Infant colds: What’s normal and what’s not

Learn the cold's causes, symptoms, how parents can help, and when to get care

Infant colds: What’s normal and what’s not

Dr. Todd Twogood, a pediatrician at the Sanford Medical Center in Bismarck, North Dakota, talks about infant colds and what parents can do to help.

What causes the common cold?

The general cause of a common cold is a virus. A few common viruses are rhinovirus, enterovirus, and respiratory syncytial virus (RSV).

RSV is a common virus that causes symptoms such as a runny nose, decrease in appetite, coughing, sneezing, fever and wheezing. Though it mimics the symptoms of the common cold, it can lead to more serious problems and possibly hospitalization. An RSV immunization is recommended for all infants younger than 8 months who are born during or are entering their first RSV season.

Related: Is it a cold or RSV? Know when to call your child’s doctor

What are the symptoms of a cold in an infant?

Symptoms of a cold in an infant generally start with a low-grade fever and nasal congestion. Infants get all plugged up inside and then two to three days later generally start having a lot of post-nasal drip, increasing a cough and causing a runny nose.

If your child has a green or yellow runny nose in the first three to four days of a cold, that’s normal and not considered a sinus infection — it’s just that the mucus has been sitting in the nose for so long. That generally fades away within seven to 10 days and the fever is usually gone in two to three days.

Is there anything parents can do to prevent a cold?

Children in daycare or school often spread colds to each other. Keep your child at home if they have a cold or if many children in the class have colds.

Avoid close contact with your child. More specifically, no sharing cups, spoons or straws. Your child should also have their own towel when they have a cold. You should avoid close kissing as well. You can maybe kiss them on the forehead, but not too close.

What do you know about the common cold? Take our quiz.

What can a parent do at home to help a child with a cold?

Humidified air is one of the best things you can do. It will help lubricate the nasal sinuses and prevent cough. If your child’s uncomfortable, use of Tylenol and Ibuprofen would be appropriate. Use upright positioning for small infants and children, but only while they’re awake, and flat positioning while they sleep. Nasal saline can also help congestion.

Is there anything that a parent should NOT do?

The first thing a parent shouldn’t do is worry. Most colds last seven to 10 days. As long as your child is comfortable and does not have prolonged fever or respiratory difficulties, hang in there and things will get better. Just provide supportive care to your child. Visit a health care professional if you have further concerns.

When does a child need to see a physician?

During a cold, your baby may need to see a physician or health care professional if:

  • Their fever lasts longer than 24 hours (in children younger than 2 years) or longer than three days (in children 2 years old or older)
  • Their cold symptoms last longer than seven to 10 days
  • They have symptoms such as irritability or respiratory difficulty

How long will it take for the child to get better?

With a cold, your child should get better within seven to 10 days. If you have more serious concerns, be sure to call or visit your provider. Children with disabilities or chronic health conditions may need to be seen earlier or with special consideration. But all of our children deserve that special love and attention.

Recommendations from Academy of Pediatrics

The American Academy of Pediatrics strongly advises not using over-the-counter (OTC) cold and cough medicines for children younger than age 4. From age 4 to 6, these medicines should only be used if your child’s health care provider tells you to. Several studies show that cold and cough products don’t work in young children and they can have possibly serious side effects.

Many products also have a mix of ingredients meant to treat more than a single symptom, possibly including symptoms your child does not have. This also increases the risk that your child may overdose on an ingredient if you are giving your child more than one medicine.

Ask your child’s health care provider what they advise for different symptoms. Do this before your child gets a cold.

Here are some common cold symptoms and ingredients to look for on labels if your child’s provider advises medicine.

Fever and pain in kids

Typical colds don’t cause more than a slight fever in kids. It’s OK to let a slight fever run its course if your child is taking liquids and acting well. In fact, fever may help your child’s natural immune system fight off the infection sooner. Only two OTC fever or pain medicines are available for children: acetaminophen and ibuprofen. Others are available by prescription. Both help aches and ease fevers. Some multi-ingredient cold medicines contain one or the other of these ingredients. So read labels carefully so you won’t give extra medicine that may not be needed.

Never give aspirin to infants, children, or teens because of the risk for Reye syndrome. This is a rare but possibly fatal disease that can cause liver and brain damage.

Call your child’s health care provider right away if your child is younger than 3 months old and has a fever over 100.4°F (38°C).

Stuffy nose and sneezing

If your child has a runny nose, use a bulb syringe to gently suction out the mucus. Or have your child blow his or her nose. Antihistamines only work if the runny nose is caused by allergies. Antihistamines don’t work well for the common cold.

For a blocked nose, saltwater (saline) spray or drops may help. They dilute the mucus. This makes it easier for the child to blow it out or for you to suction it out. There are no medicines that can remove mucus from the nose. You can buy saline drops and spray at the pharmacy. Or you can make your own by mixing ½ teaspoon of salt in eight ounces of warm tap water. For babies, use the drops before feeding. Older babies and children may use the drops or spray whenever their nose is blocked. Don’t give your child OTC medicated nasal sprays without first talking with your health care provider.

Coughing in babies and children

For babies younger than one year, it is enough to keep them well hydrated and comfortable. Ask your child’s health care provider if your child should have extra water or warm fluids. For children older than a year, honey may be more helpful than any OTC cough medicine and is much safer. Give your child ½ to one teaspoon of honey as needed. Don’t give honey to babies younger than a year. They are at risk of getting a disease called infantile botulism.

Children in daycare or school often spread colds to each other. Keep your child at home if they have a cold or if many children in the class have colds.

Your child can help prevent colds by washing their hands often, by not touching their nose or eyes, and by staying away from people with colds or upper respiratory infections. Alcohol-based hand gels can help prevent spreading a cold or other viral infection.

Feeling better without medicine

There isn’t enough scientific proof to back claims about vitamin C, echinacea and zinc for cold relief. But the following suggestions may help your child feel more comfortable:

  • Liquids. Give your child plenty of water or other liquids to drink.
  • Cough drops. Lemon and peppermint drops can help a scratchy throat. Cough drops should only be given to older children who can handle hard candies without a risk of choking.
  • Bed rest. If your child seems tired, let them relax.
  • Steam. Steam treatment can be helpful. Use cool mist humidifiers at night. Warm humidifiers are not advised because they can burn a child. Mold can grow in any humidifier. So clean the equipment well between uses. Running a warm shower in the same room as your child may also ease symptoms if you don’t have a humidifier.

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Posted In Bismarck, Children's, Family Medicine, Health Information, Specialty Care