Colds and Coughs

The common cold, with its associated congestion and cough, is the most frequent infection your child will have.  The average preschooler who stays at home will have six colds per year.  Those children attending day care will average eight to twelve colds per year, particularly during the first year of exposure.  The cold is caused by a virus, and this germ is not affected by antibiotics.  Our treatment efforts, therefore, must be aimed at making your child more comfortable.  Your child will experience one or more of the following symptoms: loss of appetite, fever, irritability, aches, runny/stuffy nose, or cough.

General Treatment

1. Expect your child's appetite to be decreased during an illness.  Don’t worry - he will eat again when the illness passes.  In the meantime, encourage your child to drink liquids frequently.

2. If fever, irritability, or aches accompany the cold, use acetaminophen (Tempra/Tylenol) or ibuprofen (Children’s Advil/Motrin). (See Medication Dosages)

3. A runny/stuffy nose is bothersome and aggravating.  It is not a threat to your child’s ability to breathe.  In infants less than six months of age, suctioning with a nasal aspirator may be helpful.  Putting two drops of saltwater solution (1/4 tsp. table salt in 4 oz water) in each nostril prior to suctioning helps remove thick, stubborn mucus.  Over six months of age, medicated nose drops (Neo-Synephrine 1/4%, Pediatric Afrin, Pediatric Otrivin) may be used.  They should be used at bedtime and for only three nights in a row.

4. Antihistamine/decongestants (“cold preparations”) have not been found uniformly effective in the treatment of colds.  However, some children may benefit.  Over-the-counter examples are Novahistine, Triaminic, Pediacare, Dimetapp, Chlor-trimeton and Benadryl.  These may be used after age six months, see medication dosages for the correct amount for your child.  In addition to having questionable beneficial effect, these drugs sometimes cause irritability, restlessness, and strange behavior.  Discontinue the medication if you note these reactions.

5. A child’s cough is a protective function and serves to clear bothersome, irritating mucus from the bronchi.  Cough preparations that promote loosening the cough or helping move mucus are not effective.  We feel that encouraging fluids is a better approach.  When a child’s cough disrupts sleep or causes vomiting, a product containing dextromethorphan may be helpful.  These products are available without prescription and include Novahistine-DMX, Robitussin-DM, Benylin, etc.

All of these symptoms will pass with time.  Most colds last 10 - 15 days.  Try to make your child as comfortable as possible using these suggestions.  In a few days, your child (and you) will be feeling better.