Colds in Children

Immunity and Anatomy

Newborn children acquire temporary immunity to cold viruses from their mother. By six months, this immunity has waned, and children are then susceptible to the over 100 cold viruses.

Children have close and intimate contact with their parents and other adults and children.

Young children are not able to practice good personal hygiene, such as hand washing and covering coughs and sneezes.

Sinus and ear drainage passages and bronchial tubes are small in children and easily obstructed by mucus and mucosal swelling.

These factors combine to make children very susceptible to colds and the primary reservoir for cold viruses.

Stuffy Nose

Children are particularly at risk for virus infections which affect the lower airway such as pneumonia and bronchiolitis and to middle ear infection (otitis media). Sinus development is incomplete in young children, but they also develop viral and bacterial sinusitis.



  • Young children (<5 years) are not able to describe cold symptoms and may only show nasal discharge and cough. (67)
  • Preschool age children often have a fever (38 deg. C, 100.5 deg. F) in the first 3 or 4 days of a cold.
  • Colds in children tend to last longer (10-14 days) than in adults (7-10 days).
  • The value of commercial cold treatments has been difficult to evaluate in children.

Recommended Treatment

In children with early colds, begin acetaminophen or ibuprofen in an appropriate dose on a regular schedule (every 4 hours) during the waking hours.

Other symptomatic treatments may be used if they appear to be helpful. These include:

  • Topical and systemic decongestants (neo-synephrine, pseudoephedrine); decongestants may cause excitability.
  • Antihistamine (especially at bedtime). Antihistamine may cause drowsiness.
  • Mucoevacuants (guafenesin)

Children should never be given aspirin because of the danger of it causing brain damage. (Reyes syndrome)

Antibiotics do not shorten a cold, reduce the severity of the illness, or prevent secondary bacterial complications.

Consider consulting your doctor (68):

  • If the child develops a "second fever" later in the course of the cold.
  • If the nasal symptoms and cough are no better or worsen after 10-14 days.
  • If the child complains of ear pain (or the young child pulls at the ear).