Cold season is officially here. But, to be honest..did it really ever go anywhere? I swear since 2020, viruses have just been year-round. And frankly, I’m tired of them. I’m writing this as I have four out of five sick beings in the house (yes, the dog too) and after a year of mostly health; we’re dealing with some back-to-back illnesses for our youngest. (If you've got a child in daycare or school, you're probably very familiar with this. One runny nose goes away, and the next one's already in the carpool line.

Most colds are viral; they'll sort themselves out, and antibiotics are of no use. So when my own kids get a cold, I'm not looking for a cure per se; I'm just trying to keep them as comfortable as possible so they can rest, sleep, and let their immune system do its job.

I went through my entire cough and cold routine in a YouTube video. This is the quick read version, starting with the one thing I'd take out of the cabinet if I could only have one thing.

Saline is salt water, and it might be the most underused tool in pediatrics (and frankly for adults) for treating cough and cold.

Think of it as a rinse cycle for the nose. When kids have a cold, their noses produce a lot of mucus, and it can become thick and stuck. The saline thins it out so it can drain or be blown out, and it also adds moisture to a nose that's dry and cranky from all the wiping. 

It also helps with the cough. Much of the coughing associated with a cold comes from mucus running down the back of the throat (nerd out with me on this video), which is why so many children cough up a storm the moment they go to bed at night. Those cough triggers are in the nose and all down the airway so moisture can help reduce the trigger. 

Why I love it so much: it's mild enough for babies, there's no dosing to work out, it doesn't have any interactions with other drugs, and it's low cost. Very few things in medicine actually tick all those boxes. It’s also MY go-to. My husband was recently sick with a cold and I immediately tossed him his own saline spray bottle (yes, I have many extra) and said go to town. It really can help at the first sign of illness and during the illness. And there’s some promising data that saline may actually help us feel better faster. 

Hypertonic saline is just a saltier version of normal saline. In the ELVIS Kids trial the Scottish researchers gave 407 children (age 6 and under) either saltwater nose drops (approximately 2.6% salt) or standard care when they had a cold. The kids who got the salt water had symptoms for 6 days rather than 8, required fewer medications, and had fewer family members getting the cold (46% vs 61%). Very impressive for saltwater.

A couple of honest caveats. The parents in this study made the drops at home using sea salt, and the researchers have made it clear that pharmacy saline drops are not the same strength as the ones used in the study. They do provide instructions for making the drops if you're interested, but again, please check with your GP/pediatrician first, particularly for babies.

For normal day-to-day use, I stick with plain saline (0.9%, also known as isotonic) as it's mild and readily available.

I keep saline drops or spray, Boogie Wipes for sore little noses, and a saline mist for a deeper rinse.

One tip: don't go suction happy. Too much suctioning can irritate the inside of the nose. I reserve the suctioning for when the kids are really stuffed up and saline on its own isn't going to do the job. For toddlers, let them do the spraying. A kid who feels in control is a kid who will co-operate (most of the time).

For children over 1 year of age, honey is one of my go-to cough remedies, and the evidence is very good. In a 2007 study, a spoonful of honey before bed was better at reducing the frequency and severity of nighttime cough than either a common over-the-counter cough suppressant or no treatment at all. The AAP notes that honey can outperform store-bought cough syrups in reducing the number and severity of nighttime coughs. The usual amount is 1/2 to 1 tsp.

Never give honey to a baby under 1. There's a risk of infant botulism (it's a very rare condition but it can be serious).

In our house, we frequently drink Haldi doodh, also known as turmeric milk or golden milk, which is a traditional Indian home remedy rooted in Ayurvedic medicine, a healing system that dates back thousands of years.

In our house, we frequently use honey in golden milk (warm milk with a touch of turmeric, a pinch of black pepper, and honey) also called haldi doodh. The kids love it. And y'all know I LOVE a good home remedy when possible! Especially one rooted in culture and passed down through generations.

While turmeric has anti-inflammatory properties, research on haldi doodh itself is limited. But a warm, soothing drink can absolutely be part of supportive care when you're feeling under the weather. Just remember, traditional remedies can offer comfort without replacing medical care when it's needed!

At the first sign of a cold, I'll make golden milk for myself as well (usually twice a day). It's my own little comfort ritual and when you're parenting sick kids a little comfort for you goes a long way.

