Dr. Bob: My three children (two in grade school and one in kindergarten) seem to have colds all the time in the winter. The sneezing and coughing don’t seem to go away. Not only do the kids get colds and pass them around, each child has cold after cold. And of course, my husband and I get sick also. Why does this happen and what can we do?
Answer: You are expressing a frustration that so many parents have once the cold weather starts. Colds (excess mucus production, sneezing, cough, decreased appetite, decreased activity, some mild discomfort, slight fever) are so common in children when the cold weather arrives. Colds are caused by viruses (much smaller than bacteria) and are not treatable by antibiotics.
Colds are self-limited (they go away on their own) but seem to continue all the time because –
- There are many different respiratory viruses that are being passed around.
- Your school age children are constantly exposed to viruses from their classmates.
- Children are often passing the virus before they actually have symptoms.
- Once symptoms develop, the sneezing and coughing (air transfer of the virus) is enhanced by hand contact and spread of the virus with their classmates and siblings.
The treatment of colds is symptomatic. Decongestant and antihistamine medicines are not recommended for children (more side effects than benefit) unless your children have significant underlying health conditions. Plenty of fluids and rest are very important, and a humidifier at night might be of some benefit. Saline nose drops can help loosen up mucous and make it easier to breathe when the child is very congested. Menthol rubs might provide some nighttime relief but should be used sparingly, put away after use and not be used on children under 2.
We should all be reminded that antibiotics are not used for colds and for good reason. Antibiotics do not treat viruses (only bacteria). Overuse of antibiotics leads to germs that become resistant to antibiotics and can make their use ineffective in the future when they will really be needed. Plus, overuse of antibiotics can lead to bacteria that might cause more serious infections in vulnerable people. So, don’t go to the doctor expecting to get antibiotics for an uncomplicated cold.
I’m sure you want to know when you should take your children to the doctor. If a fever persists for more than a day or is not just low grade, the cough worsens, the mucous turns green, vomiting develops or the child just looks sick, a visit to the pediatrician is indicated. Remember that a fever is not necessarily a bad thing (it is the body’s way to fight infection) but a high fever could be a sign of a spreading infection (ears or lungs). Children can be very sick without a fever so if symptoms are lingering too long or the child is more exhausted than usual, please go see the doctor. Colds are rarely emergencies so delay visits to the emergency room unless necessary.
Decreasing the spread of the virus out in public and at home requires a concerted effort by all. When sneezing or coughing, it should always be in the crook of the bent arm. If tissues are used, they should be discarded right away. Hand washing and the use of consistent use of hand sanitizer will help decrease the spread.
The bad news is that colds are annoying and common. The good news is that they will go away without much harm if you follow the tips above.
Dr. Saul is Professor of Pediatrics (Emeritus) at Prisma Health and his website is www.mychildrenschildren.com. Contact Dr. Bob at askdrbobsaul@gmail.com with more questions.