Cold vs. Flu Symptoms in Children

I have already received the e-mail below twice from two different moms, and it is undoubtedly being spread like a cold virus from mom to mom. The email was meant to be helpful, but the information is not accurate. It is not always easy to tell which is which. It is also unknown where the content is from. The American Academy of Pediatrics (AAP) has a good FAQ about cold vs. flu (and a good explanation about swine flu), the Centers for Disease and Control and Prevention (CDC) has thorough information about the flues, and WebMD does a decent job differentiating cold vs. flu symptoms. While one of the ways (not the only way) to stop the epidemic is to share information, the ultimate way is to protect yourself and others by washing your hands with soap and water (for 20 seconds or sing Happy Birthday to you twice) frequently and to cover your mouth and nose when you sneeze or cough (with your sleeve and not with your hands, please). If your child is sick, keep him/her home to rest and get better. Do call the pediatrician for advice if you suspect it is not just a common cold. Over-the-counter cold and flu medicines do not cure either the cold or the flu; just rest, plenty of fluids, and flu antiviral medicine (if recommended by the pediatrician). Pass it on...

My additions are in blue in the table. H1N1 flu is about to be upon us and we need to be on top of information regarding it. Here is a comparison to the normal cold symptoms . Know the Difference between a Cold and H1N1 Flu Symptoms Symptom Cold H1N1 Flu (seasonal flu, too) Fever Fever is rare with a cold. A slight fever is typical in children with a cold. Fever is usually present with the flu in up to 80% of all flu cases. A temperature of 100.4°F or higher for 3 to 4 days is associated with the H1N1 (or seasonal) flu. Coughing A hacking, productive (mucus- producing) cough is often present with a cold. A non-productive (non-mucus producing) cough is usually present with the H1N1 (or seasonal) flu (sometimes referred to as dry cough). Aches Slight body aches and pains can be part of a cold. Severe muscle aches and pains are common with the H1N1 (or seasonal) flu. Stuffy Nose Stuffy nose is commonly present with a cold and typically resolves spontaneously within a week. Stuffy nose is not commonly present with the H1N1 flu. Actually, stuffy nose can sometimes occur with the flu. Runny nose is common with the flu, but antihistamines will not help. Chills Chills are uncommon with a cold. 60% of people who have the H1N1 (or seasonal) flu experience chills. Tiredness Tiredness is fairly mild with a cold. Your child should be able to keep up with usual activities. Tiredness is moderate to severe with the H1N1 (or seasonal) flu and can last 2-3 weeks. Sneezing Sneezing is commonly present with a cold. Sneezing is not common with the H1N1 flu. Actually, sneezing sometimes occurs with the flu. Sudden Symptoms Cold symptoms tend to develop over a few days. The H1N1 (or seasonal) flu has a rapid onset within 3-6 hours. The flu hits hard and includes sudden symptoms like high fever, aches and pains. Headache A headache is fairly uncommon with a cold. A headache is very common with the H1N1 (or seasonal) flu, present in 80% of flu cases. Sore Throat Sore throat is commonly present with a cold. It may also be a scratchy throat and/or hoarse voice. Sore throat is not commonly present with the H1N1 flu. This is false, children with the flu can have sore throat also. Chest Discomfort Chest discomfort is mild to moderate with a cold. Chest discomfort is often severe with the H1N1 (or seasonal) flu (more so in adults). Other symptoms of the flu may include nausea, vomiting, and belly ache. The only way to stop the spread of the epidemic is to spread the awareness. Colds and flues spread via contact with droplets from sneezes, coughs, and runny noses. Have your child wash his hands frequently with soap and water (use alcohol-based hand sanitizers if soap and water are not available) and cover his mouth when he sneezes or coughs. Throw away tissues and wash hands immediately.

No cough/cold meds for kids under 4 - Don't worry, be happy

With the frequent weather changes, I'm preparing myself for colds in one, if not both, of my children.  Kids get 6-10 colds a year, according to the NIH.  This was definitely true when my daughter was an infant.  Yes, I had many nights of interrupted sleep because of her colds, but I never gave her any OTC cough or cold medicines.   No antihistamines to help her fall asleep, either.  Instead, I tried putting saline drops in her nose, suctioning it out with a bulb, propping her up on a pillow, using a cool-mist humidifier when the heat was on in the room, giving her plenty to drink, and just being patient.  Sometimes it took more than one of these methods, but in the end we both got more sleep.  

I avoided the medicines because I didn't want her to feel more miserable with palpitations from decongestants or excessive drowsiness from the cough medicines.  Besides, she wouldn't have been able to tell me any of that.  Of note, most of the products that had "infant" on their labels referred consumers to their physicians for dosing in children under 2.  As a pediatric pharmacist, I have been asked by pediatricians for my recommendations.   I did not always have an answer, though, because some products have not been studied in children.  So, when the drug companies pulled their infant cough/cold products off of the shelves a year ago and the Food and Drug Administration (FDA) made the recommendation this past January to forgo these products in children under the age of 2, I voiced my support.  Until we have more data to support their use in young children, they should be avoided.  Earlier this month, the members of the Consumer Healthcare Products Association (CHPA) volunteered to update the product labels to state "do not use" in children under 4 and to provide new measuring devices with the products.   The FDA will continue to seek more information about these medicines.

In the meantime, don't worry about these medicines being removed from your ammunition against colds in younger kids.  Instead, be happy that the FDA is taking action to make sure that the medicines indeed work and are safe for our children.  For tips on using OTC medicines safely in older children, check out this Daily News article.  The American Academy of Pediatrics has some great additional non-medicine tips for relieving the symptoms of a cold.  Remember that a cold is caused by a virus, and even these methods will not shorten the course of the illness (1-2 weeks), but it can help your child feel better without your worrying about side effects.  Do NOT give adult medicines to your child.  As a pediatrician I worked with always used to say, "a tincture of time" will do wonders.   Oh, and don't forget to give your child the flu shot this year.