Health Topic

Colds

COLDS

Main Symptoms

  • Runny or congested nose
  • The nasal discharge may be clear, cloudy, yellow or green
  • Usually associated with fever. A sore throat often is the first symptom.
  • Sometimes associated with a cough, hoarseness, watery eyes, and swollen lymph nodes in the neck

Cause

  • Colds are caused by viruses. Influenza is just a bad cold with more fever and muscle aches. Healthy children average 6 colds a year.
  • Colds are not serious. Between 5 and 10% of children develop a bacterial complication (ear or sinus infection).

Colds: Normal Viral Symptoms versus Secondary Bacterial Infections

  • Colds cause nasal discharge, nasal congestion, sinus congestion, ear congestion, sore throats, hoarseness, coughs, croup, and red, watery eyes. When you combine all these symptoms, colds are the most common reason for calls to the doctor.
  • Cold symptoms are also the number one reason for office and ER visits. Hopefully, this information will save you time and money and help you avoid some unnecessary trips to the doctor. You can be reassured the following are normal cold symptoms and children with these symptoms don’t need to be seen:
    • Fever up to 3 days
    • Sore throat up to 5 days (with other cold symptoms)
    • Nasal discharge and congestion up to 2 weeks
    • Coughs up to 3 weeks
  • Using this guideline, you can select out the 5 to 10% of children who have ear infections or sinus infections. Many are identified with specific symptoms and patterns. Some are suspected because symptoms last too long:
    • Earache
    • Sinus pain not relieved by nasal washes
    • Fever present > 3 days
    • Fever that goes away > 24 hours and then returns
    • Sore throat present > 5 days
    • Nasal discharge present > 2 weeks
    • Cough present > 3 weeks

See More Appropriate Topic (instead of this one) If

WHEN TO CALL YOUR DOCTOR FOR COLDS

Call 911 Now (your child may need an ambulance)

  • Severe difficulty breathing (struggling for each breath, unable to speak or cry because of difficulty breathing, making grunting noises with each breath)

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
  • Difficulty breathing not relieved by cleaning out the nose
  • Fever > 105° F (40.6° C)
  • Age < 12 weeks with fever > 100.4°F (38° C) rectally

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

  • You think your child needs to be seen
  • Earache or cloudy discharge from ear canal
  • Yellow or green eye discharge
  • Sinus pain (around cheekbone or eyes)
  • Fever present > 3 days
  • Fever returns after going away > 24 hours

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • Blocked nose interferes with sleep after using nasal washes several times
  • Yellow scabs around the nasal openings
  • Sore throat present > 5 days
  • Nasal discharge present >14 days

Parent Care at Home If

  • Mild cold and you don't think your child needs to be seen
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HOME CARE ADVICE FOR COLDS

  1. For a Runny Nose With Profuse Discharge: Blow or Suction the Nose.
    • The nasal mucus and discharge is washing viruses and bacteria out of the nose and sinuses.
    • Blowing the nose is all that's needed. For younger children use nasal suction.
    • Apply petroleum jelly to the nasal openings to protect them from irritation (cleanse the skin first).
  2. For a Blocked Nose: Use Nasal Washes.
    • Use warm water OR saline nose drops to loosen up the dried mucus followed by child blowing or parent suctioning. Instill 2-3 drops in each nostril. (Caution: if < 1 year old, use 1 drop at a time) Do 1 side at a time. Repeat nosedrops until clear. Do nasal washes at least 4 times a day or whenever your child can't breathe through the nose.
    • Saline nosedrops - add ½ teaspoon of table salt to 1 cup (8 oz.) of warm water.
    • Importance: A young infant can't nurse or drink from a bottle unless the nose is open.
    • Note: Most stuffy noses are blocked by dried/sticky mucus and suction alone or blowing the nose cannot remove it.
    • Use a wet cotton swab to remove mucus that's very sticky.
  3. Humidifier: If the air in your home is dry, use a humidifier.
  4. Medicines: Most cold medicines are not helpful. They can't remove dried mucus from the nose. Antihistamines are only helpful if your child also has nasal allergies. Antibiotics are not helpful unless your child develops an ear or sinus infection.
  5. Treatment for Associated Symptoms of Colds:
    Fever - Use acetaminophen (e.g., Tylenol) or ibuprofen for muscle aches, headaches, or fever > 102°F (39° C).
    Sore Throat - Use warm chicken broth for > 1 year old and hard candy for >4 years old.
    Cough - Use cough drops for children over 4 years old, and corn syrup (2 to 5 ml) for younger children over 1 year old.
    Red Eyes - Rinse eyelids frequently with wet cotton balls.
  6. Contagiousness: Your child can return to day care or school after the fever is gone and your child feels well enough to participate in normal activities. For practical purposes, the spread of colds cannot be prevented.
  7. Expected Course: Fever 2-3 days, nasal discharge 7-14 days, cough 2-3 weeks.
  8. Call Your Doctor If:
    • Fever lasts > 3 days
    • Any fever occurs if < 12 weeks old
    • Nasal discharge lasts > 14 days
    • Cough lasts > 3 weeks
    • Your child becomes worse or develops any of the "Call Your Doctor" symptoms
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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Pediatric HouseCalls Online. Copyright © 2000-2005 Barton Schmitt, M.D. FAAP

Reviewed 8/2005

Revised 8/2005

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