"Colds" are the childhood infections marked mostly by runny nose, congestion, sometimes fever and sneezing and coughing that we expect children to experience many times a year. In fact it is usually true that a typical toddler will have 8-12 "colds" per year and slightly fewer number in the early school age years. Colds are caused by respiratory viruses and there at least 110 different ones your child can and will get in their younger years. The "common cold" is caused by one or the other of these many viruses and most of them are easily managed and mild in the discomfort they cause. *As parents, it is important to know the difference between a simple cold and more serious infections, such as sinusitis, pharyngitis (sore throat) and ear infection. These illnesses are usually accompanied by high fever and misery but very young children may not be able to express the pain in ways a parent can easily understand. Look for a sudden change of mood for the worse in a child with a lingering set of ordinary cold symptoms, or a change for the worse in appetite, or balance (ear infections typically set your child off kilter) and particularly if associated with a sudden rise in temperature, seek a pediatrician's advise and examination.

Young children, under 3 , with ordinary colds, are easily upset and hard to console when their breathing passages are stuffy or runny. Even a mild amount of nasal congestion can make an infant miserable and solving this can make all the difference in sleep, appetite and mood. If your infant is over 2 months of age and has a runny nose and a low grade fever (up to 102F rectally) you can usually manage the situation on your own with a few simple measures.

Provide your baby with extra fluids in the form of water either directly or indirectly by adding a little water to their formula (be careful to resume normal concentrations of formula when the cold passes so your baby gets adequate nutrition). Breathing heavily from congestion causes your child to lose fluids and can lead to dehydration especially if there is also a fever going on.

Provide the humidity that is needed for your child's airway to function comfortably and optimally. It is impossible for the body's natural nasal defenses to operate if they are bogged down in sticky mucus so getting the airways moist by dribbling saline drops into the nostrils and setting up either a cool mist humidifier or a brief visit to a steamed up bathroom (not too long for the infants - too hot is not good for the lungs) can do a lot both for comfort and for hastening the healing process. The little hairs in the airways, cilia, need to beat freely in order to evict the bad guys, like viral particles and debris and to repair the damage the cold has wrought. All of us know how awful we feel in the early morning after a night of mouth breathing and a sticky nose full of snot! Imagine how your baby feels - she can't even clear her throat or blow her nose to help herself! I do not recommend you go digging with an aspirator in your child's nose since that rarely accomplishes much and really upsets the baby further, causing more mucus and tears to flow. I especially discourage the use of cotton swabs to "clean" out the nose since that also irritates and can flatten the cilia even further by smearing the hairs of the nose down into the mucus as you "clean". Ykkkk! There is no absolute quantity of saline you need use; saline is a normal body component so just dribble a few drops in every hour or so when needed. Often the child will sneeze shortly after and this also helps to empty the passages of congestion. By the way, mucus is produced mostly by your body in response to the invasion of a virus and is probably an attempt by your body's defenses to inactivate and wall off the virus - mainly it is annoying but it can't be altogether bad for you so don't get too aggressive about getting rid of it - just keep it loose so your child can be comfortable.

Treat simple fevers with loose fitting clothing, comfortable room temperature (no over heated rooms), tepid baths (if your child enjoys the water), increased fluids, and acetaminophen if fever is over 101F rectally and your child is uncomfortable. Know your child's exact weight (or close to it) so that you can carefully dose correctly - the instructions on the bottles of medicine are too vague and based on age or large weight ranges and are often under dosed for your particular child - acetaminophen should be given in 4 hour intervals at most, at the dose of 12-15 mg. per kilogram of child's weight. If , for example, your child weighs 40 pounds and has a fever of 101.6F rectally, the correct dose would be 20 (kilos = approximately « the pound weight) times 12-15mg which = 240 to 300mg per dose. Since most children's acetaminophen comes as 160 mg per teaspoon this child needs at least one and a half teaspoons of medicine for a mild fever. (If the temperature were over 102F you would aim for the higher end of the dose range and give closer to 2 teaspoons per dose.)

Occasional use of over the counter cold remedies can have a role in alleviating discomfort but be aware that cold medicines do not cure anything and can even cause additional discomfort if the side effects are prominent in your particular child. All of us react differently to cold medicines and some of us even react with "paradoxical" behavior - this means that a cold medicine with anti-histamine (intended to dry up the mucus and cause some sleepiness) can instead cause some children to become agitated and irritable instead. Clearly not a situation you would want for your child, particularly in the evening - I advise parents who do wish to try cold medicines to first trial them during the daytime so that the side effects, if any, can wear off by bedtime.

