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Decode Your Child's Cold



As miserable as a phlegmy cough or stuffy nose can make your child feel, it’s helpful to know that these common cold symptoms can often seem worse than they actually are.

In fact, “congestion is a normal, healthy response to a virus or an irritant. It’s generally the body’s way of trapping it in the nose and throat so it doesn’t get to your lungs,” says Michael Brady, MD, a member of the American Academy of Pediatrics committee on infectious diseases. And coughing is the body’s way of clearing and protecting airways from irritating mucous and other secretions.

Still, coughs and congestion can sometimes signal something more serious. Here’s what you need to know to decipher your child’s cold symptoms and the best ways to handle them.

Cold Clues

Chest or Nose?

What seems like chest congestion might not be. “Parents will often tell me they can hear their child’s chest rattling, but most of the time, they’re hearing noises being made in their child’s nose that get transmitted down to their child’s chest,” says Dr. Michael Brady. True chest congestion produces a unique noise that pediatricians need a stethoscope to detect.

When a virus, bacteria or an allergen such as hay fever pollen invades your child’s nose (or less often, the air passages in her chest), cells lining them swell and produce mucous.

Clogged nasal and throat passages help block the bad bug or irritant from traveling further. As part of this inflammatory response, your child can develop a runny nose, which helps shed the virus.

Other common cold clues include sneezing and a phlegmy cough from post-nasal drip — a slow leak of mucous from the nose that irritates the back of your child’s throat. None of these symptoms require a visit to the doctor.

When to Worry

The cold-like symptoms you should be concerned about include distressed breathing (your child can’t catch his breath, even when trying to breathe through his mouth), a high fever (100.5°F or greater), loss of appetite, disrupted sleep, a lack of energy or chest congestion. These symptoms can signal pneumonia, bronchitis or asthma, so call your doctor if they persist.

If your child’s breathing seems distressed, contact the doctor immediately. See the pediatrician if your child’s cough and stuffy nose persist for more than 10 days without improving. Sometimes a cold can start off as a viral nasal

infection and develop into a secondary bacterial infection in the lungs such as pneumonia, which requires medical attention. Your little one could also have asthma, allergies, sinusitis (a bacterial infection often brought on by a cold) or even enlarged adenoids, which inhibit breathing.

Cold Comfort

Doctors say you can’t shorten the duration of a cold. A cold is viral, not bacterial, so antibiotics don’t work. Over-the-counter cough and cold medications are not recommended for children younger than age 6 because of the risk of side effects. Besides, “they haven’t actually been shown to be effective in children,” Dr. Brady says. Instead, try these ways of easing a cold’s symptoms.

Honey and lozenges. Instead of cough suppressant products, try honey. Use ½ teaspoon for ages 2-5; 1 teaspoon for ages 6-11; and 2 teaspoons for older kids. If you give your child honey before bed, make sure she brushes her teeth afterwards. Honey isn’t recommended for children under age 1 because of the risk of botulism.

Cough drops increase saliva production, which can soothe his throat and loosen his cough. “But don’t give them to children under age 6,” says pediatrician Bonnie Kvistad, MD, because lozenges pose a choking hazard.

Clear nasal passages. Use a moist air humidifier in your child’s bedroom to help moisten airways, which can reduce coughing. Be sure to clean the humidifier often and use it only when needed. “If you run a humidifier full-time, there’s a greater chance you’ll create mold spores, which your child can inhale,” says Lawrence Rosen, MD, an Oradell, NJ pediatrician. A steamy shower can also help hydrate nasal membranes and make mucous easier to dislodge.

For babies and toddlers, use nasal saline drops and a bulb aspirator to suction a runny nose, which helps nasal breathing when they are nursing or having a bottle. Use saline spray for older kids, which lubricates mucous so it’s easier to blow out.

Fill up on fluids. Clear fluids such as water can help your child stay hydrated, which thins mucous and clears nasal secretions. The steam from hot liquids such as chicken soup or herbal tea can help open nasal passages.

Milk may make secretions at the back of your child’s throat thicker, which is why clear liquids are best, but if you have a baby younger than age 1, stick with breast milk or formula.

Aromatherapy. Rubbing massage oil mixed with a drop or two of eucalyptus essential oil on your baby or toddler’s chest can sometimes relieve congestion. “Breathing in the smell helps open air passages,” Dr. Rosen explains. The essential oils of mint and menthol are other options.

Sandra Gordon is a freelance writer.

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