A Pediatrician's Tips on How to Manage the Common Cold

Cold and flu season is upon us. This month, Dr. Arthur Lavin breaks down the common cold and how to manage it. Don't forget you can get more trusted health information from Dr. Lavin on the ParentTalk Podcast!

The common cold, though common, can be a very hard misery to endure. And because it’s common, we get them all the time, especially young children who seem to catch these colds with astonishing regularity. This winter, let’s take a fresh look at this old problem.

As a pediatrician with more than 25 years of experience, I am no stranger to helping families cope with cold symptoms. Here are my tips for managing the common cold.

Every cold is a viral infection of the lining of the cells that touch air in our body, including the: 

• Nose
• Throat
• Mouth
• Upper airways
• Lungs
• Lining of the eyes  

The common cold virus attaches to those living cells and eventually gains entry. Then, the virus squirts a tiny bit of genetic material into the cell, commanding it to make a zillion copies of the virus. Those zillion copies explode out of our poor cell and then infect zillions of other cells that line our eyes, nose, throat and lungs. This destroys the cell, causing it to leak fluid – eyes make more tears, noses run, lungs start crackling, etc.

The body catches on and sends its army in to destroy the virus so you can recover. The immune system rids us of our cold by killing every cell that has a cold virus to stop it from making copies and infecting more cells. 

The great battle to destroy the cold virus creates the mucus that crusts our eyes, that makes our runny nose go from clear fluid noted above to thick crusty mucus, coughs with thick mucus, etc. And also, the other horrible experiences when you have a cold – fever, achiness, lethargy, malaise, loss of appetite, interrupted sleep – that’s your body fighting the cold.

For many thousands of years, the viruses that cause colds have fallen into just a handful of categories. Some you will recognize, but maybe not all.

The most common category is the world of the rhinovirus, of which many, many different types exist to cause about 30-50% of all colds. The rhinovirus is around all year, so you can get a cold in any season from this type of cold virus. 

Also very common are the influenza viruses. Across a whole year, three to four variants show up to cause 5-15% of all colds (with that number rising to about 30% in the winter). Influenza viruses are seasonal. Very few people in the U.S. have colds and flus from this virus in July, for example. But every winter, most typically around December, this virus suddenly floods all of America and stays until April or May.

Next come the coronaviruses. The infamous one, COVID, is about four years old, but there are four others that have been around for about 8,000 years and cause about 10-15% of all colds every year. The old coronaviruses cause illnesses that look just like any other common cold. As we all know the new one, the SARS-CoV-2 virus, causes COVID, which can cause a tremendous variety of harms, but also just a common cold.

Is RSV the common cold? Many people are also familiar with this group of common cold viruses, the Respiratory Syncytial Virus (RSV), so called because when this virus enters your airway cell to make zillions of copies, it fuses many of the infected cells into one giant cell, called a syncytium. RSV can cause some severe inflammation, aka, a much worse cold.  

The three remaining categories of known cold viruses include:

• Adenoviruses – Can cause a nasty pink eye and severe inflammation in the throat and lung
• Parainfluenza viruses – Responsible for many cases of croup, which causes swelling around the vocal cord, a barking cough and trouble breathing
• Metapneumovirus – The least well known publicly and not a common virus of the common cold

Aches, sore throats, runny noses, terrible coughs – these are the common miseries of the common cold. But, these viruses are also capable of causing more severe disease as well.  

Cold viruses may inflame the lungs so bad we call it viral pneumonia, which can be very serious. Fortunately in childhood, viral pneumonia tends toward being milder than in adults, but it remains a concern. 

COVID is a cold virus that still causes far more intense inflammation than others, and we are all familiar with its power, if unimmunized, to take life even now. Influenza viruses still take life, too, at a lower rate than COVID, but still, about 30-50,000 people die every year from influenza viral infection.

The tragedy of the cold is that we have very, very few tools to rid our bodies of the virus (and even fewer medications to heal it). Here’s what you can do.

The best way to manage the misery of a cold is to keep it from happening. The yearly influenza vaccine, new RSV vaccines and interventions available during pregnancy, infancy and over age 60 can help to prevent contracting a cold virus (as can being sure you are fully up to date with your COVID vaccine).  

The other option for prevention is to wash your hands, wear a mask and keep your distance. This strategy wiped out nearly ALL colds in the winter of 2020. As we know, the cost of isolation was too high and we no longer do this, so the colds are back. But, the isolation did demonstrate that it works. 

For all those types of cold viruses mentioned above, only two really offer any medications to lessen the misery. The most effective drug for any cold is the one for COVID, Paxlovid. You can’t get it unless you are in a high risk group and over age 12.

The other virus that there is a drug for is influenza. Tamiflu offers very limited benefits.  Its ability to help drops dramatically after two days of symptoms. Even so, if you are in the ICU or otherwise in severe risk, even a bit of help can make a huge difference. But if you are young and healthy, the benefit of Tamiflu may not exceed its risks. In many studies of healthy youth, Tamiflu changed the length of the cold from an average of 7 days to an average of 6, not very worthwhile.

For many, many years, companies have been hawking decongestants, cough suppressants, antihistamines and combinations of such to get rid of the symptoms of a cold, and, failing that, at least to slow them down, reduce them, even a touch. 

I really would love for some of these to work. We need relief! The problem is that they just don’t work. People who try them report success, but in essentially every trial of all these drugs, they help, but at the same level that simply drinking water does. Stay hydrated and skip them!

Being bundled up or read to, watching a movie, taking ibuprofen, being massaged and held – these steps may not be clinically proven to work, but never underestimate the healing power of simple comforts. At the very least, they can make a cold more bearable. 

Of course, an incredibly effective form of self care is sleep. Sleep will help your child’s immune system do its important work and will also give them relief from feeling their cold symptoms for the length of their sleep. And, if you’re reading this post, then you already know that Naturepedic is in your corner when it comes to helping your family get healthier sleep.

Let’s hope this winter is a healthy one for your family, and if colds strike, they stay mild and heal quickly!

-Dr. Arthur Lavin