Children and winter colds: Practical tips for parents

We’re having a mild winter and — so far — a mild flu season, but the common cold makes its rounds every year and can be especially hard on small children, and their parents. Explaining to a four year old that her runny nose, sniffling, cough, and fever really will go away soon is sometimes a hard sell. Cortez pediatrician Kate McCall, MD, has some tips for parents worried about sick kids.

One looming question parents often face is when they should take their child to the doctor for a cold. “Trust your instincts,” said McCall. “If you feel your child needs to be seen by a doctor, by all means call for an appointment.” Situations that indicate the need for a visit to the doctor include a fever that lasts for more than two or three days, cold symptoms that last longer than a week, severe ear pain, persistent sore throat or neck swelling, and any difficulty breathing.

Fortunately, most common cold symptoms can be managed at home. Parents can generally take the “watch and wait” approach with older children who have the typical symptoms of a cold such as a mild cough, runny nose, and low grade fever. There are things parents can do at home to help children of all ages suffer less when they have a cold.

“For babies, you can help relieve nasal congestion by putting 2-3 drops of a saline solution in each nostril and then using a suction bulb to gently clean out the nose,” said McCall. Purchase prepared saline solution that comes with a dropper at any pharmacy, or make your own by combining 1/2 teaspoon of table salt with one cup of warm water. “Suctioning before feeding the baby will make it easier for them to eat,” said McCall. Follow this procedure before putting the baby down to sleep, as well.

For toddlers, one-half to one teaspoon of buckwheat honey given at bedtime has been shown to ease nighttime coughing as well as or better than over-the-counter medicines. “Honey should not be given to infants under 12 months of age,” warned McCall.

Vapor rub can be used in children over the age of two. “A 2010 study showed that this can help children with colds sleep better. The study’s authors suspected that the benefits may be attributable to the camphor, menthol, or eucalyptus that the rub contains” said McCall.

School aged children can be taught to gargle with warm salt water to relieve sore throat symptoms. For children of all ages, using a cool mist humidifier can help loosen up congestion. Encouraging fluid intake to maintain good hydration is also helpful when children have cold symptoms and fever.

Over-the-counter children’s cold medications have not been proven to be effective in relieving symptoms, according to McCall, so it’s probably best to stick to basic home remedies and perhaps a little Tylenol or Advil (or their generic equivalents, acetaminophen or ibuprofen) to treat low-grade fevers and sore throats. Research has shown that over-the-counter cough and cold medicine should not be given to children under the age of four. They offer little benefit to children and can have potentially serious side effects. Children under the age of 18 should never be given aspirin.

Having a child spike a temperature can be especially concerning to parents, but in most cases, fevers are not dangerous. “A fever is the body’s natural response to fighting an infection,” said McCall.

Parents sometimes fear that a fever can cause brain damage, but that is very rare. “A fever has to get up to 107 to cause brain damage,” said McCall. This is usually seen in an environment situation such as when a child is left in a hot car.

There are exceptions to the rule that fevers are not usually a cause for concern. “If a child is under two months of age and has a rectal temperature greater than 100.4, that’s an emergency,” said McCall. In this case, a parent should call the baby’s doctor immediately or take the baby to the emergency room.

In general, call the doctor if your child is between three and six months of age and has a fever of over 101. Children six months and older should be seen if temperatures spike to 103. The decision to call the doctor should also take into account the associated symptoms. In the adolescent age group, for example, a fever combined with a sore throat that persists might indicate a strep infection or mono, both of which should be evaluated by a doctor.

Preventing the spread of colds is especially important this time of year. “It’s a judgment call about whether to send kids with mild symptoms to school or not,” said McCall, adding that if they don’t feel well enough to get anything out of being in school, it’s probably best to keep them home. A child with a fever or suspected flu should always be kept at home until they are without a fever for 24 hours without the use of acetaminophen or ibuprofen.

Frequent hand washing should be encouraged for the entire family, especially when someone in the home is not feeling well. New babies should not be handled by anyone with cold or flu symptoms. McCall recommends the flu vaccine for all children over the age of six months, as well as for parents. “The whole family should get the vaccine to help protect small children,” she said.

Hopefully, your little ones will sail through this winter without even a sniffle, but if a cold does occur, follow these tips to help children feel better until the symptoms pass. Visit the American Academy of Pediatrics website,, for additional reliable advice on caring for children.

Southwest Health Notes is a public service feature provided by Southwest Memorial Hospital in Cortez, Colorado. The information is not intended as patient-specific medical advice or as a substitute for consultation with your personal health care provider.

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