Use the hyperlinks to go to the sections you would like to review:
- Prevention (keeping household members healthy)
- Symptoms of upper respiratory tract infections (AKA URI and "common cold")
- Symptoms of secondary bacterial infections
- Trouble breathing
- Treatments of URIs
- Return to school or daycare
- Cough (separate page)
If anyone in the home is sick, use preventative measures to limit further spread:
- Wear masks when you must be around anyone with a virus that spreads through the air, such as cold and coughs. Infected people over 2 years should attempt to mask as much as possible. Use quality masks (well fitted N95, KN95 or KF94) to help protect the wearer from infection.
- Wash hands frequently. Hand sanitizers can also be used for most respiratory infections but are not effective against all infections, especially viruses that cause vomiting and diarrhea.
- Wipe down countertops, handles, and other surfaces with a disinfectant frequently. Some germs, such as norovirus (which commonly causes vomiting and diarrhea) are not inactivated by commercial disinfectants. When vomiting or diarrhea is a concern, a bleach solution (1/2 cup chlorine bleach and one gallon of water) is recommended for disinfecting contaminated surfaces and items.
- Clean toys: Plush toys can be washed in the washer machine. Solid plastic toys, like rubber rings, animal figures and building blocks and bricks can easily be cleaned in your dishwasher's top rack or cleaning products (Clorox or Lysol wipes, a cloth wet with a a 3% hydrogen peroxide solution, 1/2 cup chlorine bleach and one gallon of water.) If a cleaning solution is used, follow the package directions. If bleach water is used, allow it to stay wet for 5 minutes before air drying. After fully cleaning, you can rinse with water to remove products.
- ​Turn your home heating/cooling system's fan to "on" rather than "auto" to circulate air better.
- If weather is appropriate, open windows. Just a crack helps!
- Consider a HEPA filter box fan DIY air filter. If you need information about various filters, Clean Air Stars has a helpful spreadsheet .
TYPICAL VIRAL SYMPTOMS: AKA THE COMMON COLD
It's normal for healthy children to get at least
6 colds a year, and up to 12 is possible for younger kids and infants. 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 but sometimes getting sick tires our immune system, leaving us more susceptible to the next virus that comes our way.
The normal cold lasts about 2 -3 weeks. There are no drugs to make it go away sooner. Antibiotics will not help any viral infection.
The nasal mucus and discharge is the body's way to take germs (and pollen) out of the nose and sinuses. The color of the mucus can be clear, yellow, or green. This does not vary based on type of infection (virus vs bacteria) but changes due to how long the mucus is in the nose and sinuses. White blood cells fight infections of all types, and the longer they're in the sinus tract, they change from yellow to green.
Most parents know when their child has a cold. Sometimes, they have it too or other children in school have it. Most of the time you don't need to call or see any medical professional - you can follow the tips below.
Cold viruses can cause
- runny nose
- sore throat
- hoarse voice
- cough
- croup
- stuffiness of the nose
- sinus pain
- plugged feeling in ears
- red watery eyes
- fever
The cold symptoms listed below are normal.
- Fever up to 3 days in vaccinated children over 2 months of age
- Sore throat up to 5 days (with other cold symptoms - if no congestion/runny nose, consider Strep throat)
- Nasal discharge and congestion up to 2 weeks - if it gets better then comes back, it could be back-to-back colds, so think of symptoms over time
- Coughs up to 3 weeks but no distress or vomiting with cough
Please have your child assessed by us or an outside healthcare facility:
- Trouble breathing (urgent or emergent)
- Earache (routine office hours)
- Fever lasts more than 3 days (routine office hours)
- Any fever if under 12 weeks old (call for instructions)
- Nasal discharge lasts more than 14 days (routine office hours)
- Cough lasts more than 3 weeks (routine office hours)
- Cough leading to vomiting (routine office hours)
- You think your child needs to be seen (call for advice)
- Your child becomes worse (call for advice or be seen urgently)
What to Expect:
- Fever commonly lasts 2-3 days, but longer with certain viruses
- Nasal drainage can last 7-14 days
- Cough can last 2-3 weeks
SYMPTOMS OF SECONDARY BACTERIAL INFECTIONS:
In about 5 to 10% of children who have a cold a secondary bacterial infection may arise. (Use the links to visit related pages.)
Many will have an ear infection
or sinus infection
.
