Colds & Viruses
by Fredric T. Serota, MD
Colds, contrary to what our grandparents believed, are not caused by being out in the cold. Colds, rather, are caused by viruses, germs smaller than can be seen by a microscope. Cold viruses infect the nose, sinuses and air passages. A stuffy, runny nose, watery eyes and cough accompanied by fever, earache or sore throat, usually follow. A child under the age of 5 years may have 8-10 colds per year, mostly during the fall and winter months, and cough for as long as 6 weeks, or more, after each cold. By the time a child reaches adolescence, the frequency of colds (or upper respiratory tract infections, URI's, as doctors refer to them) decreases to 2-3 per year. There is an increased incidence of URI's in children placed in Day Care. However, those having more colds when younger, may have less trouble with them when they start school. You should call the doctor if your child seems much more ill than just a cold, develops localized pain, has difficulty breathing, a fever lasting more than 48 hours, or has ear or throat pain. Call if he or she does not wet a diaper or urinate for more than 18 hours, the cold lasts longer than a week, or new or different symptoms develop. Even if your child shows none of these, if you are worried, please feel free to call us at any time.
Everyone seems to have a favorite cure for the common cold. However, the only real cure is time: colds will run their course over about 7-10 days no matter how they are treated. Cold viruses do not respond to Penicillin or other antibiotics, which are useful only for treating bacterial infections. Acetaminophen (Tylenol, Tempra, Pannadol, St. Joseph's Aspirin Free, etc.) may help relieve fever and the discomfort of the infection, and a humidifier can often help a stuffy nose and sore throat. Be careful about giving your child "cold pills" or nose drops without discussing the potential side effects with us.
We usually recommend using a cold (rather than hot) mist vaporizer or humidifier. Although both are effective, the cold mist vaporizer is safer. Many children are burned on hot mist vaporizers, either because they touch the machine, or because hot water spills on them. It is not necessary to put medication in the water: this is an ineffective way of administering medication, and is a waste of your hard earned money. Be sure to clean your humidifier daily to prevent bacterial contamination.
Nose drops are also problematic in children: the effect of medicated nose drops is brief, and often associated with significant side effects such as increased heart rate, blood pressure, and a marked swelling of the tissues of the nose when the drops are stopped. We prefer not to use them except for special circumstances. Salt (or saline) nose drops are sometimes used to moisten dried nasal secretions. If you are making your own, be careful about the salt you are adding. Children have reportedly been administered too much salt by well meaning parents. We prefer to use a vaporizer or humidifier for this purpose, without anything added to the water.
Also, use cough syrup sparingly. A cough is the body's way of keeping a cold from entering the lungs, causing pneumonia. It is a protective mechanism that one doesn't want to stop entirely. We prefer to use cough medicines only if a persistent cough is really incapacitating a patient, preventing them from resting or sleeping. Use other cold preparations sparingly. These medications usually combine the effects of an antihistamine with that of a decongestant. Antihistamines dry profuse nasal secretions and mucous; decongestants shrink nasal vessels. They are often combined because the major side effect of an antihistamine is sedation and that of the decongestants is stimulation. The hope is that the side effects will cancel. However, different children respond differently to the various combinations. Use medication with caution, only as long as necessary and use the smallest dose necessary to minimize side effects. Don't give your child medicines prescribed for someone else. If in doubt, please call us.
Instead, give your child extra fluids, not only to keep the secretions loose so that your child can cough them up more easily, but also to replace fluids lost through extra sweating when feverish. Clear liquids are best; milk may upset the stomach when a child is ill. However, if milk is the only fluid a child wants, it is certainly better than none. Remember, fluids include jell-o, popsicles, soups, sodas (usually made flat) such as ginger ale and coke syrup and juices. Your child may not feel like eating for a few days, and nothing is gained by forced feedings. However, he or she should be encouraged to continue to drink liquids.
Children don't need to stay in bed; they don't heal illnesses faster if forced to rest. However adequate rest often helps the child feel better. Young children will usually set their own limit on activities. If they are active, in general, it's because they don't feel ill. However, it is best that they don't return to activities that will leave them exhausted until they have recovered. For sure, schools will not want a child to return until they no longer have a fever, are no longer contagious to others and feel well enough to participate in most activities again.
It is impossible to prevent your child from getting a cold, but you may lessen the number of colds by seeing that your child gets enough sleep, eats a well balanced diet and dresses appropriately for the weather. At least that is what most experienced grandmothers tell us. Let us know your favorite remedy.
