Colds

Definition
A cold or Upper Respiratory Infection (URI) is a viral infection of the nose and throat.  The cold viruses are easily spread from person to person.  Most healthy children get at least 6 colds each year, because there are so many different cold viruses.  Symptoms include:

  • Runny or stuffy nose, fever and sore throat
  • Sometimes associated with a cough, hoarseness, red eyes, and swollen lymph nodes in the neck

Similar Conditions 

  • Vasomotor rhinitis. Many children and adults have a profusely runny nose in the winter because of the cold air.  This usually clears within 15 minutes of coming indoors.  It requires no treatment beyond a handkerchief and has nothing to do with infection.
  • Chemical rhinitis. Chemical rhinitis is a dry stuffy nose from excessive and prolonged use of vasoconstrictor nose drops (more than 1 week ).  It will be better within a day or two of stopping the nose drops.

Expected Course 

Usually the fever lasts less than 3 days, and all nose and throat symptoms are gone by 1-2 weeks.  A cough may last 2 to 3 weeks.  The main things to watch for are secondary bacterial infections such as ear infections, yellow drainage from the eyes, sinus pressure or pain (often indicating a sinus infection), or difficulty breathing (often caused by pneumonia).  In young infants, a blocked nose can interfere so much with the ability to suck that dehydration can occur.

Home Care :  Not much can be done to affect how long a cold lasts.  However, we can relieve many of the symptoms.  Keep in mind that the treatment for a runny nose is different from the treatment for a stuffy nose.
Treatment for a Runny Nose with Profuse Discharge:  Suctioning or Blowing.  The best treatment
is clearing the nose for a day or two.  For younger babies, use a soft rubber suction bulb to remove secretions gently.  Nasal discharge is the nose’s way of eliminating viruses.  Medicine is not helpful unless your child has a nasal allergy.
Treatment for a Stuffy or Blocked Nose with Dried Yellow-Green Mucus.  Most stuffy noses are
blocked by dry mucus.  Blowing the nose or suction alone cannot remove most dry secretions.  Nose
drops of warm tap water are better than any medicine you can buy for loosening mucus.  If you prefer
normal saline nose drops, mix 1⁄2 level teaspoon of table salt in 8 ounces of water.  Make up a fresh
solution every day and keep it in a clean bottle.  You can also purchase a commercially prepared product at your local pharmacy.  Use a clean dropper to insert drops.
For the younger child who cannot blow her nose: Place three drops of warm water or saline in each
nostril.  After 1 minute use a soft rubber suction bulb to suck out the loosened mucus gently.  To
remove secretions from the back of the nose, you will need to seal both nasal openings completely
with the tip of the suction bulb and your fingers.  You can get a suction bulb at your drug store for about $2.
For the older child who can blow her nose:  Use three drops as necessary in each nostril while your
child is lying on her back on a bed with the head hanging over the side.  Wait 1 minute for the water or
saline to soften and loosen the dried mucus.  Then have your child blow her nose.  This can be
repeated several times in a row for complete clearing of the nasal passages.
Errors in using nose drops: The main errors are not putting in enough water or saline, not waiting
long enough for secretions to loosen up, and not repeating the procedure until the breathing is easy.
The front of the nose can look open while the back of the nose is all gummed up with dried mucus.
Use nasal washes at least 4 times per day or whenever your child cannot breathe through the nose.
The Importance of Clearing the Nose in Young Infants.  A child cannot breathe through the mouth
and suck on something at the same time.  If your child is breast-or bottle-feeding, you must clear the
nose so she can breathe while sucking.  Clearing the nasal passages is also important before putting

Treatment for Associated Symptoms of Colds 

  • Fever:  Use acetaminophen or ibuprofen for aches or mild fever.
  • Sore Throat:  Use acetaminophen or ibuprofen and warm chicken broth for children over 1 year old.
  • Cough:  Use honey, maple syrup or corn syrup for children over 1 year of age.  Remember never give honey to a child under 1 year of age.  Run a humidifier and offer warm clear liquids.
  • Red Eyes:  Rinse frequently with wet cotton balls.
  • Poor Appetite:  Encourage fluids of the child’s choice.

Prevention of Colds 
A cold is caused by direct contact with someone who already has one.  Over the years, we all become
exposed to many colds and develop some immunity to them.  Since complications are more common in children during the first year of life, try to avoid undue exposure of young babies to other children or
adults with colds, to day care nurseries, and to church nurseries.  A humidifier prevents dry mucous
membranes, which may be more susceptible to infections.  Vitamin C, unfortunately, has not been
shown to prevent or shorten colds and large doses (e.g., 2 grams) cause diarrhea.

Common Mistakes in Treating Colds 
Most over-the-counter cold remedies or tablets are worthless.  Nothing can shorten the duration of a
cold.  If the nose is really running, consider a pure antihistamine (such as diphenhydramine products).  Especially avoid drugs that have several ingredients because they increase the risk of side effects.  Avoid oral decongestants as they can make your child jittery or keep her from sleeping at night.  Use acetaminophen or ibuprofen for a cold only if your child also has fever, sore throat, or muscle aches. Left-over antibiotics should not be given for uncomplicated cold because they have no effect on viruses and may be harmful.

Call Our Office Immediately if…
Breathing becomes difficult and no better after you clear the nose.
Your child starts acting very sick or listless.

Within 24 hours if…
The fever lasts more than 3 days
The nasal discharge lasts more than 14 days
There is any suggestion of an earache or sinus pain
You have other questions or concerns.