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Kids’ Colds

As the school year starts and the temperature drops, many of us will be saying hello to our old familiar friend — the perpetual drippy nose and congestion of the winter season. It’s normal for children to contract one cold per month from September through April, and the symptoms can last for two weeks at a time. Do the math and that’s fifty percent of the fall-through-spring months spent blowing, wiping and coughing. Given that colds and flu are so common, it’s surprising how much misinformation there is on the subject, says New York City pediatrician Yael Wapinski.

Cold and flu: the definitions aren’t as simple as we think
We use the terms cold and flu a lot, but they’re not just two illnesses. To doctors, a “cold” means an upper respiratory infection, which makes for congestion and running nose. A cold is usually caused by a virus (not bacteria, as many people think), and there are dozens of virus types that lead to the typical cold symptoms. The “flu” refers to the influenza virus, but again, flu is often a misnomer — many viruses lead to chills, aches, and fever.

In other words, the terms cold and flu are just ways that we cluster symptoms, but in reality it doesn’t say much about their cause. The same virus could cause runny nose, sore throat, fever, vomiting, or any combination thereof, depending on the person’s immune system and the strength of the virus.

You don’t “catch a cold” from being underdressed
Viruses follow a seasonal pattern, showing up more commonly in the colder months, but contrary to popular belief, being chilly doesn’t make us more susceptible. When it’s cold, we get sick because some viruses thrive in lower temperatures, and in the winter we tend to crowd inside and give colds ample opportunity to spread.

The most common mode of transmission is when one person sneezes or coughs and sends airborne particles flying or sneezes into a hand and touches another person or a common surface. Viruses can live for hours outside a person’s body.

Preventing cold and flu
The most straightforward and effective way to lower the chance of contracting a virus is to get the seasonal flu shot. Every year, scientists try to predict which viral strains will be the most common and include them in the shot — it’s not a sure thing, but it will make you more immune to popular viruses. Wapinski recommends it to all the children in her practice, and kids benefit if adults get the shot too because of overall “herd immunity.”

Basic hand washing (warm soap and water is equivalent to antibacterial gels) before meals and after coming home from an activity will slow the spread of germs. Viruses take hold when they make contact with eyes, nose, and mouth, so try to keep your hands way from your face and teach kids to do the same.

Treating symptoms: What works, what’s myth, and what’s dangerous
According to Wapinski, the basic treatment of both cold and flu (remember they’re more related than most of us think) is to hydrate with fluids like water and clear liquids and give an antipyretic (a fever reducer like acetaminophen or ibuprofen) if your child has a temperature. Nasal saline sprays can help as well; just check to make sure you’re using the right one for your child’s age. Forget antibiotics unless there is a complicating illness like an ear or lower respiratory infection because, remember, the cold and flu are caused by viruses, not bacteria.

As for supplements and natural remedies, the jury is still out. Studies on vitamin C and echinacea have mixed results and tend to be flawed in their research design, making it hard to draw a clear conclusion. When parents ask about using honey to treat a cough, Wapinski’s stance is why not? Some data indicates it might help and, if your child is over the age of one, it’s okay to give him a spoonful.

In 2008 an FDA advisory said that over-the-counter cold medications are not safe for children under two, but more recently the stance is that they should be used cautiously for children six and under. These are the cold meds with decongestant and cough suppressant properties, and they usually have many different ingredients listed, like pseudoephedrine and phenylephrine. The safety and proper dosage of these medications has not been adequately tested in young children, so until we know more, we’re better off avoiding them.

Another myth Wapinski hears a lot in her practice is that cutting down on dairy helps with congestion. Parents ask about this a lot, she says, but reducing milk and cheese intake doesn’t affect a child’s symptoms.

One more piece of information that might help ease a parent’s mind: Wapinski says many moms and dads come in concerned that their child seems perpetually sick in the winter, and they worry that the child isn’t recovering from a virus after weeks of symptoms. She asks if there were one or two symptom-free days mixed in. If so, it’s likely that the child caught two different viruses back to back, and there’s no real cause for concern. Remember that one cold per month is normal for young children, and symptoms often drag on for two weeks.

For most of us, viruses are an inevitability, but with a little advanced planning (like getting the flu shot early — it’s available soon), and rest and hydration once they hit, hopefully they won’t slow us down too much this season.

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