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Wednesday, May 15, 2013

Post #38 The Common Cold


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.

1 comment:

Jess Toons said...

Thanks for sharing this article,e its been a really great read. I've been needing help with my pediatricians in Columbia MD, for some time. I hope this helps.