Infections

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Common Cold

The common cold or upper respiratory infection (URI) is very common and most children will suffer 3 to 8 colds a year. 10-15% of children will suffer at least 12 colds her year especially those that are in daycare or around other kids. Many times those children will seem to never be well or free of a runny nose but may simply be getting back to back colds. The most common time is in the fall and winter months, although, they can occur year round.

What are the symptoms? The usual symptoms are nasal congestion and a sore throat. Within several hours you may then see sneezing, a clear runny nose and others symptoms such as a low-grade fever (100-102), sleepiness or difficulty sleeping, headache, decreased appetite and body aches. After a day or more the nasal drainage typically gets thicker and changes color as the cells of the upper respiratory tract are sloughing off. This change in color does not indicate a bacterial infection. Cough occurs very commonly and is not necessarily a sign that the cold has become complicated.

How long will it last? The majority of symptoms will last 2 – 7 days and should be improving within 10 days. Some symptoms however, do tend to last longer and those include cough and nasal drainage which can last more than 2 weeks.

How can colds be avoided? The common cold virus is transmitted from person to person through sneezing, coughing or from direct contact of a viral particle on an object (cups, toys, ect.). Viruses are very contagious especially in first several days of symptoms. Remind your child to cover their cough with their elbow, wash hands frequently and to avoid putting their hands in their mouth or touching their nose or eyes.

How can it be treated? First it is critical to remember that kids are not little adults and treatment is not the same. The FDA issued a public health advisory recommending that cough and cold medications should never be used in children less than 2 years of age. The American Academy of Pediatrics (AAP) recommends against the use of cough and cold medications in children under the age of 6. These over-the- counter medicines have not been proven to be effective and may have dangerous side effects.

15316 Huebner Rd, Ste 102; San Antonio, TX 78248 (210) 479-9292 www.throughtheyearspediatrics.com Infections

If these medicines are used in children ages 4 to 6 the exact medicine and dosage should be recommended by your child's doctor. If they are used by children over age 6 the package labeling should be followed although we recommend using them in caution as many combination medications have ingredients that may not be recognized and can cause accidental over dosing.

What about antibiotics?  Antibiotics will not help with the common cold as they are caused by a virus.  Using antibiotics when not necessary can be potentially harmful and increases the risk of resistant organisms.

The best treatments for the common cold are actually home remedies and simple measures for symptomatic relief. If your child is having symptoms but they are not causing discomfort or interruption of sleep then there is no need to do anything.

Fever: Is a sign that the body is combating the illness and is not a bad thing. If there is discomfort with fever you can give either Acetaminophen or Ibuprofen (if older than 6 months). See the website for details on dosing and different formulations. Aspirin should never be given to a child under 18 years of age.

Runny nose: If it is runny then let it run, have them blow their nose or gently then suction it out with a bulb syringe or a device such as the Nose Frida. Giving anti-histamines or allergy medicines won't help unless the drainage is due to allergies.

Nasal congestion/blockage: With infants use 2-3 nasal saline drops in each nostril then suction one at a time. This can be repeated every 1-2 hours, particularly before feeding or sleeping. With older children that can blow their nose, use several drops of saline spray then allow them to blow until clear. Saline rinses may be helpful as well. To make your own saline mix 8 ounces of distilled water with ½ teaspoon of table salt. Make sure you make a new batch daily and keep mixture in a clean bottle.

Cough: Coughing is a protective mechanism of your respiratory system to help clear mucous. If your child is having a coughing spasm, try having them inhale the steam from a hot shower. In infants 3 to 12 months old, giving warm fluids such as water or apple juice 5-15 ml at a time may be helpful. This can be repeated several times a day when coughing.

15316 Huebner Rd, Ste 102; San Antonio, TX 78248 (210) 479-9292 www.throughtheyearspediatrics.com Infections

After a year of age, you may offer 2-5ml of honey every couple of hours to help decrease the cough. If your child is older than 6 years, cough drops or hard candy can be used to soothe the throat.

Other helpful tips than can be used:  Encourage fluid intake to help thin secretions and prevent dehydration.  For nursing infants, continue to nurse frequently. You may offer additional fluids such as Pedialyte to help.  A cool mist humidifier in your child’s room may help with congestion and sleep.  Vicks vapor rub may be used on your child’s chest for symptomatic relief.

Can a common cold become complicated? Occasionally, a cold will lead to a secondary bacterial infection such as an ear infection, sinus infection, or pneumonia. Usually your child will seem to be improving from the cold and then suddenly seem worse or get a new fever when this occurs.

When should I bring my child in to get seen? If symptoms are worsening, persistent without improvement for 10 to 14 days, having fever > 72 hours or at any time if there are concerns. If your child is less than 3 months of age with a fever of 100.4 or more, they should be evaluated immediately.  Call during business hours o If fever lasting > 72 hours o If cough lasting > 3 weeks o If persistently fussy or not sleeping well despite symptomatic care  For afterhours concerns, call the Call a Nurse line at 22-NURSE or 210- 226-8773 or the office at 210-479-9292 if they are unable to address your concerns the on call doctor will be paged. o Go to the emergency department if there any concerns of: . Difficulty breathing: wheezing, pulling of skin around ribs or in neck with each breath, especially if appears to be working hard even after nasal clearing. . Not tolerating or refusing fluids and not voiding every 6-8 hours. . Acting very ill, not able to respond as usual, appears very ill and you are concerns.

15316 Huebner Rd, Ste 102; San Antonio, TX 78248 (210) 479-9292