Is it a cold…or something more?

by Kourtney Santucci, MD

“With each illness lasting an average of seven to 14 days, a child may just be improving from one viral illness, only to encounter another.”

Kourtney Santucci, MD, is a pediatrician at T.C. Thompson Children’s Hospital at Erlanger. For more information, call Erlanger’s physician referral line at 423-778-LINK(5465).

Healthy children, in a typical year, will experience six to 12 “cold or flu-like” illnesses. These illnesses tend to cluster during the cold weather months, but can occur throughout the year. With each illness lasting an average of seven to 14 days, a child may just be improving from one viral illness, only to encounter another. At times, it may seem to a parent that their child has been persistently ill with a cold for the majority of the winter or spring season, and certainly this may be the case!

So when should a parent worry that the “common cold” may be something more? Typical cold and flu illnesses caused by respiratory viruses may cause fevers, usually in the first three days of a new infection. Fevers may be appreciated by touch, and confirmed with a reliable thermometer, with temperatures higher than 100.4 degrees Fahrenheit regarded as a “fever.” Parents should contact their doctor’s office for advice on managing fever, especially to confirm proper dosing for common fever-reducing medicines like acetaminophen or ibuprofen. Patients with very high fevers (typically regarded as above 103 degrees), fevers persisting beyond 4 days, or any fever associated with abnormal activity in the child, such as poor feeding, decrease in alertness, or failure to wake for feedings in young babies, should be promptly evaluated by medical personnel.  ANY fever in a child under 2 months of age may be a medical emergency, and should be promptly discussed with your physician’s office.

Most children will experience a change in their typical appetite during a cold. They may eat smaller amounts more frequently, or may show less interest in foods altogether. In general, maintaining the child’s intake of appropriate fluids is more important during these times than ensuring solid food intake. Talk with your doctor about which fluids are most appropriate for your child’s age, as this differs from infants to older kids. If your child has had fewer than three wet diapers per day, or has dry mouth, or is generally much less active than normal, seek advice from your doctor’s office promptly, as the child may be dehydrated.

If your child is following a typical pattern for a viral respiratory illness (sniffles, mild cough, and low-grade or absent fevers) with no difficulty breathing, best treatments will be plenty of rest, plenty of fluids to drink, and doing your best to prevent the spread of this illness to others. Older children should be taught to “cough into their elbows” and wash their hands after cleaning their noses. Most schools require that kids remain home until they are fever-free at least 24 hours, which helps to limit the spread of the virus when the child is at his/her most contagious, though care should still be taken to wash hands carefully and not share beverages with others even once fevers are gone. Over-the-counter cough and cold remedies are not recommended for children age 4 and younger, and should be used with cautious attention to dosing instructions in older children.

While we still don’t have a cure for the common cold, we do have effective vaccines against influenza, and the CDC and Academy of Pediatrics recommend universal flu vaccines annually for all people older than 6 months of age. In this case, an ounce of prevention can be worth a pound of cure!

Kourtney Santucci, MD, is a pediatrician at T.C. Thompson Children’s Hospital at Erlanger. For more information, call Erlanger’s physician referral line at 423-778-LINK(5465).