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Ask the Pediatrician: Cold or Flu?

February 18, 2014 by Maralee | 0 comments

*This post is part of a series of guests posts by my friend Dr. Mark McColl*

 

What is the biggest mistake you see parents making in treating the common cold or flu?

 If a child has a cold, when would it be necessary to see a doctor? If they have the flu, when would it be necessary?

What are the pros and cons of cold medicine for children?

The common cold and influenza are both caused by viral infections of the respiratory tract.  That’s about where the similarities end.  The common cold is caused by over 200 different strains of viruses while influenza only has a couple predominant strains each year.  The common cold causes a runny nose, congestion, a sore throat, cough, and often a mild fever.  Influenza on the other hand can be devastating.  It causes a violent infection of the upper respiratory tract (the nose and throat) as well as usually infecting the lower respiratory tract (the trachea, bronchi, and lungs).  Fevers up to 104F are typical.  The common cold hits its stride during the fall and winter months but can be a problem all year long.  Influenza tends to come in mini-epidemics for individual communities.  January through mid February is the peak season for my town.

The biggest mistake I see parents making in treating the common cold or influenza is seeking medical care at the wrong time.  For most of the year when a child gets a fever and has a runny nose or sore throat that’s just a symptom of the common cold.  A lot of TLC and chicken noodle soup will help them along until the body clears that infection in about 7-10 days.  No amount of medication will change that time frame.  If the common cold infection causes enough disruption in the body’s normal defenses, bacteria that are always around trying to invade will take the opportunity to set up shop.  A new fever, new pain, and focusing of symptoms to the affected spot would be an indication that something different is occurring. This could be fluid build up in the middle ears, the sinuses, and even just the nose.  Bacteria grow and cause an ear infection, a sinusitis, or a rhinitis. Medical attention would be a good idea at that time.

During influenza season a new pronounced fever (>102F) especially if there is a known exposure should prompt a evaluation right away.  After about 48-72 hours of symptoms antiviral medications that help limit influenza’s spread don’t work.  The person just has to ride it out at that point which is often a two week process.

I classify the common cold as a ‘desert island disease’.  If you have the common cold and are stuck on a desert island, then you are still stuck on a desert island.  No matter what you do or what medicine you take you will get better.  That is often not the case for influenza which sadly has claimed the lives of several people in my town already this year.
In choosing medications or therapies to help with the common cold we should pick options with low possibility of side effects. Since the cure will come from ourselves we need to realize that nothing we do is strictly necessary to get better. That will happen anyway.
That being said I like using medications for specific symptoms. If I have a congested cough then I’ll take an expectorant. If I have nasal congestion I’ll take a decongestant. There are many preparations available for multisymptom treatment. I don’t like those as much but that’s just my personal preference.  Since these drugs are not curative and can have side effects if used too much, I try and take as little as possible to obtain some relief and for as short a time as possible. Less really is more in these situations.
Generally you should avoid cold medications in children under two years of age. They don’t really work anyway at that age and aren’t necessary for getting better either. We all want to make our kids feel good but we don’t want to put them at unnecessary risk however slight it may be.
Fever and pain treatment are amazingly helpful in keeping kids feeling better while their body does its job. Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) are useful medications to relieve these aches and pains from infections and are good fever reducers. Remember not to use ibuprofen in children under six months of age.

 

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