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Dear Dr. Lanny: I have two kids, one in school and one in daycare, and in the winter, especially, they’re always getting colds or flu. You seem pretty skeptical about alternative medicine—but what am I supposed to do when I’m not supposed to give cough medicines to my children and there seem to be a lot of other over-the-counter medicines that doctors frown on? How can I treat coughs, congestion, aches and other common symptoms? (And, yes, we try to wash hands and use hand sanitizer as often as is practical, given the children’s ages, but they still get sick.) A:
What kind of a world is this? We can send men to the moon. We have mochafrappacappuccino available at practically every corner. We have cell phones smaller than a head of a pin and yet we can’t prevent or cure the common cold.
Presuming that your children are otherwise healthy and growing, frequent colds are perfectly normal. Toddlers and young children can be expected to have six to 10 colds a year!
There are hundreds of viruses that can cause a cold, also called an upper respiratory infection (URI), and they are all new to a child. But by the time your kid reaches second or third grade, your child’s body has dealt with many viruses and you will see a dramatic decrease in the number of illnesses he or she gets each year.
Fall and winter are the “bad” times of year mainly because we are cooped up indoors in tight quarters without continuous exchange of fresh air. The dry conditions in our heated homes and schools also make it harder for our noses to filter viruses out of the air we breathe. Your children get sick from other sick people.
Before discussing treatment, I would like to say a few words about antibiotics and colds. Antibiotics have NO place in the treatment of colds, bad colds, or even really bad colds. If a health care provider says, “You have a cold,” and then offers an antibiotic, something doesn’t make sense.
So now that you know that numerous colds are a part of early life, you want to know what to do when Bubba and Buster are ill. An easy answer: “tincture of time.” That’s “time,” not thyme. There really is no prescription or over-the-counter medication that will significantly alter a cold.
As you stated in your question, doctors do not advise any of the dozens of cold medicines available at any pharmacy. This recommendation is based on studies that show no significant value to the many cough medications, all using the same active ingredient, as well as the infrequent but real potential for serious side effects. For the age group we are discussing, skip the medicines.
What about alternatives such as vitamin C, zinc or honey? As brilliant as Linus Pauling was, and he earned two Nobel Prizes, vitamin C as a cold medication has clearly been disproven. Drink real orange juice. It provides vitamin C your body needs, and it tastes great, but that is all you should expect.
The value of zinc is a little less clear. For every study that shows any benefit, there is another study that shows no value. If you wish to try zinc, use the lozenge form rather than the nasal spray, as the spray has been associated with anosmia (loss of smell). If you want an excellent source of zinc in your child’s diet, no food has anywhere near as much as a serving of oysters. Did you ever see an oyster with a cold?
Honey is yummy. It is soothing but I cannot find evidence that it helps a cough. (Honey is not to be used in children less than 1 year old, due to the rare risk of infant botulism.)
Yet another old favorite treatment for colds, particularly in infants, is salt water (saline) nose drops or spray. Hard to find any studies to support salt water’s benefit, but it is harmless and does seem to soften “boogers” somewhat, thereby helping in suctioning out the nose. Do not expect the patient to appreciate this technique.
Fever reducers (Tylenol, Motrin and the zillion brand name and generic clones) are good for the aches and pains associated with viral illnesses, but they cure nothing. Treatment of fever is not without controversy and I personally see fever as part of the body’s defense against illness.
Appetite decreases with illness, but usually only briefly, and rarely is this a concern. Dehydration is not usually a problem unless there are substantial fluid losses, as with vomiting and diarrhea. Encourage fluids, and don’t worry about milk causing mucus buildup. I can find no credible evidence supporting this old parent’s or doctor’s tale.
Vaporizers have two benefits. The noise they make seems to lull children to sleep, and the extra moisture they put in the air is comforting when your nose is stuffed and you are breathing through your mouth. I am also unaware of proof that anything other than water in the vaporizer/humidifier is of value.
So, once again Dr. Freshman has little to offer. On the other hand, I can reassure you that this cold too shall pass, and you will have saved some money and maybe some side effects as well. Dr. Alan Freshman, father of two grown boys, practices at Syracuse Pediatrics. Consult your own physician before making decisions about your family’s health care. Send e-mail to him at firstname.lastname@example.org.