Colds  

This Care Guide Covers:

  • The common cold is an infection of the nose and throat
  • Main symptoms are a runny nose and sore throat
  • You think your child has a cold.  Reason: Other family members, friends or classmates have same symptoms.
  • The common cold is caused by a virus
  • Also called an Upper Respiratory Infection (URI)

If not, see these topics
When to Call Your Doctor

Call 911 Now (your child may need an ambulance) If
  • Severe trouble breathing (struggling for each breath, can barely speak or cry)
  • You think your child is having a life-threatening emergency
Call Your Doctor Now (night or day) If
  • Your child looks or acts very sick
  • Not alert when awake
  • Trouble breathing not gone after cleaning out the nose
  • Weak immune system. (Such as sickle cell disease, HIV, cancer, organ transplant, taking oral steroids)
  • Fever over 104° F (40° C)
  • Age under 12 weeks old with fever. (Caution: Do NOT give your baby any fever medicine before being seen.)
  • You think your child needs to be seen urgently
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen, but not urgently
  • Earache or ear discharge
  • Yellow or green eye discharge
  • Sinus pain around cheekbone or eyes (not just congestion)
  • Fever lasts more than 3 days
  • Fever returns after gone for more than 24 hours
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
  • Blocked nose wakes up from sleep
  • Yellow scabs around the nasal openings. (Use an antibiotic ointment.)
  • Sore throat lasts over 5 days
  • Sinus congestion (fullness) lasts more than 14 days
  • Nasal discharge lasts over 14 days
Parent Care at Home If
  • Mild cold with no complications
Causes & Health Information

Symptoms

  • Runny or stuffy nose
  • The nasal discharge may be clear, cloudy, yellow or green
  • Fever can also be present
  • A sore throat can be the first sign
  • At times, the child may also have a cough and hoarse voice. Sometimes, watery eyes and swollen lymph nodes in the neck also occur.

Cause

  • Colds are caused by many respiratory viruses. Healthy children get about 6 colds a year. Influenza feels like a bad cold with more fever and muscle aches.
  • Colds are not serious. With a cold, about 5 and 10% of children develop a complication. Most often, this is an ear or sinus infection. These are caused by a bacteria.

Colds: Normal Viral Symptoms

  • Colds can cause a runny nose, sore throat, hoarse voice, a cough or croup. They can also cause stuffiness of the nose, sinus or ear. Red watery eyes can also occur. Colds are the most common reason for calls to the doctor. This is because of all the symptoms that occur with colds.
  • Cold symptoms are also the number one reason for office and ER visits. Hopefully, this information will save you time and money. It can help you to avoid some needless trips to the doctor. The cold symptoms listed below are normal. These children don't need to be seen:
    • Fever up to 3 days
    • Sore throat up to 5 days (with other cold symptoms)
    • Nasal discharge and congestion up to 2 weeks
    • Coughs up to 3 weeks

Colds: Symptoms of Secondary Bacterial Infections

  • Using this guide, you can decide if your child has developed a complication. This happens in about 5 to 10% of children who have a cold. Many will have an ear infection or sinus infection. Look for these symptoms:
    • Earache or ear discharge
    • Sinus pain not relieved by nasal washes
    • Trouble breathing or rapid breathing
    • Fever lasts over 3 days
    • Fever that goes away for 24 hours and then returns
    • Sore throat lasts over 5 days
    • Nasal discharge lasts over 2 weeks
    • Cough lasts over 3 weeks

Return to School

  • Your child can go back to school after the fever is gone. Your child should also feel well enough to join in normal activities. For practical purposes, the spread of colds cannot be prevented.
CARE ADVICE FOR COLDS

