The common cold is a viral infection of the upper respiratory tract — most often caused by rhinovirus — that cannot be treated with antibiotics. Symptoms typically last 7–10 days in children and include a runny nose, cough, mild fever, and congestion. Most colds resolve on their own with rest and fluids. Call your pediatrician if your child is under 3 months with any fever, if symptoms worsen significantly after day 5, or if they have not improved at all after 10 days.
Dr Shawn Binns, MD, helps us navigate this runny nose time of year. 
It’s back to school season once again, and we all know what that means – a return of those all-too-familiar coughs, sniffles, and sneezes. That’s right, cold and flu season is upon us once again.
The common cold is a viral illness that is associated with varying amounts of cough, congestion, sore throat, fevers, headaches, decreased appetite, and fatigue. It is not caused by just one type of virus – rather by many different viruses including rhinoviruses, adenoviruses, enteroviruses, and parainfluenza viruses. RSV is also a common cold virus, though may cause more significant symptoms in infants and young toddlers. Influenza viruses tend to cause a more abrupt onset of symptoms, higher fevers (102-104F), body aches, and more of an upset stomach than the common cold does. I’ll mainly focus on the common cold today, but check back later this season for more information on the flu.
How do you get it?
Cold viruses are usually transmitted via droplets that spread from a cough or sneeze of an infected person or from touching a virus-contaminated surface and then touching our nose or eyes – no wonder they’re so easy to catch!
It is entirely normal for your child to have around 6-8 colds every year, possibly even more if your child has recently started daycare or preschool. While this can mean a seemingly endless stream of sniffles and coughs those first few months, know that children who previously attended daycare or preschool tend to have fewer colds during school-age due to having built up prior immunity from all the bugs they had as toddlers.
How can we treat the common cold?
So I have both bad news and good news for you – the bad news is that there is no treatment that will immediately treat your child’s underlying virus. This means we don’t have silver bullet meds like antibiotics that we use to treat bacterial infections. The good news is that our bodies already have all the tools it needs to fight off these nasty bugs, and there are even some things you can do to help:
Hydration, hydration, hydration
– Keeping your child well-nourished will help their body stay in the fight against these viruses. Your body will need even more nutrition, especially from fluids, to help keep the virus at bay and eventually overcome it. Make sure your child is drinking plenty of fluids and urinating regularly. Continue to offer food regularly, but don’t be shocked if your child’s appetite is less than usual while they are sick – their appetite should come back in full force once they recover.
Tylenol and Ibuprofen
– Fevers are a normal and healthy response by your body – they help to keep the viruses from continuing to replicate and spread throughout your body and give your immune system a chance to catch up and eventually win the battle. Despite these benefits, fevers can make your child feel pretty crummy, and make them breathe harder and faster while decreasing their appetite and energy levels. You can help them feel better by giving Tylenol or Ibuprofen (AKA Motrin, Advil) for comfort. Ibuprofen should not be given to infants under 6 months of age. Please see our table at https://springvalleypediatrics.net/medication/ for weight-based dosing recommendations.
Is there anything I can do about that stubborn cough, stuffy nose, or sore throat?
– In fact, there is! Warm fluids, such as tea or soup, can help soothe sore throats and relieve congestion. You can also use a cool mist humidifier to help your child breathe a little easier at night. For children older than 12 months, you can give 1 teaspoon of honey either straight or mixed into a beverage to help with cough and sore throat (honey should be avoided in children under 12 months old due to the risk of botulism). For infants, you can use nasal saline drops – apply several drops to each nostril and suck out those pesky boogers with a NoseFrida.
– There are also numerous over-the-counter cough and cold medicines – too many to fully discuss here. Many of these medications may not be very helpful or may even have unwanted side effects. Please call your pediatrician if you have questions regarding these medications.
When should we be concerned that this is more than just a cold?
Most common colds resolve after about 5-7 days, though it is common for a cough to linger for a bit longer than that. If the other symptoms are resolving and the cough is steadily improving, this is not necessarily a concern and can be monitored at home. If the cough lasts for more than 2 weeks or does not seem to be improving, please follow up with your child’s pediatrician.
Fevers due to a common cold generally only last up to 3-4 days. You should call your pediatrician if your child has a fever for more than 3 days in a row without any sign of improving, especially if accompanied by a persistent sore throat or cough. If your child is under 3 months old and has a rectal temperature of 100.4F or higher, you should call your pediatrician immediately as this can be a sign of a more serious illness and may require evaluation in the emergency room.
Other reasons to contact your child’s pediatrician include if your child is working hard to breathe, if their symptoms initially improve but worsen again within a few days, if they develop a brand-new fever or ear pain several days into their illness, or if symptoms persist without improvement for more than 1 week.
How can we prevent spreading these germs to others?
The best methods for preventing the spread of these cold viruses are the tried and true – frequent handwashing/use of hand sanitizer and avoiding frequent touching of your face. Sneezing or coughing into a tissue or into the crook of your elbow will help to limit the number of respiratory droplets spread into the air and thus, decrease the risk of transmission.
If your child is experiencing viral symptoms and must go out, please encourage them to wear a mask to help prevent spread. Once your child has been fever-free for 24 hours with improving symptoms, they may return to school unless otherwise specified by your pediatrician.
And as always, get your yearly flu vaccines.
Frequently Asked Questions About The Common Cold
How long does a cold last in children?
Most colds in children last 7–10 days. You may notice symptoms get worse around days 3–5 before they begin to improve — this is normal. A cough can linger for up to 2–3 weeks after other symptoms resolve. If your child is significantly worse after day 5 or shows no improvement by day 10, call your pediatrician.
When should I call the pediatrician about my child’s cold?
Call Spring Valley Pediatrics if your child is under 3 months old with any fever, has a fever above 104°F, has difficulty breathing, has ear pain, develops an eye infection (yellow or green eye discharge), seems to be getting significantly worse after 3–5 days, or has had symptoms for more than 10 days without improvement.
Can I give my child over-the-counter cold medicine?
The FDA advises against giving OTC cough and cold medicines to children under age 4. For older children, these medicines do not significantly shorten a cold. Honey (for children over 12 months) can soothe a cough more effectively than most OTC medicines.
How do I tell the difference between a cold and the flu?
The flu usually comes on suddenly with a higher fever (often 101–104°F), body aches, headache, and significant fatigue. A cold typically starts gradually with a runny nose and mild sore throat. If your child develops sudden high fever with body aches and severe fatigue, call your pediatrician — Tamiflu is most effective when started within 48 hours.
What actually helps a cold in kids?
Rest, fluids, and time. A cool-mist humidifier and saline nasal drops help with congestion. Honey soothes a cough in children over 12 months. Acetaminophen or ibuprofen (for children over 6 months) can manage fever and discomfort. There is no shortcut — the immune system needs time.
Does green or yellow mucus mean a bacterial infection?
Not necessarily. Green or yellow mucus is a normal part of how the immune system responds to a cold. It is not a sign of a bacterial infection or a reason for antibiotics on its own. Signs that may suggest bacterial infection include symptoms that worsen after day 5, persist beyond 10 days, significant facial pain or pressure, or a fever that returns after initially improving.
When can my child go back to school with a cold?
Most schools require that children be fever-free for 24 hours without fever-reducing medication before returning. A mild runny nose does not necessarily require staying home.
How do I prevent my child from catching a cold?
Thorough and frequent handwashing is the single most effective prevention. Teach children to sneeze or cough into their elbow. There is no vaccine for the common cold as rhinoviruses have more than 100 known strains.
