HOW TO TAKE CARE OF YOUR CHILD WITH A COLD
HOW CAN YOU HELP YOUR CHILD WITH A COLD FEEL BETTER?
DOSAGES FOR COLD MEDICINES
COMPLICATIONS OF COLDS

HOW TO TAKE CARE OF YOUR CHILD WITH A COLD
Colds are also known as viral Upper Respiratory Infections

            Colds are the most common childhood illnesses.  A typical child will have about six colds a year.  A child in daycare can be expected to have more.  Since most colds occur in the winter, it can seem for some children that they have colds all winter long.  Frequent colds are not a sign of a problem with the immune system. 
Colds are caused by viruses. Cold viruses are usually passed from child to child by one child touching a surface that has been touched by another child with a cold.  Cold viruses can also be passed through the air on tiny moisture droplets from an infected person’s breath.  Colds are not caused by drafts, fans, not wearing hats, going outside when it is cold out, teething, or getting water in the ears. 
            The best way to prevent colds is to wash hands frequently!  It also helps to avoid close contact with people who have a cold.  Unfortunately dressing warmly and wearing hats does not prevent colds (it sure helps to keep a child more comfortable in the cold weather though).  In the past some people believed that Echinacea, an herbal supplement, was useful to prevent colds.  However in careful scientific studies it was proven to be of no value in preventing colds or in helping people to get over a cold more quickly.
            Most colds last about a week.  The start of a cold is often accompanied by a scratchy throat, low grade fever (less than 102), cough, and a runny nose.  Nasal drainage is usually clear at the beginning of a cold, but often turns yellow or green as the cold is drying up.  Nasal drainage is usually yellow or green on waking as well.  Discolored nasal drainage alone is not a sign of a serious illness.

HOW CAN YOU HELP YOUR CHILD WITH A COLD FEEL BETTER?

            There are NO medicines that cure colds or make them go away more quickly.  Antibiotics do not help.  Antibiotics kill bacteria germs but have no effect on virus germs. Children who receive antibiotics for colds may increase their risk in the future of having bacterial infections that are harder to cure, because of their previous exposure to antibiotics.
            You don’t need medicine to treat a cold.  In fact, almost no medicine helps very much.  Encourage your child to drink plenty of liquids.  This helps to keep the nose draining and to avoid the decrease in body fluids that can be caused by a runny nose and fever.  Encourage nutritious foods.  There is no need to stop formula or milk during a cold.  For infants, breastmilk is the best drink in all situations.  Humidifiers or vaporizers can help a child with a stuffy nose or scratchy throat to feel more comfortable.   Humidifiers and vaporizers do not make the cold go away faster or prevent ear infections or pneumonia.  Elevating the head of the bed with pillows or placing a towel roll under a crib mattress can help your child to sleep easier.
            Infants are particularly frustrated by a stuffy nose because they are not very coordinated at breathing through their mouth.  You can make your infant more comfortable by clearing his nose with salt water nose drops and/or bulb suctioning.  If the nasal mucous is runny it can be gently removed with the bulb syringe alone.  The best bulb syringes for the nose are often labeled as “ear syringes” at the pharmacy.  They have a fat bulb with a tapered extension and a blunt tip.  They are easier to use than the smaller bulb syringes that have a narrow pointed tip.  To suction the nose, squeeze the bulb portion of the syringe firmly.  Create a seal with the nose by pressing the tip against the nostril opening and releasing the bulb slowly.  Squirt out the mucous that is removed onto a cloth or tissue and repeat until the nose is clear.  For a stuffy nose, saline nose drops may be necessary to loosen the mucous.  Saline nose drops can be bought at the pharmacy.  Place one drop of saline in the nostril and either allow your infant to snuffle it out or use a bulb syringe to remove the loosened mucous and saline.
            Cold medicines should not be given to children less than 2 years old.
 Decongestant cold medicines can temporarily make the nose less runny, but they will not help heal the cold more quickly.  Decongestants do not prevent a cold from turning into an ear infection or pneumonia either.  Medicines that contain decongestants usually say, “for runny noses.” There are two kinds of decongestant.  Phenylephrine and pseudoephedrine.  Pseudoephedrine containing products like Sudafed and Pediacare Infant Decongestant drops are kept behind the counter, although they are not prescription. Phenylephrine containing products like Triaminic and Dimetapp are found in the cough and cold aisle.  There is no major difference between the two.
Antihistamines are helpful for allergy symptoms.  They do not help colds at all except that they help some children sleep and can help suppress a cough. However they have a downside, which is that they make the nasal drainage thicker and stickier.  This can make people feel more congested.  In addition there was a study that showed that children are more likely to have prolonged middle ear fluid when they take decongestants with colds.  Medcines that contain antihistamines usually say, “for stuffy noses.”
Cough medicines can temporarily lessen the urge to cough.  They do not shorten the length of the cold.  They do not prevent pneumonia, asthma, or ear infections.  The only ingredient in cough medicines that is useful is dextromethorphan.  Expectorants and mucous thinners are not helpful.
Many children get no help from cold medicines at all.  If you try a decongestant or cough medicine and it doesn’t help, STOP using it.  Don’t give medicine that doesn’t obviously make your child feel better.  There is no need to switch medicines since they are all really pretty much the same anyhow.
Acetaminophen (Tylenol or Feveral) and ibuprofen (Motrin and Advil) can temporarily help your child feel less achy and soothe a sore throat.  They do not shorten the length of the cold or help to prevent ear infections or pneumonia.  Use them only if your child looks uncomfortable and seems to get relief with them.  The low grade fevers that accompany colds are part of the body’s infection fighting defenses and do not need treatment with fever lowering medicine.  Don’t buy cold medicines that combine acetaminophen or ibuprofen with decongestants and cough suppressants.  The dose of acetaminophen or ibuprofen in these combination products is too low to effectively lower fever when the decongestant ingredient is dosed correctly.

