It seems as though some of us have a runny nose and congestion that lasts for months in cooler weather. Cold viruses commonly cause illnesses that include a cough, congestion, runny nose, sore throat, body aches, headaches, crabbiness and low-grade fever.
Influenza, or the flu, is a different type of virus that causes similar symptoms that are much more intense and can often lead to infections such as pneumonia. It’s important to recognize whether kids have a common cold or symptoms that mean they might need extra help.
Causes of Cold and the Flu
There are more than 200 kinds of viruses that cause colds, so almost everyone catches at least one every cold-weather season. Young children catch on average six colds each year between fall and early spring, and the typical cold causes symptoms that last two to three weeks and occur at any time of the year.
Most kids with a cold start with a little bit of nasal congestion that gets worse over a couple of days. Mucus that starts out clear can often thicken and become colored during this time. A nighttime cough or a mild daytime cough is common. Cold symptoms are usually worst on days four to seven, and then get better gradually. Although children feel bad when they have a cold, they are usually able to play, sleep and eat well (although their appetite is less than normal).
Influenza is a virus that has a predictable season in the U.S., typically between November and February. People with the flu have medium-to-high fevers (102° F to 103° F are common), body aches (especially the back, legs and upper body), a dry cough that continues day and night, a sore or scratchy throat and a headache.
The most common viruses that cause colds normally make people have yellow, thick mucus. So, it’s normal that your little one has a clear runny nose that turns yellow or green on and off during the day. This is a big problem if a child doesn’t know how to blow his nose properly or won’t do it regularly. Often, the darkest mucus color is noted first thing in the morning. The old-wives’ tale that anyone with colored nasal drainage has a sinus infection is not true. It’s also untrue that drinking milk or eating dairy products will make the mucus thicker.
A lot of kids with colds have coughs. Most coughs are actually good because they help clear the throat of drainage and keep the airways clear. Children younger than eight to nine years don’t do a good job or clearing phlegm, so it’s very common for them to get a tickle cough when drainage goes down the back of their throats. This usually causes a cough that’s bad when they first lie down at night, and often worse when they first get up because mucus builds up in their throats while they lie flat. Or, they will cough a couple of times on and off during the day as they try to clear their throats. Sometimes they end up with a sore throat or hoarse voice from coughing or drainage.
Every child with a cough does not have to be evaluated by a healthcare provider. A child who is usually pretty happy, and is playing, sleeping and eating normally has a very low chance of having a serious illness causing the cough. Influenza doesn’t cause vomiting and diarrhea; those symptoms are usually caused by another type of virus.
You should contact your child’s provider if:
1. Your baby younger than six months has a cold. During that time, babies can’t breathe through their mouths, so having a congested or runny nose can make it tough for them to breathe.
2. Your child’s cold symptoms last longer than two weeks without getting better, or were getting better and suddenly get worse.
3. Your child develops a fever after that first four-to-five days of illness. It’s normal for children over the age of four months to have temperature under 100° F, so a fever is a body temperature over 100.5° F. Call your provider if your child develops a high fever (over 102° F, especially if she has a cough).
4. Your child has been exposed to influenza, especially if he has chronic health problems such as asthma or sickle cell anemia.
5. Your child is coughing until he is gagging, is breathing too fast, says his chest hurts or seems to be out of breath.
6. Your child has a sore throat and fever, especially if she doesn’t have nasal congestion or a cough.
7. Your child is not playing, eating or acting normally. This especially troubling if your child is sleepier than usual or is not drinking enough to urinate as much as normal.
8. Any time your instinct says something is wrong, call your child’s provider. You know your kids better than anyone else, so trust your gut when something tells you your child is really sick.
Helping Your Child Feel Better
Antibiotics don’t kill viruses; they only kill bacteria. So giving your child antibiotics for a cold or the flu will put her at risk for intestinal infections and antibiotic-resistant infections later on without making her feel better. Tips on what to do to improve her symptoms while her body fights off a virus follow.
1. Help her stay well-hydrated, which will help clear mucus from her throat, and prevent dehydration, which worsens body aches.
2. Use over-the-counter medicines such as acetaminophen and ibuprofen for aches, pains and fever.
3. Don’t give cough and cold medicines to a child younger than four-years-old. These medicines can cause serious side effects and are not considered safe for young kids. This includes decongestants, anti-mucus medicines and cough medicines. Cough and cold medicines do not make the cold or flu go away any quicker, but they help with symptoms. So, if your child is happy, no medicine is needed.
4. Honey at rest and bedtime can help with coughs. But never give honey to a baby younger than one-year-old.
5. Warm-water gargles can help ease sore throats and help clear mucus. Most kids won’t gargle with salt water, but plain water can help.
6. Popsicles, smoothies and slushies relieve sore throats.
7. Saline spray can help babies and young kids with runny noses. Nasal irrigators help older children but must be used with distilled, not top, water.
8. Raise the head of your child’s bed, or consider using a humidifier in the room to help a cough. Be sure to empty and dry out the humidifier daily when your child isn’t in the room.
Important strategies to prevent colds and the flu include getting an annual flu shot, using good hand-washing techniques, eating well and avoiding going out in public when you’re sick. With a little bit of home care and a lot of parent snuggles, most kids will do fine at home while recovering from a virus.
Dawn Lee Garzon Maaks, PhD, CPNP-PC, PMHS, FAANP, is a primary care PNP with more than 20 years’ experience working with children and families in primary care clinics and urgent cares. She is passionate about keeping kids healthy and making sure parents have the knowledge and support they need.