Children and Colds
Dear Readers,
First, I would like to express my gratitude to all the readers for all the positive feedback and the warm words that were expressed to me since starting to write this column. I hope that Beezrat Hashem I will be a fit shliach (messenger), to suggest helpful advice to my precious readers.
I was personally asked this week to discuss common colds. Being that I just experienced one myself, I thought it was a great opportunity to share with you some tips that I found in one of the American Academy of Pediatrics publications.
As was mentioned by our sages centuries ago: “everything is in the hand of shamayim (G-d) except for common colds”. It seems that our sages felt that there was some measure of prevention given to us humans when it comes to colds. Therefore, in addition to the publication, I tried to blend in my own “recipe” for treating colds.
My child seems to get a lot of colds. Is this normal?
Your child probably will have more colds, or upper respiratory infections, than any other illness. In the first two years of life alone, most youngsters have eight to ten colds. And if your child is in child care, or if there are older school-age children in your house, she may have even more, since colds spread easily among children who are in close contact with one another. That’s the bad news, but there is some good news, too: Most colds go away by themselves and do not lead to anything worse.
How colds spread
Colds are caused by viruses, which are extremely small infectious organisms (much smaller than bacteria). A sneeze or a cough may directly transfer a virus from one person to another. The virus also may be spread indirectly, in the following manner.
A child or adult infected with the virus will, in coughing, sneezing, or touching her nose, transfer some of the virus particles onto her hand.
She then touches the hand of a healthy person.
This healthy person touches her newly contaminated hand to her own nose, thus introducing the infectious agent to a place where it can multiply and grow—the nose or throat. Symptoms of a cold soon develop.
The cycle then repeats itself, with the virus being transferred from this newly infected child or adult to the next susceptible one, and so on.
Signs and symptoms of a cold
Once the virus is present and multiplying, your child will develop the familiar symptoms and signs:
Runny nose (first, a clear discharge; later, a thicker, often colored one)
Sneezing
Mild fever (101–102 degrees Fahrenheit [38.3–38.9 degrees Celsius]), particularly in the evening
Decreased appetite
Sore throat and, perhaps, difficulty swallowing
Cough
On-and-off irritability
Slightly swollen glands
Pus on the tonsils, especially in children three years and older, may indicate a strep infection.
If your child has a typical cold without complications, the symptoms should disappear gradually after seven to ten days.
When to Seek Medical Attention
An older child with a cold usually doesn’t need to see a doctor unless the condition becomes more serious. If she is three months or younger, however, you should see the pediatrician at the first sign of illness. With a young baby, symptoms can be misleading, and colds can quickly develop into more serious ailments, such as bronchiolitis, croup, or pneumonia. For a child older than three months, see the pediatrician if:
The nostrils are widening with each breath, the skin above or below the ribs sucks in with each breath (retractions), or your child is breathing rapidly or having any difficulty breathing.
The lips or nails turn blue.
Nasal mucus persists for longer than ten to fourteen days.
The cough just won’t go away (it lasts more than one week).
She has pain in her ear.
Her temperature is over 102 degrees Fahrenheit (38.9 degrees Celsius).
She is excessively sleepy or cranky.
Your pediatrician may want to see your child, or he may ask you to watch her closely and report back if she doesn’t improve each day and is not completely recovered within one week from the start of her illness.
Treatment
Unfortunately, there’s no cure for the common cold. Antibiotics may be used to combat bacterial infections, but they have no effect on viruses, so the best you can do is to make your child comfortable. Make sure she gets extra rest and drinks increased amounts of fluids.
Pain Control
If she has a fever and is very uncomfortable, give her single-ingredient acetaminophen or ibuprofen. Ibuprofen is approved for use in children six months of age and older; however, it should never be given to children who are dehydrated or who are vomiting repeatedly. (Be sure to follow the recommended dosage for your child’s age and the time interval for repeated doses.)
Beware of Cold Medicines
It’s important to note, though, that over-the-counter (OTC) cough and cold medicines should not be given to infants and children under two years old because of the risk of life-threatening side effects. Also, several studies show that cold and cough products don’t work in children younger than six years and can have potentially serious side effects. In addition, keep in mind that coughing clears mucus from the lower part of the respiratory tract, and ordinarily there’s no reason to suppress it.