Look for these symptoms and schedule a visit or come to our walk in clinic if you notice:
- Earache or ear discharge
- Sinus pain not relieved by nasal washes
- Lots of pus in the eyes (eyelids stuck together after sleeping)
- Trouble breathing or rapid breathing (see below and call after hours to see if an outside urgent care or ER is recommended)
- Fever lasts over 3 days
- Fever that goes away for 24 hours and then returns
- Cough that causes vomiting
- Sore throat without any runny nose or cough (may have Strep throat )
- Nasal discharge lasts over 2 weeks
- Cough lasts over 3 weeks
TROUBLE BREATHING: HOW TO TELL
Trouble breathing is a reason to see a doctor right away.
Here are symptoms to worry about:
- Struggling for each breath or shortness of breath
- Tight breathing so that your child can barely speak or cry
- Ribs are pulling in with each breath (called retractions)
- Breathing has become noisy (such as wheezes)
- Breathing is much faster than normal
- Lips or face turn a blue color
Home treatments for colds
- Mucus management:
- Blow the nose or suck out the snot as often as needed. Saline can help (see below).
- For younger children, a nasal aspirator that is either battery operated or the adult provides the suction with a mouthpiece are preferred over bulb syringes. Bulb syringes do not work well and they are not easily cleaned.
- Saline: Saline sprays and rinses can help thin and remove mucus from the nose so it doesn't drip into the throat and trigger a cough. Learn how to use nasal rinses in Nasopure's Library . It's important for kids to feel comfortable with this before you try it or it will not go well. This and other brands are available over the counter.
- Protect the nose skin: Put petroleum jelly on the skin under the nose to protect the skin from being rubbed raw.
- Encourage Hydration: Plenty of fluids like water, herbal teas, or clear broths to help thin mucus and soothe the throat. (Infants under 6 months should drink their typical breastmilk or formula primarily and never offer water or other drinks under 4 months of age.)
- Use Humidifiers: Running a cool mist humidifier during cold/dry months can help keep the air moist, which may ease coughing. Once the air is warm enough to run the air conditioner, do not use a humidifier. Warm air holds more water and can lead to mold growth if the humidity gets too high.
- Elevate the Head: Extra pillows while sleeping can be used for those old enough to stay propped up. Infants should only sleep on a flat surface.
- Warm Baths: A warm bath before bedtime can help relax muscles and soothe the cough.
- Avoid Irritants: Avoid smoke, vapors, strong odors, and other environmental irritants that can worsen cough.
- Rest: Ensure plenty of rest to help the body recover from illness and reduce coughing episodes.
- Medicines:
- Cold Medicines. Don't give any drugstore cold or cough medicines to young children. They are not approved by the FDA under 6 years.They are not safe and can cause serious side effects. They are not helpful even in older kids and adults. They can't remove dried mucus from the nose. Nasal saline works best.
- Allergy Medicines. They are not helpful unless your child also has nasal allergies. See our Allergy Medications Page for more information.
- Antibiotics. Antibiotics are not helpful for colds. Antibiotics may be used if your child gets a secondary bacterial infection.
- Other Symptom Treatment:
- Pain or Fever. Use acetaminophen or ibuprofen (over 6 months) to treat muscle aches, sore throat or headaches. These can also be used for fever, but the goal is pain management, not to get to a normal temperature. Fever is there to fight the infection, so if your child is not uncomfortable, there's no need to lower the temperature.
- Sore Throat. Warm and cold things feel good on a sore throat. For children over 6 months, offer warm drinks, such as broth or herbal tea. Smoothies, popsicles or ice cream may also be enjoyed by children old enough to like the cold foods.
- Honey: For children older than one year, honey can be a natural cough suppressant. (DO NOT give to infants under a year due to botulism risk.) It can be given on a spoon, on toast, or mixed with warm water or herbal tea. For children over 1 year old, give honey ½ to 1 teaspoon (2 to 5 mL).
- Cough drops: If over 6 years of age, you can also use cough drops. Avoid cough drops before 6 years due to risk of choking.
- Matted Eyes. Rinse eyelids often with wet cotton balls. If the eyes are matted, use baby shampoo to relax the crust. If the eyes are also red, schedule an appointment to check for pink eye (and ear infections that often go with pink eye).
Return to School or Daycare:
Your child can go back to school or daycare after the fever is gone for 24 hours without any fever reducer as well as they feel well enough to join in normal activities and your school/daycare doesn't have other requirements.
