What to do with the sniffles and snuffles.

We're, hopefully, coming to the end of cold season. Part of the reason for my delayed posting is because cold season is very busy in the office and I'm just not always the most motivated writer. My apologies if you faithfully read my posts... Cold season is VERY frustrating to parents and causes pediatricians to often rethink how they approach their practices.

The fancy name for a cold is "upper respiratory infection." This unfortanate naming causes all sorts of trouble for pediatricians. This term encompasses ear infections, sinus infections, sore throats and infections of the airway below the nose, but outside the lungs, such as croup. Colds are triggers for all these problems, but don't necessarily include all these problems.

By definition, a cold is caused by a virus. There is a list of several dozen viruses that cause colds, each of which comes in a variety of sub-types. It is this large number of sub-types that causes people to catch cold after cold after cold instead of becoming immune to the common cold. This same variation in sub-types makes it impossible, for now, to create a working vaccine.

The symptoms of the common cold are well known to most people. Cough, congestion, sore throat and fever are the most common symptoms. Headaches, muscle aches, ear aches and chest pain are not uncommon other symptoms. Usually the fevers are low grade, 101 or less, and last no more than 72 hours. The congestion and nasal drainage usually starts out clear, but often will turn yellow or green within 72 hours and stay that way for several days. Our mothers always taught us that green means we need an antibiotic, but it's pretty clear now that this is not true. Your average cold will last 10-14 days, regardless of age. Some fortunate individuals seem to fight off their colds in a much shorter time frame.

Treatment of the common cold is symptomatic. Nasal saline or nasal saline washes (Netti pots) can help relieve congestion. A spoonful of honey as needed, for individuals older than 12 months, can be used to help supress cough. Cough drops may also be helpful. Running a humidifier keeps nasal congestion loose and easier to breath through. Elevating the head of the bed may help the drainage and cough to be more tolerable. Tylenol or Motrin (for those over 6 months old) helps with the muscle aches and fevers.

Cold medications available by prescription or over-the-counter have not been shown to make a difference in symptoms. Available studies suggest that they are merely sedating, which may help with sleep, but not with symptoms.

Colds that have fevers higher than 103, fever lasting longer than 72 hours, cough and congestion longer than 14 days or colds with unusual or severe symptoms need to be evaluated. A common question is "what is more severe?" The most concerning is a headache with neck stiffness as a symptom of meningitis. Shortness of breath and "windedness" may suggest pneumonia. Significant facial or tooth pain may indicate a sinus infection. As always, if you have concerns, discuss your symptoms with your regular physician.