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When Your Child Has a Cold or Flu

Respiratory system
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Colds and influenza (flu) affect the upper respiratory tract. This includes the nose, nasal passages, sinuses, mouth, throat, and larynx or voice box. Both illnesses are caused by germs called viruses, and both share some of the same symptoms. There are many other illnesses with different causes that affect the upper respiratory tract. Bacterial infections, like strep throat, and seasonal allergies or hay fever, are two examples. When your child has symptoms that concern you, call his or her health care provider.

What Is a Cold?

  • Symptoms include runny nose, cough, sneezing, and sore throat. Cold symptoms tend to be milder than flu symptoms.

  • Cold symptoms usually come on slowly, over a few days.

  • Children with a cold can still take part in most of their usual activities. During the first few days, when they may be coughing and sneezing a lot, it's a good idea to keep them home to prevent others from getting sick.

What Is the Flu?

  • The flu, or influenza, is also an upper respiratory infection.

  • Symptoms include fever, headache, tiredness, cough, sore throat, runny nose, and muscle aches. Children may also have an upset stomach and vomiting.

  • Flu symptoms tend to come on quickly.

  • Children with the flu may feel too sick to take part in normal activities.

How Do Colds and Flu Spread?

The viruses that cause colds and flu spread in droplets when someone who is sick coughs or sneezes. Children can inhale the germs directly. But they can also pick up the virus by touching a surface where droplets have landed. Germs then enter a child’s body when she touches her eyes, nose, or mouth.

Why Do Children Get Colds and Flu?

Children get more colds and flu than adults do. Here are some reasons why:

  • Less resistance: A child’s immune system is not as strong as an adult’s when it comes to fighting cold and flu germs.

  • Winter season: Most respiratory illnesses occur in fall and winter when children are indoors and exposed to more germs.

  • School or daycare: Colds and flu spread easily when children are in close contact.

  • Hand-to-mouth contact: Children are likely to touch their eyes, nose, or mouth without washing their hands. This is the most common way germs spread.

How Are Colds and Flu Diagnosed?

Most often, the diagnosis of a cold or the flu based on the child’s symptoms and a physical exam. Children who are very sick may have throat or nasal swabs to check for bacteria and viruses. Your child’s health care provider may perform other tests, depending on your child’s symptoms and overall health.

How Are Colds and Flu Treated?

Most children recover from colds and flu on their own. Antibiotics aren’t effective against viral infections, so they are not prescribed. Instead, treatment is focused on helping ease your child’s symptoms until the illness passes. To help your child feel better:

  • Give your child lots of fluids, such as water, electrolyte solutions, apple juice, and warm soup.

  • Make sure your child gets plenty of rest.

  • Have older children gargle with warm saltwater.

  • To relieve nasal congestion, try saline nasal sprays. You can buy them without a prescription, and they’re safe for children. These are not the same as nasal decongestant sprays, which may make symptoms worse.

  • Use “children’s strength” medication for symptoms. Discuss all over-the-counter (OTC) products with the doctor before using them. Note: Do not give OTC cough and cold medications to a child under 6 years unless you get instructions from your child's health care provider.

  • Never give aspirin to a child under age 18 who has a cold or flu. (It could cause a rare but serious condition called Reye’s syndrome.)

  • Never give ibuprofen to an infant 6 months of age or younger.

  • Keep your child home until he or she feels well enough to participate at school. Ask your child's provider is it's safe to return to school or daycare.

Preventing Colds and Flu

Girl at bathroom sink, showing her soapy hands

To help children stay healthy:

  • Teach children to wash their hands often—before eating and after using the bathroom, playing with animals, or coughing or sneezing. Carry an alcohol-based hand cleaner (containing at least 60 percent alcohol) for times when soap and water aren’t available.

  • Remind children not to touch their eyes, nose, and mouth.

  • Ask your child’s provider about a flu vaccination for your child. Vaccination is recommended for all children 6 months and older. The vaccination is given in the form of a shot or a nasal spray.

Tips for Proper Handwashing

Use warm water and plenty of soap. Rub the hands together well.

  • Clean the whole hand, under the nails, between the fingers, and up the wrists.

  • Wash for at least 15-20 seconds (as long as it takes to say the alphabet or sing “Happy Birthday”).

  • Rinse well. Let the water run down the fingers, not up the wrists.

  • In a public restroom, use a paper towel to turn off the faucet and open the door.

When to Call Your Child's Health Care Provider

Call your child’s health care provider if he or she doesn’t get better or has:

  • Shortness of breath or fast breathing

  • Thick yellow or green mucus that comes up with coughing

  • Worsening symptoms, especially after a period of improvement

  • Fever:

    • In an infant under 3 months old, a rectal temperature of 100.4°F (38.0°C) or higher

    • In a child of any age who has a repeated temperature of 103°F (39.4°C) or higher

    • A fever that lasts more than 24-hours in a child under 2 years old, or for 3 days in a child 2 years or older

    • Your child has had a seizure caused by the fever

    • With a rash

    • Fever that doesn’t respond to medication to reduce fevers

  • Severe or continued vomiting.

  • Symptoms of dehydration: a dry mouth; dark or strong-smelling urine or not urinating in 6-8 hours.

  • Trouble waking up.

  • Ear pain.

Online Medical Reviewer: Holloway, Beth, RN, M.Ed.
Online Medical Reviewer: MMI board-certified, academically-affiliated clinician
Last Review Date: 8/28/2014
© 2000-2014 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.