It's been around for centuries, and there is
no cure. Millions of people every year are miserable because of it, but there
is no vaccine. It is the common cold.
Back in the 16th century, folks dubbed it a
"cold" because symptoms seemed to pop up in conjunction with exposure
to cold weather.
Today, science has identified more than 200
different types of cold viruses that are specific to humans.
Most children will catch six to 12 colds per
year, typically in rapid succession and usually in the wintertime – and this is
actually quite normal.
Kids with colds can be quite miserable,
leaving parents desperate for relief and pediatricians quite frustrated at
their inability to treat it. Since doctors can't treat the virus, parents are
often eager to treat the symptoms.
Unfortunately cough and cold medications do
not work.
You're probably surprised to hear that,
especially since countless options line the aisles of pharmacies. But decades
of research on cough and cold medications have shown a lack of effectiveness in
children.
More concerning is the fact that cough and
cold medications can actually cause dangerous side effects in children, even to
the point of death.
In January 2008, the Food and Drug
Administration (FDA) issued a public health advisory for parents and caregivers
stating that over-the-counter (OTC) cough and cold products should not be used
to treat infants and children less than 2-years of age because of serious and
potentially life-threatening side effects.
The American Academy of Pediatrics (AAP) goes
even further, recommending that children less than 6-years of age should not
use cough and cold medications. According to the AAP, "a variety of rare,
serious health problems have been associated with use of these medications in
children, including death, convulsions, rapid heart rates and decreased levels
of consciousness."
Why don't they work? The answer is Mother
Nature.
Infection begins when a cold virus lands in
the nose or mouth, either from contaminated fingers or from the droplets in the
coughs and sneezes of an infected individual.
The in-flight virus then attaches itself to
the surface of the skin inside the nose (the mucus membranes.) From there, the virus invades a nearby cell,
where it hijacks part of the cell's regular function. The virus replicates, the cell ruptures, and
the newly-replicated viruses quickly overwhelm unsuspecting cells.
One of the key parts of this cycle is the
destruction of nasal skin cells. The
presence of germs and the death of cells results in an inflammatory reaction –
and miserable cold symptoms begin.
Inflammation and damage to the inner nasal
skin cells is exactly why there is very little that can be done to help heal a
common cold. In this case, Mother Nature, not a pediatrician, is the healer. It
simply takes time and has to run its course.
Think back to the last time you fell and
skinned your knee. You probably cleaned
it with alcohol and dabbed antibiotic ointment on the skin to prevent it from
getting infected. It eventually scabs
over, and when the scab peels off, fresh new skin is revealed.
With a cold, the damaged skin surface in the
nose and at the back of the throat is similar to the damage sustained on a
skinned knee. Just as the knee takes
time to heal, so does the inner skin that lines the nose and throat.
No amount of cough or cold medications will
accelerate the healing process. Until healing occurs, there will be mucus and
there will be coughing. Depending on the amount of damage, this process takes
at least two to four weeks.
Coughing is a protective mechanism designed to
move mucus through the respiratory track. In a child with or without asthma,
coughing can be worse at night because during the day gravity and activity
helps mucus drain and clear from the airways; however at night, laying
horizontal and the lack of movement allows mucus to pool in the airways thus
increasing the coughing bouts.
Nasal congestion and nasal discharge usually
signals the beginning of a viral infection.
The mucus is clear for the first few days, cloudy for several more, and
then clear again near the end. Any mucus
that has been in the nose or throat for longer than one day is often a cloudy
yellow or green color.
Contrary to popular belief, this is not a sign
of bacterial infection nor is it a reason for antibiotics. The color is caused
by enzymes in the body's immune system. It's a normal stage in the life cycle
of a viral upper respiratory infection.
Congestion is usually the worst from day two
to six of the illness.
Coughing usually begins soon after congestion
starts. Most coughs represent the body's
efforts to protect the airway. When
mucus slides down the windpipe from the nose, it stimulates a cough reflex to
prevent mucus from invading the lungs.
Babies are not very efficient coughers, so
they tend to have more difficulty clearing their airway. Concerned parents will
often visit the pediatrician on day three to five of the illness because that's
when the coughing keeps everyone up at night.
Fever sometimes announces the beginning of a
viral infection. The fever typically resolves after two to three days, but can
last longer than one week.
While the symptoms of a cold can be annoying
and lengthy, the good news is that it will eventually resolve and improve
without intervention. Rest, tender
loving care and little bit of Tylenol and Motrin to help keep the child
comfortable is all that is typically needed.
FAQs
Is it possible to avoid getting a cold? If so,
how?
It is virtually impossible to avoid catching
colds from time to time. However,
careful hygiene – the most important being washing of hands – can reduce the
frequency. Vitamin C, Echinacea and nearly all alternative forms of treatment
have not been shown to be effective in preventing colds.
When do I need to see the doctor?
Any cold can become complicated by a secondary
infection such as a middle ear infection, sinus infection, or pneumonia. Typically, a child will appear as if they are
getting better from the cold, when all of a sudden, there will be a sudden
increase in symptoms including (but not limited to): a spike in fever, increase in fussiness,
labored breathing, and loss of activity.
While a cold cannot be treated and will get better with time, secondary
infections need to evaluated and appropriately treated.
What else can I do to treat the cold?
Unfortunately, other than time nothing works
great. A few things that are safe and
might help.
1.
Sleeping with the head propped higher than the body can allow gravity to
help drain unwanted mucus away.
2.
Frequent suctioning can help.
Nasal saline solution can help break up the mucus. Bulb suctions are good, but the NoseFrida
suctioning device is even better. Any
irritation and nose bleeds from suctioning trauma can be treated with small
dabs of petroleum jelly.
3. Cool
mist humidifiers can help mask the tickly feeling in the back of the throat and
also help to keep the mucus from becoming too thick. They are hit or miss, but not harmful. Medicated humidifiers are not recommended as
there is no evidence to support their use.
4. In
children over 1 year of age, 1-2 teaspoons of honey can be given frequently to
help soothe the throat and mask the tickly feeling in the back of the
throat. This can help control the cough.
