Colds and Cough

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Colds, referred to as upper respiratory infections, are usually caused by viruses, which unfortunately don’t respond to antibiotics. While uncommon in the first month or two of life, children seem to never be able to get rid of them after that! It is quite common for older infants and toddlers to have 6-10 colds a year, with each one lasting up to a week or two. Since most colds occur in the fall and winter months, it can seem like your child is sick all winter. As long as there are at least a few days when your child is acting well prior to getting sick again, they have probably just been unfortunate enough to pick up a new cold strain right after getting over the first.

It is not uncommon for children to run a low-grade fever for the first few days of a cold. Other symptoms include runny or stuffy nose, sneezing, coughing, fatigue, loss of appetite and hoarseness. The nasal drainage often starts out clear, becomes yellow or green, then becomes clear again. If it is persistently very thick or the cold lasts more than 14 days, let us know, as this might indicate a sinus infection that requires antibiotics. It is also unusual for the fever to last more than 3 or 4 days or to go away and come back again a few days later. Return of fever might indicate a secondary bacterial infection (ear or sinus) that does require antibiotics.

Unfortunately, there is no good treatment for colds. The reason there are so many over the counter remedies is that none of them work very well. Nasal saline (Ocean drops, etc) followed by suctioning with a bulb syringe, especially prior to feeding, is usually recommended in infants and toddlers who can’t blow their nose. It can also be helpful to run a humidifier to loosen secretions and to elevate the head of the bed or have babies nap in their car seat since nasal drainage with post-nasal drip can cause an impressive cough. It is not rare to feel congestion rattling around in the chest, but the lungs are most often clear when we listen with the stethoscope.

When your baby or child has a cold don’t expect them to eat as much as usual. As long as they are drinking enough to avoid dehydration, their appetite will eventually come back. Under six months old, we prefer that you check with us before using any over the counter cough and cold medicines since some of the ingredients cause irritability in babies. Above six months it is okay to try the over the counter remedies, knowing that they might not help much. If your child is running a fever with their cold you can use fever reducers like Tylenol or ibuprofen (just make sure that the cold preparation doesn’t also contain a fever reducer, in which case you could be overdosing your child).

Be sure to call us if your child’s cold lasts more than 14 days, the fever lasts more than a few days or goes away and then comes back or if your child starts to complain about ear pain. We should also know if your child has thick nasal drainage accompanied by sinus tenderness, severe sore throat, difficulty breathing or seems very ill.

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