Contrary to what you may have been taught, exposing the body to outside cold temperatures while not wearing a hat or coat will not cause a cold.Colds are caused by viruses, which can be transferred from one person to another by direct or indirect contact. Direct contact occurs when an infected individual sneezes or coughs without using a tissue or other covering for his mouth or nose. An unsuspecting healthy person then inhales the cold virus nasally or orally. Indirect contact occurs when the infected person rubs his nose or coughs into his hand, then transfers the cold germs to a healthy person by shaking hands or touching an object such as a door knob or computer keyboard, etc. The healthy person touches the same object, then touches her nose or mouth, thus introducing the virus into her body.
Cold viruses are quite infectious, especially during the winter months when individuals are in close quarters such as schools, dorms and daycare. Exposure to sick individuals increases significantly because of these circumstances.
The usual course of a cold begins within a few days of exposure to an infected individual. Stuffy nose, sneezing, mild fever, sore throat, slightly swollen glands, cough and changes in behavior are the usual symptoms. Colds usually last only five to ten days. The usual course of nasal discharge begins as clear and watery. About day two to three of the cold, the nasal discharge becomes thicker and changes color to white/yellow or even green. As the cold resolves, the nasal discharge becomes clear and then dries.
Coughing is usually worse at night, due to post-nasal drip. If your child develops a constant cough throughout the day, has a fever lasting more than 48 hours, has difficulty breathing or shortness of breath, has bluing lips or bluing nail beds, ear pain, excessive sleepiness or crankiness, contact your health care provider immediately. You may need an appointment so your provider can determine if there are other concerns or issues stemming from the cold virus.
Older children may develop a sinus infection after ten days of a cold that does not improve. Nasal secretions will be thick yellow/green. Fever occurs after ten days of the upper respiratory illness, coughing continues, a headache may be present, along with dark circles under the eyes and possibly bad breath. Your primary care provider should evaluate your child, and may prescribe antibiotics along with other comfort measures.
There is no cure for the common cold. Antibiotics are for bacterial infections, and should not be used to treat a viral illness such as a cold. Bacteria have become more resistant to certain antibiotics because of inappropriate and overprescribing for illnesses that don’t respond to antibiotics.
The common cold calls for comfort measures. Most kids will need extra rest, healthy fluids such as therapeutic hydration, decaffeinated tea, soup, gelatin and other fluids containing salt and sugar. Use plain water sparingly. Chicken noodle soup is a great cold comfort food. If a fever or discomfort is present, you may administer acetaminophen or ibuprofen. Never give ibuprofen to children under 12 months of age or to a child who is vomiting or is dehydrated. Do not alternate acetaminophen and ibuprofen. The overdosing of these medicines can be very harmful. Pick one anti-fever/pain medication, and dose it according to the manufacturer’s recommendations. Acetaminophen is given every four hours; ibuprofen, every six to eight hours.
In 2008, the Food and Drug Administration (FDA) strongly recommended that over-the-counter (OTC) cold medications be restricted in children younger than four years of age. The side effects of these preparations may outweigh their usefulness in relieving cold symptoms. These food products can be found weekly on the Kroger weekly ads or Ralphs Weekly ads. Check out latest of Kroger ads.
Old-fashioned home remedies are effective in helping to relieve cold symptoms. A cold mist humidifier (avoid hot) helps liquefy mucous secretions. Remember to clean the vaporizer daily per manufacturer instructions. The use of vapors in the vaporizer may make a child feel more comfortable.
Encourage older kids to blow their noses frequently. Using saline nose drops may help loosen secretions, enabling more productive blowing. Having your child sleep in a more upright position (on two pillows) may help with nasal drainage. Nasal secretions cause a post-nasal drip and cough, especially when a child is lying down. For kids older than one year, honey may help reduce the frequency and severity of a cough. The usual dose of honey is 1/2 to 1 teaspoon as needed. You can add honey to tea or other healthful fluids. Children older than six years of age can use cough drops to relieve throat irritation.
If your child is not bothered by the cold symptoms, especially if he is active, playing and sleeping normally, no intervention is needed. Treat your child only if the cold symptoms are disrupting normal activities or sleep.
Though preventing a cold is sometimes nearly impossible, taking the following simple steps may help reduce the chances of spreading it.
• Don’t send an ill child to school or to daycare.
• Cover the nose and mouth with a tissue during a cough or a sneeze.
• Wash hands frequently.
• Remember that most colds resolve with TLC, comfort foods, healthy fluids and rest.
If your child complains of a persistent sore throat, or has a fever, a change in behavior or a decreased urine output, contact your primary care provider as soon as possible.
Any child who has a fever, a sore throat, a headache, a stomachache or who is vomiting should be tested for strep pharyngitis. Only a throat culture will determine if this bacterial infection is present. Antibiotics are prescribed for all strep throats.
PANDAS (pediatric autoimmune neuropsychiatric disorders) are rare phenomena that may occur during a streptococcal throat infection. The most recent research suggests that some kids with chronic tic disorder or obsessive-compulsive disorder may be more vulnerable to strep throat, experiencing exacerbated symptoms. There is currently no treatment for PANDAS. Should your child display a sudden change in behavior while she has strep throat, notify your primary health care provider as soon as possible. You may be referred to a neurologist.
Jo Ann Serota, DNP, CPNP, IBCLC, is co-owner of Ambler Pediatrics, Ambler, PA. She has been a primary care NP for more than 25 years. She is NAPNAP Foundation President and a past president of NAPNAP. She is also an editor for the Journal of Pediatric Health Care.
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