Cold – Canyon View Medical

In my first blog post, I discussed what the common cold was and how it’s usually managed. I also described the normal course for these viral infections. In this next series, I will address what physicians call a “secondary bacterial infection.” Secondary bacterial infections are a concern when your child’s cold doesn’t seem to follow the expected course.

These infections include bacterial complications of colds such as ear infections, sinus infections, and pneumonia. While most children with colds do not develop bacterial infections, their management is different and usually requires a visit to the doctor to determine the best treatment options. For instance, your doctor can help decide if antibiotics are appropriate or not. Remember, the first clues that your child’s cold may have led to bacterial infection are worsening fever, fevers for more than 5 days, or increasingly sick appearance of your child after the first 2 days of a cold.

Let’s start with ear infections.

Bacterial ear infections are the most common complications of colds, occurring in up to one-third of children with colds. They happen more often in younger children and toddlers, aged 6 months through 4 years, due to the anatomy of their ear canals. Ear infections become less common as children get older. Additionally, frequent ear infections do not typically indicate that there is something wrong with your child’s overall health or immune system. If you are concerned about this, you should ask your doctor about your child’s next visit.

When ear infections develop, they often appear 3 to 5 days after cold symptoms start, or as cold symptoms start to improve. They may, however, appear earlier in the course of your child’s cold. Children tend to develop sudden onset of ear pain and often new fevers over 100.5 degrees. A quick trip to the doctor’s office for an examination can reveal whether or not your child has an ear infection requiring antibiotics. If antibiotics are prescribed, be sure to complete the entire course. Proper treatment can help prevent some rare but serious complications of bacterial ear infections.

In older children, the body is often able to clear the infection on its own without antibiotics. Avoiding unnecessary antibiotic use can be beneficial in many ways including limiting your child’s risk of side effects (such as diarrhea, rashes, yeast infections, and allergic reactions to name a few) and preventing your child from developing a bacterial infection with resistance to antibiotics. Your doctor will help decide the best course of action if an ear infection is found.

Regardless of whether or not antibiotics are prescribed, treating the pain with acetaminophen or ibuprofen is the best first step in managing any ear infection. Ibuprofen is oftentimes more helpful in relieving pain. Be sure to check with your physician about appropriate dosing. Also remember that, at the beginning of your child’s cold, even though they may have ear pain, there might not be a bacterial ear infection present and antibiotics may not be prescribed. This can possibly change however, so it’s important to remember to monitor your child for worsening pain and new, high, or persistent fevers.

Important points to remember about ear infections:

Most ear infections start off with viral colds
Antibiotics may not always be recommended, but if they are, be sure to complete the entire course
Treating the pain with ibuprofen or acetaminophen is very important

As we head into the winter season, you may notice that your children are becoming sick more frequently. The most common illnesses encountered by our pediatric group during this time of year are upper respiratory infections, croup, sore throats, and ear infections. There are many common concerns that parents have such as Why is this cough lasting so long? Does my child need antibiotics? How high of a fever is too high? Does my 18-month old has Strep throat? Why is my child always sick?

One of the most common reasons for a parent to bring their child to the Doctor’s office this time of year is a viral upper respiratory infection, otherwise known as “the common cold.”

The common cold may be caused by any one of hundreds of different viruses and do not require antibiotics. Antibiotics are medications that have been developed to treat infections caused by bacteria and have no effect on viruses. That being said, when your child develops a cold due to a virus, they can become susceptible to bacterial infections such as ear infection, sinus infection, or pneumonia.

Cold symptoms can include a combination of sore throat, cough, stuffy and/or runny nose, fevers in the first 1-2 days, and headache. While worrisome, if the symptoms have been present for a week to 10 days and seem to be improving, little more than rest and symptomatic management are required. Most colds will worsen over the first 3 to 5 days, start to improve around day 7, and mostly resolve around day 10. The cough, however, can sometimes last up to 20 days.

The mainstay of cold treatment continues to be treating your child’s symptoms and making sure they get plenty of rest.

Acetaminophen and ibuprofen are best for controlling fevers and discomfort. Be sure to check with your doctor about appropriate dosing. Cough is difficult to treat and often times over the counter medications provide little to no relief. In children older than 12 months, one tablespoon of honey can help decrease cough and is very safe to give during the day and before bedtime. It can be given in some warm water, mixed in with a tea, or just right from the spoon. Cough drops may be used in older children as well. Nasal saline irrigation is very helpful for clearing the nose of mucus, which often makes it difficult for your child to breathe while eating and sleeping. Using just a few drops in each nostril, then using a bulb suction to remove some of the mucous (or having your older child blow their nose) can really help make them feel more comfortable. Humidifiers, if available, can also provide some comfort.

While the typical cold may last up to 10 days without causing concern if you are noticing improvement, there are some signs to watch for that may mean your child has developed a bacterial infection. The first clue is if a fever over 100.5 degrees develops after other cold symptoms improve. Increased fevers after 5 days of symptoms should always be evaluated by your physician.

Important points to remember:

Fevers in a normal viral cold occur in the first 1-3 days
Cough can normally last up to 20 days, as long as it’s not worsening
New or ongoing daily fevers over 100.5 degrees after 5 days of cold symptoms should always be evaluated by a physician
Nasal congestion or runny nose that is worsening or not improving after 10 days may be a sinus infection
If you are ever in doubt or have concerns, schedule an appointment with your child’s physician

Be sure to return as I will be discussing these in the next few blog posts.

If you would like your child to be seen by a Canyon View Pediatrics provider please call 801-894-1333 to schedule an appointment.

Tag: Cold

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