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Common Cold Symptoms and Treatment

What is the Common Cold?

A “cold” is the common term for what is medically referred to as an “upper respiratory infection” (URI). Colds are caused by any of over 200 different viruses. Cold symptoms include runny or stuffy nose, runny eyes, cough, fever, sore throat, and hoarse voice. Colds are spread by direct contact, sneezing, and coughing. Most children between the ages of 1 and 6 years old will have an average of 6-12 colds per year. A typical cold will last 7-10 days, although the fever will usually last only 3 days. If the symptoms last more than 10 days or the fever lasts greater than 3 days, you should see your health care provider. Infants under the age of 3 months should be seen by their health care provider with each episode of cold. Over 3 months of age, the need to see a health care provider should be made on a case by case basis. If you have concerns, speak directly with your child’s health care provider. It is important to remember that anytime your child appears lethargic, irritable, refuses to drink, or has a rash, especially a non-blanching rash, you should also contact your health care provider.

Common Cold Symptoms

1. Yellow nasal discharge does not mean sinus infection–you can have a sinus infection with clear or colored nasal discharge just as you can have a URI with clear or colored nasal discharge.

2. A sore throat does not necessarily mean strep infection. Strep is usually associated with fever and sore throat. It is not usually associated with a runny nose, cough and hoarseness–these are typical of viral illness.

3. Although a URI is caused by a virus, you can get a bacterial superinfection on top of the viral infection. So if your child has prolonged fever or specific complaints such as ear pain(ear infection) or difficulty breathing (pneumonia), you should contact your doctor.

4. A clear runny nose without any other symptoms could represent allergies (in children older than 3 years) or could be a reaction to cold air in the winter (this will clear up on coming inside).

Common Cold  Treatment

Plenty of fluids: Don’t worry as much about solids during this time, most children with a cold will not want to eat. As long as they are drinking well, and urinating normally, a couple of days without much solid food will be OK. The increased fluids will keep the mucus flowing and less sticky.

For stuffy or runny nose in an infant

An infant can be cleared by using saline drops and a suction bulb. Place 2-3 drops of saline solution (available in the pharmacy) in each nostril, one nostril at a time, and let sit for 10-20 seconds, then suction with the bulb. You can do this every 2-3 hours as needed. Do not stick the tip of the bulb into the nose, keep the tip at the opening of the nostril.

For stuffy or runny nose in a child

A child can sometimes benefit from over the counter “cold” preparations. While there is no evidence that sinusitis or ear infections can be prevented with these medications, if your child appears more comfortable while using the medications, then you should use them. Remember that you should not use over-the-counter cold medications longer than 4-5 days in a row. On the other hand, if your child does not appear to be benefiting from these medications, you should discontinue using them. There are 2 major classes of “cold medications”, antihistamines and decongestants. Antihistamines in cold preparations tend to be the ingredient that ends in -amine (diphenhydramine, brompheniramine, chlorpheniramine and others). These medications are better for allergies, however, they have some role in drying secretions (sometimes, but not always desirable) and may be especially beneficial at bedtime, because the major side effect is sleepiness. Decongestants tend to end in -rine (pseudoephedrine, neosynephrine, and phenylephrine). These medications act by drying mucous, decreasing the production of mucous, and opening passageways.

For fever

Use of acetaminophen or ibuprofen is recommended.

For cough

You may use over-the-counter cough preparations. There are 2 over-the-counter cough syrup medicine ingredients, dextromethorphan and guaifenesin. Dextromethorphan suppresses the sensation of cough. Guaifenesin decreases cough by making mucous less sticky and easier to clear with each cough. Cough drops are either medicated (usually with menthol which acts as a topical anesthetic) or unmedicated (pectin is the “active” ingredient). Unmedicated cough drops do work, and can be used liberally, but are no better than hard candy, working only as long as the drop is in the mouth. Cough drops should be reserved for daytime hours in children 10 years of age or older. Children under 10 should not be given cough drops to avoid the risk of choking.

For throat irritation:

Oral antihistamines and decongestants can be helpful for the symptom of throat irritation (see above). Additionally soups and hot chocolate beverages can be quite soothing and every bit as helpful as medications. Medications specifically for throat irritation come in the form of lozenges or sprays. The common ingredients for both forms act as topical anesthetics including menthol, diclonine, benzocaine and hexylresourcinol. Note that taste buds are nerves, thus the flavor of foods is temporarily affected by these medications. Lozenge use should be limited to daytime hours in children over 6 years of age to reduce the risk of choking. Sprays may be used in children as young as two years of age.

  • Zinc preparations: The benefit of zinc lozenges in children has not been satisfactorily established.
  • Vitamin C: There may be some small beneficial effect of very high doses of vitamin C with regards to the duration or severity of symptoms, however this has not been clearly established and is not currently recommended.


A word about prescription cough and cold medications:

Prescription cough medications are narcotic opiates (codeine, hydrocodone and others) that are chemically related to the over-the-counter medication “dextromethorphan,” but have the added commonly seen side effects of constipation and drowsiness and the very rare risks of respiratory depression, and addiction. The doses of these medications when used for cough are small, and they are really quite safe when used under a physician’s direction in children over the age of 2 years. Nevertheless, because there remains some risk, their use should be reserved for severe or prolonged cough.

Prescription cold medications (antihistamines and decongestant combinations) do not offer much benefit over the over-the-counter preparations. The ingredients are quite similar to the over-the-counter brands, with the addition of an agent that requires a prescription. (Often, the requirement of the prescription is because the added ingredient is less safe, not because it works better.) These combinations are distinct from the newer prescription antihistamines (loratadine (Claritin), fexofenadine (Allegra), and cetirizine (Zyrtec)), which are recommended for allergies because of the reduced degree of drowsiness associated with their use as compared to over-the-counter antihistamines.

Prevention Tips

Prevention of colds or URIs, and prevention of spread, is best achieved by good hand washing for everyone in the house with warm water and soap. Limiting contact with clearly infected individuals is advised when possible, and is an absolute must when newborn infants are involved. The role of sanitizing wipes or sprays while in public (i.e. for cleansing shopping cart handles, door knobs etc.) is unknown, but potentially beneficial. There is no role for vitamin C supplementation (above and beyond the RDA–recommended daily allowance) in the prevention of the common cold.