Head colds are one of the most common illnesses that children have. They are caused by any one of a number of viruses. Children in the first year of life have on average 6 to 10 viral infections. After that, most children get 5 to 8 viral infections per year.

We are all familiar with the common cold. Cough, runny nose, congestion, possibly sore throat, stomach ache or earache, maybe nausea or vomiting or diarrhea. What most people don’t realize is the natural course of a cold. Colds are usually at there worst the third to fifth day, so they do get worse before they get better. Then they fade away over the next 7 to 10 days. The cough can sometimes go on for up to three weeks. Parents often get concerned if their child has green nasal discharge. All colds start out with clear nasal discharge that turns green a few days into it then clear again. First thing in the morning or after a nap the mucous that has sat in the nose will have thickened and oxidized which makes it turn green.

Cold symptoms get worse at night. There is a reason for this. One’s cortisol, our natural stress hormone is lowest at night. Because of this, inflammation goes up at night. This leads to more cough, more congestion, more runny nose.

Green nasal discharge can also be a sign of a sinus infection. In a younger child, a cold clearly getting worse after the fifth day, such as new onset of fever, or a cough that is becoming more during the day than night or daytime and nighttime cough for more than 10 days could be a sinus infection and they should be checked. In an older child, frontal headache or headache behind the eyes that gets worse when they move around with significant cough and possibly fever could be a sinus infection and they should be seen.

It is not recommended to give children under age 6 over the counter cold medicines as they can have significant side effects or lead to overdose if not given at a proper dose. Besides, they have never been shown to shorten the duration or reduce the severity of a cold in children of this age (it is fine to give acetominophen (Tylenol) or ibuprofen (Motrin or Advil) for fever).

For infants and toddlers, saline nasal drops with bulb suction is the best way to clear the nose, since they can’t blow their noses. Saline drops are available at any grocery store or pharmacy. Just put 3-4 drops in one nostril, wait 10-15 seconds, then suction that nostril with your bulb. It makes it easier to get the mucous out, or causes it to run down the back of the throat and open the nostrils. Other measure include a vaporizer in the room (if your child is mobile, make sure it is a cool mist one so they don’t burn themselves with the steam), putting your child in a steamy bathroom for 10-15 minutes to loosen the phlegm and elevating the head of their bed or crib to about 15 degrees by putting a book or pillow between the mattress and frame. They make a Vicks vapor rub for children that can decrease the cough and congestion (don’t use in young babies).

For older children, you can use an over the counter medicine that treats the symptoms your child has if you wish. Use only as directed and only if it seems to be helping them. Lots of fluid and rest are just as important.

Most viral colds are infectious for the first four to five days so don’t rush your child back to school.

If your child seems to be having difficulty breathing, significant fussiness, ongoing ear pain, inability to sleep because of cough or anything else concerning, get her in to see your doctor.