Another winter cold and flu season is well underway and I find myself staring in disbelief at the amount of fluorescent green mucus dripping from my son’s raw nose. I start trying to count how many days it’s been since I’ve seen his nose NOT full of snot. Let’s see… 1,2,3….8. Ok so it’s been 8 days this time. I’m not sure it’s getting better but he seems fine. The only thing bothering him is his mother constantly trying to wipe his nose. At this thought, I reach over and attempt to clear out his nose with a tissue for the hundredth time today. He pushes my hand away again and wipes his drippy nose on his sleeve. At 9-years-old he knows he does NOT like the taste of Sudafed or Mucinex and would rather have a root canal than let me spray Afrin in his nose. He simply doesn’t care that he cannot breathe through his nose and that his mother is grossed out. He’s fine. So I wait another couple of days and then, “poof,” the snot has disappeared as if it were never been there in the first place.
Not the flu, not a sinus infection, just a “common cold” and there was nothing I could do but wait it out.
Winter brings a variety of generally benign respiratory viruses that cause the “common cold” or “viral upper respiratory infection.” Young children in daycare can have 8-10 colds a year and most of these will fall during the winter months. Influenza is a respiratory virus that causes a more significant “cold.” Kids with influenza or “the flu” look and feel sicker than they would with a cold. Sinus infections can follow the flu or a common cold and can sometimes be difficult to separate from the back-to-back colds (aka “daycare boogies”) that young children catch in daycare. Sinusitis in older children will often have more classic symptoms of headaches and sinus pain or pressure while diagnosis in younger children may be based on duration of runny nose or cough or prolonged or returning fever. Color of nasal drainage is not an indicator of one type of infection over another. Snot can take on the colors of the rainbow in any infection – viral or bacterial.
Picture this: A playful child with low grade fever for 3-4 days, runny nose, coughing and congestion. These symptoms gradually worsened over the first 4-5 days but then level off for a couple of days and are begin to improve in the second week of illness. By 2 weeks, this child is free of symptoms.
This is the common cold
Now picture this: A slightly less playful child with coughing, congestion or runny nose for 2 or more weeks, worsening after the first 7-10 days or fever returning after resolving. Was more playful and recently has become less active and more tired. Fever had resolved after the first 3-4 days of illness then returns on day 8 of symptoms. Additional symptoms common in older children include headaches, sinus pain or pressure, tooth pain.
This is a sinus infection
And finally this: A very unhappy, tired, ill appearing child with sudden onset of sore throat, chills, fever to 104, body aches, congestion and coughing. Symptoms remain unchanged for 5-7 days, then fever resolves and the child begins to regain appetite and activity. Once the fever has resolved for 24 hours, it does not return and the coughing does not worsen after the first 5-7 days of illness.
This is influenza
Helping your child feel better
If you suspect a sinus infection, your child should see seen by your pediatrician. If you suspect influenza, you should talk to you pediatrician, who may then want to see your child. Antibiotics are used to treat sinus infections. Your doctor may recommend Tamiflu under certain circumstances for influenza but this is not a cure like an antibiotic will be for a sinus infection. The best “treatment” for influenza is still PREVENTION with yearly flu shots. Even during years when the flu vaccine is not as effective, it still effectively decreases the severity of illness as well as prevents complications and death from influenza infection. Would you rather feel like you were “hit by a mack truck” without the flu vaccine or feel like you have a really, bad cold with some bodyaches and fever with the flu vaccine? Get the vaccine.
There is no treatment for the “common cold” and more children are not as bothered by their symptoms as their worried parents tend to be. It’s important to keep in mind that if you child is drinking, sleeping and generally feeling and acting well, you do not need to treat their cold symptoms.
Tips for 2 of the more annoying symptoms of upper respiratory illnesses.
-If your child is older than 4, you can use over-the-counter medications to relieve nasal congestion. Nasal congestion can interfere with sleeping and eating. Mucinex and Sudafed both have pediatric preparations and can be helpful in improving nasal congestion. Afrin nasal spray works very well to decrease congestion and can be used for up to 3 days. These medications also help with the postnasal drainage that many children find annoying when dealing with a cold, flu or sinus infection
-Younger children can find relief from nasal congestion with saline drops and nasal suction. The Nose Frida has become a very popular suction device, particularly for young infants with nasal congestion. Nasal congestion in young infants can make feeding and breathing through the nose very difficult. Many parents of young infants find themselves praising the Nose Frida!
-Cool mist humidifier or vaporizer helps with congestion and coughing in all ages
-If over the age of 12months, you can use honey for coughing. Honey is a natural cough suppressant and has the ability to thin mucus and help with postnasal drainage which is often triggering coughing. You can give the honey on a teaspoon or in warm tea or water.
-Young infants can get some cough relief from snot suction (as above), humidifier in room and elevation of the crib mattress for sleep. Do not put a pillow or any other bolster directly under infant’s head to create the incline.
When to call your doctor about upper respiratory symptoms
-Anytime you are concerned
-Fever more than 3 days in a child more than 3 months of age
-When the child is not drinking
-Any worsening symptoms after a week
-Fever that recurs after initial resolution
-Child is having trouble breathing
-Infant under 3 months of age
-Signs of influenza