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Head colds make us miserable, but they do go away on their own. For comfort, you may use a vaporizer or humidifier in the child’s room.  There are several varieties; all work well.  You do not need to put anything in the water (unless the steam vaporizer instructions require salts to make it work).  Steam vaporizers may work a little better than a cold-mist humidifier, but you must watch that your small child does not get scalded by getting too close to the steam.

Saline (mildly salty water) drops in the nose can help prevent nose bleeds.  They can also be useful if the child has trouble eating or sleeping due to stuffiness.  You may use saline drops as often as needed.  You do not need a prescription.

Non-prescription cold and cough medications can be helpful.  Look for medications containing an antihistamine and decongestant.  They will not hasten the resolution of the cold, but they might help the child feel better for a few hours.

In my own experience, cough and cold medications have proven safe and effective.  But in August 2007, the FDA issued a warning that cold and cough medications occasionally have serious side effects in children, especially if an incorrect dosage is given.  The FDA now recommends that children under 4 years of age avoid taking them, unless the physician recommends it.

Cough and cold medications manufactured for older children are still available.  My advice is to use them sparingly, perhaps only for sleep, and to double-check the dose.  Dimetapp®, Pediacare®, and other brands are well-known.

I used to recommend that children between 2 and 6 take half of the dose for 6 year olds (usually ½ teaspoon). Children between 4-6 months and 2 years used to be given half the dose for 2 year olds (usually ¼ teaspoon).  However, the FDA now recommends against this practice.  Children under 4-6 months should usually not be given decongestants.

If the child develops fever, you may use acetaminophen (Tylenol® etc.) or Ibuprofen (Motrin® etc.).

Head colds probably go away faster if the child gets enough fluids, and enough rest.  Echinacea, Vitamin C, and other “natural” remedies have not been proven to improve the symptoms or shorten the course of head colds, but there is no demonstrated harm to using reasonable doses if you wish to experiment.  I don’t usually encourage parents to use them.

Please call us, or return to the office, if:

• the fever lasts for over 3 days;
• if the fever stays over 104°;
• if the cough and congestion have not improved in 7-10 days, or
• if the child seems especially sick or the symptoms are worsening.
   

Copyright © David Epstein MD, 2007, 2008