Snort, Sniffle, Sneeze, & Cough, Cough, Cough - What to do?!

Stuffy noses and coughs can make us miserable! Unfortunately, we have no cure for the "common cold," which is a viral illness. You can try to make your child comfortable while their immune system gets to work. Make sure your child gets extra rest and drinks to stay hydrated. See below for tips to help kids with stuffy noses, coughs, and fevers.

Does your child need a COVID-19 test? It is never wrong to get tested. We cannot tell if symptoms are from COVID-19 or another virus without a test.

A note about antibiotics: Antibiotics may be used to fight bacterial infections, but they have no effect on viruses. Antibiotics save lives, but anytime antibiotics are used, they can cause side effects and lead to antibiotic resistance. Antibiotics are appropriate treatments for pneumonia and painful ear infections in young children.  We will sometimes use antibiotics for bacterial sinus infections, but those are less common than viral sinus infections and do not occur in young children. At Concord Pediatrics, we are dedicated to providing the best possible treatment for your child's illness, and to prescribing antibiotics only when needed. Check out Why Most Sore Throats, Coughs & Runny Noses Don’t Need Antibiotics for more information.

Call Concord Pediatrics or make an appointment with us urgently if:

• Your infant under 3 months has a rectal temperature of over 100.4
• Your baby over 3 months has a fever (temperature of over 100.4) for more than 2 days.
• Your child has a fever (temperature over 101) for more than 5 days.
• You see no decrease in your child's temperature after giving Tylenol or Ibuprofen (Ibuprofen is only for kids over 6 months old).
• You note a new fever at the end of a cold illness.
• You are worried that your child is not hydrated (dry lips, mouth, decreased energy, urinating/peeing less).
• Your child seems to be working harder to breath - flaring nostrils, sucking in ribs, or moving the belly a lot when breathing.
  • Nasal Flaring and Substernal/Subcostal Retractions in Infant
  • Intercostal Retractions in Two Year Old
  • Intercostal and Suprasternal Retractions in 3 Year Old
  • 3 Year Old Using neck muscles during breathing

• If symptoms are not improving, suddenly worsen, or are not all better after 10 days.
• You have questions or concerns about your child's health.

Ways to help your child's stuffy nose feel better:

Saline nose drops or spray 

• Use salt water/saline nose drops (1 to 2 drops in each nostril) or spray (1 to 2 sprays in each nostril). For infants, use a rubber suction bulb to suck out the extra drops or spray. When using the suction bulb, remember that before you put the bulb on the nose, you should squeeze the bulb part first, then gently stick the rubber tip into one nostril, and then slowly let go of the bulb. This slight amount of suction will pull the clogged mucus out of the nose and should help her breathe and suck at the same time once again. You'll find that this works best when your baby is under 6 months of age. As your baby gets older, he or she will fight the bulb, making it difficult to suck out the mucus, but the saline drops will still help - just let the mucus wash down the back of the throat (that is ok). 
• For older toddlers and kids - consider the NeilMed Sinus Rinse Kit (use only with distilled water) or nasal saline spray from a can such as this. It really gets the saline rinse up one nostril and out the other! There are videos online demonstrating adults and kids using this product.
• Note: Blowing out the nose, sucking mucus from a baby's nose, or spitting out mucus after coughing does not prevent "sinus" or ear infections, nor pneumonia. The main reason to "get the mucus out" is just to make it more comfortable to breathe and eat. If your efforts to get the mucus out are making things worse and irritating your child's nose- it's okay to stop!

Humidity

• Put a cool-mist humidifier (also called a vaporizer) in your child's room to make the mucus thinner so it is easier for your child to breathe. Put it close to your child (but safely out of your child's reach). Be sure to carefully clean and dry the humidifier each day to stop bacteria or mold from growing; bacteria and mold can make your child sick. Hot-water vaporizers should not be used, because the hot water can burn your child.
• Take a nice steamy shower or bath 1 to 2 times a day to help clear out the nose (the steam thins the mucus).

What to do to for your child's cough: 

Remember that while coughing can be uncomfortable and annoying, it is the body's way of keeping the airways and lungs open and clear. The goal is often not to stop the cough completely but just sooth the upper airway. Most importantly, if you child's cough is getting worse, we would like to examine them to make sure there isn't wheezing (airways tightening) or a pneumonia that we could treat to address the underlying reason for the cough. Call for an appointment today if you have concerns about your child.

Honey

• Do not give honey to babies under one year—it is not safe. 
• Try half a teaspoon of honey for toddlers or 1-2 teaspoons for older kids, by the spoonful or mixed with warm water.
• If honey is given at bedtime, make sure your child's teeth are brushed afterward.

Cough drops or lozenges

• Consider cough drops or lozenges for older kids and teens. Do not give cough drops or lozenges to younger children because they could choke on them. Also, do not give your child more cough drops than what the instructions on the package say.

Mentholated rubs (Vick's) or Zarbee's Chest Rub

• These rubs can be very irritating to the eyes and airways. The AAP does not recommend their use in children under 2. In children over 2 years, use these with caution, and stop using if they do not clearly help the cough, or your child complains that they do not like it.
• Use carefully as directed on the jar.  For children ages 2 years and older: Rub a thin layer on top of the skin on the chest and the front of the neck (throat area), or feet, and cover with pajamas so the child cannot get it on their hands and then into their eyes.
• The body's warmth helps the medication go into the air slowly over time. The child breathes in this air, which helps to soothe a cough, so the child might sleep better.
• After using the medicine, put the medication container away and out of reach of children.

Over-the-counter cough & cold medicines:

• Over-the-counter (OTC) cough and cold medicines are generally not recommended. These medicines should not be given to infants and children under 4 years of age because of the risk of dangerous side effects. Studies show that cold and cough products that are taken by mouth don't work in children younger than 6 years and can have potentially serious side effects.
• Avoid "combination" cough and cold remedies and teach your teenagers to avoid these as well. Many cold medicines already have acetaminophen (Tylenol or generic) in them. If you give one of these medicines along with acetaminophen or (Tylenol or generic), your child will get a double dose. These combinations tend to be expensive, and are not shown to work any better than using the same medicines separately - only as needed.

To help treat your child's fever: 

A fever is part of the immune system's inflammatory response. That does not mean that treating a fever will prevent the immune system from working. If a child has a fever and is running around and playful - then it may be appropriate to observe without giving medicine (do encurage hydration!).  But if that child is in pain, tired, or achy, treating their fever (even if "low grade") may help them sleep better and stay hydrated which will lead to a faster recovery. Do not exceed the max daily dosing of these medicine.

Acetaminophen or Ibuprofen

• If your child has a fever and is very uncomfortable, you can give either acetaminophen (if over 3 months) or ibuprofen (if over 6 months). Always call your pediatrician right away if your child is under three months of age and has a fever.
• Check the label or our dosing charts to see how much medicine to give. 
• Ibuprofen can be used in children 6 months of age and older; however, it should never be given to children who are having a lot of trouble drinking enough liquids (children who are dehydrated) or who are throwing up a lot.
• Never give your child aspirin, which has been linked with Reye syndrome, a rare but very serious illness that affects the liver and the brain.
• Always measure each dose using a tool (syringe, dosing cup, or measuring spoon) that is marked in milliliters.