Coughs and Colds in Young 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 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. A coughing child will not choke or stop breathing.
• 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.

You can buy various other 'cold remedies' and 'cough mixtures'. There is little evidence that they do much good, but some people find them useful. Note: they often contain several ingredients. Some may make children sleepy (which may be useful at bedtime). Some contain paracetamol, so be careful not to give more than the maximum dose of paracetamol if you are already giving the child paracetamol. Some contain a decongestant which may help to ease a bunged up nose. (But note: do not give decongestants to children under two years old.)

Another popular treatment for a bunged-up 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 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 or difficulty breathing
• persistent earache
• a cough that persists longer than 3-4 weeks
• persistent high temperatures
• drowsiness
• 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.

References

1. Common Cold Clinical Knowledge Summary SCHIN 2007
2. Cough medications in children. Drug and Therapeutics Bulletin 1999;37:19-21
3. Nilangi Virgincar and Robert Spencer. Management of upper respiratory tract infection Prescriber 19 October 2003

© EMIS and PIP 2007   Updated: February 2007   PRODIGY Validated