Common Cold

A “cold” is an infection in the upper respiratory passages (nose and throat) caused by a virus.

The symptoms of a cold include one or more of the following: running or “stopped-up” nose, sore throat, hoarseness, “dry” cough (producing little or no “phlegm” or sputum), fatigue, and sometimes generalized aches.

Colds last from 3 to 14 days, usually with a gradual one to two day onset, followed by full-blown symptoms.  Antibiotics including Penicillin are of no benefit in treating colds because they have no effect on any of the viruses that cause colds.  Treatment, therefore, cannot be specific but only symptomatic.  Treatment is aimed at reducing the intensity of the symptoms to make the patient more comfortable.

Young children can normally get up to 8-12 colds a year, while adolescents average 2-4 per year.  In young children, these frequent colds are important in building future immunity.  A cold may be caused by hundreds of different viruses.  Infection by one gives only immunity to that one specific virus which still leaves us susceptible to any of the other viruses.  This explains the “all winter cold” which is really one infection after another.

Crowding indoors results in easy spread of the different viruses.  This is why colds are more common in the winter as well as the beginning of school when children are grouped together.  For the same reason, colds are extremely common in nursery school and in large families.  Young infants, even newborns, are not immune to colds.

There is no point in trying to keep a child with a cold in bed.  It will not speed recovery and will only cause unhappiness for all.  On the other hand, encourage rest from time to time.  In nice weather, the child may even play outdoors.

Children’s colds almost always seem worse at night.  In daytime, the child swallows the secretions from his irritated nose without much difficulty.   But in sleep, the secretions accumulate in the throat.  This causes a gag or cough.  Strange as it seems, coughing is a good thing in one sense, for it guards against aspirating mucus into the lungs.  The spells of coughing may on occasion progress to retching, even vomiting.  A humidifier (vaporizer) will help (preferable a cool mist).   A certain amount of night-time disturbance, however, seems inevitable with colds.

When your child has a cold, their bowel movements may change.  She/he may have less frequent stools because they are eating less.  There is rarely a reason to treat this decrease in frequency of stools (See Constipation).  Or the child may have softer or watery stool from the virus itself.    If the stools should become diarrhea, manage the situation as you would in other cases of diarrhea (see Vomiting and Diarrhea).

Children are most contagious from a cold just prior to symptoms begin and when they have a fever.  If feeling well other than a runny nose and a cough, the child may go to school or daycare after they have been fever free for 24 hours.

TREATMENT

  1. Diet: Accept the fact that there will be loss of appetite during a cold.  Do not be concerned if your child shows little interest in eating.  Appetite should return in a few days to about a week.  Drinking is very important, so encourage fluids.
  2. Congestion and cough management: If your child has only mild runny nose that is not bothering him/her, promote rest and encourage fluids.  No medication or further treatment needs to be given.   If the patient has difficulty with the congestion and coughing, follow the instructions below:

Infant-1 Year of Age

1. Patient should use a cool mist vaporizer or humidifier.  Vaporizer only needs water.  No medication is needed.

2. Allowing the child to sleep upright, in an infant car seat sometimes helps clear the congestion.

3. If the child is still having problems eating or sleeping use normal saline nose drops.  Place 2-3 drops with an eyedropper into one nostril.  Wait about 15 seconds and then suck out with a nasal bulb syringe.  Repeat for other nostril.  (Normal saline nose drops can be bought or made as follows…Boil water for 5 minutes and then let it cool.  Pour into an 8 oz bottle add 1/4 oz a teaspoon of salt.  And shake solution.)

4. Do not use medication unless directed by a doctor. Over the counter medicines are not effective and may not be safe in this age group.

Older than 1 year and less than 6 years:

1. Use a vaporizer or humidifier as above.

2. Patient older than 2 years old may try a teaspoon of Honey at bedtime.  There are some studies that show this helps somewhat with cough.  Do not use medication unless directed by a doctor. Over the counter medicines are not effective and may not be safe in this age group.

For Children 6 years and older:

1. Use a vaporizer or humidifier as above.

2. Patient may also use Dimetapp, Claritin, Triaminic, Pediacare or Benadryl as per the directions or one may try a teaspoon of honey as above.

Call the office if…

  1. The infant/child does not respond to the above treatment.
  2. For fever not responding to fever instructions (see Fever).
  3. Increasing pain in throat over 48 hours and or appearance of white spots on tonsils or other parts of throat.
  4. Cough that is longer than the interims of not coughing, or one that produces thick yellow, green or gray phlegm (sputum).
  5. Shaking chills.
  6. Chest pain.
  7. Shortness of breath.
  8. Earache.
  9. Pain in the teeth or over sinuses.
  10. Skin rashes.
  11. Lethargy, to an unusual degree.
  12. Irritability, to an unusual degree.
  13. Cough persisting longer than 10 days and not improving.
  14. Difficult or labored breathing between bouts of coughing.
  15. Glands in the neck become large and tender.
  16. Dusky blue or gray color develops in lips, nail beds, and/or skin.
  17. Wheezing without history of asthma. (If asthmatic, treat with short-acting asthma medicine e.g. Albuterol).