Colds can be quite a nuisance for parents. Know what to expect and what to do
Every fall/winter we go through the same dreaded respiratory virus season. What exactly does that mean? For doctors it means very busy days in the office. For patients it means lots of colds, coughs, croup, sinus infections, RSV (respiratory syncytial virus) and influenza to name a few. And now, we have to consider COVID-19. The most likely upper respiratory infection you and your kids will come across in a typical season is the common cold.Colds are the most common reason for missed school and visits to the doctor. Because there are hundreds of rhinoviruses, as well as other viruses, that cause a common cold, it is possible to get more than one. Even if you think you are immune to one, there is always a different cold virus out there waiting to attack. Young children have had less infections than adults and are therefore less immune. Furthermore, they aren’t always good about washing their hands, covering their coughs, or keeping their hands from their face.That means most children will get, on average, 6-8 colds per winter. However, colds can also happen in summer so anytime is a good time for parents to brush up on their common cold 411.
What is the upper respiratory tract?
Let’s start with some anatomy. The upper respiratory tract consists of the nose, the nasal pharynx (back of the nose), mouth, pharynx (throat), sinuses and larynx (vocal cords). Viruses infect the mucous membranes that line these structures causing swelling and inflammation.The inflammation causes the initial symptoms we all feel at the start of a cold and any part of the respiratory tract can be affected.
Symptoms of an upper respiratory infection, or common cold
As the virus invades the mucous membranes, they begin to swell causing several different symptoms. At the same time, the early attackers from the immune system are attacking the virus and the mucous membranes, also contributing to symptoms. Most people will have any of the following:
- Runny nose
- Sore throat
- Sneezing
- Nasal congestion
- Cough due to post nasal drip
- Hoarse voice due to inflammation of the vocal cords (laryngitis)
Once the immune system is fully triggered, several other symptoms are likely to occur.
- Green, thick mucous (not always a sign of bacterial infection!)
- Worsening cough due to thick mucous draining down the back of the throat, cough may also become productive of thick phlegm (post-nasal drip)
- Fever
Both the virus running amok and the immune system firing can also cause you to feel tired and achy. However, if you are feeling very fatigued and achy with a sudden onset of high fever, talk to your doctor about testing for the flu.
Treatment
Common colds are caused by viruses.Viruses do not get better with antibiotics (which kill bacteria). Colds are typically self-limited, lasting about 7-10 days. Therefore, treatment is mostly geared toward temporarily alleviating symptoms. General recommendations include:
- Push lots of fluids–this keeps the secretions looser and easier to clear while overall maintaining hydration
- Cool mist humidifier–this helps moisturize the mucous membranes and relieves congestion
- Saline to the nose–not only moisturizes the mucous membranes, but also breaks up thick mucous making it easier to clear (or suction out for babies)
- Honey–honey is very effective for coughs and can be given straight up on a spoon or mixed with some warm water or herbal tea. HOWEVER, NEVER GIVE HONEY TO A CHILD LESS THAN 1 YEAR OF AGE
- Medication–medications like acetaminophen or ibuprofen are helpful to treat fevers, sore throats and aches or pains. Please check with your pediatrician for dosing and never give ibuprofen to babies less than 6 months old. For children over 4 years old, over the counter remedies like decongestants and cough suppressants may help but are not very effective. However, these medications are only for symptom relief and do not make the cold go away. If a medication isn’t working, don’t give it because they all have potential side effects.
*Never give Aspirin to children for their fever due to the risk of Reye Syndrome. Never give children cough syrup with codeine.
Complications
Colds do not actually move around. A head cold may feel like it has moved to the chest after several days but what is actually happening is the thick mucous draining down the back of the throat and causing a wet sounding cough. Similarly, colds do not “turn into” other infections but secondary bacterial infections can occur. These include ear infections, sinus infections and pneumonia. If you are worried about any of these infections it is a good idea to visit the doctor. Keep in mind that in children, sinus infections are not routinely diagnosed until the cold has persisted beyond 10 or more days and is getting worse instead of better. Even if the diagnosis is made, guidelines state that the child can wait another 2-3 days for possible resolution before starting antibiotics.
Prevention
The best way to prevent a cold is to wash your hands frequently and avoid anyone who is newly sick. Unfortunately for kids, their buddies are spreading the virus before they are sick enough to stay home from school. So no matter what you do, your little ones may still get sick. However, keeping your kids healthy by ensuring a good amount of sleep each night and providing a healthy diet can better equip them to fight off the cold virus. There are things you can prevent! One is the flu so be sure to schedule your child’s flu shot today! The other is COVID-19. As of September 2021, the vaccine made by Pfizer is approved under emergency use authorization for children 12 years old and up. Hopefully, the vaccine will be approved for children 5-11 years old very soon.
Why are kids getting colds if they are wearing masks?
Masks do a great job at preventing the release of respiratory droplets that may contain viral particles. For viruses that are airborne, like SARS-CoV2, this is an excellent way to control spread. Some viruses, like colds and influenza, are larger and drop easily to surfaces. When a child with a virus wipes their nose and touches a surface, other children can pick it up. Children are still participating in sports, eating lunch and playing on the playground without masks where they can easily spread germs, and pick them up.