Coughs and Colds in Children

What causes coughs and colds and what are the symptoms?

Most coughs and colds are caused by viruses. Many different viruses can infect the nose and throat. They are passed on by coughing and sneezing the virus into the air. An average pre-school and primary school child has 3-8 coughs or colds per year. Sometimes several coughs or colds occur one after the other. A child who lives with smokers has an increased risk of developing coughs and colds.

• The common symptoms are a cough and a runny nose. The cough is often worse at night. Coughing does not damage the lungs.
• In addition, a child may have: a raised temperature (fever), a sore throat, headache, tiredness, and be off their food. Sometimes children vomit after a bout of coughing.
• A build up of mucus behind the eardrums may cause dulled hearing or mild earache.

What are the treatments for coughs and colds?

There is no magic cure! Typically, symptoms are worse in the first 2-3 days, and then ease over the next few days. An irritating cough may linger for up to 2-4 weeks after other symptoms have gone. Antibiotics do not kill viruses, so are of no use for common coughs and colds.

Treatment aims to ease symptoms whilst the immune system clears the virus. The most useful treatment is to give paracetamol (Calpol®, Disprol®, Tixymol®, etc) to ease aches and pains, headaches, and fever. Ibuprofen is an alternative. Also, make sure your child has enough to drink. Dehydration (low body fluid) may develop if a child has a fever and does not drink much.

Another popular treatment for nasal stuffiness (blocked nose) in a baby is to put a few drops of saline (salt water) into the nose just before feeds. Some people feel that this helps to clear the nose to make feeding easier. There is little scientific evidence as to how well this works, but it may be worth a try if feeding is difficult. You can buy saline drops from pharmacies.

What about cold and cough remedies?

In March 2009 an important statement was issued by the Medicines and Healthcare products Regulatory Agency (MHRA) which says:

"The new advice is that parents and carers should no longer use over-the-counter (OTC) cough and cold medicines in children under 6. There is no evidence that they work and can cause side effects, such as allergic reactions, effects on sleep or hallucinations.

For 6 to 12 year olds these medicines will continue to be available but will only be sold in pharmacies, with clearer advice on the packaging and from the pharmacist. This is because the risks of side effects is reduced in older children because they weigh more, get fewer colds and can say if the medicine is doing any good. More research is being done by industry on how well these medicines work in children aged 6-12 years."

Note: paracetamol and ibuprofen are not classed as cough and cold medicines and can still be given to children.

A recent research development

Research studies suggest that a mineral called zinc sulfate appears to reduce the severity of cold symptoms in healthy children. However, it has no effect on the duration of cold symptoms. It is not clear if this will become a routine treatment or if it is still in the bounds of research. See the reference at the end for details.

What symptoms should I look out for?

Most coughs and colds get better without complications. Sometimes a more serious 'secondary' bacterial infection develops from an initial virus infection. For example, an ear infection, pneumonia, etc. Symptoms to look out for that may mean more than just a cold include:

• Wheeziness, fast breathing, noisy breathing (stridor) or difficulty breathing.
• Persistent earache.
• A cough that persists longer than 3-4 weeks.
• Persistent high temperatures.
• Drowsiness.
• Unusual irritability or persistant crying in a baby.
• Chest pains.
• Any symptom that you cannot explain.

See a doctor if any symptoms develop that you are concerned about. Doctors are skilled at checking children over to rule out serious illness. They may not be able to prescribe anything more effective for a common cough or cold, but a check-over can be reassuring.