Keep a handle on hygiene during your child's illness so that you are not infecting others, yourself in particular since you are already stressed by the illness of your child and not getting all the rest you need by a long shot, and to minimize reinfecting your own child or the siblings as well. Wash your hands often and discard tissues well and clean surfaces with a disinfectant after your sick child has played or eaten on it. Use separate spoons and toothbrushes (good ideas even when your family is not sick) and carry wipes when you are in transit so you can clean up after sneezes more effectively. It is impossible to prevent the spread of viruses completely but it's never too soon to start teaching your children to use tissues and cover their mouths when they cough or sneeze (and then wash their hands!). Setting these examples of course helps too but young kids need your specific instruction to learn to do the right things, in this and in so many other areas we take for granted. Don't give up - my dad taught my 6 month old to do a primitive nose blow while I was away on vacation - I wouldn't believe this possible if I hadn't seen it proudly demonstrated to me on my return!! She is a great nose blower by the way, and good thing she catches every cold that passes! Luckily my son is rarely sick since he did not learn grandpa's "trick" so well! Sleep and nutrition are always on the lists of "do" but mostly very hard to get "done" when it comes to children. Certainly try to feed your child healthy food at all times but don't over do it during illness. Fluids are really more important than calories when ill unless the illness lasts a long time. As for sleep, all you can do is make your child comfortable in the ways outlined here, provide a quiet and peaceful environment (mood music helps) and read quietly nearby to comfort your child into rest. I don't recommend video and TV marathons - most kids fight to stay awake just to keep seeing them. Not a restful thing in my book.

Knowing the difference between ordinary colds and more serious infections is vital. Call your pediatrician if you are not sure or if a cold lingers for more than 10 days or has a rising fever associated with it. A child old enough to tell you should be taken to the doctor if she complains of a sore throat (after good hydration so you are not just dealing with a dry throat), or of ear pain and always trust your instincts in the pre-verbal child - better to be safe than sorry. These infections are sometimes caused by bacteria and usually require the use of antibiotics (viruses are not responsive to antibiotics and in fact should not be treated with them "just in case" since that can even make the child sicker). Call the doctor if you aren't sure what's going on and run the story by - try to stick to important information such as length of illness, duration and height of fever, presence or absence of appetite, mood change or sleep disturbance. Tell the doctor exactly how old your child is since she may not recall exactly and if you have more than one child she may even have them confused in her mind age-wise (forgive us - we don't always have the chart before us and we may have some memory lapses of the minor details - it takes very little to just remind us that Jenny is 6 years old! Thanks.) Know that most colds last no longer than 2 weeks and more often only 5-10 days. Your child is contagious for as long as there is fever and as long as he is actively sneezing and coughing. Good luck and get some sleep while you can!

Description

"Colds" are the most common childhood illness and consists of runny nose, congestion, low grade fever and sneezing and coughing. Most affected children feel tired, irritable and have poor appetites although these symptoms may be extremely mild. What causes illness "Colds" are caused by a group of viruses called Rhinoviruses and they invade the mucus membranes especially when the air is cold and dry. Children "catch" colds from other children via their sneezing or coughing or touching surfaces that have been sneezed on recently and putting hands to mouth or nose.

Usual course

Most colds last from several days up to 2 weeks, the longer colds are usually seen in the younger child. Most children with runny nose will feel gradually less and less comfortable unless they are helped to clear the airways. If the congestion becomes thick the child will experience ear pain and difficulty swallowing as well. Mild fever and headache may accompany a cold with improvement in these symptoms occurring at various times in the day, particularly after nose clearing and increased fluid intake and fever reduction. Recovery is variable but usually complete and depends in part on the child's background status before this cold (were they just recovering from the last cold?) and on how much rest and fluids the child gets.

Management tips and treatment

Increase clear fluids - add extra water to infant's formula if your baby won't drink water. Increase humidity-the body's natural defenses in the membranes of the nose and mouth and throat work best when they are moist and not sticky with mucus. Use saline drops for infants and a clean, cool mist humidifier or brief visits to a steamed up bathroom for clearing passages. Treat fever-low grade temps can be managed with loose fitting clothing, comfortable room temperature, tepid baths (if enjoyable), increased fluids and acetaminophen for fever over 101F rectally.

Occasional use of over-the-counter remedies with your doctor's guidance may help some children to feel better although this will not shorten the course of the virus. Be aware of potential side effects and interactions with other medications your child may be taking before choosing a remedy. Some cold meds can help a child 's congestion and result in a better night's sleep for all.

Attend to your child's hygiene-both to decrease the spread of the cold through your own home and also to prevent reinfection. Wash hands often and discard tissues well. Clean eating and playing surfaces with a disinfectant and always use separate cups and toothbrushes. Teach children to cover their mouths when sneezing and coughing and to wash their hands right after. Carry pre-moistened wipes for more effective clean up when in transit with a sick child and discard them in a baggie until you get to a disposal.

Sleep and good nutrition are always a good idea but don't overdo the feeding during illness. Let your child's hunger be your guide on quantity except for the fluids which you need to encourage. Avoid TV and video marathons as children are better off listening to quite music or a story so that they will more likely fall asleep.

Stay at home an extra day after recovery since the immune system takes a little time to get to full snuff. Your child is less likely to pick up the next rhinovirus (there are over 100!) if they are fully recovered from the last. Your child is contagious at least for as long as he has fever and as long as he is actively sneezing and coughing.

When to call the doctor

Any time an illness lingers longer than expected or has a sudden, very high fever that persists for over a day or 2, a call to the doctor is indicated. Complaints of ear pain, severe sore throat, inability to swallow liquids or severe headache are also reasons to see the doctor. Difficulty breathing even after measures to clear a stuffy nose have succeeded may indicate a more deep infection such as bronchiolitis or pneumonia and needs immediate attention. In very young children a significant change in mood may be all you have as indication that a more serious infection has arrived, such as a sinusitis or otitis media (middle ear infection) and your child may need prescription medication.