The winter season is here. It’s a time for celebrating the holidays, playing outside in the snow and warming up with hot cocoa. It’s also the time when I see so many kids coming in with sore throats, runny noses and coughing that keeps them and their parents up all night. Most winter illnesses are caused by viruses and the others are bacterial infections.

Signs of a bacterial infection include being sick for more than 10 days, thick yellow/green nasal discharge for several days or high fevers of at least 102 degrees Farenheit beyond the first couple of days. Bacterial infections like strep throat, ear infections and pneumonia respond well to antibiotics. Everyone’s thrilled when a sick child bounces back quickly. However, antibiotics may cause side effects like upset stomach and diarrhea and overuse of antibiotics can cause bacteria to change and become resistant to commonly used antibiotics. 

For the colds and viruses that are common in kids, especially during the first few years of life, there’s usually no vaccine or cure. What are the best ways to help your child recover? The most effective is to keep your child comfortable and let the virus run its course, which usually takes about seven to 10 days. 

Nasal saline drops or sprays can help clear a clogged nose, especially in infants and young children, who are not very good at blowing their nose. Cool-mist humidifiers can also help with nasal congestion, especially overnight when sleep is often interrupted by coughing. Tylenol or Motrin will help with fevers and help reduce the achiness that often comes with viral illnesses.

Parents often ask about cough medicine – either from a prescription or over-the-counter. Unfortunately, over-the-counter cough and cold medicine often is not very helpful, and in fact it can be harmful in young children. The American Academy of Pediatrics recommends against giving cold medicine to kids under 4 years of age, and advises parents to use caution for children slightly older than that. 

More effective ways to treat the cold symptoms are home remedies like the nasal drops and humidifier I mentioned earlier, honey for children over 1 year and warm fluids for kids of any age. Warm steam from boiling water or a hot shower will help ease coughing fits, and might help the entire family sleep if done right before bedtime. Cough drops or throat lozenges may also be helpful, but they can pose a choking risk and shouldn’t be given to children less than 4 years old or to any kids when reclining or lying flat.

While most colds and other viruses can be managed at home, there are a few times kids should be taken to the doctor. Any baby under 3 months old should be seen if he or she has a fever higher than 100.5 degrees Farenheit.  Children should also be seen if they show signs of difficulty breathing or dehydration, or if they are not getting better. 

Signs of breathing difficulties include nostrils flaring out when exhaling, the skin between or above the ribs sucking in when inhaling, or rapid breathing. Dehydration causes decreased urine output, dry-appearing eyes and mouths, and lethargy. It’s often difficult to tell a virus from a more serious illness, so to be sure, or reassured, don’t hesitate to contact your child’s doctor.


Dr. Laura Shefner writes about pediatric care for the Cleveland Jewish News. She is a pediatrician at The MetroHealth System and practices in Beachwood and Parma. 

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