Test Your Knowledge

There is no cure for the common cold or flu (influenza). Most treatment remedies focus on reducing or eliminating symptoms.

There is some controversy surrounding the treatment of cold or flu symptoms in children. Symptom relief is based on the assumption that medications that work to alleviate symptoms in adults will have similar effects in children. However, this has not been validated since young children are unable to adequately assist in measuring the effectiveness of medications in clinical studies.

When using medications to treat children, parents must be careful to administer the proper dosage (based on age and size) and proper type of medication for the symptoms that are present. In addition, all medications (prescription and over-the-counter) have side effects that can be dangerous for young children. Parents should consult with their child’s pediatrician to weigh the possible benefits of certain medications against potential side effects. Prolonged use of medications should be avoided and medications should only be administered to a child under the close supervision of a parent or guardian.

In addition, the Food and Drug Administration (FDA) has only approved the use of over-the-counter cold and flu medications in children older than 2 years old. In children younger than age 2, studies have concluded that such medications are not effective in relieving cold or flu symptoms and, in some cases, can be unsafe and even life-threatening for this population.

Antibiotics are not effective against viral infections (e.g., colds, the flu). Yet, every year, millions of people visit the physician for diagnosis or treatment of the common cold. Some of these visits result in prescriptions for antibiotics that do not relieve cold or flu symptoms. 

The following medications may provide relief from cold and flu symptoms. However, parents should consult with a physician before treating their child with any of the following:

• Nasal decongestants. These drugs shrink nasal passages and help reduce nasal congestion. They are available in pills, drops or spray form, although sprays are not approved for use in children under 2 years old. Side effects include central nervous system (CNS) stimulation, hypertension and irritability.
  
  
• Antihistamines. These medications dry up mucus to help stop a runny nose. Only antihistamines that have a sedative effect (first-generation antihistamines) reduce cold symptoms – non-sedating antihistamines (second-generation antihistamines) have no effect on cold symptoms. This appears to be due to the drug’s anticholinergic (anti-spasmatic) properties. Side effects of antihistamines include sedation, nasal irritation and bleeding.
  
  
• Mild analgesics. Pain medications that help relieve fever, sore throat, muscle aches and headaches. This includes acetaminophen, NSAIDs (e.g., ibuprofen) and aspirin – although the use of aspirin in children with a viral infection should be avoided, due to an increased risk of Reye syndrome. NSAIDs are approved for use in children 6 months and older, but should never be given to children who are dehydrated or vomiting continuously.
  
  
• Bronchodilator therapy. May be used to expand the airways – aiding breathing when congestion or mucus buildup is severe – or to treat a persistent cough.

Expectorants (drugs that thin mucus for ease in coughing it up) are not an effective anti-cough remedy. Antitussives (drugs designed to reduce coughing) are not necessarily effective. Some studies have indicated that a placebo (an inactive material, such as a sugar pill, usually used for research purposes) actually worked better than certain over-the-counter medications designed to reduce coughing. Antitussives should never be used if a child is coughing up mucus.

In the case of the flu, a physician may prescribe antiviral drugs to reduce or eliminate symptoms in patients with a high risk of complications (e.g., infants ages 12 months to 23 months). These must be administered within 48 hours of symptom appearance, and may only work against a certain type of flu. Some may be administered as a preventive remedy as well as a treatment.

Other remedies that may ease the symptoms of a cold include:

• Saline nose drops. Saltwater drops into the nostrils. These drops can aid nasal congestion by loosening mucus and moistening the tender skin in the nose.
  
  
• Blowing the nose. This is the best way to get rid of mucus.
  
  
• Gargling with warm salt water. May ease a sore throat. Very young children may not be able to do this (gargle without swallowing).
  
  
• Petroleum jelly under the nose. May soothe skin that is irritated from mucus and constant rubbing with tissues.
  
  
• Hard candy or cough drops. May soothe a sore throat, but should only be used in children over the age of 3 years. They may pose a choking hazard in younger children.
  
  
• Warm bath, heating pads. Can help soothe aching muscles sometimes associated with colds and the flu.
  
  
• Steam. Sitting in a bathroom full of steam from a hot shower may help the child breathe easier.
  
  
• Cool-mist humidifier. Adds moisture to the air, without the risk of skin burns (as with a warm- or hot-air humidifier). This makes breathing easier (if symptoms include nasal congestion) and may soothe a scratchy throat and itchy eyes.
  
  
• Chicken soup. The warmth of chicken soup can help a sore throat feel better. Also, chicken soup contains an amino acid called cysteine, which has mucus-thinning properties. Some research has shown that chicken soup may help control certain white blood cells called neutrophils that can cause congestion.
  
  
• Plenty of liquids. Fluids (e.g., water, fruit juices, broth) help prevent dehydration as the result of fever and mucus production. Also, when children have a stuffy nose, they may breathe through their mouth, resulting in a loss of fluids when their mouth or throat becomes dry. Warm fluids may be particularly soothing on a sore throat, and can help clear mucus.
  
  
• Avoiding caffeinated beverages. Drinks that contain caffeine (e.g., some sodas, iced tea) should be avoided since they increase urination and may increase the risk of dehydration.
  
  
• Avoiding cigarette smoke. Inhaling smoke (whether from smoking or inhaling second-hand smoke) can worsen cold or flu symptoms.
  
  
• Wearing layers. Layered clothing that is easy to take off and put on can help a patient become comfortable as they alternate between being hot and cold during a cold or the flu. 

Strengthening the body’s immune system can help lessen symptoms when a person is exposed to a virus. This includes getting plenty of rest, eating a balanced diet and getting adequate exercise.