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Harvard Commentaries
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A Parent's Life A Parent's Life

Survival Guide for Kids' Colds -- Managing Without Medication

November 14, 2013

By Claire McCarthy M.D.

Boston Children's Hospital

It's bedtime and your little ones are sick with bad colds. There's a symphony of sniffles, snortles and coughs coming from the bedroom. You're wondering how anybody is going to get any sleep. You wish you could reach for the cough medicine, but you can't.

Your kids are younger than age six and the U.S. Food and Drug Administration (FDA) and American Academy of Pediatrics (AAP) say you shouldn't give them over-the-counter cold medicines. That's because early in 2007, the Centers for Disease Control and Prevention (CDC) reported that about 1,500 kids had health complications from taking cold medicines in 2004 and 2005. There were even some deaths. These findings spurred the FDA and AAP to take action — and rightly so. What's a parent to do, then, with a miserable, snuffly child?

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The "Cold" Truth

Before you feel too sorry for yourself, the truth is that cough and cold medicines don't do much anyway. Study after study has shown that they are no more effective than placebos. But Americans have continued to spend millions of dollars a year on them.

Colds are caused by viruses that you catch from other people. You don't get a cold from going outside without a jacket — or with wet hair. We don't have many medicines to treat viruses. They go away by themselves, in their own time.

Even though frequent hand washing with soap and warm water will help prevent the spread of the cold viruses, kids tend to pass things easily between themselves no matter what we do. (Carry alcohol-based gel with you for those times you're not near a sink.)

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How Can I Make My Child Feel Better?

When we talk about "treating" a cold, we're really talking about making your child (or anyone else) feel better while the cold goes away. It's still okay to give acetaminophen or ibuprofen for fever, and for aches and pains. Check with your doctor for the right dose.

There are many other ways you can make your child feel better without using medication:

  • Clear out the mucus. Your kid will hate you for it, but using a bulb syringe in the nose (with a couple of drops of saline first) to clear out mucus can make a huge difference when it comes to breathing better.


  • Keep a humidifier running. This keeps the mucus thinner, which makes it easier to cough, blow, or syringe out. Use the cool-mist kind. It's more effective than a vaporizer — and safer. (Be sure to clean it regularly. You don't want to fill the air with mold and bacteria, too.) Some folks swear by adding a little bit of menthol to the water, which can help nasal passages feel more open and sometimes help calm a cough. Talk to your doctor first if you have a newborn or a child with asthma.


  • Elevate your child's head. This helps the mucus run down, so it doesn't get stuck at the back of the throat and cause coughing. For the out-of-crib crowd, an extra pillow can do the trick. Never use pillows in the crib because they can increase the risk of SIDS. Try putting a folded blanket or two under the head side of the mattress, or propping up the head of the crib by placing books under the two legs.


  • Give lots of fluids. You child doesn't have to eat if he doesn't want to (sometimes a lack of appetite is the body's way of conserving energy), but he needs to drink to make up for losses from fever — and to keep the mucus moist. Give lots of water, 100% juices (not the sugary stuff) and soup. (Chicken soup, with its salt, nutrients, and mucus-thinning steam, is a great option.) Some folks say that dairy increases mucus and should be avoided. I've researched this and can't find any convincing evidence either way. Avoiding dairy in infants is not, in my opinion, a good idea — they need the nutrition. Breastfed children should breastfeed as often as you can get them to, as the milk is not only easily digested but has antibodies to help them fight off the infection.


  • Avoid giving your sick child junk food or sugary snacks. The body needs healthy foods when fighting off a cold.


  • Encourage rest. This sounds obvious, but a startling number of sick kids spend their days playing video games and watching television — both of which tend to keep a sleepy child awake. I'm not saying that sick days need to be totally boring. But do your best to make the environment conducive to sleep.


  • Try herbal remedies. There is a dizzying array of natural remedies out there marketed for the common cold. Many of them can be effective. The problem is that "natural" doesn't always mean safe, because these products are not regulated by the FDA. Try peppermint or menthol in tea, or rubbed on the chest (not on a baby younger than six months). It can make the nose feel less stuffy and quiet a cough. Chamomile tea (usually caffeine-free, but check to be sure) can help with cold symptoms too. But before giving anything else, check with your doctor or a licensed provider of complementary and alternative medicine. You can also check with the National Center of Complementary and Alternative Medicine.


  • Snuggle. This always makes a kid feel better, and may actually support the immune system. Babies seem to know this instinctively — all sick babies want to be held constantly. Give your child a back rub, or curl up and read books together. Sure, it means you're more likely to catch the germs. But did you honestly think you were going to escape them anyway?

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When To Call the Doctor

Be sure to call your doctor if your child:

  • Is less than six months old (for advice and a possible office visit)
  • Has a fever of 102 or higher, or a lower fever that lasts more than 2 to 3 days
  • Has a very bad cough, or any trouble breathing
  • Won't drink or eat
  • Seems much sleepier than usual
  • Is much crankier than usual
  • Has any severe pain, or a milder pain that lasts more than 2 to 3 days
  • Has a rash
  • Isn't better within 5 to 7 days

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Claire McCarthy, M.D. is an assistant professor in pediatrics at Harvard Medical School, an attending physician at Children's Hospital of Boston, and medical director of the Martha Eliot Health Center, a neighborhood health service of Children's Hospital. She is a senior medical editor for Harvard Health Publications.

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