Colds

Young children, under 3 , with ordinary colds, are easily upset and hard to console when their breathing passages are stuffy or runny. Even a mild amount of nasal congestion can make an infant miserable and solving this can make all the difference in sleep, appetite and mood. If your infant is over 2 months of age and has a runny nose and a low grade fever (up to 102F rectally) you can usually manage the situation on your own with a few simple measures.

1. Provide your baby with extra fluids in the form of water either directly or indirectly by adding a little water to their formula (be careful to resume normal concentrations of formula when the cold passes so your baby gets adequate nutrition). Breathing heavily from congestion causes your child to lose fluids and can lead to dehydration especially if there is also a fever going on.

2. Provide the humidity that is needed for your child's airway to function comfortably and optimally. It is impossible for the body's natural nasal defenses to operate if they are bogged down in sticky mucus so getting the airways moist by dribbling saline drops into the nostrils and setting up either a cool mist humidifier or a brief visit to a steamed up bathroom (not too long for the infants - too hot is not good for the lungs) can do a lot both for comfort and for hastening the healing process. The little hairs in the airways, cilia, need to beat freely in order to evict the bad guys, like viral particles and debris and to repair the damage the cold has wrought.
   All of us know how awful we feel in the early morning after a night of mouth breathing and a sticky nose full of snot! Imagine how your baby feels - she can't even clear her throat or blow her nose to help herself! I do not recommend you go digging with an aspirator in your child's nose since that rarely accomplishes much and really upsets the baby further, causing more mucus and tears to flow. I especially discourage the use of cotton swabs to "clean" out the nose since that also irritates and can flatten the cilia even further by smearing the hairs of the nose down into the mucus as you "clean". Ykkkk! There is no absolute quantity of saline you need use; saline is a normal body component so just dribble a few drops in every hour or so when needed. Often the child will sneeze shortly after and this also helps to empty the passages of congestion. By the way, mucus is produced mostly by your body in response to the invasion of a virus and is probably an attempt by your body's defenses to inactivate and wall off the virus - mainly it is annoying but it can't be altogether bad for you so don't get too aggressive about getting rid of it - just keep it loose so your child can be comfortable.

3. Treat simple fevers with loose fitting clothing, comfortable room temperature (no over heated rooms), tepid baths (if your child enjoys the water), increased fluids, and acetaminophen if fever is over 101F rectally and your child is uncomfortable. Know your child's exact weight (or close to it) so that you can carefully dose correctly - the instructions on the bottles of medicine are too vague and based on age or large weight ranges and are often under dosed for your particular child - acetaminophen should be given in 4 hour intervals at most, at the dose of 12-15 mg. per kilogram of child's weight. If , for example, your child weighs 40 pounds and has a fever of 101.6F rectally, the correct dose would be 20 (kilos = approximately « the pound weight) times 12-15mg which = 240 to 300mg per dose. Since most children's acetaminophen comes as 160 mg per teaspoon this child needs at least one and a half teaspoons of medicine for a mild fever. (If the temperature were over 102F you would aim for the higher end of the dose range and give closer to 2 teaspoons per dose.)

4. Occasional use of over the counter cold remedies can have a role in alleviating discomfort but be aware that cold medicines do not cure anything and can even cause additional discomfort if the side effects are prominent in your particular child. All of us react differently to cold medicines and some of us even react with "paradoxical" behavior - this means that a cold medicine with anti-histamine (intended to dry up the mucus and cause some sleepiness) can instead cause some children to become agitated and irritable instead. Clearly not a situation you would want for your child, particularly in the evening - I advise parents who do wish to try cold medicines to first trial them during the daytime so that the side effects, if any, can wear off by bedtime.

5. Keep a handle on hygiene during our child's illness so that you are not infecting others, yourself in particular since you are already stressed by the illness of your child and not getting all the rest you need by a long shot, and to minimize reinfecting your own child or the siblings as well. Wash your hands often and discard tissues well and clean surfaces with a disinfectant after your sick child has played or eaten on it. Use separate spoons and toothbrushes (good ideas even when your family is not sick) and carry wipes when you are in transit so you can clean up after sneezes more effectively. It is impossible to prevent the spread of viruses completely but it';s never too soon to start teaching your children to use tissues and cover their mouths when they cough or sneeze (and then wash their hands!). Setting these examples of course helps too but young kids need your specific instruction to learn to do the right things, in this and in so many other areas we take for granted. Don't give up - my dad taught my 6 month old to do a primitive nose blow while I was away on vacation - I wouldn't believe this possible if I hadn't seen it proudly demonstrated to me on my return!! She is a great nose blower by the way, and good thing she catches every cold that passes! Luckily my son is rarely sick since he did not learn grandpa's "trick" so well!

6. Sleep and nutrition are always on the lists of "do" but mostly very hard to get "done" when it comes to children. Certainly try to feed your child healthy food at all times but don't over do it during illness. Fluids are really more important than calories when ill unless the illness lasts a long time. As for sleep, all you can do is make your child comfortable in the ways outlined here, provide a quiet and peaceful environment (mood music helps) and read quietly nearby to comfort your child into rest. I don't recommend video and TV marathons - most kids fight to stay awake just to keep seeing them. Not a restful thing in my book.