Colds in Children

Colds (or upper respiratory infections) are illnesses caused by several different viruses. Viruses are extremely small infectious organisms (much smaller than bacteria). A sneeze or a cough may spread a virus from one person to another. The virus may also spread if a child touches something (such as a toy) that has the virus on it and then touches her eyes, mouth or nose.

What are the symptoms of a cold?

  • Runny nose (first, a clear discharge, later, it is thicker, often colored yellow or green)
  • Sneezing
  • Fever (often 101–102 degrees Fahrenheit or 38.3–38.9 degrees Celsius)
  • Low interest in eating and/or drinking
  • Sore throat
  • Cough
  • Fussiness or low energy
  • Slightly swollen glands/lymph nodes in the neck and underarms

How long do cold symptoms last?

If your child has a typical cold (without complications), the symptoms usually resolve after 7-10 days. Cough may last longer, often 14-21 days.

What are the treatments for a child with a cold?

The body will cure itself of the cold virus with time. Antibiotics have no effect on viruses. The best thing you can do is make your child comfortable and wait for their body’s immune system to fight the virus.

  • Make sure your child gets extra rest and drinks increased amounts of fluids.
  • If your child has a fever and is uncomfortable, you can give them acetaminophen or ibuprofen. Do not give Ibuprofen to children 6 months of age or younger. Ask your doctor for guidance on proper dose and frequency based on your child’s weight. Aspirin should always be avoided in children.
  • For nasal congestion, clear the nose with saline (saltwater) nose drops or spray. Place two to three drops in each nostril for children older than age 1 and one drop per nostril for children less than one year old.
  • You may suction the nose with a suction bulb or NoseFrida® device every few hours or before feeding and bedtime in a child too young to blow his nose.
  • Placing a cool-mist humidifier (vaporizer) in your child’s room also will help keep nasal secretions thin. Be sure to clean and dry the humidifier thoroughly each day to prevent bacterial or mold contamination.
  • Protect the skin around stuffy noses with petroleum jelly or lanolin ointment.
  • You can give children older than 1 year, a spoonful of honey to help with their cough 2-3 times a day.

Should I give my child over-the-counter cold and cough medications?

No. Do not give over-the-counter cough and cold medications to children younger than six years. Using these medications in children is dangerous for three reasons:

  • The safe dose of the ingredients used in most cold medicines in children has not been studied.
  • Studies have not shown much improvement in symptoms of children taking cold medicines.
  • There have been rare deaths in children taking cold medicines.

In children older than 1 year old, Honey may provide some symptomatic relief from cough.

Is it normal for my child to get multiple colds each year?

Yes, your child probably will have more colds than any other illness, which can be frustrating to some parents. In the first few years of life, most children have eight to ten colds per year. And if your child is in child care, or if there are older school-age children in your house, they may have even more. To prevent cold viruses from spreading, wash hands often and teach children to cover their cough with their elbow.

Is it normal for my child to be coughing 1-2 weeks after a cold?

Yes, recent studies have shown that average cough lasts 18 days after cold symptoms improve.  It is common for children to cough for 2-3 weeks, as long as fevers are improving and the child seems to be feeling better.  Coughing helps clear mucous and viral debris from the airway and is protective. 

Cough suppressants are not recommended.  Please call your physician if child has persistent coughing episodes at night, worsening cough after exercise.  Limiting exposure to tobacco smoke may decrease the cough as well.   

When do I need to call my child’s doctor?

Call the doctor if your child has any of the following:

  • Fever lasting more than three days.
  • Cough lasting more than 14 days.
  • Widening (flaring) nostrils with each breath.
  • Skin above or below the ribs sucks in with each breath (retractions).
  • Breathing that is fast or hard (distressed).
  • Pain that does not respond to pain medication.
  • Ear pain that is severe or lasting more than a day.
  • Inability to drink or make urine like usual
  • Sleepiness
  • Irritability
  • Worsening cold or cold that does not improve after 10 days

If your baby is younger than 3 months of age, contact your pediatrician at the first signs of illness.

Additional resources:

 Written/reviewed by Ashley DeHudy, MD, Alison Lea Dickson, MD, Jessica Fealy, MD

Reviewed by Sydney Ryckman, MD, January 2022