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Colds (0-12 Months)


  • Runny nose and sore throat caused by a virus
  • You think your child has a cold.  Reason: family members, friends or other children in child care have same symptoms.
  • Also called an Upper Respiratory Infection (URI).
  • If your child has a cough, also see the Cough care guide. Reason: it can be a more serious symptom.

Symptoms of a Cold

  • Runny or stuffy nose
  • The nasal discharge starts clear but changes to gray. It can also be yellow or green.
  • Most children have a fever at the start.
  • At times, the child may also have a cough and hoarse voice. Sometimes, watery eyes and swollen lymph nodes in the neck also occur.

Cause of Colds

  • Colds are caused by many respiratory viruses. Healthy children get about 6 colds in the first year.
  • Influenza virus causes a bad cold with more fever and muscle aches.
  • Colds are not serious. With a cold, about 5 to 10% of children develop a complication. Most often, this is an ear or sinus infection. These are caused by a bacteria.

Trouble Breathing: How to Tell

Trouble breathing is a reason to see a doctor right away. Respiratory distress is the medical name for trouble breathing. Here are symptoms to worry about:

  • Struggling for each breath or shortness of breath
  • Tight breathing so that your child can barely 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

When To Call

Call 911 Now

  • Severe trouble breathing (struggling for each breath, can barely cry)
  • You think your child has a life-threatening emergency

Go to ER Now

  • Not alert when awake ("out of it")
  • Ribs are pulling in with each breath (called retractions)

Call Doctor or Seek Care Now

  • Trouble breathing, but not severe. Exception: gone after cleaning out the nose.
  • Wheezing (purring or whistling sound) occurs
  • Breathing is much faster than normal
  • Trouble swallowing and new onset drooling
  • Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
  • Milk amount taken is less than half of normal
  • High-risk child (such as with chronic lung disease)
  • Weak immune system. Examples are sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
  • Fever higher than 104° F (40° C)
  • Fever in baby less than 12 weeks old. Caution: do NOT give your baby any fever medicine before being seen.
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Age less than 6 months old
  • Earache or ear drainage
  • Yellow or green pus from eyes
  • Fever lasts more than 3 days
  • Fever returns after being gone for more than 24 hours
  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Blocked nose wakes up from sleep
  • Yellow scabs around the nasal openings. Use an antibiotic ointment.
  • Nasal discharge lasts more than 2 weeks
  • You have other questions or concerns

Self Care at Home

  • Mild cold with no other problems

Care Advice

What You Should Know About Colds:

  • It's normal for healthy children to get at least 6 colds a year. 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.
  • Most parents know when their child has a cold. Sometimes, they have it too or other children in child care have it. Most often, you don't need to call or see your child's doctor. You do need to call your child's doctor if your child develops a complication. Examples are an earache or if the symptoms last too long.
  • The normal cold lasts about 2 weeks. There are no drugs to make it go away sooner.
  • But, there are good ways to help many of the symptoms. With most colds, the starting symptom is a runny nose. This is followed in 3 or 4 days by a stuffy nose. The treatment for each symptom is different.
  • Here is some care advice that should help.

For a Runny Nose with Lots of Discharge: Suction the Nose

  • The nasal mucus and discharge are washing germs out of the nose and sinuses.
  • For younger children, gently suction the nose with a suction bulb.
  • Put petroleum jelly on the skin under the nose. Wash the skin first with warm water. This will help to protect the nostrils from any redness.

Nasal Saline to Open a Blocked Nose:

  • Use saline (salt water) nose spray to loosen up the dried mucus. If you don't have saline, you can use a few drops of water. Use distilled water, bottled water or boiled tap water.
  • Step 1: put 1 drop in each nostril.
  • Step 2: suction each nostril out while closing off the other nostril. Then, do the other side.
  • Step 3: repeat nose drops and suctioning until the discharge is clear.
  • How Often: do nasal saline rinses when your child can't breathe through the nose.
  • Limit to no more than 4 times per day. Before breast or bottle feedings are a good time.
  • Saline nose drops or spray can be bought in any drugstore. No prescription is needed.
  • Reason for nose drops: suction alone can't remove dried or sticky mucus. Also, babies can't nurse or drink from a bottle unless the nose is open.
  • Other option: use a warm shower to loosen mucus. Breathe in the moist air, then suction each nostril.
  • For young children, can also use a wet cotton swab to remove sticky mucus.

Fluids - Offer More:

  • Try to get your child to drink extra formula or breastmilk.
  • Goal: keep your child well hydrated.
  • It also will thin out the mucus discharge from the nose.
  • It also loosens up any phlegm in the lungs. Then it's easier to cough up.


  • If the air in your home is dry, use a humidifier.
  • Reason: dry air makes nasal mucus thicker.

Drugstore Medicines for Colds:

  • Cold Medicines. Don't give any drugstore cold or cough medicines to young children. They are not approved by the FDA under 6 years. Reasons: not safe and can cause serious side effects. Also, they are not helpful. They can't remove dried mucus from the nose. Nasal saline works best.
  • No Antibiotics. Antibiotics are not helpful for colds. Antibiotics may be used if your child gets an ear or sinus infection.

Other Symptoms of Colds - Treatment:

  • Pain or Fever. Use acetaminophen (such as Tylenol) to treat muscle aches, sore throat or headaches. Another choice is an ibuprofen product (such as Advil). Caution: avoid ibuprofen until 6 months or older. You can also use these medicines for fever higher than 102° F (39° C).
  • Red Eyes. Rinse eyelids often with wet cotton balls.

Return to Child Care:

  • Your child can go back to child care after the fever is gone.
  • For practical purposes, the spread of colds can't be prevented.

What to Expect:

  • Fever can last 2-3 days
  • Nasal drainage can last 7-14 days
  • Cough can last 2-3 weeks

Call Your Doctor If:

  • Trouble breathing occurs
  • Earache occurs
  • Fever lasts more than 3 days or goes higher than 104° F (40° C)
  • Any fever if under 12 weeks old
  • Nasal discharge lasts more than 14 days
  • Cough lasts more than 3 weeks
  • You think your child needs to be seen
  • Your child becomes worse


Barton Schmitt MD, FAAP
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
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