Your child may not feel well and may have a fever. In infants and toddlers the temperature might reach 103-104, but after giving some acetaminophen or ibuprofen, the temperature will be lower and your baby will seem better. In older children there might be a low-grade fever or none at all.  But here comes the runny nose!

Should you treat the runny nose?
The million dollar over the counter (OTC) cold remedy industry would not like you to hear this, but the truth is that there is now a fair body of research that shows that decongestant and combination decongestant-antihistamine products should not be used in infants, do not work very well in small children and provide only modest relief to teens and adults. And none of these cold medicines will cure a cold. When they do work, they will simply relieve the symptoms such as congestion. And the relief will only last about four to six hours.

To make matters worse, side effects of decongestants can include: irritability or hyperactivity, nervousness, tingling sensations to the skin, and difficulty sleeping. (just like a strong cup of caffeine). Since it is a stimulant it also has effects on other organs such as the heart. Antihistamines have a drying effect on the mucous areas of the nasal tract and some people find this helpful, but the most common side effects, are dry mouth, drowsiness, dizziness, and headache. In some small children it may cause irritability or hyperactivity. In older kids, they may have trouble concentrating in school.

What does work is simple salt water (or saline) nose drops or sprays combined with a cool mist vaporizer or humidifier at night. Children can use an extra pillow to help with postnasal drip. Drinking plenty of fluids help keep the throat moist so the drip is less bothersome.

During the middle phase of a cold, a child may develop a cough because of the congestion from the nose.  During this time the fever is usually gone, and your child might be back to their activities, despite the runny nose and mild cough.

Should you use a cough medicine?
There are only ingredients shown to be effective in suppressing coughs are codeine and dextromethrophan (DM) and the research data is mixed. There is no indication for using codeine to treat the cough from the common cold, especially in small children. When used as directed and in the proper doses, DM is safe and has some effect on coughs in older children and teens. But its abuse in recent years by teens has made it more regulated by pharmacists.

Expectorants, such as guaifenesin are supposed to loosen mucous and phlegm to make it easier to cough up. But some experts believe that this does not work well in the doses usually found in cold preparations.

What does work for coughs is keeping a child hydrated by drinking fluids, using lozenges in an older child, keeping a child upright at night and keeping the air in the room moist with a vaporizer.

It's a good sign when the mucous starts to thicken and become crusty. At this point it's just wiping the nose and using humidifiers to help your child breathe easier at night.

Other cold cures?
There has been a great deal of research on this topic in the last decade but unfortunately, no encouraging news for alternative therapies or even home remedies. This includes the use of Vitamin C, zinc lozenges, aromatic rubs, or most recently Echinacea. Even chicken soup has been studied! But at least there is some nourishment there and most kids and adults will agree that it can make you feel better, especially when it's made with love.

About the Author
Dr. Mary Ann LoFrumento, MD, F.A.A.P., pediatrician, mother and author, has more than 20 years experience answering parents' questions about how to raise their children. She recently launched Simply Parenting, a book and DVD series designed to end parents' anxiety and insecurity and bring parenting back to basics.