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Teaching Topic: Treating Upper Respiratory Infections

By Boys Town Pediatrics

Baby lying on stomach.

​Upper respiratory infections are the most common illness you will be treating. It’s normal for children to have as many as eight to 12 colds a year the first two years they are in contact with other sick children. After about two winters of being in day care or school, your child will have immunity to the common community viruses and will only be susceptible to new viruses in the community.

Viruses are spread from one person to another by hand contact, coughing and sneezing. They are not caused by cold air, drafts, etc. Frequent hand washing, the use of the alcohol hand sanitizers and covering your cough will help decrease the spread of viruses.

The expected course of an uncomplicated cold is as follows:

  • Fever – Lasts one to three days. (Call if it lasts longer than 72 hours or returns later during the cold.)
  • Runny nose – Clear drainage days one through three; cloudy, and often green, drainage days four through eight; less drainage after day eight and gone by days 10 to 14.
  • Cough – Gone in two to three weeks.

Treatment of the common cold consists of attempting to make your child more comfortable and watching for signs of a secondary bacterial infection. Since colds are caused by viruses, antibiotics are only useful to treat the secondary bacterial infections such as middle ear infections, sinusitis, etc.

Treat the fever as outlined on the fever sheet. Call if the child seems very ill or if the fever lasts longer than 72 hours or returns later during the cold.

Treat the runny or stuffy nose as follows:

  • Suctioning with a nasal aspirator is necessary in infants and smaller children. You may use normal saline nose drops before suctioning to loosen the secretions.
  • Oral decongestants may help by opening up nasal passages, but do not shorten the duration of colds or prevent complications. Because the risk of side effects exceeds beneficial effects, they are no longer available over the counter for young children. If you choose to use an over-the-counter decongestant for a child older than 2 years, carefully follow the directions on the label of the product to be sure that you are dosing correctly. You also need to read the labels of all products you are giving your child (including fever medications) to make sure you are not overdosing your child by giving two products that contain the same medication.

Treat the cough as follows:

  • Over-the-counter cough medications have not been found to be as effective as honey and/or cough drops. Parents should be cautious using cough drops for they are a choking hazard in younger children. (Do not use honey if under 1 year of age.)
  • Humidifiers/vaporizers are helpful if the air is very dry in your home and there is no concern of allergic reactions to molds in the water of the unit.
  • Recommendations for treating a cough have changed over time. It is advised to contact your pediatrician for the most appropriate treatment option.