Extra Care During a Cold

Reviewed by: HU Medical Review Board | Last reviewed: August 2021

Children with spinal muscular atrophy (SMA) often have breathing problems that become worse during colds. This is because they cannot cough strongly enough to remove mucus from the lungs. This can block airways and lead to serious breathing problems.1,2

During colds, children with SMA require extra care. This includes closer monitoring of breathing and more often airway clearance. Depending on the severity of SMA and cold symptoms, increased breathing support may also be needed.1.2

Take steps to prevent colds by reducing exposure to viruses. This includes regular vaccinations, washing hands regularly, and keeping your child away from large crowds.1,2

Why do children with spinal muscular atrophy need extra care during colds?

Colds are caused by viruses that spread between people through the air and on surfaces. Colds are highly contagious and occur most often in the late fall and winter. Colds are very common, with adults having 2 to 3 colds per year and children having more than that.3

When you get a cold, the nose makes mucus to wash out the virus. In chest colds, the airways produce mucus in the lungs. Strong coughs help to clear the mucus and prevent airway blockage.3,4

During a cold, children with SMA may have difficulty clearing mucus from their lungs. This is because they do not have strong chest muscles to cough strongly. With poor coughing, mucus and secretions stay in the lungs and impair breathing. Mucus stuck in the lung can also lead to lung infection (pneumonia).1

What extra care is needed during a cold?

During colds, children with SMA need their airway cleared often. Talk to your doctor about what techniques to use and how often to perform them. Experts recommend following these steps every 4 hours:1

  • Loosening secretions using chest physiotherapy or intrapulmonary percussive ventilation (IPV)
  • Using a cough machine to remove loosened secretions
  • Positioning the child at an incline with the head lower than the chest to drain secretions
  • Repeating the cough machine to remove loosened secretions

During colds, monitor your child’s blood oxygen levels often using a pulse oximeter. This will tell you if there is a breathing problem and if they need help coughing. Talk to your doctor about what breathing support techniques to use at certain blood oxygen levels. If their blood oxygen is very low, they may need emergency treatment.1

Most children with type 1 or 2 SMA will need more breathing support during colds. This could mean using a non-invasive technique more often than usual. It could also mean transitioning to invasive ventilation until they recover. People with type 3 SMA usually do not need breathing support. However, they may need non-invasive support and cough assistance during colds.1,2

What are the symptoms of a cold?

Cold symptoms happen as your body tries to remove the virus from the body. These include:3

  • Sneezing
  • Stuffy or runny nose
  • Sore throat
  • Coughing
  • Mucus dripping down the throat
  • Watery eyes
  • Mild aches and fatigue

How can colds be prevented?

Take steps to prevent exposure to colds and other viruses. This is especially important in the first few months of a child’s life. Some steps to take include:1,2

  • Washing your hands before touching your child
  • Keeping your child away from anyone with symptoms of a cold
  • Keeping your child away from crowded areas
  • Keeping your child away from tobacco smoke
  • Reducing exposure to groups of children during cold and flu season
  • Keeping your child and other household members up-to-date on vaccinations

One particularly life-threatening virus is respiratory syncytial virus (RSV). For most children, RSV looks and sounds like the common cold. However, RSV can lead to severe breathing problems for children with SMA. Talk to your doctor about medicine that can be prescribed to prevent RSV. This medicine, called palivizumab, is given as an injection only to high-risk children.3-5

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