Some of it is just nostalgia, really. My mom used to rub Vicks on my chest when I was ill, and I do the same for my kids now. There's some research to back it up. A 2010 study in Pediatrics looked at 138 children aged 2 to 11 and found that applying a vapor rub to the chest and neck at bedtime was better than applying plain petroleum jelly or doing nothing at all for reducing nighttime cough and improving sleep. Bonus: the parents also slept better. A remedy that improves the sleep of the whole house? I'm rubbing it in.

Now, there are competitor brands that all really do the same thing–it’s honestly about brand preference. 

A few rules. Regular Vicks is for kids 2 and upwards. You rub it on the chest and neck, keep it well away from the nostrils and you put it up high when you're finished. For children with asthma, check with their clinician first. Strong scents can irritate sensitive airways and trigger coughing or wheezing in some kids. For kids under 2, regular Vicks is a no. Their smaller airways are more vulnerable to irritation, and ingredients like camphor can be dangerous if swallowed.

Vicks BabyRub is a different product. It's non-medicated, contains no menthol or camphor, and is labeled for babies 3 months and older. It's more of a soothing, scented massage than a treatment for congestion. And because it still contains fragrance, I'd be cautious with children who have sensitive airways.

Being sick doesn't just make kids stuffy. They're achy and cranky. I give ibuprofen when my kids are sick, whether they've got a fever or not, because it helps with sore throats and body aches, especially before bed. In our house, we refer to it as liquid gold, as it can take a child from miserable to manageable in a very short period of time.

I've got both ibuprofen and acetaminophen on hand. Ibuprofen is my go-to for a cold as it deals with both pain and inflammation and can be given every 6 to 8 hours. It's not for babies under 6 months, though, so for the younger babies it's acetaminophen. [link calculating meds video]

A tip that works in our house is letting our older son have a say in the matter. I'll ask him if he'd like some medicine, and often he will say yes, as he knows it does help him. That tiny bit of choice gives him a bit of control at a time when it's otherwise all very unpleasant.

I think of saline, honey, and pain relief as the main course. Vicks, the humidifier, and popsicles are the side dishes. They won't cure the virus, they just make the kid more comfortable and a comfortable kid is a kid who can rest. That's where the healing occurs.

Over the counter cough and cold medicines. The AAP say the risks outweigh the benefits in children under 4 and don't recommend them in that age group. I've never felt the need for them at all in the first place (saline, honey, pain relief etc) so I don't even have them in the house. IF you are exploring cough medicines for your child over 6+, watch this video for more education on how they differ. 

A cough at 2 a.m. is not easy to listen to, but remember that coughing isn't all that bad. It is the body working to clear the airways, and that in itself makes it much easier to resist the temptation to put something in the child's system to stop every single hack. If the cough in your older child is actually getting in the way of normal functioning, then you should talk to your pediatrician, of course, but in my experience the basics do the trick.

Under 1, my plan was the same, just no honey. Saline, gentle suction when they were blocked up, BabyRub once they were old enough and lots of breastmilk and formula to keep them hydrated. Occasionally I'd run a hot shower and just sit with them in the steamy bathroom for a bit which seemed to help loosen things up.

Full confession: our first son was barely ever sick as a baby thanks to the pandemic closures. We didn't see another soul for those first few months! When the colds did come later on though (and boy did they), those simple tools got us through.

Being a pediatrician means I can keep a close eye on things at home, but the signs I watch for are the same ones I would want any parent to know.

Call if your child is working hard to breathe, is not drinking well or has fewer wet diapers, seems unusually sleepy, has a cough lasting more than about 10 days, or has a fever over 100.4 that sticks around more than a few days. For babies under 3 months, any fever of 100.4 or higher is a call right away. And if your gut says something is off, that is reason enough to call.

Colds are annoying, and it's terrible to watch your child suffer. The good news is that most of the best tools are pretty simple, cheap, and already in our pocket.

And when I get sick? I do the same things. Golden milk, saline spray, and yes, occasionally the kids' berry ibuprofen (as it's just down in the cabinet).

A more expensive medicine cabinet doesn't lead to a faster recovery. Most colds just need time, comfort, and a parent who knows the basics. Saline first, then honey (only after 1 year of age), and a touch of Vicks (after 2 years of age), and then just let the kid rest.

Hit reply: What's the one comfort remedy your family will absolutely swear by? I'd love to know.

Dr. Mona will answer these questions in a future Sunday Morning Q&A email. Chances are if you have a parenting concern or question, another parent can relate. So let's figure this out together!