Thursday, 11 June 2020

Misconceptions About The Common Cold An Unwelcome, Misunderstood Guest

 Misconceptions About The Common Cold
An Unwelcome, Misunderstood Guest

Common cold in kids

Unwanted and universally abhorred, the common cold is an unwelcome guest; unsightly with its nasal discharge, irritating with its accompanying sneezing, coughing and stuffiness, and a total bore with its associated fatigue. When you see your child suffer as the unwilling host, all you want to do is oust this intrusive pest from her body.  After all, it’s a Mom’s job to “make it all better.” But, contrary to our wishes, the common cold does not respond to medical curatives. Rather, it holds its own course, marching to the beat of a different drummer. No wonder it is so misunderstood.


Medical studies and organizations such as the American Academy of Pediatrics and the Joint Council of Allergy, Asthma and Immunology have identified several misconceptions about the common cold. By “de-bugging” these misconceptions, we can better partner with our pediatricians to manage our children’s colds, and to distinguish the common cold from conditions that are amenable to medical treatment.


Misconception # 1-My child is sick half the time something is very wrong


Fact: It is typical for any young child to get up to twelve colds in one year.  Young children are susceptible to these infections due to their immature immune systems and exposure to other children with colds. Given that colds usually last one week, but can last as long as ten days, your child may in fact be sick 120 days of the year. That is almost half the year! As your child matures, so does his immune system and, consequently, his ability to fight off cold viruses.


While you should always contact your pediatrician if your baby is under two months of age and exhibits cold symptoms, or if you are concerned about your older child’s symptoms (trust your instincts!), the common cold is not cause for alarm.

Misconception #2: The common cold is caused by a bacterial infection.


Fact: The common cold is caused by an infection, but not by a bacterial is caused by a virus infection.


Misconception #3: Antibiotics kill viruses.


Fact: Antibiotics cure bacterial infections, not viral infections. Ask your pediatrician about using a cool-mist vaporizer, lots of fluids, acetaminophen to reduce fever, and decongestants to relieve symptoms of cold viruses.


Misconception #4: Antibiotics are harmless.


Fact:  For every course of antibiotics your child takes, bacteria sensitive to the antibiotic are killed, but bacteria resistant to the antibiotic may grow and multiply. The more courses of antibiotics, the greater your child’s risk of infection by resistant bacteria. If infected with resistant bacteria, your child might require hospitalization for intravenous administration of a more powerful antibiotic.  Some resistant bacterial infections are untreatable.  Antibiotics should be used only when medically indicated by a bacterial infection such as strep throat, sinusitis, bacterial pneumonia, and some (but not all!) ear infections.  Your child should complete the entire course of antibiotic.


Misconception #5:  Yellow or green mucus means that my child has a bacterial infection and needs an antibiotic.


Fact:  It is normal for the mucus to get thick and change from clear to yellow or green during a viral cold.  Antibiotics are not used to treat a viral cold.


Misconception #6: A fever means that my child has a bacterial infection and needs an antibiotic.


Fact: A child with a viral cold will often have a mild fever at the cold’s onset. Once again, antibiotics are not used to treat a viral cold.


Contact your pediatrician if your child’s fever rises during the week or continues past 3 days, or if your child  has a fever and is younger than 2 months of age. Your baby needs a same day visit if she is under 3 months of age and has a temperature of 100.4 or higher, or is between 3 and 6 months of age with a rectal temperature of 101 or higher. Your infant or toddler needs a same day visit if he is between 6 months and 2 years with a rectal temperature of 104 or higher.


Misconception # 7: Parents feel more satisfied with their pediatrician’s care when an antibiotic is prescribed.

Fact:  Medical studies have found that physicians acknowledge prescribing antibiotics when they are not indicated, in response to their perception that parents expect to receive an antibiotic prescription for their children. However, studies have also shown that the only factor that significantly predicts parent satisfaction with pediatric care is physician communication with the parent about the course of events at the visit. So, let your pediatrician know that you want to understand your child’s condition and how you can work together to get your child well, rather than receive an unnecessary antibiotic!


Misconception #8: The cluster of symptoms characteristic of the common cold, including nasal congestion, runny nose, sneezing, itching of the nose, and/or post nasal drainage with cough, is trivial.

Common cold in kids

Fact: This same cluster of symptoms also characterizes “Rhinitis;” an inflammation of the membranes lining the nose. And it is nothing to sneeze at. Rhinitis can significantly reduce the quality of your child’s life by causing fatigue, headache, cognitive impairment and missed school days. In order to better manage your child’s health, be sure to inform your pediatrician about the extent to which rhinitis compromises your child’s daily life. For example, by gaining an understanding of how often your child is too tired to engage in regular activities or how many school days your child misses due to this condition, your pediatrician will better understand the significance of this condition and the need for improved health management.

 Allergic rhinitis is the most common type of rhinitis and affects up to 40% of children.  Symptoms may be seasonal or in response to specific allergens, or triggers, such as mold, animal dander or cigarette smoke. If you notice a pattern symptom recurrence that you suspect may be triggered by allergens, have your child examined by your pediatrician, and ask for help with identifying and avoiding possible triggers, as well as treatment options such as oral antihistamines.


How You Can Partner With Your Pediatrician To Distinguish The Common Cold From Other Conditions


Okay, so now our misconceptions about the common cold have been de-bugged. How do we know it isn’t something more serious…a condition that does require medical treatment?


Cold symptoms and symptoms of other conditions, such as sinusitis, asthma, ear infection and allergic rhinitis, can mimic one another.  A common cold can also become complicated by a bacterial infection or appear prolonged by an allergic condition. An otherwise healthy child might have bouts of severely dry skin (eczema) followed by a cough or runny nose that develops into asthma; this progression is known as the "allergic march."   


 In order to make the differential diagnosis, physicians and nurse practitioners begin by assessing information obtained from the parent-reported history of the child’s symptoms. Specifically, information on the frequency, duration and intensity of symptoms and their association with precipitating factors, provide a clinical pattern to assist your physician with discerning whether your child is suffering from the common cold or some other ailment.  The more accurate the information, the sooner the pediatrician can make the correct diagnosis and initiate an effective treatment plan.


The Partnership


In today’ busy pediatrician’s office, the ten minute visit often does not allow sufficient time to obtain an adequate patient history.  Parents can help by arriving prepared, with a completed symptom history in hand.

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