My baby has a common cold…what should I know?

[mme_highlight] Young children have about 6 to 8 colds per year. The most common virus causing colds are rhinovirus in all age groups. The symptoms of a common cold are seen about 10-12 hours after the viral infection. Generally cold is well tolerated by babies but in certain situations take your baby to the doctor for medical help. [mme_highlight]

According to research studies, young children have about 6 to 8 colds per year. During the initial years of life, boys seem to have more respiratory infections as compared with girls. Daycare attendance has been cited as one of the most important risk factors for respiratory illnesses in children and it is known that the frequency of cold increases with the number of children in a daycare group with respiratory infections.

What causes common cold?

Studies have reported that there are more than 200 different cold viruses. The relative proportion of the virus causing cold is dependent on factors such as age, season and viral detection method. The most common virus causing colds are rhinovirus in all age groups. It has been found that by the age of 5 years, virtually all children have been exposed to one or the other cold virus. 5% of all the patients suffering from cold are dually infected by two viruses.

Research studies have shown a high incidence of rhinovirus infection in children during their first years of life. By the age of 6 months, over 20% of the children have shown a rhinovirus infection confirmed by the laboratories. By the age of 2 years rhinovirus infection has been proved in almost 79% of the children while 91% had developed antibodies against the rhinovirus infection.

The table below enlists the most common viral causes of common cold (Heikkinen & Jarvinen, 2003).
[mme_databox]

Virus	Estimated annual proportion of cases
Rhinovirus	30-50%
Coronavirus	10-15%
Influenza virus	5-15%
Respiratory syncytial virus	5%
Para influenza virus	5%
Adenovirus	<5%
Enterovirus	<5%
Metapneumovirus	Unknown
Unknown	20-30%

[/mme_databox]

What are the symptoms of common cold?

The symptoms of a common cold are seen about 10-12 hours after the viral infection, while influenza virus may take 1 to 7 days to present symptoms. The mean duration of a common cold is 7 to 10 days in children but in younger children it may linger longer.

The most common symptoms of common cold in babies and children are:

Runny nose (watery discharge at first, which later becomes thicker and yellowish);
Sneezing;
Nasal congestion.

More aggravated symptoms (which are rare) are;

Dry cough worsening when the baby lies down;
Fever;
Itchy throat;
Fatigue;
Loss of appetite.

What can be the complications of a common cold in my child?

The symptoms of a common cold may persist in some children even after 3 weeks. The most common complication arising as a result of coldis acute otitis media occurring in almost 20% of children with viral upper respiratory infections; the viral infection may the middle ear fluid and cause inflammation in the mucosa of the middle ear. Bronchitis, pneumonia and sinusitis are other complications associated with cold.

How is common cold diagnosed?

The biggest problem associated with a cold in infants and younger children is that they may not show the typical symptoms. Diagnosis in infants is especially difficult when fever is the major symptom during the early phase of the infection and the doctor is faced with the difficulty of distinguishing viral infections from severe bacterial infections.

A survey conducted for Disease Control and Prevention in 1991 showed that almost two thirds of three year olds had taken a medicine for cough or cold in the preceding 30 days. It is very important that physicians correctly diagnose the cold before deciding on the use or refuting the use of medications in young babies.

How is common cold treated?

There is not a cure for common cold, but symptoms can be treated to provide relief for the baby or the young child. The treatment options that have been recommended for common cold in babies and young children are the following:

Suctioning of mucus with a suction bulb. Over the counter saline nasal drops may be used to soften the hard mucus before the suctioning of mucus. This will help the baby to feed properly and sleep well.
Keep the air in the room humidified to moisten the air, reduce congestion and facilitate breathing in babies.
Make the baby sleep on his /her belly with head elevated to ease breathing.
Petroleum jelly or similar ointment should be applied lightly to the outside of and under nose to prevent chapping and reddening of the skin.
Decongestants prescribed by the physician should be given to ease congestion so that the baby can eat and sleep properly.
Nose drops may be used when prescribed by the doctor to ease the congestion. Overuse may lead to a rebound reaction, thus worsening the condition of the baby.
Cough medicine may be prescribed by the doctor to ease a dry cough in extreme cases. However, generally, cough suppressants are not prescribed for the babies. The American Academy of Pediatrics cautions against the use of any cough medicines in infants and children. Antibiotics should be used only in case of secondary bacterial infection.
The baby should be isolated from others in the family for the initial three days to prevent spreading of the cold to others.
Dietary changes: baby should be continued on normal diet. The intake of milk and other dairy products may be reduced as these can thicken the secretions. Fluid intake should be increased to replenish the lost fluids. Vitamin C rich foods, like strawberry and orange, should be given to the baby.

What are the alarm signs parents should be aware of?

Generally cold is well tolerated by babies but in certain situations take your baby to the doctor for medical help. These situations are:

If this is the first cold of your baby;
If your baby is under 3 months or 4 months of age and has a fever over 101˚F (38 ºC);
If the temperature suddenly goes up or stays high for more than 2 days;
A dry cough lasting more than 2 weeks or interfering with the baby’s sleep, or which causes choking or vomiting, becomes thick and productive or wheezy;
A cough lasting for more than three weeks in an infant or six weeks in an older baby;
If breathing difficulties develop;
If a thick greenish yellow nasal discharge develops lasting for more than a day;
If the nasal discharge is streaked with blood;
Unusual amount of crying or loss of appetite.

Summary and Recommendations

It is normal for young children to have common colds: the average frequency is estimated in 6 to 8 per year. It seems to be more prevalent in boys.
Being at a daycare facility is a risk factor to catch a common cold.
The most frequent agent causing common cold is rhinovirus.
It has been documented that almost all fiver-year-old have already contacted with common cold viruses.
Possible complications are: acute media otitis, bronchitis, pneumonia, and sinusitis.
Some options to relieve symptoms are: nasal mucus drainage, keeping air humidified, use decongestants when you have a medical prescription, reinforce oral hydration and give your child aliments rich in vitamin C.
Your baby’s first cold, a cold in young infants, dry cough that lasts more than 2 weeks and difficulty to breathe are indications to seek for a doctor.

[mme_references]
References

Eisenberg, A., Murkoff, H. E., & Hathaway, S. E. (1996). When Baby is Sick. In A. Eisenberg, H. E. Murkoff, & S. E. Hathaway, What to Expect The First Year (pp. 418-420). NewYork: Workman Publishing.
Heikkinen, T., & Jarvinen, A. (2003). The Common Cold. THE LANCET, 361, 51-59.
NHS, C. (2011, June 10). Common Cold in Children. Retrieved from NHS choices: http://www.nhs.uk/Conditions/Cold-common/Pages/Commoncoldinchildren.aspx
Simasek, M., & Blandino, D. A. (2007). Treatment of The Common Cold. American Family Physician, 515-520.

[/mme_references]