Common Concerns

Coughs & Colds

How to recognize the common cold (or viral upper respiratory infection)
Children with colds have runny and/or stuffy noses. They also may have a cough, a sore throat (especially when coughing, or first thing in the morning), and a fever (especially in the first 2–3 days). The nasal drainage may range in color from clear, to yellow or green.The symptoms will last 10–21 days, and usually are improving by the last 3–4 days. Children under five years commonly have 10–12 colds per calendar year. Most of these occur between October and April.

How to treat cough and cold symptoms
A virus is the germ that causes the common cold. For this reason antibiotics (which are designed to treat bacteria) will not help. Instead we recommend treating the most bothersome symptoms, providing plenty of fluids, and allowing adequate rest for the body to fight off the infection.

Cough/cold medications
We do not recommend using these medications in children under six years of age. While they are probably not extremely harmful, there is no scientific evidence that these work better than placebo (a sugar pill). In addition, they may cause side effects such as irritability and wakefulness. For these younger children and infants, we recommend nasal saline drops (available at pharmacies without a prescription, or made at home by mixing 1/4 tsp salt in 8 ounces of warm water), elevating the head for sleep, and possibly using a vaporizer in the bedroom if the nose is just stuffy and not runny. A cool mist vaporizer is safest. Taking a shower with you before bed may also help to clear out the nose. A bulb syringe should be used infrequently and cautiously so the stuffiness doesn't get worse from too vigorous cleaning.

For children over six years of age, cough and cold medications should be used conservatively in order to help the child sleep, or to deal with symptoms that are very bothersome to the child (such as a nonstop runny nose, or a constant cough). Symptoms that bother you, but don’t bother your child do not need to be treated. For example, sometimes children sound stuffy, but are sleeping and eating normally. They do not need medicine. Many children will have side effects from these medications, such as irritability, wakefulness, hyperactivity, or sleepiness.

In general, the medicine used should fit the symptom. If the nose is stuffy, use a plain decongestant (such as Sudafed). If the nose is stuffy and runny, use a decongestant plus antihistamine (such as Dimetapp, or Triaminic cold & allergy). The decongestant will help the nasal stuffiness and the antihistamine will help dry up the drainage. A dry cough might be helped by a plain cough suppressant, such as Robitussin DM or Delsym. A wet cough will respond better to a cough suppressant plus an antihistamine, such pastrami Nighttime, or Delsym plus Benadryl Allergy (an antihistamine). A croupy (barky, seal-like) cough will respond best to a vaporizer, steam from the shower, or going outdoors for 10–15 minutes to breathe cool air.

When should a child with a cold or cough be seen at the pediatrician’s office?
If your child seems to have persistent pain (in infants this may show up as extreme fussiness or poor sleep) they should come in to the office They may have an ear infection. If the cough is associated with wheezing (a high-pitched sound made upon exhalation) or labored breathing (breathing too fast, having difficulty talking, or using the chest and abdominal muscles to breathe) we also want to see your child. You may also consider having your child evaluated if the cold symptoms are persisting beyond three weeks and either worsening or showing no sign of improvement. The color of your child’s nasal drainage should not influence your decision to bring your child to the office It is very common for simple viruses to cause yellow or green nasal drainage. Colored drainage does not automatically mean your child has a sinus infection. A sore throat causes some to worry about “strep throat.” Most sore throats associated with a cold are just caused by drainage or “post-nasal drip.” These sore throats are worse in the morning and tend to improve throughout the day. They are associated with a runny, stuffy nose and a cough and have been present for most of the duration of the cold. Usually there is not much of
a fever. If the sore throat is like this then your child probably does not need to be evaluated for strep throat.


Common Concerns

Adolescent Stress

Caring for Your Newborn


Coughs & Colds


Dietary Guidelines

Ear Pain



Flu Facts

Milk Allergy

Runny Nose

Pink Eye


Sore Throat

Vaccines for Adolescence





Trestlewood Pediatrics
5082 Lovers Lane, Building C Kalamazoo MI 49002   |   269-382-0118   |   Email Us

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