exclusively to bottle because he hadn't grown strong enough to nurse yet, and my husband went on a business trip for a week, during which time all five children fell ill with Norovirus . . . and my husband fell ill with it in his hotel room 3,000 miles away. There was one 24-hour period of that week when I didn't sleep at all because so many children were vomiting so frequently. Using my techniques below--most especially using latex gloves--I held off catching that extremely communicable illness for five days until my a few hours after my husband got home.

• First, if you want to read up on alternative or 'natural' methods to stay well or get well, there are innumerable blogs or websites to share those ideas. This is really about some pragmatics to function when you're in the trenches.
• Second, if I may, let me direct you to reading this lovely post by Leila Lawler at "Like Mother, Like Daughter" in which she tries to teach the beautiful art of taking care of sick loved ones and shows why it is such a vital role.
• Third, I don't think I write as beautifully as she does, but I still think there is a place for this blog post detailing a few more pragmatic ideas.

1. Cancel all events and appointments and stay home.

I always wish some other sick family had stayed home and not infected us, so I make every effort to keep us home until well past being contagious.

It's very useful to get to know various illnesses by studying reliable sources, like the CDC: know how long gestation takes so you can figure out where your child likely caught the illness, know how long your child is likely to remain contagious from onset of symptoms!

For example, Norovirus continues shedding for two weeks (source: CDC), so a child trapsing around to activities who has not washed his hands absolutely perfectly after visiting the bathroom is still spreading that virus to other families. Norovirus can survive for weeks on surfaces not disinfected (source: Wikipedia). Norovirus does not confer future immunity, so you can catch it again and again.

Another example is influenza, which can cause five days of fever--significantly longer than most average illnesses--and two weeks of lingering cough. When one medicates in order to go to school, work, or church, one is still spreading the virus (and maybe more of the virus because the fever is not doing its job), potentially causing serious illness or death to the frail among us (babies, elderly, those with compromised health). Note this older article: "Study: Fever Treatments May Cause More Flu Deaths." (The editor in me doesn't like the title: people going out in public while sick is what causes more influenza deaths.)

Knowing the facts about Rotavirus, enteroviruses, influenza and influenza-like viruses is very helpful. Know that antibiotics do not help viruses whatsoever (but do cause other harm). Know to be on alert to a fever that resurfaces later because that is indicative of a secondary infection, like pneumonia (which antibiotics can sometimes help).

I have downloaded a free app to my iPhone called Doctors Report, which shows the illness trends throughout the country. As I write this, my town of Charlotte is one of only four in the whole United States under a special (bad) warning about influenza, and I can see on the map that my area of the city is hit more severely than any other.

Know thy enemy.

2. Keep a List

At the first sign of a highly communicable illness, I grab a spiral notebook so all the papers are together and start to keep notes. Each child gets a page, and I track by the day the symptoms and medications given. This becomes so useful when Mama is sleep-deprived and addle-brained and has to remember when the last medication was given, or when taking the children to see a doctor.

This list is also vitally important for a husband and wife to work together. If my husband is handling the wakings of certain sick children during the night, he does not need to wake me to ask when so-and-so got his last dose of what medicine: he can check the list. Then if I take the early morning shift with the sick kids while my husband sleeps later, I can check the list and see what any children received in the nighttime.

3. Use Plastic Barriers

I'm hoping this blog post will be known as "that one about latex gloves." Wearing latex gloves has been the most important tool for my keeping myself healthy while I care for sick children.

Because I have a larger family than average, I have started to think about what hospitals do to prevent the spread of illness and often, these practices are very helpful. I am running a mini hospital!

I keep latex gloves (which I buy off Amazon) stocked in my house at all times, in bathrooms upstairs and down. One must be prepared for illness to strike. I buy them in size XL so they fit my husband's hands too, instead of buying my smaller size or buying multiple sizes.

Transmission of certain of the vomiting illness is virulent.

For example, "Noroviruses are highly contagious. A person with norovirus infection can shed billions of norovirus particles. But, it only takes as few as 18 viral particles to infect another person." (Source: CDC) Don't mess around, folks.

When a large family has an illness going through the house is not the time to try to reduce, reuse, and recycle. It is time to desperately try to halt the illness, spread it to as few vulnerable people as possible, and keep the parent who is handling the majority of the infected material from getting sick herself--because then the whole household is sunk!

Would a doctor or nurse ever handle a sick patient, or literally handle the vomit of a patient, with bare hands? Never! You'd be horrified to see it! So why do mothers do this? We are not more "loving" by handling our children's vomit bare-handed: we are more foolish.

When there is sickness in the home, I use latex gloves liberally and throw them away when handling all laundry, cleaning all toilets, scrubbing vomit or collecting up snotty tissues strewn about by a feverish child.

Plastic trash bags are highly useful to stuff with infected sheets and bedding, and dirty pajamas. I keep a box of these in my upstairs and downstairs bathrooms at all times. In some severe illnesses, those bags of laundry have built up in my laundry room, but at least they were contained carefully and no child was digging into them. Then throw away the bags: do not reuse them!

