As we move into the cold and flu season, children often develop symptoms of a respiratory infection, contracted through day care or school or other contacts. A common cold typically involves runny nose, nasal congestion, cough and occasionally fever and is caused by various viruses that affect the upper respiratory tract.
This year it will be important to seek medical care and testing to distinguish the SARS-CoV-2 virus that causes COVID-19 from other types of viral infections. On this week’s On Call for All Kids, Joe Perno, M.D., vice president of Medical Affairs and Chief Medical Officer at Johns Hopkins All Children’s Hospital, explains what parents need to know about the common cold and viral respiratory infections.
Why don’t we use antibiotics for a cold?
Antibiotics are only effective against bacterial infections, they have no effect against viruses or colds. Actually, giving antibiotics for a cold can be harmful because of side effects of the antibiotic treatment and due to antibiotic resistance that forms in bacteria exposed to antibiotic treatment when we are not treating a bacterial infection.
How do you differentiate between a cold and a sinus infection? What about COVID-19 or other viral infections?
Most colds last five to seven days. A bacterial sinus infection is more likely than a cold or the flu to cause headache, sinus pressure, and more than 10 days of nasal congestion or runny nose. Differentiating between the common cold and COVID-19 can be challenging as symptoms overlap. Although not absolute, reviewing whether or not your child has had any COVID exposures can help.
Loss of smell or taste is very suggestive of COVID-19, but it is difficult or impossible to make a specific diagnosis of COVID-19 versus other respiratory viral infections from other symptoms such as sore throat, nasal congestion, headache or fever without testing. Anyone with respiratory symptoms this season should contact their provider to see if COVID-19 testing is warranted. While awaiting results, your child should remain at home and away from others.
Why shouldn’t over-the-counter cough and cold medication be used in children?
It’s been found these medications are generally not effective in treating the symptoms of a cold. Also, children, especially young children, can sometimes develop dangerous side effects from these medicines. There is no point in giving any medicine if it has no proven benefit and can be potentially harmful (accidental overdoses, extreme drowsiness and increased heart rates). Although there are many products marketed to children to combat cold symptoms, we do not recommend their use for children under the age of 8 years.
How can parents treat children with colds?
In young children, a bulb syringe and saline drops can be used to help clear the nasal passages. A cool mist humidifier is helpful for both cough and congestion. For children older than 1 year of age, honey is a very effective cough suppressant. If the child has a fever, treating with acetaminophen or ibuprofen can be helpful to make the child more comfortable. Encourage plenty of liquids. It’s OK if their appetite is down, but they must continue to drink and avoid dehydration. If the child is older than 8 years old, you could try an over-the-counter cough and cold medicine, but if it is not working, please stop using it.
It is important to teach children to frequently wash their hands when they have a cold. Also, it is important to cover their nose and mouth when they sneeze and to cough into their elbow. Obviously, keeping children isolated from others as much as possible when they have cold symptoms is essential for helping to decrease the spread especially if it may be COVID-19. These techniques will help decrease the spread to other children. Please remember to contact your child’s provider to discuss symptoms and whether testing for COVID-19, flu, RSV or other viral infections is needed.
On Call for All Kids is a weekly series featuring Johns Hopkins All Children’s Hospital experts. Visit HopkinsAllChildrens.org/Stories each Monday for the latest report. Check out more advice from Joe Perno, M.D.