COMMON COLD

Common Cold

Unfortunately, at some time or another, every baby and child is going to catch a cold. Colds are caused by several different viruses and are usually spread person-to-person from the infected nose or throat. The most prevalent respiratory viruses that children catch in the United States are:

• Rhinovirus: Rhinoviruses (RVs) are the most common family of viruses to cause colds. There are many serotypes of Rhinovirus, hence you can catch it many times. They are especially common among children. They can cause symptoms like runny or stuffy nose, sneezing, sore throat, and cough.
• Respiratory Syncytial Virus (RSV): RSV is a leading cause of respiratory tract infections in infants and young children. It causes symptoms similar to a cold, such as cough, runny nose, and fever. Although RSV may only cause common cold symptoms in most children, it can progress to a more serious form of respiratory infection called bronchiolitis. We describe this condition page 211 of this handbook. RSV infections usually occur during fall, winter, and early spring.
• Influenza virus: Influenza, also known as the flu, is another common viral infection among children. Influenza symptoms can range from mild to severe and typically include fever, cough, sore throat, body aches, fatigue, and sometimes vomiting or diarrhea. We describe this condition page 180 of this handbook. 
• Enterovirus: Enteroviruses are a diverse group of viruses that can cause respiratory illnesses, as well as gastrointestinal symptoms and rashes. Enterovirus infections are more common during summer and fall and can rarely lead to complications like meningitis or myocarditis. 
• Adenovirus: Adenoviruses can cause a wide range of respiratory infections, including the common cold, sore throat, croup, and bronchitis. They can also cause viral conjunctivitis (pink eye), diarrhea, and other symptoms. 

In addition to common cold symptoms, these viruses can also cause croup, and viral pneumonia. Cold viruses can also play a significant role in the development of otitis media and the development of asthma flare ups.

Most everyone will come down with a cold from time to time. Thankfully, most cases are mild and self-limited. Colds usually begin with a watery discharge from the nose accompanied by sneezing and watery eyes. The child can also develop fever, cough and a sore throat. Usually, the cough and sore throat are not particularly severe. 

The child may run fever for two to three days. As a cold progresses, the nasal drainage often becomes thicker and may turn yellow or green. This may be the final stage in the resolution of a cold and no additional treatment is needed if your child is otherwise doing well. The total duration of a cold may be as short as four to five days, or as long as 14 days or even longer. 

So far, there is no cure for the common cold. Since the infection is due to one of the many viruses identified above, antibiotics are not helpful. Treatment of a cold is aimed at relieving symptoms and keeping the body well hydrated and nourished so that it can fight off the infection.

Treatment:

1. Rest. Stay in bed for a while. Sleep.
2. Encourage plenty of fluids, especially clear liquids. This will keep the mucus thin and prevent dehydration. Keeping your child well hydrated is essential during respiratory illnesses.
3. Encourage your child to eat nutritious foods during a cold. Starches can provide comfort and soothe symptoms. The BRAT diet (bananas, rice, applesauce, toast) is gentle on the stomach and helpful during illness. Other easy-to-digest starchy options include mashed potatoes, pasta, crackers, and oatmeal, which can provide energy when appetite is low. Warm broths or soups with noodles or potatoes can also offer hydration and relief for sore throats or congestion. While these foods can provide temporary relief, they should be part of a balanced diet that includes other nutrients to support overall health and recovery.
4. Acetaminophen (Tylenol) for fever and/or aches (see Dosing Guide) if these are particularly bothersome. Please see the section on fever for information on the benefits of fever in fighting off infections.
5. Saline nose drops are helpful for young children who cannot blow their noses. Brands like AYR, Salinex, Ocean, and Simply Saline work well. To use, place two or three drops in each nostril, wait a minute, and then suction the nose with a nasal aspirator. Insert the aspirator tip about half an inch into the nostril and aspirate. You can make saline drops at home by mixing half a teaspoon of salt with four ounces of warm water. Let it cool before using and prepare a fresh batch daily. In addition to nasal aspirators, other suction methods include the NoseFrida, where a tube is placed in the baby's nostril and the parent manually suctions out the mucus. Battery-operated nasal suction devices are also available. 
   
6. Cool mist vaporizers can help reduce nasal congestion and thin mucus, making it easier for children to cough it out. Use the vaporizer especially at night, and clean the water tank daily to prevent mold growth. While warm mist machines can be slightly more effective, they pose a burn risk. Some newer models emit mist at a safer temperature and are acceptable to use. In Arkansas, avoid frequent use of vaporizers and humidifiers, as they can increase humidity and promote the growth of black mold, Stachybotrys. Limit their use to only a few days.
7. Taking a long hot shower can help loosen mucous and help your child breath easier. 

Call the office for an appointment if your child experiences any of the following symptoms:

1. Nasal drainage that persists beyond 14 days, becoming thicker and yellow, creamy, or green, indicating possible sinusitis.
2. A severe cough accompanied by a fever over 102°F, which may signal pneumonia or influenza.
3. Persistent cold symptoms throughout the year, as this may suggest allergies.
4. A fever over 101°F lasting more than three days.
5. A particularly severe sore throat or bad breath, which may indicate strep throat.
6. Ear pain, suggesting a possible middle ear infection.
7. Significant breathing difficulties or wheezing. See RSV bronchiolitis.

Do not use leftover antibiotics, as they do not cure the common cold and can be harmful.

Note on cough and cold medication safety for Children: 

In 2008, the FDA strongly recommended against giving over-the-counter cough and cold medicines to children who were under 2 years of age. Pediatricians had long prescribed these medications to infants and children for cold symptom relief. This action by the FDA abruptly changed our pattern of practice on the treatment of cough and colds. 

The FDA took their position on this matter because only adult studies for this class of medications had been done and there were reports of rare deaths in children under the age of two years which were thought to be due to these cold type medications. In response to this recommendation, the makers of children’s cold and cough medications have voluntarily re-labeled their products stating on the labeling that these medications should not be given to children less than 4 years of age. Some labels go even further, withholding doses for even older children aged six to even twelve. 

 So, what can be given to a child under the age of 6 years for relief of cold symptoms, such as runny nose and cough? Well, nothing.  Actually, nothing is needed. Children get over colds and coughs just as quickly without cold medicines as with them. Nothing cures a cold, but a little time.

You can consider using honey for coughs or sore throat for kids, but only if they are older than one year of age. Zarbee’s is one such commercial honey cough medication. It may help soothe symptoms just a little. But, remember it does nothing to stop or relieve the cold. Therefore, it is essentially useless.