Face masks would also be good to use (although I haven't yet used them) because vomit "aerosolizes," which means the tiny particles float into the air, and Mama is breathing them in while on her hands and knees scrubbing the carpet. Face masks would also help minimize the spread of influenza within a home.

4. Protect the Beds and Carpets

Scrubbing vomit out of carpet is challenging, to say the least, and it often stains permanently. Laundering towels is much easier, so I lay beach towels near all the beds where a sick child might wake up in the midst of vomiting and not make it to the bathroom in time.

I lay a trail of towels from the sick child's bed all the way down the hall to the bathroom.

I remove the pretty bath rugs from bathrooms and replace them with towels or with nothing at all, as it is easier to wipe and disinfect tile.

Also, I remove any expensive or difficult-to-wash bedding from beds when illness is sweeping through the house. If a gorgeous, large comforter requires going to a laundromat or a dry cleaner to be laundered, I do not want it vomited upon, so I hide it away for several weeks until the danger is passed.

Each time one of our children graduates to a big boy/girl bed, I spend less than $20 to buy an inexpensive, waterproof mattress cover to protect that $200 mattress (for example, I've bought this one several times). I also have waterproof protectors on the master and guest beds. Even if a family does not cosleep, if a sick or potty training child is ever in a big bed, I want the investment of that mattress protected.

What if the child is sick and it soaks through the mattress protector in the night? And the vomiting is going to continue all night? I will lay bath towels in layers on the bed because those can be stripped very quickly in the night, replaced with another bath towel.

5. Never Stop Cleaning

During my down moments of an illness, I disinfect toys, objects, door knob handles, dishes, and laundry. Like McDonald's says, "If you've got time to lean, you've got time to clean."

Use bleach, or Purell Surface Sanitizer, which is food safe. Note that "Clorox bleach wipes" and "Lysol wipes" do not have bleach in them, nor do they kill Norovirus.

I will disinfect the toys I take to Nursery on Fridays before I let them be in my house again.

I try to stay on top of the laundry, even when I am sick. It builds up too fast and it would be really bad to have six children vomiting and no more towels or sheets left.

I temporarily label all cups to decrease likelihood of sibling sharing and I run the cups through the dishwasher each night.

6. Sickness Supply Station

Each night, during the thick of things, I will set up a Sickness Supply Station in the upstairs bathroom near all the bedrooms.

This is the bathroom where you or your spouse will stumble, bleary-eyed, responding to yet more vomiting children. I like to set out a box of latex gloves, baby wipes (to get the bulk of material wiped off of a child), plastic trash bags (in which to contain all vomited-upon laundry or infected trash), and any medications one might be using for said illness (fever-reducers, Zofran or other anti-emetics, Benadryl to dry up mucus, etc.).

Another tip: I always check dosages with every single medicine with every single child. I don't trust myself to remember "Oh, Mary gets two of these Advils." Which Advil? Which dosage is that pill? Is it Mary, or her older or younger sibling who gets two? I check every time.

7. Get Help

As I said, my husband is one who travels for business, so I've had to manage some doozies of illnesses in his absence.

It's important to have outside help in a true emergency. Some people have family living nearby, but we don't, so I rely on friends and businesses.

Who can I call for help? Will a neighbor or friend or church acquaintance drop off a meal on my porch? Or pick up emergency supplies for me at the pharmacy?

If I had to take one child to the hospital, is there an adult who would come stay with my other sick children?

There are so many businesses now for shopping without going into a store: I almost never shop in a store even when I'm well, so I certainly don't do it when we're sick. Amazon Prime ships to one's door in two days, one can pay extra for same-day shipping, and now I hear there is 2-hour grocery shopping. There are innumerable online grocery shipping services. If one can still drive, one can do online shipping and go pick up the order. Also, many of those local stores offer delivery of groceries for a fee, such as $10, which I would pay if we were desperately ill (or, as above, I'd ask my neighbor to go get them). Even the pharmacy offers drive-through service.

Bonus . . . Getting Better

In a large family especially, an illness will drag out as it infects one person at a time and all the folks' illnesses overlap each other. An illness might take two or three weeks to finish in a family. At some point, as normalcy is returning for some children, but not the sick ones yet, Mama has to start returning the healthier children to a bit of regularity.

I may let the sick ones watch TV but I'm telling the healthier ones that they're no longer allowed to watch TV all day and literally must leave the room and go occupy themselves. We homeschool, so, if they're well enough, they need to do independent work (but I can't teach until my duties taking care of sick children are concluded). They need to help out more, even if it's "not my turn today!" These are opportunities to explain that we all must pitch in, it's "time for all hands on deck," and anyone who is healthy enough must help serve the family in times of need.

Also, there may be a point at which the first sick kids are well and not contagious, but the second batch of kids is still contagious. Maybe we parents can divide and conquer, but maybe those healthy kids are just going to have to learn a character lesson about sacrifice by continuing to stay home. Maybe mom is just too exhausted to start taking healthy kids on their outings while she is still caring for sick kids and getting little sleep at night . . . and that's okay. Kids who have been bored and home for one or two whole weeks aren't going to die from having to be bored a few more days. They can even be required to pitch in and help with the current sick kids.

Practice saying "life ain't fair" while tousling a kid's hair affectionately.



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