Coughs and Colds in Children

Coughs and colds are usually caused by a viral infection. They normally clear away on their own, and antibiotics are usually of no use. Paracetamol or ibuprofen may ease some of the symptoms. Make sure the child has enough to drink.

Most coughs and colds are caused by viruses. Many different viruses can infect the nose and throat. They are passed on by coughing and sneezing the virus into the air. An average pre-school and primary school child has 3-8 coughs or colds per year. Sometimes several coughs or colds occur one after the other. A child who lives with smokers has an increased risk of developing coughs and colds.

  • The common symptoms are a cough and a runny nose. The cough is often worse at night. Coughing does not damage the lungs.
  • In addition, a child may have: a raised temperature (fever), a sore throat, headache, tiredness, and be off their food. Sometimes children vomit after a bout of coughing.
  • A build-up of mucus behind the eardrums may cause dulled hearing or mild earache.

There is no magic cure! Typically, symptoms are worse in the first 2-3 days, and then ease over the next few days as the immune system clears the virus. An irritating cough may linger for up to 2-4 weeks after other symptoms have gone. Antibiotics do not kill viruses, so are of no use for common coughs and colds.

Coughs and colds often do not need any treatment. Make sure your child has enough to drink. Dehydration (low body fluid) may develop if a child has a fever and does not drink much.

Treatment aims to ease symptoms. Paracetamol can ease aches and pains, headaches, and fever. Ibuprofen is an alternative. Both are sold in pharmacies in liquid form for children. There are various brands - ask the pharmacist if you are unsure what is suitable.

A popular treatment for nasal stuffiness (blocked nose) in a baby is to put a few drops of saline (salt water) into the nose just before feeds. Some people feel that this helps to clear the nose to make feeding easier. There is little scientific evidence as to how well this works, but it may be worth a try if feeding is difficult. You can buy saline drops from pharmacies.

Vapour rubs are another popular treatment. They can be applied to the chest and back (avoid application to the nostril area in small children, for safety reasons). Again, there is little scientific evidence as to how well they work.

What about cold and cough remedies?

Cough or cold remedies may be advertised and are sold in pharmacies. They contain various ingredients or combinations of ingredients such as paracetamol, decongestants, antihistamines and cough remedies. However, there is no clear evidence that these cough and cold remedies work. Also, they may have side-effects such as allergic reactions, effects on sleep or hallucinations.

In March 2009 an important statement was issued by the Medicines and Healthcare products Regulatory Agency (MHRA) saying, that parents and carers should no longer use over-the-counter (OTC) cough and cold medicines in children aged under 6. For 6 to 12 year-olds these medicines will continue to be available (as there is less risk of side-effects in older children). However, they will only be sold in pharmacies, with clearer advice on the packaging and from the pharmacist. Note: paracetamol and ibuprofen are not classed as cough and cold medicines and can still be given to children.

Zinc supplements

Previous research studies suggest that a mineral called zinc appears to reduce the severity of cold symptoms in healthy children. A recent review of the research on zinc supplements and the common cold found that zinc supplements may reduce the length and severity of cold symptoms, when taken within 24 hours of the first symptoms of a cold. However, there were possible side-effects such as unpleasant taste and nausea. The review concluded that it is not yet clear whether zinc should be recommended as treatment for colds. See the reference at the end for details.

Vitamin C

There has also been research looking at vitamin C for preventing or treating colds. A recent review found that taking vitamin C regularly did not seem to prevent colds in the ordinary population. However, it did seem to reduce the length and severity of symptoms. Also, in trials where people were exposed to short periods of extreme physical stress (for example, marathon runners and skiers) vitamin C halved the risk of developing a cold. More research is needed to answer the question of whether vitamin C can help once the cold symptoms have already started.

Other treatments

Echinacea (a herbal treatment) and garlic have traditionally been used for treating colds. However, recent reviews of research could not find any clear evidence about whether or not they are helpful. The MHRA also advises that echinacea should not be given to children under 12 years old. This is because of rare allergic reactions, which can be severe. 

Most coughs and colds get better without complications. Sometimes a more serious secondary bacterial infection develops from an initial viral infection. For example, an ear infection, pneumonia, etc. Symptoms to look out for that may mean more than just a cold include:

  • Breathing problems - wheeziness, fast breathing, noisy breathing (stridor) or difficulty breathing.
  • Being unable to swallow (this may show up as excessive drooling).
  • Drowsiness.
  • Unusual irritability or persistent crying, in a baby, or if the baby is not taking feeds.
  • A rash.
  • Chest pains.
  • Persistent high temperatures, particularly if a baby aged less than three months has a fever higher than 38°C.
  • Severe or persistent headache, sore throat, earache or swollen glands.
  • A cough that persists for longer than 3-4 weeks.
  • Symptoms getting worse rather than better after about five days of a cold.
  • Symptoms (other than a mild cough) lasting more than about ten days, particularly if your child has mucus or sputum (phlegm) which is green, yellow or brown - this may indicate a bacterial infection.
  • Any symptom that you cannot explain.

See a doctor if any symptoms develop that you are concerned about. This is particularly important if your child has a long-term illness or medical condition - for example, chest/breathing/heart problems or neurological disease. Doctors are skilled at checking children over to rule out serious illness. They may not be able to prescribe anything more effective for a common cough or cold, but a check-over can be reassuring.

Original Author:
Dr Tim Kenny
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Peer Reviewer:
Dr Tim Kenny
Document ID:
4227 (v39)
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