Regardless of lecturing nurses in Child Health for years I often ask myself, how can it be that in 2015 we are still battling with colds when there have been so many incredible strides in medical science? Well it seems the not so common cold is something of a mighty titan and we’re no-where near beating it. However understanding what it is, and how to make children more comfortable has progressed.
A cold is a viral infection that affects the nose, throat and sinuses. While adults usually have two to four colds a year, children can catch as many as seven to ten.
Cough and colds are self-limiting and will usually get better by themselves. Bare in mind, they don’t have to have a cold to get a stuffy nose.
Simple measures such as ensuring your child has plenty to drink and gets enough rest will help. Paracetamol or ibuprofen can also be used to reduce your child’s temperature to make them more comfortable. As always with any medication, make sure you read the dosage carefully and that it is ‘in date’– any medicine can be harmful if given incorrectly.
Nasal congestion (blockage of the nose due to the nasal membrane being swollen) can be a problem in young babies and make them feel unhappy especially if they are unable to clear or blow their own nose. Babies tend to breathe through the nose rather than the mouth anyway, which is something to be mindful of as it makes it more difficult to take a bottle.
Let’s talk about medicine. Current NHS advice is that parents and carers should no longer use over-the-counter cough and cold medicines containing a range of ingredients, in children under six. The reason for the change is that the MHRA (Medicines and Healthcare products Regulatory Agency) review found no robust evidence that the medicines in question work, though they may cause side effects such as allergic reactions, effects on sleep or hallucinations. (NHS Choices, Accessed January 2015) http://www.nhs.uk/news/2009/02february/pages/childcoldflumedicines.aspx
However there are a few things you can do to help:
Encourage lots of fluids, give them their usual milk feeds but offer extra water/juice, do not worry too much about eating solids as babies and children will usually make up for this when better. With younger babies keep an eye on how much fluids they have, if they drink very little and stop having wet nappies contact your GP.
Rest really helps, the babies’ routine may well change while they are unwell and they may need more naps than usual so do let them sleep when they want even if it is near bedtime.
Monitor their temperature – digital thermometers are recognized as usually being the best. Hold the baby comfortably and place the thermometer under their armpit (always use the thermometer under the armpit with children under five). Gently, but firmly, hold their arm against their body to keep the thermometer in place, for the time stated in the manufacturer’s instructions (usually about 15 seconds). Some digital thermometers beep when they are ready. The display on the thermometer will then show you your child’s temperature.
A normal temperature in children is about between 36.2C to 37.2C but this does differ slightly from child to child. A fever is usually considered to be a raised temperature of 37.5C (99.5F) or above.
Babies will also show signs of a fever by:
Feeling hotter than usual to the touch – especially on their forehead, back or stomach, children with high temperatures can have cold arms and legs. Babies may also feel sweaty or clammy and have flushed cheeks.
You can usually tell when their temperature is going up as they become more distressed or very quiet when previously they have been playing happily.
Treat with Paracetamol or ibuprofen to make them more comfortable. Take off clothes and cover with a light sheet or blanket only. Do not use a fan directly facing a child but you it can be used to cool a hot room.
To help with nasal congestion if you have central heating it can help to have a bowl of water next to the radiator with a wide opening to increase the moisture content in the air. Safety wise make sure this is out of reach, children can drown in less than 3 inches of water. There are also a number of humidifiers you can buy.
With babies who are struggling to feed, you can use saline nose drops prior to feeds and before putting down to sleep at night. You can also get a spray for older children.
Another idea is to try raising the pillow-end of the baby’s bed or cot, perhaps by placing a pillow under the mattress. Never put a pillow in the top of a cot with a baby.
How do I know if my baby is really unwell and needs to see a doctor?
First step take a deep breath then look at your baby? What do you see? Are they taking their feeds ok? Take their temperature? All babies cry but you will soon get to know what’s normal for your baby. Trust your instincts. If a minor problem, keep an eye on the baby and see if he/she settles.
NHS Direct say – All babies under three months with a temperature of more than 38°C (100.4°F) should be urgently assessed by a doctor, as should babies aged three to six months with a temperature higher than 39°C (102.2°F).
If your baby is unable to eat, is loosing or not gaining weight then see your doctor.
If your child has persistent vomiting or very loose poos over the day, young babies can dehydrate quite quickly. If in doubt see a doctor.
If you baby is constantly crying, pulling the legs up and not having poo’s see a doctor.
If you have any concerns over breathing always see your doctor.
- Call an ambulance if:
- Your child has severe breathing difficulties or exhaustion from trying to breathe. You may see the muscles under your child’s ribs sucking in with each breath, your child may be grunting with the effort of trying to breathe, or they may be pale and sweaty.
- Your child has a rapid breathing rate of more than 60 breaths a minute.
- You are unable to rouse (wake) your child or, if roused, they do not stay awake.
- Your child’s breathing stops for more than 10 seconds at a time (this is known as recurrent apnoea).
- Your child’s skin begins to turn ashen (very pale) or blue, particularly around the lips or fingernails (known as cyanosis).
- Your child becomes floppy.
- Remember your Health Visitor is there to help and you can phone them to ask advice.
- Also use family to support you. Grannies can be very useful!!!
Lecturer in Child Health
MD Riverside Cares
The expert team at Riverside Cares are available to help you with experienced childcarers, paediatric first aid and first aid for families
training, alongside Parenting Know-How sessions for mothers, fathers and carers. Jill is also available for one to one consultancy with parents.
The information contained in the following topics is not intended nor implied to be a substitute for professional medical advice. You assume full responsibility for how you choose to use this information. Always seek the advice of your doctor or other qualified healthcare professional if you are concerned about you baby or child.