Does my child have a "common cold" or something more?
Upper respiratory infections; when to take your child to the doctor

As we head into the season when the frequency of the common cold increases, it's an ideal time to review a cold's characteristics and recommended treatments, as well as some potential complications, says Hugh F. Brainard, M.D, new pediatrician at Ingham Internal Medicine Associates.

It is estimated 26 million school days and 23 million workdays are lost each year because of the common cold and other causes of rhinitis (runny, itchy nose).  Pre-school children generally have between three and nine colds per year, or one every six weeks or so. This frequency increases in school-age children, or those in pre-school or day care, particularly during the winter months.

The common cold is a self-limited viral illness (meaning it will go away on its own) that causes a congested, runny nose, a cough, and a low-grade fever of less than 102 degrees Fahrenheit. 

This lasts about one week, but the runny nose and cough can last up to two weeks. The best treatment is increasing the amount of fluids the child drinks, and treating the fever or discomfort with a non-aspirin pain reliever, such as acetaminophen (Tylenol, a common product) or ibuprofen (Motrin, a common product.).  Do not give aspirin, which has been linked to the development of Reye's syndrome in children with colds and other viral-caused illnesses. In young infants, using a saline (salt-water) nasal spray or drops before feeding may be helpful.

Neither vitamin C nor antibiotics are effective for the treatment of this viral illness. Most cold remedies sold over the counter are combinations of antihistamines and decongestants. Many add expectorants (to make the cough more watery) or cough suppressants. 

While antihistamines can dry up a runny nose to some degree, this is probably more of a side effect than a direct action. Most antihistamines sold over the counter cause some drowsiness, and can cause irritability and dizziness. 

Decongestants can open up a congested, stuffy nose, but can also stimulate the child and cause nervousness and dizziness.  Coughing is a protective respiratory reflex that acts to either bring up secretions or to open up the airways in the lungs. 

Coughing should probably only be suppressed at night if the child has a dry, irritating cough that is interfering with sleep.  Expectorants have little effect on most children with a cold, and like the other types of drugs listed above, expectorants can have negative side effects, especially in infants less than six to nine months of age.

One commonly held misconception is that a green-colored nasal discharge means the sinuses or nose has become infected with a bacteria, and that antibiotics are needed.  Medical opinions vary on why nasal discharge can be clear, white, yellow, or green with a cold.  A better indication of a bacterial infection is a prolonged nasal discharge lasting more than 10 days, or a pain, in or behind the cheeks, nose or face.

Because the same virus that will cause a "head cold" in an older child can move into the chest of a young infant and require different treatment, any infant younger than four months old with a prominent cough or fever greater than 100.4 degrees Fahrenheit rectally (or 100 degrees under the arm, without adding or subtracting anything) should see their physician .

Other symptoms that warrant a visit to the physician include: blood or blood-streaked nasal discharge or sputum, a fever greater than 102 degrees Fahrenheit or that lasts several days, an earache, sore throat, a cough that lasts longer than 10 days, or the infant or child refusing to eat or drink fluids.

Note: This article was written by Hugh F. Brainard, M.D., FAAP, a board certified pediatrician at Ingham Internal Medicine Associates.