What causes a Cold or Flu?

There are several different types of viruses which cause the common cold or flu.

What is a viral infection?

A virus is different from bacteria and cannot be killed with antibiotics.  A virus cannot reproduce by itself.  It makes you sick by taking over some of your cells in your body in order to multiply.  When it takes over cells in your nose this leads to injury of your cells causing a runny nose and congestion.  Some of your symptoms, such as fever, are a direct result of your immune system fighting the virus.

What are the symptoms of a Cold or Flu?

Common symptoms: nasal congestion, cough, sore throat, fever, headache, muscle ache, and weakness.

How often will my child catch a Cold?

Most children who do not attend day care will catch 6-8 colds per year.  Children who attend day care will catch up to 8-12 colds per year.

What is the treatment?

If you do get the cold or flu, antibiotics will not help.  Symptomatic treatments include over-the-counter medications, but these medications will not cure you or prevent complications.  The best cure for the cold and flu is time.  Your child will start to feel better within one week, however some symptoms can last 2-3 weeksIf your child is not improving as expected, you should return to our office for another examination. For more detail on when you should return to see us, please refer to the other side.

What medications can I take?

No medications will eliminate your child’s disease, again only time will cure your child.  There has never been a study which has proven that cough medications work in children.  Additionally, cough is a natural defense mechanism of your body which helps to keep your airways open and prevents the pooling of mucous in your lungs, therefore we do not recommend using cough meds for our patients. Also, most cough/cold meds are not approved by the FDA for children under 2 years. The following things can be done safely in all children:

  1. The best help is to use a bulb suction with any nasal saline drops. This can be done as frequently as needed (safely). However, if your child’s nose begins to bleed, you may want to take a break from this and apply some Vaseline 3 to 4 times day to any raw areas.
  2. Putting a humidifier in their room at night can help their cough. A cool mist is typically best.
  3. Elevating the head of the bed by 10°-15°, by raising two legs of the crib, may help with mucous drainage. If your baby tends to move around the bed, your baby should be monitored while in this position as they can slide to the front of the crib into a position that may compromise their breathing.
  4. In children over 1 year of age, 1-2 teaspoons of honey (mixed with water/lemon or given by itself) can be given 6 to 8 times a day as needed, which may help reduce coughing.
  5. The NoseFrida is more effective than the typical bulb suction and can be used to remove mucus from your child’s nose. It is available at most local drugstores.  Blue Fish parents have tried and appreciated the NoseFrida.

The American Academy of Pediatrics and Blue Fish Pediatrics do not recommend cold and cough medicines for children as they are not proven to help.

Nasal congestion and nasal discharge usually signal the beginning of a viral infection.  The mucus is usually clear for the first few days, cloudy for several more, and then clear at the end of the cold.  Any mucous that has been in the nose or throat for longer than one day (expressed by a deep cough or good nose blow) is usually a cloudy yellow or green color.  Enzymes that are a part of your immune system cause the mucus to change color.  This is not a sign of bacterial infection or that antibiotics are needed.  It is a normal part of having a viral upper respiratory infection. Congestion is usually the worst on days two to six of the illness.

Cough usually begins shortly after the congestion starts.  Most coughs represent the body’s effort to protect your airway.  When mucous slides down your windpipe from your nose, it stimulates a cough reflex that tries to keep the mucous from going into your lungs.  Babies are not very efficient coughers, so they tend to have more difficulty clearing their airway.  They have particular difficulty doing so if they are lying down.  For this reason, cough is usually worse at night.  Most babies come into the office on days three to five because this is when the coughing begins keeping everyone up at night.  Sleeping upright can improve coughing.  Severe cough, fever, and fast breathing warrant an office visit.

Sore throats are usually caused by viruses (~85%).  The rest are typically caused by bacteria called group A streptococcus, “strep throat”.  A sore throat accompanied by headache, abdominal pain, chills, fever, pus on the tonsils, or a red, sandpaper-like rash might be a “strep throat” and needs a confirmatory throat swab test and subsequent antibiotic treatment.  Sore throats caused by viruses usually start to improve after several days and are usually gone by day six or seven of illness.  Blisters in the mouth or throat are almost always caused by viruses.  Ibuprofen or a benadryl-maalox 1:1 mix (gargle and spit out 3-4x/day) can usually help.  Consult us concerning the appropriate dose.

Fever can mark the beginning days of a viral infection.  Usually, fever caused by a virus resolves after two to three days but can last up to one week.  Older children can be observed for a day or two if there is no obvious source of fever (i.e. burning with urination, ear pain, trouble breathing, strep throat).  Younger children need to be seen sooner if fever should occur.  For example, a child less than three months of age with a temperature of 100.4 or more rectally, should be discussed with a doctor immediately.  If fever persists in any child for longer than two days, lasts for longer than two days after seeing us in our office, or returns later in the illness, the child should be reexamined or discussed over the telephone to be certain that something else is not prolonging the fever such as a secondary bacterial infection of the ear, lungs, or sinuses.

If a child has day and night time cough and nasal discharge that lasts longer than ten days without any signs of improvement, they should be evaluated for a bacterial sinusitis that might be prolonging the symptoms.  However, of patients with symptoms lasting 2 weeks or longer, 80% will NOT need antibiotics as the illness is still an uncomplicated viral infection.

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