Colds in children

Highlights

Children with asthma are at higher risk of complications from respiratory viruses.

In young children (preschool aged or younger), asthma attacks are often triggered by a cold or flu.

If your child has asthma, make sure he takes all medications as prescribed.

Although all children over 6 months old should get a flu shot every year, the vaccine is especially important for children with chronic conditions, like asthma.

The 'common cold' is caused by viruses (germs) that infect the nose, throat and sinuses. Colds are most common in the fall and winter when people are indoors and in close contact with each other.

It may seem like your child has one cold after another all winter. Young children haven't built up immunity (defenses) to the more than 100 different cold viruses that are around. That's why they can get as many as 8 to 10 colds each year before they turn 2 years old.

Once you have had a cold virus, you become immune to that specific germ. That's why children get fewer colds as they get older.

How do colds spread?

Children can catch colds from siblings, parents, other family members, playmates or caregivers. Germs usually spread in one of three ways:

Direct contact-such as kissing, touching or holding hands-with an infected person. If you have a virus, you will have germs in your nose, mouth, eyes and on your hands. By touching other people, you can pass on the virus.

Indirect contact means touching something-a toy, doorknob or a used tissue-that has been touched by an infected person and now has germs on it. Some germs, including those that cause colds and diarrhea, can stay on surfaces for many hours.

Some germs spread through the air when a person coughs or sneezes. Droplets from the cough or sneeze can reach another person's nose or mouth.

How do I know if my child has a cold?

Typical cold symptoms include:

runny or stuffed-up nose and sneezing,

coughing,

headache,

mild sore throat,

loss of appetite,

fatigue (being tired), and

mild fever.

The influenza (flu) virus causes high fever, cough and body aches. It strikes more quickly than a cold and makes people feel worse. Children with colds usually have energy to play and keep up their daily routines. Children with the flu are usually in bed.

When should I call my doctor?

Babies under 3 months of age can find it hard to breathe through a stuffed-up nose, which can make feeding difficult. Call your doctor to make an appointment or take your baby to an emergency department if your baby:

is having trouble breathing,

is not eating or is vomiting, or

has a fever (rectal temperature of 38.5°C or higher).

Some respiratory viruses that cause colds in older children and adults may cause more serious illness in babies and toddlers. These illnesses include croup (hoarseness, noisy breathing, barking cough), pneumonia (lung infection), bronchiolitis (wheezing, trouble breathing), or sore eyes, sore throat and neck gland swelling. Children with these conditions need to be seen by a doctor.

Children of all ages should see a doctor if the cold seems to be causing more serious problems. Call your doctor to make an appointment or take your child to an emergency department if you notice your child:

is breathing rapidly or seems to be working hard to breathe,

has blue lips,

is coughing so bad that he is choking or vomiting,

wakes in the morning with one or both eyes stuck shut with dried yellow pus,

is much sleepier than usual, doesn't want to feed or play, or is very fussy and cannot be comforted, or

has thick or coloured (yellow, green) discharge from the nose for more than 10 to 14 days.

Call your doctor if your child shows any sign of a middle ear infection (ear pain, drainage from the ear), which can be caused by a cold.

What can I do if my child has a cold?

There is no cure for the common cold. Colds usually last about 1 week but can continue for as long as 2 weeks. They usually go away on their own.

Keep your child as comfortable as possible. Offer plenty of fluids and small, nutritious meals.

Check your child's temperature. To ease pain, aches or a fever with a temperature greater than 38.5°C, use acetaminophen. Ibuprofen may be used for children over 6 months old. Unless your doctor says otherwise, give the dose recommended on the package every 4 hours until the child's temperature comes down. Do not give acetylsalicylic acid (ASA [eg, Aspirin])-or any medicine containing it-to children and teenagers with colds because it can lead to brain and liver damage (Reye syndrome) if the person happens to have the flu.

If your baby or toddler is having trouble breastfeeding because of a stuffed-up nose, use a suction bulb to clear mucus from the nose. Use saline nose drops or saline nose spray if the mucus is very thick. The spray goes well into the nasal passages and may work better than the drops.

Don't give over-the-counter (OTC) cough and cold medicines (which don't need a doctor's prescription) tochildren younger than 6 years old unless your doctor prescribes them.

Talk to your doctor or pharmacist before giving OTC drugs to children or to anyone taking other medicines or with a chronic illness. Read label instructions carefully. Do not give more than is recommended.

Coughing helps clear mucus from the chest. Many OTC cough and cold products contain drugs to ease coughing. Usually they include dextromethorphan (also called DM) and/or diphenhydramine. Most studies of these drugs have been done in adults. The few that have been done in children show no benefit.

Decongestants and antihistamines (medicine to clear nasal and sinus congestion) will not help coughing. Decongestants taken by mouth do not work very well and can cause your child to get a rapid heartbeat or to have trouble sleeping. Antihistamines do not work for colds.

Medicated nose drops or sprays provide only brief relief and shouldn't be used for more than 2 to 3 days. They can actually make the congestion worse. Don't use these products in children under 6 years old.

Cool mist humidifiers are not recommended because of the risk of contamination from bacteria and mould. If you do use one, disinfect it daily. Hot water vaporizers are not recommended because of the risk of burns.

Antibiotics will not help get rid of a cold. Antibiotics should be used only when children develop more serious illness caused by bacteria, such as an ear infection or pneumonia.

Children can continue their normal activities if they feel well enough to do so. If they have fever or complications, they may need a few days of rest at home. Your child can go to school if he feels well enough to take part in the activities.

Children with colds can still play outside.

How can I prevent a cold?

Handwashing is the most important way to reduce the spread of colds:

Wash your hands after coughing, sneezing or wiping your nose.

Wash your hands after being in contact with someone who has a cold.

Wash your own hands and your child's hands after wiping your child's nose.

When water and soap are not available, use pre-moistened hand wipes or alcohol-based hand sanitizers. Keep wipes and hand sanitizers out of your child's reach because they may be harmful if swallowed.

Keep babies under 3 months old away from people with colds, if possible.

Teach your children to cover their nose and mouth with tissues when they sneeze or cough, or to cough into their upper sleeve or elbow.

Avoid sharing toys that young children place in their mouths until they have been cleaned.

Avoid sharing cups, utensils or towels with others until they have been cleaned.

If your child attends daycare, tell the caregiver about any symptoms and ask if your child should stay home that day.

Make sure your child receives all of the recommended immunizations. While vaccines won't prevent colds, they will help prevent some of the complications, such as bacterial infections of the ears or lungs. Influenza (flu) vaccine protects against the flu but not against other respiratory viruses.