Runny Nose, Cough, Congestion

Runny nose, cough, congestion

by San Diego IM/Peds

Cough/Congestion/Runny nose Cough, congestion, and runny nose are the most common signs of upper respiratory viral infections also known as the common cold. As long as symptoms are not associated with prolonged fever or dehydration, this infection, although very frustrating, is a benign condition that will resolve on its own. Typically, secretions can last up to 3-7 days and cough for up to 10-14 days. Reasons to call the doctor are if these symptoms are associated with a deep productive cough with fever lasting more than 5 days (signs of pneumonia), associated with ear pain that does not resolve within 2 days (ear infection), dehydration, or signs of increased work of breathing with wheezing. Upper respiratory infections can also cause wheezing (a chest whistle while exhaling), which in infants is most commonly from an infection called bronchiolitis, or stridor (a chest whistle while inhaling) which is caused by croup. The First 6 Months of Life This can be a very frustrating time to develop a URI because young infants are obligate nose breathers, meaning they preferentially breathe through their nose. If the nose is filled up with secretions, it can make it difficult to feed and can make babies very fussy. As long as symptoms are not associated with prolonged fever or dehydration, this is a benign, although very frustrating, condition that should resolve on its own. Treatment involves using normal saline and a bulb syringe to mechanically suck out all of the nasal secretions (especially before feeds) and elevating the head of the bed. A humidifier by the bedside and Vicks VapoRub can be used safely as well. Either warm or cool humidifiers are effective. The only medication that is safe in this age range is neosynephrine infant decongestant drops (also called phenylephrine): 0.125% drops to each nose every 4 hours as needed for up to 5 days (the brand name is called little Noses).