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Childrens Medical Office
of North Andover, P.C. |
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The Common Cold
A "cold" is an infection in which the main symptom is a runny nose. This is the least serious and most common respiratory illness, and is usually viral. Ordinarily the nasal discharge starts clear and watery, gradually thickens, becomes yellow or green for a few days, then dries up. Often this is accompanied by fever, discomfort, sneezing, and a mild cough. Some children are prone to nosebleeds with a cold - these should be treated with direct pressure (squeeze the nose firmly where the bone ends for 10 minutes). Many of the viruses which cause a cold may also lead to loose bowel movements and a faint red rash. Similar symptoms may be caused by nasal allergy. In that case the discharge will usually remain clear and watery, itching and sneezingwill be more prominent, and generalized symptoms such as fever will be absent. To manage these symptoms you can:
1. Use a cool mist vaporizer (well cleaned regularly with bleach) to help soothe irritated nasal passages and keep secretions loose. Elevating the head of the bed may help some children sleep better as well.
2. For infants LESS THAN 4-5 MONTHS, who have difficulty breathing through the mouth and for whom a cold may therefore interfere with feeding, use a bulb syringe to suction the nose clear. This may be done as often as necessary, but is particularly helpful just before feeding. Instilling some saline nose drops (Ocean, Ayr, NaSal, many other brands) prior to suctioning may make this job easier. Don't be shy... A good seal between the syringe and the nostril is necessary for suctioning to be effective.
3. For children OVER 1 YEAR a decongestant/antihistamine combination may be useful to dry up the nose. This benefit must be weighed against the side effects of drowsiness, irritability, and modest blood pressure elevation which such medications often cause. Generally the older the child, the less significant the side effects. Dimetapp Cold & Allergy Elixir (NOT the cough suppressant or "DM" version) is perhaps the best tasting of these, and can be given 1/2 tsp. age 1-2, 1 tsp. age 3-5, and 2 tsp. age 6-12.
4. DO NOT use over-the-counter decongestant nasal sprays unless specifically instructed by a physician, as they can be dangerous. (Saline nasal sprays are o.k.) Rub on preparations such as Vicks have no scientifically proven efficacy, but are harmless.
5. "Alternative" remedies such as Echinacea, Vitamin C, or Zinc are scientifically unproven, but may have some benefit and are harmless as long as not take in excessive amounts.
6. Consider seeking medical attention if the runny nose continues for more than a week, is persistently green and/or foul smelling for more than 2-3 days, or as other symptoms (pain, cough, etc.) may mandate. |
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