Coughs and colds also commonly called “flu” are usually caused by a virus infection. They normally clear away on their own, and antibiotics such as Amoxicillin and others are usually of no use. Paracetamol or ibuprofen may make the child feel a lot better. It is important to ensure that the child has enough to drink.

What causes coughs and colds and what are the symptoms?
Most coughs and colds are caused by viruses. Many different viruses can infect the nose and throat. They are passed on by coughing and sneezing the virus into the air. An average nursery school and primary school child has 3-8 coughs or colds per year. Sometimes several coughs or colds occur one after the other. Studies show that a child who lives with smokers is at higher risk of developing coughs and colds.

• The common symptoms are a cough and a runny nose. The cough is often worse at night. NB. Coughing does not damage the lungs.
• In addition, a child may have: a raised temperature (fever), a sore throat, headache, tiredness, and a lousy appetite. Sometimes children vomit after a bout of coughing.
• A build up of mucus behind the eardrums may cause dulled hearing or earache.

What are the treatments for coughs and colds?
There is no wonder cure! Normally, symptoms are worse in the first 2-3 days, and then ease over the next few days. Some people do get an irritating cough that may last for up to 2-4 weeks after other symptoms have gone. Commonly in Uganda people tend to obtain Antibiotics such as Amoxicillin, Septrin®, to combat these symptoms, however antibiotics do not kill viruses and so have no effect on the symptoms. It can be compared to putting water in a petrol engine, worst case- it could damage the engine or simply have no effect.
The aim of treatment should be to ease symptoms whilst your immune system clears the virus. Paracetamol is given to relieve body aches, headaches, and fever. Ibuprofen is also a good alternative. Dehydration (very low amount of water in the body) may develop if a child has a fever and does not drink much, therefore you should ensure your child has enough to drink.

Another popular treatment for nasal stuffiness (blocked nose) especially for babies is to put a few drops of saline (lightly salted water) into the nose just before feeds. Some people feel that this helps to clear the nose to make feeding easier. There is little scientific evidence as to how well this works, but it may be worth a try if feeding is difficult. You can buy saline drops from pharmacies.

What about cold and cough syrups?
We advise that parents should no longer use over-the-counter (OTC) cough and cold medicines in children under 6 years. There is no evidence that they work and can cause side effects especially due to wrong dosing, such as allergic reactions, effects on sleep or hallucinations.

More research is being done on how well these medicines work in children aged 6-12 years.

What symptoms may indicate a more serious problem?
Most coughs and colds get better without complications. Sometimes a more serious 'secondary' bacterial infection develops from an initial virus infection. For example, an ear infection, pneumonia, etc. Symptoms to look out for that may mean more than just a cold include:

• Wheezing, rapid breathing, noisy breathing (stridor) or difficulty breathing.
• Persistent earache.
• A cough that persists longer than 3-4 weeks.
• Persistent high temperatures.
• Drowsiness.
• Unusual irritability or persistent crying in a baby.
• Chest pains.
• Any symptom that you cannot explain.

See a doctor if any symptoms develop that you are concerned about to rule out serious illness. They may not prescribe anything more effective for the flu and cough, but a checkup can be reassuring.

Reviewed by: Andrew Sekitoleko MBChB
Date reviewed: October 2011