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Mendo Lake Family Life

Decode Your Child’s Cold

By Sandra Gordon

As miserable as a cough or stuffy nose can make your child feel, it’s helpful to know that cold symptoms can often seem worse than they actually are. Still, coughs and congestion can sometimes signal something more serious. What’s worrisome and what’s not? Here’s what you need to know to decipher and treat your child’s cold symptoms.

Cold Clues Nasal congestion is often the first sign of a cold. It’s an inflammatory response to bacteria or, most commonly, a virus. When a virus invades your child’s nose or less often, the air passages in her or his chest, cells lining the nose and/or the chest area swell and produce mucous. Clogged nasal and throat passages help block the bad bug from traveling further. As part of this inflammatory response, your child’s nose can also run, which helps shed the virus. The body can also produce other chemicals in response to the virus that can make your child feel lousy.

Post-nasal drip—a slow leak of mucous from the nose that irritates the back of the throat—can also cause a runny nose, and sneezing and a phlegmy cough (without wheezing or fast breathing, day or night). None of these symptoms requires treatment.

When to Worry Cold-like symptoms you should be concerned about include distressed breathing (your child can’t catch his or her breath, even when trying to breathe through the mouth), a high fever (100.5°F or greater), loss of appetite, disrupted sleep, a lack of energy, and/or chest congestion. Call your doctor if your child has any of these symptoms, especially if your child’s cough and stuffy nose persist more than 10 days without improving, even if they’re not causing other symptoms. Rarely a cold can start off as a viral nasal infection and develop into a bacterial infection in the lungs, aka pneumonia, which does require medical attention.

Your little one could also have asthma, allergies, or even enlarged adenoids, which inhibit breathing. Older kids could have sinusitis (a bacterial infection that’s often brought on by a cold) or an allergy. It could also simply be seasonal stuffiness. When the humidity level in the air drops along with the thermometer, mucous membranes in the nose can swell.

Cold Comfort You can’t shorten the duration of a cold, but you can help your child feel better by trying these tactics:

Sweeten the deal. Since a cold is viral, not bacterial, treatment won’t require antibiotics. And since the Food and Drug Administration doesn’t recommend over-the-counter cough and cold medications for children under age 6 because of the risk of potentially life-threatening side effects, they aren’t options either. It’s just as well. “They haven’t actually been shown to be effective in children,” Michael Brady, M.D., says.

So try honey. “In studies, it works better than dextromethorphan, a component of cough suppressants,” says Bonnie Kvistad, M.D. Give a half a teaspoon to 2–5-year-olds; 1 teaspoon for 6–11-year-olds, and 2 teaspoons for kids ages 12 and older. If administered before bed, make sure your child brushes her or his teeth because it can cause tooth decay. Honey isn’t recommended for children under age 1 because of the risk of botulism.

Cough drops are another option for loosening coughs and soothing sore throats. “But don’t give them to children under age 6,” says Kvistad. Like any hard candies, lozenges pose a choking hazard.

Keep nasal passages as clear as possible. Using a cool-mist humidifier in your child’s bedroom will help moisten airways. But be sure to clean the humidifier often and only use it when your child is congested.

“If you run a humidifier full time, there’s a greater chance you’ll create mold spores in the room, which your child can inhale,” says Lawrence Rosen, M.D. As a result, kids can develop an allergy to mold and a chronic cough.

For babies and toddlers, use nasal saline drops and a nasal aspirator to suction a runny nose. This is important so your child can breathe through the nose when nursing or having a bottle. Your child may not drink as much otherwise, which can lead to dehydration. Use saline spray for older kids.

Fill up on fluids. Drinking plenty of clear fluids, such as water (for babies older than 1), can help your child stay hydrated, which helps thin mucous and clear nasal secretions. Avoid milk, which may make secretions at the back of the throat thicker. For babies under age 1, stick with breast milk or formula. If your baby is vomiting, Rosen recommends alternating formula or breast milk with Pedialyte. But check with your doctor to be sure. Don’t give babies under 1 year old straight water, Rosen advises. Infants are susceptible to water intoxication, a potentially lethal condition. 

Sandra Gordon is an award-winning freelance writer.