The Common Cold and Sick Kids - What You Should Know

The common cold is often associated with children – but what is often unclear is what can be done for them, and when should a child with a cold should be seen by the child's health care provider. Below are some helpful guidelines:

1. Colds that start with runny nose, congestion, coughing and/or fever are likely viral, and cannot be "fixed" by a visit to the doctor.
2. Mucus production is actually the body's way of trapping the viral particles and removing them from the body through sneezing or coughing or nasal secretions.
3. Fevers with viral colds are common and will usually only last 72 hours. They will usually stay under 105, whether you give medication for fever or not. If the child has a fever > 105 or one of over 100.0 lasting longer than 72 hours, have them seen.
4. Cold medicines like decongestants and cough suppressants do not work well, and are not recommended for children younger than 6 years of age.
5. The most helpful treatments for colds are aimed at helping the body do what it is designed to do—humidifiers to keep secretions moving, saline sprays or rinses of the nose to unstuff it and remove secretions, fluids to soothe throats and keep secretions from getting too thick. Also menthol chest rubs can be helpful in children 6 months of age and older. A teaspoon of honey can quiet a cough, but never give to a child less than 12 months of age.
6. Babies who cannot breathe through the nose are likely to be miserable, but will still be ok. (They usually do not eat or sleep well if the nose is blocked.) Bulb suctioning with or without saline drops is helpful, even though they usually hate it! Having them sleep with a blanket roll or towel roll under the head of the mattress to elevate the head slightly may help as well. Never place a pillow directly under the infant for any reason.
7. Ibuprofen or acetaminophen may relieve some discomfort and will help with fever associated with colds. (See dosage chart.) For babies less than 6 months of age give only acetaminophen.
8. The first week of a cold is usually the most uncomfortable, but is also usually the time the child does NOT need to be seen by his/her doctor. Doctors are watching for a child that suddenly worsens the second week of symptoms—when secretions have had a chance to get hung up somewhere and have bacterial overgrowth, as in the case of ear or sinus infections. Bacterial conditions (rarely present the first week) respond to antibiotics, viral conditions do not.
9. Color of the mucous in the nose typically varies from clear to yellow to green. A change in color is expected as the cold progresses and does not indicate a bacterial sinus infection.
10. Any child having trouble breathing with a cold, other than a stuffy nose, needs to be seen. If there is shortness of breath, nostrils flaring out at the edges with breathing or the chest looks like it's working harder than usual to expand—take the child to the Emergency Room for evaluation.

If this information did not help you with questions about your child's cold, please call your health care provider and discuss it with them.