When it comes to treating the common cold, it is the time-tested remedies – rest, liquids, moist air and an elevated head – that provide the most relief for children. There is no cure for the common cold, but “parents still want to feel that they are doing something,” says Dominque Foulkes, a pediatrician and medical director of Pediatrics at Suburban Hospital in Bethesda, Md. “That’s the challenge. At the end of day, they are left with only being able to treat the symptoms.”
It is called the common cold for good reason. There are more than one billion colds annually in the United States. “The common cold, which peaks between October and March, accounts for 22 million missed school days and 20 million absences from work each year,” says Nancy C. Kim, a pediatrician with Pediatrics of Arlington in Arlington, Va. “The average infant gets 8-12 colds a year.” Because a cold can linger for up to two weeks, parents may feel their baby spends almost as much time sick as well. As children grow, however, they develop immunities and learn hygiene practices that help reduce the number of colds they contract.
Treating symptoms of the common cold, particularly when it comes to the use of over-the-counter medicines, varies by age. Hydration and cool-mist humidified air, which keep nasal secretions loose, can help ease a child’s suffering at any age. But infants – who are “obligate nose breathers,” says Foulkes – may require additional treatment to reduce congestion. The pediatrician recommends saline drops and frequent clearing of the nose with a bulb syringe. A NoseFrida, which relies on human suction, is another popular way of removing mucus from an infant’s nose. Elevating an infant’s head also can help lessen nasal congestion. Young infants may benefit from sleeping in a car seat, says Foulkes, while older babies may benefit when the head of their mattress is propped up from underneath, allowing them to sleep on an incline.
Apart from blowing his nose, an older child might find relief from a nasal irrigation device, such as a Neti pot, says Kim. Because these devices flood the nasal passages with a saline solution, younger children may have difficulty tolerating the treatment. Parents should take care in cleaning these devices, as the U.S. Food and Drug Administration has raised concerns about the risk of infection when handled improperly.
Be sure to purchase petroleum jelly, just apply a thin layer, and tissues with lotion to minimize skin abrasion under the nose from repeated wiping and blowing. Abstain from purchasing over-the-counter nasal decongestants, which are not recommended for children under the age of 12. “They don’t really work because young kids don’t have receptors in their body,” says Foulkes.
Decongestants may benefit teenagers, but there are risks – such as an increased heart rate, elevated diastolic blood pressure and heart palpitations – associated with their use, says Kim. Stick to medications with a single ingredient, such as pseudoephedrine, which is found in oral Sudafed. A nasal spray – such as Afrin, which contains phenylephrine – may be effective in teens, but it also may have side effects, such as nose bleeds.
“Coughing can be alarming for families,” says Foulkes. “But a cough is actually a protective mechanism, helping to keep inflammation out of the lungs.” As a result, pediatricians prefer not to suppress a child’s cough, unless it compromises breathing or sleeping or causes vomiting.
To treat coughs, try warm fluids – such as soup or tea – and honey, suggests Kim. “Honey should not be given to children under the age of one due to the risk of botulism,” she says. “Give your child a half of one teaspoon, straight or mixed with another liquid.” Nonmedicated lozenges can be beneficial for children ages six and up.
While the effectiveness of dextromethorphan, found in many popular over-the-counter cough and cold products, remains unclear, it is not recommended for children under the age of six. “We do not promote using it, as we want the child to cough it up,” says Kim. “But we recognize that parents get desperate at night time.”
Foulkes does not generally recommend a cough suppressant but allows that a single-ingredient preparation containing only dextromethorphan can be given at night to treat symptoms in children starting around elementary school age. “A lot of cough and cold medications have more than one ingredient – acetaminophen, decongestant and cough suppressant – and should not be used,” she says.
Cough medicine with codeine, once commonly prescribed, is no longer recommended for children or teens. “In the olden days, we used to use codeine for kids over 12 years of age,” says Kim. “But now we know that there are differences in the way kids metabolize the drug.” Last September, the American Academy of Pediatrics called on physicians to stop prescribing codeine, due to a growing body of evidence indicating that it can cause life-threatening or fatal respiratory reactions in children.
Acetaminophen and ibuprofen are best for treating fever associated with a cold. Follow the manufacturer’s recommendation for dosage. Fever in infants three months or younger should always be evaluated by a physician, no matter what the symptoms, says Foulkes.
Caused by more than 200 viruses, the common cold is highly contagious and thrives in enclosed spaces with lots of people. While a germ’s survival rate is usually just a few hours, rhinoviruses, which cause nearly half of all colds, have been known to live up to two days. That said, personal contact – such as a handshake or a hug – with an infected person is the most common way these germs spread, notes the Mayo Clinic. That’s why teaching a child to wash his hands is so important.
Also important is covering his nose and mouth when coughing or sneezing. It turns out that virus-containing droplets can travel more than two feet from a cough or sneeze. So, sneezing into a tissue or coughing into one’s sleeve can contain those germ-filled droplets.
While an ounce of prevention is generally worth a pound of cure, don’t expect that it will completely safeguard your child from the common cold. But when the cold virus strikes, and the odds are that it will – and probably more than once, try turning to your kitchen cabinet rather than your medicine cabinet to relieve your child’s symptoms.
Colds in Kids: How to Know When it's More Than Sneezes & Wheezes
Karen Finucan Clarkson is a Bethesda freelance writer and the mother of three sons.