COLDS

Your child probably will have more colds, or upper respiratory infections, than any other illness. In the first two years of life alone, most youngsters have eight to ten colds. And if your child is in child care, or if there are older school-age children in your house, she may have even more, since colds spread easily among children who are in close contact with one another. That’s the bad news, but there is some good news, too: Most colds go away by themselves and do not lead to anything worse.

How colds spread
 Colds are caused by viruses, which are extremely small infectious organisms (much smaller than bacteria). A sneeze or a cough may directly transfer a virus from one person to another. The virus also may be spread indirectly, in the following manner.

  1. A child or adult infected with the virus will, in coughing, sneezing, or touching her nose, transfer some of the virus particles onto her hand.
  2. She then touches the hand of a healthy person.
  3. This healthy person touches her newly contaminated hand to her own nose, thus introducing the infectious agent to a place where it can multiply and grow—the nose or throat. Symptoms of a cold soon develop.
  4. The cycle then repeats itself, with the virus being transferred from this newly infected child or adult to the next susceptible one, and so on.

Signs and symptoms of a cold
 Once the virus is present and multiplying, your child will develop the familiar symptoms and signs:

  • Runny nose (first, a clear discharge; later, a thicker, often colored one)
  • Sneezing
  • Mild fever (101–102 degrees Fahrenheit [38.3–38.9 degrees Celsius]), particularly in the evening, usually not more than 3 days in row
  • Decreased appetite
  • Sore throat and, perhaps, difficulty swallowing
  • Cough
  • On-and-off fussiness or crankiness
  • Slightly swollen glands in the neck

If your child has a typical cold without complications, the symptoms should disappear gradually after seven to ten days.

Treatment
An older child with a cold usually doesn’t need to see a doctor unless the condition becomes more serious. If she is three months or younger, however, call the pediatrician at the first sign of illness. With a young baby, symptoms can be misleading, and colds can quickly develop into more serious ailments, such as bronchiolitis, croup, or pneumonia. For a child older than three months, call the pediatrician if:

  • The noisy breathing of a cold is accompanied by the nostrils’ widening with each breath, or difficulty with moving breath in and out.
  • The lips or nails turn blue.
  • Nasal mucus persists for longer than ten to fourteen days. The cough just won’t go away (or it lasts more than 10 days).
  • She has pain in her ear.
  • Her temperature is over 103 degrees Fahrenheit (38.9 degrees Celsius) and does not respond to medication, even by going down ¼  of a degree 45 minutes after administration.
  • She is excessively sleepy or cranky, doesn’t even attempt to play when fever is down, or is unable to take fluids well.

Your pediatrician may want to see your child, or he may ask you to watch her closely and report back if she doesn’t improve each day and is not completely recovered within 10 days from the start of her illness.

Medicines
 Unfortunately, there’s no cure for the common cold. Antibiotics may be used to combat bacterial infections (like strep throat), but they have no effect on viruses, so the best you can do is to make your child comfortable. Make sure she gets extra rest and drinks increased amounts of fluids.

If she has a fever and is very uncomfortable, give her acetaminophen or ibuprofen. Ibuprofen is approved for use in children six months of age and older; however, it should never be given to children who are dehydrated or who are vomiting continuously. (Be sure to follow the recommended dosage for your child’s age.) For children under 6 months especially, temperature should be taken rectally.

Never give her any other kind of cold remedy without first checking with your pediatrician. Over-the-counter treatments often dry the respiratory passages or make the nasal secretions even thicker. In addition, they tend to cause side effects, such as drowsiness.

One final note about medications: Never use cough medicines or cough/cold preparations in a child under two years of age unless prescribed by your pediatrician. Coughing is a protective mechanism that clears mucus from the lower part of the respiratory tract, and ordinarily there’s no reason to suppress it.

Managing a stuffy nose

  • Suction bulb. If your infant is having trouble nursing because of nasal congestion, clear his nose with a rubber suction bulb before each feeding. When doing so, remember to squeeze the bulb part of the syringe first, gently stick the rubber tip into one nostril, and then slowly release the bulb. This slight amount of suction will draw the clogged mucus out of the nose and should allow him to breathe and suck at the same time once again. You’ll find that this technique works best when your baby is under six months of age. As she gets older, she’ll fight the bulb, making it difficult to suction the mucus.
  • Nose drops. If the secretions in your baby’s nose are particularly thick, your pediatrician may recommend that you liquefy them with saltwater (saline) nose drops, which are available without a prescription. Using a dropper that has been cleaned with soap and water and well rinsed with plain water, place two drops in each nostril fifteen to twenty minutes before feeding, and then immediately suction with the bulb. Never use nose drops that contain any medication, since excessive amounts can be absorbed. Only use normal saline nose drops.
  • Humidifier. Placing a cool-mist humidifier (vaporizer) in your child’s room also will help keep nasal secretions more liquid and make her more comfortable. Set it close to her so that she gets the full benefit of the additional moisture. Be sure to clean and dry the humidifier thoroughly each day to prevent bacterial or mold contamination. Hot-water vaporizers are not recommended since they can cause serious scalds or burns.

Prevention
If your baby is under three months old, the best prevention against colds is to keep her away from people who have them. This is especially true during the winter, when many of the viruses that cause colds are circulating in larger numbers. A virus that causes a mild illness in an older child or an adult can cause a more serious one in an infant.

If your child is in child care and has a cold, instruct her to cough and sneeze away from others, and to use a tissue to cough into and wipe her nose. Doing this may prevent her from spreading the cold to the others. Similarly, if your child would be in contact with children who have colds and it is convenient for you to keep her away from them, by all means do so. Also teach her to wash her hands regularly during the day; this will cut down on the spread of viruses.

By the way, the use of a tissue or a handkerchief is preferable to having your child cover her mouth with her hand when sneezing and coughing. If the virus lands on her hand, it can be transmitted to whatever she touches—a sibling, a friend, or a toy. 

Published online: 10/07

Source: Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2004 American Academy of Pediatrics, Updated 5/05)
To order a copy of this book visit the AAP Bookstore.

Modified for use by patients of Louisville Area Pediatrics PSC 11-2007