  1. What You Should Know:
    • It's normal for healthy children to get at least 6 colds a year. This is because there are so many viruses that cause colds. With each new cold, your child's body builds up immunity to that virus.
    • Most parents know when their child has a cold. Sometimes, they have it too or other children in school have it. Most often, you don't need to call or see your child's doctor. You do need to call your child's doctor if your child develops a complication. Examples are an earache or if the symptoms last too long.
    • The normal cold lasts about 2 weeks. There are no drugs to make it go away sooner.
    • But, there are good ways to help many of the symptoms. With most colds, the starting symptom is a runny nose. This is followed in 3 or 4 days by a stuffy nose. The treatment for each is different.
    • Here is some care advice that should help.
  2. For a Runny Nose With Lots of Discharge: Blow or Suction the Nose
    • The nasal mucus and discharge is washing germs out of the nose and sinuses.
    • Blowing the nose is all that's needed.
    • For younger children, gently suction the nose with a suction bulb.
    • Put petroleum jelly on the skin under the nose. Wash the skin first with warm water. This will help to protect the nostrils from any redness.
  3. Nasal Washes To Open a Blocked Nose:
    • Use saline nose drops or spray to loosen up the dried mucus. If you don't have saline, you can use warm tap water.
    • STEP 1: Put 3 drops in each nostril. (If age under 1 year old, use 1 drop. Also, do 1 side at a time.)
    • STEP 2: Blow (or suction) each nostril out while closing off the other nostril. Then, do the other side.
    • STEP 3: Repeat nose drops and blowing (or suctioning) until the discharge is clear.
    • How often: Do nasal washes when your child can't breathe through the nose. Limit: No more than 4 times per day.
    • Saline nose drops or spray can be bought in any drugstore. No prescription is needed.
    • Saline nose drops can also be made at home. Use 1/2 teaspoon (2 ml) of table salt. Stir the salt into 1 cup (8 ounces or 240 ml) of warm water.
    • Reason for nose drops: Suction or blowing alone can't remove dried or sticky mucus. Also, babies can't nurse or drink from a bottle unless the nose is open.
    • Other option: use a warm shower to loosen mucus. Breathe in the moist air, then blow each nostril.
    • For young children, can also use a wet cotton swab to remove sticky mucus.
  4. Fluids:
    • Try to get your child to drink lots of fluids.
    • Goal: Keep your child well hydrated.
    • It also will thin out the mucus discharge from the nose.
    • It also loosens up any phlegm in the lungs. Then it's easier to cough up.
  5. Humidifier:
    • If the air in your home is dry, use a humidifier.
    • Reason: Dry air makes nasal mucus thicker.
  6. Medicines for Colds:
    • Age Limit. Before 4 years, never use any cough or cold medicines. Reason: Unsafe and not approved by the FDA. Also, do not use products that contain more than one medicine.
    • Cold Medicines. They are not advised. Reason: They can't remove dried mucus from the nose. Nasal washes are the answer.
    • Decongestants. Decongestants by mouth (such as Sudafed) are not advised. They may help nasal congestion in older children. Decongestant nasal spray is preferred after age 12.
    • Allergy Medicines. They are not helpful, unless your child also has nasal allergies. They can also help an allergic cough.
    • No Antibiotics. Antibiotics are not helpful for colds. Antibiotics may be used if your child gets an ear or sinus infection.
  7. Treatment for Other Symptoms of Colds:
    • Fever or Pain. Use acetaminophen (such as Tylenol) or ibuprofen for muscle aches or headaches. You can also use these medicines for fever above 102° F (39° C). See Dose Table.
    • Sore Throat. For children over 1 year old, use warm chicken broth. If over 6 years of age, your child can also suck on hard candy.
    • Cough. For children over 1 year old, give honey 1/2 to 1 teaspoon (2 to 5 ml). If over 6 years of age, you can also use cough drops. Caution: Do not use honey until 1 year old.
    • Red Eyes. Rinse eyelids often with wet cotton balls.
  8. Return to School:
    • Your child can go back to school after the fever is gone. Your child should also feel well enough to join in normal activities.
    • For practical purposes, the spread of colds can't be prevented.
  9. What to Expect:
    • Fever can last 2-3 days
    • Nasal drainage can last 7-14 days
    • Cough can last 2-3 weeks
  10. Call Your Doctor If:
    • Earache occurs
    • Fever lasts more than 3 days
    • Any fever if under 12 weeks old
    • Nasal discharge lasts more than 14 days
    • Cough lasts more than 3 weeks
    • Your child becomes worse
  11. Extra Advice - Air Travel With Colds:
    • It's safe to fly when your child has a cold.
    • He could get some mild ear congestion or even a brief earache while flying. Most often, that can be prevented. (See # 12).
    • Flying will not cause an ear infection.
  12. Extra Advice - Prevent Ear Congestion During Air Travel:
    • Most symptoms happen when the airplane is coming down in altitude. This is the descent of the plane during the 15 minutes before landing.
    • Keep your child awake during takeoff and descent.
    • Swallow during descent using fluids or a pacifier.
    • Children over age 4 can chew gum during descent.
    • Yawning during descent also can open the middle ear.
    • Drink lots of fluids throughout the flight. This will prevent the nasal secretions from drying out.

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 9/1/2012

Last Revised: 1/14/2013

Content Set: Child Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.