The common cold is a respiratory infection involving the nose and throat. It is caused by a virus. A virus is spread from one person to another by sneezing, coughing, and hand contact. Colds are common in early fall, late January, and early April. Colds are most common in preschool children, who get 3-8 colds per year. Colds are common in children who attend daycare, are exposed to secondary smoke or air pollutants, and are often in crowds.

Children, who have a cold, may have a fever, stuffy nose, watery discharge from the nose, sneezing, sore throat, headache, or desire to sleep more. Infants may be cranky and have changes in their eating and sleeping habits.

After 3-4 days, the child may develop a dry cough. The child's clear nasal discharge may change to yellow or green.

The symptoms generally last about a week; however, the nasal discharge and dry cough may last for 3 weeks.

Treatment: Antibiotics have been proven ineffective in treating the common cold- Rest and quiet indoor play is important for an ill child.

Give extra liquids such as jello, fruit juice, popsicles, and broth. Give your child small amounts of liquids every 1-2 hours. While your child is ill, it is more important that he drinks than eats. The child's appetite will be decreased but will return to normal once he is feeling better.

Measure your child's temperature once a day and when he feels hot. If the temperature is over 102F orally, 103F by rectum, or 101F under the arm for 24-48 hours, call your child's doctor.

If your child's nose is stuffy, a cool mist vaporizer can be used to moisten the air. Place the vaporizer in the child's room while he sleeps. Keep the vaporizer out of reach of the child. The vaporizer needs to be cleaned every day to prevent mold from growing in it and being blown into your child's room. Infants will need their nares cleared frequently especially before eating. To clear the nares, instill 2-3 drops of salt water (1/4 teaspoon salt per 8 ounces of warm water) in each hare then bulb suction each nare. Elevating the head of your child's bed will facilitate easy breathing.

If your child has swollen neck glands, a warm water bottle (less than 102F) may provide relief. Wrap the water bottle in a towel to prevent burning your child's neck. Check the temperature of the water bottle by touching it against the inside of your arm. It should feel warm, not hot. The warm water bottle should be used for 10 minutes every 4 hours.

Medications: Medications should only be given after consulting with your physician or nurse practitioner. Acetaminophen (Tylenol) or Ibuprofen (Advil or Motrin) may be given to reduce your child's fever and discomfort. Ibuprofen should not be given to an infant without physician approval. Over the counter-cold remedies are not recommended for children less than 6 months of age. Children over 6 months may experience temporary relief of their symptoms with the use of a decongestant or antihistamine-decongestant.

Prevention: Ill children should not play or sleep in the same bed with a healthy child during the early stages of the cold. Teaching your child to cover his nose and mouth while coughing or sneezing will help decrease the spread of the virus. Children should be taught to dispose of used tissues. Washing your child's hands after he sneezes or coughs decreases the spread of the virus.

If your child has trouble breathing (barking cough, gasping, wheezy, or grunting) or is

breathing fast. If your child becomes hoarse and cannot talk.

If your child develops a productive cough.

If your child is an infant and has refused to drink for the past 4-6 hours.

If your child has a fever for more than 24-48 hours.

If your child acts unusually ill.

If your child complains of pain when resting.

If your child does not improve in 14 days.

• Halloween is a magical time for children, but every year the holiday is marred by accidents. These safety tips will help keep your children safe.

• Establish a route for the children to take, in a known neighborhood. Tell them to use flashlights if they go out after dusk, stay on sidewalks, avoid crossing yards, and cross streets at the corner--not between parked cars. Children should stop at all corners and stay together in a group before crossing the street. They should go only to well-lit houses and remain on the porch rather than going inside.

• Young children should be accompanied by an adult. They should have their names and addresses on their costumes, know their phone number, and have coins to make a call. Children old enough to go out alone should have a curfew.

• Masks can obstruct vision and hearing. Try to talk your child out of wearing one, and if that's not possible, make sure eye and ear holes are sufficiently large. Face paint is a good substitute, but it should be nontoxic and hypoallergenic.

• Costumes should be flame-retardant, fit properly, and be marked with reflective tape. Avoid oversized shoes, high heels, trailing skirts or pants that your child could trip on, and floppy hats than might obscure vision. If a knife or sword is part of the costume, these toy weapons should be flexible--not rigid or sharp.

• Small children should not carve pumpkins. They can be allowed to draw a face on the pumpkin with markers, then let you do the cutting. Children over 5 can carve their own jack-o-lantern using the special plastic carving tools.

• If you light the jack-o'-lantern with a candle, votive candles are safest. Place lighted pumpkins on a sturdy table, away from the door and from curtains and other flammable Never leave them  unattended.                                                   
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• Tell children to bring all their treats home, so you can check them out. Watch for signs of tampering, such as small pinholes in wrappers and torn or loose packaging. Look for small items like gum, peanuts, hard candy, or small toys that pose a choking hazard for younger children.

• To keep your home safe for visiting trick-or-treaters, remove any hazards--garden hoses, toys, bikes, lawn decorations--a child could trip over. Make sure the entrance is well-lit, replace any burned-out bulbs, and sweep wet leaves from sidewalks and steps.

• If you're out in a car on Halloween, drive slowly, watch for children, and exit driveways with care.

September 1998 CONTEMPORARY PEDIATRICS 21