Irrigation with nasal Saline
If your infant is having trouble breathing or drinking because of nasal congestion, clear her nose with saline (salt water) nose drops or spray, which are available without a prescription. This can then be followed by suction with a rubber suction bulb every few hours or before each feeding or before bed. For the nose drops, use a dropper that has been cleaned with soap and water and rinsed well with plain water. Place two drops in each nostril fifteen to twenty minutes before feeding, and then immediately suction with the bulb. Never use nose drops that contain any medication, since excessive amounts can be absorbed. Only use normal saline nose drops.
When using the suction bulb, remember to squeeze the bulb part of the syringe first, gently stick the rubber tip into one nostril, and then slowly release the bulb. This slight amount of suction will draw the clogged mucus out of the nose and should allow her to breathe and suck at the same time once again. You’ll find that this technique works best when your baby is under six months of age. As she gets older, she’ll fight the bulb, making it difficult to suction the mucus, but the saline drops will still be effective.
Humidification
Placing a cool-mist humidifier (vaporizer) in your child’s room also will help keep nasal secretions more liquid and make her more comfortable. Set it close to her (but safely beyond her reach) so that she gets the full benefit of the additional moisture. Be sure to clean and dry the humidifier thoroughly each day to prevent bacterial or mold contamination. Hot-water vaporizers are not recommended since they can cause serious scalds or burns.
My Personal Tips:
Honey In recent years studies have shown that giving children 12 months and older Honey relieved the coughs more effectively then the over the counter cough medicines (I would like to remind all the readers here, never to give honey to infants younger then 12 months old, lest they develop a life threatening paralysis known as Infantile Botulism.) Therefore, I always suggest that children should be given plain honey or chamomile tea with honey whenever they have colds. How much tea? Adults should drink about 6 cups of tea per day, children 2-4 cups depending on their age.
Chicken Soup
Also known as the “Jewish Penicillin”. The use of Chicken Soup was actually scrutinized in the medical world and was found that it really works!!! Yes, your mothers were right again. Soup has a lot of beneficial vapors that loosen the mucus in the upper respiratory tracts and that means fewer post nasal drips and ear infections.
Natural Remedies
Studies have shown that Sambucol (Black Elderberry) helps prevent and treat colds. Most health food stores sell this popular item. Other remedies such as Echinacea have conflicting reports on efficacy.
Vitamins
Vitamin C is a simple, affordable and effective way to prevent or shorten the duration of colds. If the brand that you use is very flavorful, make sure that the bottle is out of reach of your kids. Overdose of Vitamin C could cause serious kidney damage.
Rest
For both kids and adults, getting the recommended amount of rest is paramount for prevention and treatment of colds. When my patients ask me what I do for my colds I often answer: I cancel my evening plans, drink plenty of tea and soup (if available) and go to bed 2-3 hrs a head of schedule. I like to call this “listening to our body”. In my opinion, taking pain medicine for colds in order to stay with the regular, demanding and rigorous daily routine is a form of abusing our bodies. I only resort to taking pain medicines if they are accompanied by a healthy dosage of physical (and emotional) rest.
Prevention
If your baby is under three months old, the best prevention against colds is to keep her away from people who have them. This is especially true during the winter, when many of the viruses that cause colds are circulating in larger numbers. A virus that causes a mild illness in an older child or an adult can cause a more serious one in an infant.
If your child is in child care and has a cold, instruct her to cough and sneeze away from others, and to use a tissue to cough into and wipe her nose. Doing this may prevent her from spreading the cold to the others. Similarly, if your child would be in contact with children who have colds and it is convenient for you to keep her away from them, by all means do so. Also teach her to wash her hands regularly during the day; this will cut down on the spread of viruses.
By the way, the use of a tissue or a handkerchief is preferable to having your child cover her mouth with her hand when sneezing and coughing. If the virus lands on her hand, it can be transmitted to whatever she touches—a sibling, a friend, or a toy.
Wishing you a Healthy Winter,
David Elazar Simai M.D.