Cold Care

Parenting in the Early Years

Cold Care

Colds, called upper respiratory tract infections, are the most frequent infection of infants and children. They are caused by many viruses that are always present in our surroundings.

The number of infections developed is directly related to how often he is exposed to infectious germs. Entrance into a daycare, pre-school or school is associated with increased numbers of colds. Children average about 6-10 colds per year, although this varies from child to child.


At the onset of a cold a child is usually restless, irritable and may run a fever for 2-3 days.

First complaints are nasal irritation, congestion and a runny nose. Congestion may interfere with nursing. Eye irritation with redness and discharge may be seen. Loose stool and increased spitting or vomiting is common.

Thick yellow or green nasal discharge develops on day 4 to 6 of a cold as cells to fight off infection are produced in the nasal lining. Throat irritation occurs at this time because of mouth breathing and mucous dripping down the back of the throat. A cough may also develop. The middle ear may collect fluid as the middle ear tube, called the eustachian tube, is blocked. This is the set up for an ear infection.

Despite the discomfort and aggravation of viral upper respiratory infections, the child does not act really ill when the fever is down. More serious bacterial infections tend to make them act ill all the time.

The duration of cold symptoms varies from 7-14 days. If a cold has not resolved by then, there is a chance that a bacterial infection has developed and may need to be treated with antibiotics. If a child runs a fever for more than 3 days, is having breathing difficulty, has ear pain or seems very ill, contact your doctor.

Treatment for Colds

Fluid and Nutrition

A child's appetite is often down during colds. It is very important to maintain good hydration by encouraging lots of fluids. Drinking additional clear liquids (water, juice, fruit drinks or soda) may help thin secretions. Encourage nutritional foods to help supply the body with the energy needed to fight off the infection.

If you are breast-feeding, continue. Breast milk has additional immunities to help fight infection.

Relief of Nasal Congestion

Saline nose drops can be used every 3-4 hours in infants. They are particularly helpful prior to feeding and before going to sleep. These can be purchased or easily made with 1/4 teaspoon of salt in 8 ounces of water. Place your child on his back and tilt the head back. Place 2-3 drops in each nostril. Be aware that most children dislike nose drops. A bulb syringe can be used to remove excess mucous.

Be cautious; aggressive use can cause damage to the lining of the nose. For older children the use of commercial nasal flushes such as a Neti Pot, SinuCleanse® or Ensol® can flush out nasal crust and secretions, giving relief.

Try raising the head of the bed to help with mucous drainage. Prop your child on pillows or place blocks under the head of your infant's crib. To prevent rolling, put the child at the bottom of the bed or place their feet to the foot of the bed.

Keep room air moist and cool. Dry hot air tends to make the child more uncomfortable because it dries and thickens nasal secretions. If you have a humidistate, it should be between 40-45 percent.

Many products called cold remedies are available. None have been shown to cure a cold, shorten its course or prevent complications such as ear infections or pneumonia. Some individuals may obtain temporary relief of symptoms with decongestants. The use of decongestants may cause side effects including irritability and sleep disturbance. The use of these medications should be discussed with your physician.

Cough Syrups Are Not Recommended

A cough is often present during a cold and is your body's protective mechanism to remove excess mucous from airways to prevent pneumonia.

While a cough may be distressing and irritating, there is no evidence that using a cough syrup in children is helpful or safe. A cough may be a sign of other problems like pneumonia, asthma, sinusitis or aspiration of an object into the airway.

If your child has a persistent cough, rapid breathing or is working harder than usual to breathe, he needs to be seen by your doctor. Simple measures such as raising the head of the bed, additional warm fluids or sucking on throat lozenges may give some symptom relief from a cough. One teaspoon of honey for a child older than 1 year of age may give some temporary relief.

When to Call Your Doctor's Office

Call your doctor if your child has the following symptoms:

  • Is ill and less than 2 months old
  • A stiff neck 
  • Fever is over 102° F for 72 hours
  • Your child is severely irritable
  • Your child is excessively sleepy
  • Pulling, tugging or rubbing her ears (See ear infections)
  • A cough for more than 7 to 10 days without improvement
  • Persistent vomiting or evidence of dehydration
  • Nasal drainage for more than 10 to 14 days
  • Wheezing or shortness of breath
  • Severe sore throat, excessive drooling or difficulty swallowing
  • Improves for several days and then becomes more ill or fever returns