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Colds

 

Upper respiratory tract infections are the most common cause of illness in children (as well as in adults). A number of terms are used (sometimes inaccurately) to describe these ailments. They include ‘colds’, ‘flu’, ‘tonsillitis’ or ‘pharyngitis’.

The average preschool child has at least six colds a year. Sometimes, especially in winter, it may seem that your child is unwell for weeks at a time, barely getting over one cold before becoming sick again. Young children are particularly susceptible, because they have not had a chance to build up immunity to the many viruses that are responsible for colds. As your child grows older, they will gradually build up their immunity and get fewer colds.

When to see the doctor

Almost all upper respiratory tract infections get better without treatment. The best you can do is use the methods described below in How is it treated? Take your child to see the doctor if they refuse to drink fluids, vomit frequently, complain of intense headache or are pale and sleepy, have difficulty breathing, or have a high fever that does not respond to paracetamol. Also see your doctor if your child does not show some improvement in 48 hours, or if you are worried. For more information, see Recognising serious illness

What causes it?

Most colds are caused by a virus. In fact there are over 200 types of virus that can cause the common cold. This is why it is not possible to be immunised against a cold.

Colds are more common in the winter months. Cold weather by itself does not increase the chance of getting a cold, but people are in closer contact with each other because they stay indoors, and are more likely to infect each other. Similarly, getting wet or chilled does not cause a cold. The viruses which cause colds are spread by sneezing, coughing and hand contact.

What are the symptoms?

Cold symptoms are essentially the same as in adults. There will be various combinations of a stuffy or runny nose, sneezing, sore throat, cough, headache, red eyes, swelling of lymph glands, and occasionally fever. Often there will be a loss of appetite, and sometimes nausea and some vomiting. Children may be miserable or irritable.

The actual symptoms will vary from child to child, and from illness to illness. Usually the symptoms will last anywhere from a few days to a week or more, and the child recovers fully without any problems.

Very occasionally there are complications, such as ear infection, laryngitis, croup, or a lower respiratory tract infection, such as bronchiolitis or pneumonia. These are relatively uncommon illnesses compared to the uncomplicated cold, which is widespread.

Is there a test?

Very occasionally your doctor will order a blood test, throat swab or, rarely, a chest X-ray, but for the majority of children with upper respiratory tract infections, no investigations are necessary.

How is it treated?

There is no cure for the common cold. There is no specific treatment that will make the cold go away more quickly. You have several options to help to relieve your child’s symptoms:

  • Give paracetamol, in appropriate doses, for up to 48 hours if your child has a fever. If the fever lasts more than 48 hours it is best to see your doctor.

    Do not give children aspirin – it can have potentially serious side effects.
  • Offer warm drinks to ease a sore throat and dry mouth.
  • Nasal drops or spray will ease a blocked nose.

What to stay away from:

  • aspirin, which can have potentially serious side effects.
  • decongestants, which have side effects such as rapid heart rate, jitteriness and insomnia and have not been shown to change the course of the illness. Decongestants go under the brand names of Actifed, Benadryl, Bisolvon, Demazin, Dimetapp, Duro-tuss, Logicin, Robitussin, Sudafed, Tussinol and Tylenol Sinus.
  • antibiotics: because colds are caused by viruses, antibiotics will not help, even though they are often prescribed. Not only are antibiotics (such as penicillin) unnecessary, but they can be harmful, by causing stomach upsets and diarrhoea.
  • cough medicines don’t help: the cough is due to irritation of the trachea or to excess mucus, and cough medicine does not affect either. Similarly, there is no evidence that vitamin C is of any benefit.
  • there is no need to stay away from dairy products, as they do not cause extra mucous production.

It is a good idea for your child to take things easy, though there is no need to stay in bed. Let your child decide how active they want to be. Although it is likely that they will not be hungry, make sure that they drink lots of fluids. Your child's appetite will return as they start to feel better.

There are a number of treatments that are not necessary. Always ask your doctor if a prescription is really necessary – all colds will get better without antibiotics, and just as quickly.

How can I prevent it?

It is virtually impossible to prevent a child from getting upper respiratory tract infections. Vitamins have not been found to increase children’s resistance to colds.

Flu injections are not necessary for the vast majority of children, and are given only to children who have:

  • a serious chest condition, such as cystic fibrosis or severe asthma requiring steroids
  • a depressed immune system
  • a chronic medical condition.