As the cold and flu season approaches a common presenting complaint is for cough and congestion. The vast majority of coughs are simply the effects of a viral illness and represent the body clearing and protecting the lungs and upper airways. In fact, in the absence of the ability to cough the lungs become much more vulnerable to serious infections. The average child in a school or daycare setting can have as many as 10-12 colds a year. That means if a common cold can last 7-14 days a child could potentially have a runny nose and cough for nearly half the year and still be normal. In general, viral cold symptoms are most severe on the 3rd to 4th day of illness and fevers generally resolve in the first 48-72 hours. The most common symptoms are listed below:
- Runny nose (first, a clear discharge; later, a thicker, often colored one)
- Sneezing
- Mild fever (101–102 degrees Fahrenheit), particularly in the evening
- Decreased appetite
- Sore throat and, perhaps, difficulty swallowing
- Cough
- On-and-off irritability
- Slightly swollen glands
No medication can stop a viral respiratory tract infection once it has started, and with the exception of true Influenza infections, no medication exists to shorten the course. That means the best management is to help optimize your body’s own immune system to fight off the virus and provide symptomatic relief.
Here are a few ideas for symptomatic relief:
- Rest, Rest and More Rest
- Good hydration to help thin mucus and promote drainage
- Steamy showers and warms baths to help clear mucus
- Acetaminophen and Ibuprofen to help with fever/discomfort
- In children over 1-year-old, a spoonful of honey can be used to help with a cough. In one study comparing Honey with Robitussin Cough Syrup, Honey performed the same to slightly better in cough suppression with no chance of overdose.
- Vapor Rubs such as Vicks or Mentholatum have been shown to help ease congestion and cough as well as promote improved sleep.
- An extra pillow at night while sleeping can help prop you up and promote better drainage and sleep.
The follow-up question to this is, “When is a cough and congestion more than just simple cough and congestion?” In an infant, less than 3 months discussing these symptoms with a doctor is always reasonable since what might be a simple cold in an older child might progress into something more serious in a child this young. In older children, the symptoms listed below may indicate that what may have started out as a simple viral infection has progressed into a more severe illness.
- The nostrils are widening with each breath, the skin above or below the ribs sucks in with each breath (retractions), or your child is breathing rapidly or having any difficulty breathing.
- The lips or nails turning blue.
- Nasal mucus persists for longer than fourteen days.
- The cough just won’t go away (it lasts more than 10 days).
- Ear pain is present.
- The temperature is over 102.5 degrees Fahrenheit.
- Being excessively sleepy or cranky.
If you are ever in doubt about your child’s cough and congestion, feel free to contact us here at Canyon View Pediatrics we are always available to help.
Additional information:
1. American Academy of Pediatrics Cough and Cold Fact Sheet