DOSAGES FOR COLD MEDICINES

New! Cold and cough medications can be deadly if used incorrectly and not recommend for children under 2. Download the CDC report here. You can also read about it in this New York Times Article 3.2.07. Cold medications are discouraged for children under 6 years of age.

ACETAMINOPHEN AND IBUPROFEN—dosing charts can be found elsewhere on the website under the heading “Fever Facts.”

COMPLICATIONS OF COLDS

Bronchiolitis caused by the RSV virus—RSV is a cold virus that in infants can cause swelling and mucous build-up in the tiny tubes that bring air into the lungs.  If your infant is having difficulty breathing characterized by rapid breathing, wheezy breathing, tugging of the belly under the rib cage, difficulty feeding, or a frightened or anxious appearance, call us as soon as possible.

Ear infections—Ear infections occur when mucous in the middle ear, formed as a result of the cold, gets infected by bacteria germs.  Ear infections are not an emergency unless your child can not be made comfortable by the use of acetaminophen or ibuprofen.  Symptoms of ear infections are painful ear, fever that begins and gets higher several days into a cold, or a cold that lasts longer than 14 days.  Not all children with ear pain and fever have an ear infection however. Call us during the next regular office hours if you suspect that your child has an ear infection.

Asthma—Cold viruses can trigger an asthma attack in children with asthma.  Call us if your child is wheezing for the first time.  If your child has a history of asthma and has not responded to his asthma management plan, call us.

Pneumonia—Pneumonia can be a complication of a cold.  Symptoms of pneumonia are a fever that develops or gets higher several days into a cold, associated with worsening cough and sometimes shortness of breath.  Children with pneumonia often complain of stomach ache, vomit, and look ill.  Call us as soon as possible if you suspect that your child has pneumonia.

Sinus Infection—Sinus infections occur when mucous in the sinuses, formed as a result of the cold, becomes infected by bacteria.  Symptoms of a sinus infection are a fever that develops or increases several days into a cold, facial pain or headache over the forehead, jaw pain, worsening cough, or a cold that lasts longer than 10-14 days without signs of improvement. Sinus infections are not an emergency.  Short term treatment includes acetaminophen or ibuprofen and decongestants.  Call during regular hours if you suspect that your child has a sinus infection.