The common cold is caused by several different viruses and has thus far escaped cure or prevention. The symptoms of a cold include watery eyes, runny nose, scratchy throat and sneezing. A child may also have low-grade fever congestion and a cough. Most colds are self-limited and will run their course in 5-20 days. In general, children three months to three years old have more frequent colds (average 5-8 each year) and symptoms that last longer. Children in group settings, such as school and day care, also have more viral infections due to their greater exposure to other children.

A child with a cold is most contagious to others in the first 72 hours of the illness. If fever is present, the child should not attend school or day care. These viral infections are usually spread by coughing, sneezing, hand-to-hand contact, and contact with contaminated objects.

Despite symptomatic treatment, colds will last an expected 5-10 days. Since they are viral infections, antibiotics are not used unless complications arise. Medicated nose drops or sprays, such as Neosynephrine or Afrin, may cause persistent nasal congestion and should not be use unless specifically recommended.

A discolored nasal discharge is not necessarily an indication for antibiotics. The nasal discharge of the common cold will typically change from a clear discharge, to cloudy, to discolored (yellow or green), then resolve without treatment. If the nasal discharge has lasted more than 10 days, is discolored and is not improving, then sinusitis may exist and a doctor should be consulted.

Colds may lead to complications or have other illnesses mistaken for them. Indications for medical attention include high fever or fever occurring several days after the onset of illness, significant sore throat, severe headache or facial pain, difficulty breathing not solved by clearing the nose, excessive sleepiness or irritability, or a child who appears more than mildly ill.

The following give guidelines for the symptomatic treatment of a cold.


  1. Clear the nose of mucous with a rubber bulb syringe before each feeding and before naps, if feeding or sleeping is impaired.
  2. Use saline nose drops to loosen mucous if necessary. This may be purchased at a drug store or mixed at home using ¼-teaspoon salt in one 8-ounce cup of lukewarm water. Place one to two drops of saline solution into one nostril, suction with the bulb syringe and repeat for other nostril.
  3. Run a cool-mist humidifier in the infant’s room if the interior air is dry. Do not run the humidifier continuously for weeks or months as this can promote allergies to mold.
  4. Offer plenty of liquids. A baby with a cold will often refuse formula and solids, but will take Pedialyte, Infalyte, Gatorade, or juices.
  5. Give acetaminophen (Tempra, Tylenol) for fever or discomfort as needed.

Older Children

  1. Encourage the child to rest with quiet activities.
  2. Run a cool-mist humidifier at night if the interior air is dry. Do not run the humidifier continuously for weeks as this can promote allergies to mold.
  3. Offer plenty of liquids to drink. The child with a cold will often refuse most solid foods and milk, but will take Gatorade, fruit juice, Popsicles and fruit snacks.
  4. Give acetaminophen (Tempra, Tylenol) for fever or discomfort.
  5. Give symptomatic cold medication such as Dimetapp, Sudafed, Triaminic, or Pediacare (all are over-the-counter). See the Medication Dosing Chart for dosage.

Posted in: Pediatric Topics