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dr. mom

My child’s cold won’t go away, what should I do?

The common cold in children is (unsurprisingly) common and there are home remedies for cough and cold.  In fact, most children will get up to 6-8 colds per year.  It is a short lived viral infection of the upper respiratory tract (the upper airway) that can result in coughing, sneezing, congestion, fevers, sore throats, and irritability.  It may occur at any time of the year, but as we know there is a big surge of colds in the fall and winter months every year.  

I often see patients in my family medicine practice complaining of symptoms of the cold and flu.  Rather than reaching for the prescription pad, I instead provide education for families about the symptoms of colds in children, and what to expect.  There are also some home remedies for cough and cold.

The duration of a common cold in children less than 6 years old can be up to 4 weeks

I often tell families that symptoms of the common cold usually peak 2-3 days after the onset of symptoms, and gradually improve thereafter.  The vast majority of colds in children will resolve within 14 days. Sometimes can last even longer than 2 weeks, particularly for families that are exposed to cigarette smoke or who have compromised immune systems.  

Families are often surprised by how long colds will last. Occasionally a cold will “linger” in some children, but almost all resolve by 4 weeks.   

What can I give my child < 6 years old while they have a cold? 

The treatment of the common cold in children is largely “supportive treatment” – meaning the treatment only helps to minimize the discomfort and minimize complications.  Rather than reaching for the prescription pad, I often educate families about home remedies for cough and cold.

Keep your child hydrated

Ensuring your child has adequate fluid intake will help improve the mucus in the airways and thin the secretions.  This will improve the discomfort and congestion caused by a cold.  

Warm fluids help soothe cold symptoms

Warm fluids such as non-caffeinated teas, and chicken noodle soup, will also help the nasal mucous and improve the respiratory secretions.  

Applying topical saline to the nasal cavity will help with irritation

Saline solution applied to the nasal cavity will help remove (temporarily) the congestion and mucus in the airways.  

Humidify the air with a cool mist humidifier

A large randomized controlled trial studied the outcomes for using cold mist humidifiers while suffering from a common cold.  What it found were inconsistent results, however some patients reported improvement in nasal secretions and congestions.  As there is limited harm that can be done from using a humidifier (so long as they are regularly cleaned), it is still reasonable to use if your child has a cold, and may provide some relief.  

Give them a little bit of Honey: 

Honey (0.5-1 teaspoons) given straight or diluted in liquid (ie: tea, water) can be given for children over 1 years old.  Honey does have evidence for mild improvement in night-time coughs in children, and is unlikely to cause any harm. In children under 1 year old, honey should be avoided for risk of botulism (a very rare serious – even life threatening infection caused by bacterial toxins).  

If at any point your child appears severely unwell or your child’s cough or cold is not getting better within an acceptable amount of time, do not hesitate to see a doctor!

Common signs suggesting your child needs to be evaluated by a medical professional.

  • Symptoms are getting worse
  • Difficulty breathing or swallowing
  • High fevers or fever more than 5 days
  • Symptoms exceeding 14 days 
  • Evidence of acute ear or sinus infections 
  • They are coughing so much they can’t breathe or are making themselves sick 

This post was co-authored by Erin Manchuk, BScPharm, BCGP and Stephanie Liu, MD, MSc, CCFP, BHSc.

References

Hendley JO, Wenzel RP, Gwaltney JM Jr. Transmission of rhinovirus colds by self-inoculation. N Engl J Med 1973; 288:1361.

Winther B, McCue K, Ashe K, et al. Environmental contamination with rhinovirus and transfer to fingers of healthy individuals by daily life activity. J Med Virol 2007; 79:1606.

Hendley JO, Gwaltney JM Jr. Viral titers in nasal lining fluid compared to viral titers in nasal washes during experimental rhinovirus infection. J Clin Virol 2004; 30:326.

Douglas RG Jr, Cate TR, Gerone PJ, Couch RB. Quantitative rhinovirus shedding patterns in volunteers. Am Rev Respir Dis 1966; 94:159.

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