The Common Cold (Upper Respiratory Infection)

28th Sep 2015

WHAT TO DO WHEN YOUR CHILD GETS A COLD

            Colds are the most common childhood illnesses, and they are more common in the winter.  A typical child will have about six colds a year.  A child in daycare can be expected to have more.  Some children will have colds almost all winter long.  Frequent colds are unpleasant, but generally not a sign of a problem with the immune system. 
Colds are caused by germs called viruses. Children get cold viruses by touching surfaces that have been touched by another person with a cold, and then touching their mouth, nose or eyes. 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 with  colds.  Don’t believe a person who tells you that their cold is no longer contagious—if they still have a runny nose or cough, they are still contagious.  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.  Washing hands frequently is the best defense!
            Most colds last about a week to ten days.  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 bacterial germs but have no effect on viral germs. Children who receive antibiotics for colds increase their risk of developing bacterial infections that are resistant to treatment with 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.  Taking a hot bath or spending time in a steamy bathroom can really help to relieve uncomfortable congestion. Turn the shower to its hottest temperature and leave it running with the bathroom door closed.  Have your child spend 10 minutes in this very steamy environment.  This is particularly helpful right before bed. Elevating the head of the bed with pillows or placing a towel roll under a crib mattress can also help your child to sleep easier.
            Infants are particularly frustrated by a stuffy nose because they are not very coordinated at breathing through their mouths.  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.  We also hear that the Nasafrida works great. 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 6 years old.  In most cases they don’t help, and they can be dangerous.

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. 

 COMPLICATIONS OF COLDS

Conjunctivitis—Conjunctivitis is irritation of the membrane that lines the eyelids and covers the surface of the eyeball.  It can be caused by the same viruses that cause colds, or bacterial germs. It can go away on its own. Healing is helped by applying warm compresses in the form of a wash cloth moistened with warm water. Antibiotic ointment can shorten the length of a bacterial conjunctivitis by a day or two, but does not help viral conjunctivitis. Call us during the next regular office hours if your child has redness of the white of the eye or discharge from the eye.  Call us sooner if there is decrease in vision, significant light sensitivity, or fever with swelling of the tissue around the eye.

 Bronchiolitis caused by the RSV virus—There are several different viruses that cause colds. 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.  Infants can be protected from RSV by avoiding contact with people with colds and by careful hand washing by adult caretakers.

 Ear infections—Ear infections occur when mucous in the middle ear, formed as a result of a cold, gets infected by bacterial germs.  Ear infections are not an emergency unless your child can not be made comfortable by the use of acetaminophen or ibuprofen. Ear infections can resolve on their own without antibiotics.  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,  or if your child has a history of asthma and has not responded to his asthma management plan.

 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 14 days without signs of improvement. Sinus infections are not an emergency and can resolve without treatment.  Sinus discomfort can be relieved by acetaminophen (Tylenol) or ibuprofen (Motrin or Advil). Children older than 6 can sometimes get relief from decongestants containing pseudoephedrine.  Call during regular hours if you suspect that your child has a sinus infection.

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