'Watchful waiting' recommended for colds, fevers

Pediatrician offers do's, don'ts for treating sick kids

As parents, we want to do all we can for our kids when they have a cold.  More often than not, though, watchful waiting is the best medicine.

Dr. Skyler Kalady, a pediatrician at Cleveland Clinic Children's, says the mainstay of treatment for a child with a cold is trying to keep them comfortable.

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"We really encourage parents to humidify the environment and use salt water drops, if needed, to help with the secretions, and bulb suctioning," said Kalady.

Kalady says most healthy children will resolve a cold with time, so supportive measures are really all you can provide. 

Kids under age 4 should never take a cough or a cold medicine. According to the American Academy of Pediatrics, research has shown they offer very little benefit to young children.

The AAP also says cough and cold medicines have more than one ingredient, which increases the chances for an accidental overdose or generate any number of side-effects.

"They can have changes in heart rate or blood pressure or just change how alert the child is - making the family worry about their mental status," explained Kalady.

The AAP recommends the same "watchful waiting" approach for a child with a fever.  They remind parents that a fever has beneficial effects in fighting infection.
They say it's more important to observe signs of serious illness and encourage fluid intake.

However, Kalady says, if your child is uncomfortable, it is acceptable to try a fever-reducer.

"If they, in addition, have fever it's fine and safe to give acetaminophen or ibuprofen," she said.

Kalady says never wake your child to give them a fever reducer and give only one type of fever reducer at a time- don't mix them.  The AAP stresses the primary goal should be to keep your child comfortable while the fever fights the infection.

Additional information from the American Academy of Pediatrics:

Acetaminophen or ibuprofen can reduce aches and pains and a cool mist vaporizer can help loosen congestion

Although many parents administer antipyretics (medications to reduce a fever) such as acetaminophen or ibuprofen to a child to reduce a fever, the AAP emphasizes that the primary goal should be to help the child feel more comfortable, rather than to maintain a "normal" temperature.

Parents should focus on the general well-being of the child, his/her activity, observing the child for signs of serious illness and maintaining appropriate fluid intake.

Parents should not wake up a sleeping child to administer a fever-reducer.

Antipyretics must be stored safely to avoid accidental ingestions. Parents should be aware that the correct dosage is based on the child's weight, and that an accurate measuring device should always be used.