THE COMMON COLD Preschool children have 3-9 colds or viral upper respiratoty tract infections (URI’s) a year. That means approximately one every six weeks. Children in day-care, play groups or school may have even more, especially during the winter months. On average, colds last 10 to 14 days. Statistically this means that young children are basically mildly ill every other day from September to April. The symptoms of upper respiratoty infections are: runny nose, cough, headache, fever, achy muscles, sneezing and scratchy throat.
Although URI’s are self-limited (go away on their own), patients and parents are tired and uncomfortable and would like advice on how to lessen the symptoms. Because colds are caused by viruses, and not bacteria, antibiotics do not work to cure the illness, nor do they prevent bacterial complications. Except in the case of influenza virus, no antiviral drugs are available to treat the common cold. Antibiotics do not work for colds!
What you can do to help: • Sleep with the head elevated. • Suction an infant’s nose with a bulb syringe, or buy a suction device that connects to
the vacuum cleaner sold in pharmacies called an orrszívó porszívó.
• Loosen mucus with several drops of saline nose drops (Ocean, Ayre, Sterimar,
Fluimare), or make your own by adding 1/4 tsp of salt to 8 oz. of water.
• Use acetaminophen (Tylenol, Panadol) or ibuprofen – (Motrin, Advil, Nurofen) for
• Older children may find relief in daily saline nasal washes. Methods which may alleviate symptoms, but have not been scientifically proven to work: • Menthol inhalation via bedtime application of a vapor rub (menthol, camphor and
• Vaporizers. • Inhalation of steam (not to be used in young children due to risk of burns). • Zinc lozenges. • Echinacea. • Expectorants such as guaifenesin or carbocisteine. • A spoonful of honey before bed, but not to be used in those less than a year of age. Many cough and cold medicines have never been proven to be safe and effective in children. An alarming increase in overdoses and deaths caused by over-the-counter cold preparations has prompted the American Academy of Pediatrics to recommend against the use of cough and cold medicines in those younger than 6 years.
These medications are currently not recommended: First generation antihistamines like fenistil, brompheniramine, diphenhydramine, chlorpheniramine and hydroxyzine have a mild drying effect on the mucosa. They can also cause dry mouth, blurred vision and sedation. Oral decongestants like pseudoephedrine, phenylpranolamine, phenylephrine, calciphedrine, rhinopront, coldrex, rhinathiol cold are vasocontrictors and decrease mucus production in the nose. They also increase blood pressure, cause headaches, nausea, nervousness, irritability and increase the incidence of strokes. Nasal decongestants like oxymetazoline, xymetazoline, phenylephrine, nasivin can topically reduce nasal congestion, but only for a few days. If you use them for longer, rebound congestion may occur. These medications have only been proven to be effective in adults, not children. Cough Suppressants: Coughing is a protective reflex and should only be suppressed when it disturbs sleep. The most common cough medicine is dextromethorphan, which is over the counter. Cough suppressants should not be used in asthmatic children. Accidental overdose can cause respiratory depression, sedation and even death. Codeine is a narcotic cough suppressant which can cause the above side effects, in addition to constipation and dizziness. When to call the doctor
• if your child has a fever over 102 (39 °C) for longer than 48 hours • if your baby is under two months and has a fever over 100.4 (38 °C) • if your child has heavy or fast breathing even after the nose has been cleared • if your child is unable to drink enough to urinate normally • if your child has an earache • if your child is very irritable, inconsolable or lethargic • if you are worried for any other reason
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