Common Cold in Children: What it is & How to Treat it

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Healthy Matters

Everyone has had colds. Sneezing, fever, runny nose, stuffy nose, cough and sore throat do not seem to be a big deal. Here is an expert guide to common colds, with all the answers you need – for you and your children, reviewed by pediatrician Dr. Eddie Cheung.


What is the common cold?

It is an upper respiratory tract infection and is usually harmless. Viruses, mostly commonly rhinoviruses, are the cause. Others include coronaviruses and respiratory syncytial viruses.


Symptoms are more serious and last longer in kids than in adults. Young children may have 6-8 colds a year compared to just 2-4 times for adults. It takes about 7-10 days or up to 2 weeks in some cases to recover.  


Your child can be infected all year round, but occurrence is more frequently observed in autumn and winter. Your doctor will make a diagnosis by reviewing the symptoms.


It is possible to get something more adverse after the common cold. Complications include acute middle ear infection, asthma exacerbation, pneumonia or bronchitis.


Common colds are contagious. Keep your child away from daycare centers and school until they recover. Wear a mask when going out.


Incubation period: Dependent on the virus involved, usually 3-4 days.


Infectious period: Infectious while symptoms are present, usually around 1 week. 

How is the common cold transmitted?

Viruses that cause colds can be spread by

  • breathing in droplets containing the viruses from coughing and sneezing
  • touching eyes, nose and mouth after being in contact with an infected person, their respiratory secretions or contaminated items.

Signs and symptoms of the common cold

Your child may have a sore throat, a cough, a runny nose, clear, yellow or green nasal discharge (does not indicate bacterial infection), stuffy nose, sneezing and a mild fever.


Infants may also be fussy, have poor appetite, sleeping and feeding difficulties. Fever is predominant in young children but uncommon in older children. It is possible to develop a second cold when the first cold is recovering.


High fever, headache, severe body pain, extreme weakness and tiredness are not the general symptoms of colds. Instead, they may suggest the flu.

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When should you see a doctor?

Visit a GP if you’re concerned about your child’s symptoms, if their symptoms are severe, unusual or worsen, or if your child:

  • has a fever and chills
  • has trouble breathing
  • experiences chest pain
  • behaves differently, e.g. becoming irritable or not responding to you
  • feels unusually tired and unwell
  • develops severe throat pain or swallowing difficulties
  • has red eyes or yellowish eye discharge
  • does not want to eat or drink for a long time
  • shows signs of an ear infection e.g. ear pain, ear pulling and fullness in the ears
  • has symptoms that are not getting better after 10 days
  • is younger than 5 years old, especially under 4 months, as there is a higher risk of complications
  • How is the common cold treated?

Colds will clear up on their own without treatment. Antibiotics are not helpful because they do not kill viruses. Always consult your doctor or a pharmacist as misuse of medications can lead to serious consequences. Also, always carefully check the active ingredients in different medicines to avoid overdose.

According to the American Academy of Pediatrics, if your child is:

  1. under 4 years old: any type of OTC or prescription cough and cold medicines should not be used.
  2. between the age of 4 and 6: only take them according to your doctor’s advice.
  3. above 6 years old: follow instructions on the medicine package.

Fever and pain relief

Never give aspirin to children under 18 years old as it can cause Reye’s syndrome.

Nasal symptoms

  • Children ≥ 6 years: ipratropium nasal spray.
  • Other management: adequate fluid intake, saline nasal sprays or drops, steam inhalation, humidifier and rubber suction bulb for nasal suction.

OTC decongestants such as pseudoephedrine, phenylephrine, oxymetazoline and xylometazoline are often used for those aged at least 12 years only.



  • Children > 1 year: 2.5 mL honey or diluted honey in water before bedtime.
  • Other management: adequate fluid intake, hard candy or lozenges.

Cough syrup contains different types of active ingredients, including expectorants (e.g. guaifenesin), decongestants and codeine. Children aged below 4 should not take it. FDA also states that codeine-containing medications are not suited for those under 18 years.


Having good personal hygiene

  • Wash hands frequently with soap and water for 15-30 seconds. Use alcohol-based hand rubs if water and soap is not available.
  • Cover mouth and nose with a tissue when coughing or sneezing and throw it away in a rubbish bin. Cough or sneeze into the inside of the elbow but not hands if no tissues are around
  • Avoid touching mouth, nose and eyes. Cold viruses can live for at least 2 hours and can be spread from objects and surfaces to hands.
  • Do not share foods, drinks or personal items such as handkerchiefs and eating utensils with someone who has a cold.

Keeping your home clean

  • Regular disinfection of frequently touched surfaces can reduce the spread. Maintaining good and proper ventilation is essential too. 

Leading a healthy lifestyle 

  • Balanced diet, regular exercise, and adequate sleep and rest can help develop a good immunity to fight off any kind of infection. 

No vaccines available for prevention

  • Common colds are caused by numerous types of viruses. Your child can be infected by different viruses each time they catch a cold. Another reason is that they go away on their own, without treatment.

Vaccines are available for influenza (flu) but not common colds.

Use of health supplements not supported by research

Zinc, vitamin C, vitamin D, garlic, ginseng, herbal products such as echinacea, and probiotics are not recommended as study results do not prove their benefits or demonstrate conclusive evidence of their roles in common cold prevention.


How is common cold treated in children?

Most of the time, children can recover on their own without treatment. Medicines should only be taken under instructions by a doctor or a pharmacist to prevent misuse. You may consult a doctor if the symptoms are serious or worsen.

When should you take your child to the doctor for a cold?
What are the symptoms of the common cold?
What is a common cold in kids?
How do you know if a cold is viral or bacterial?

Dr. Eddie Cheung 張蔚賢醫生 is a specialist in paediatrics. He received his paediatric training in Queen Mary Hospital and post-fellow paediatric cardiology training in Grantham Hospital/ Queen Mary Hospital. He is a Fellow of the Hong Kong College of Cardiology, the Vice President of Hong Kong Society of Paediatric Cardiology and Consultant of Hong Kong Association of Cleft Lip and Palate. He is currently working as Director of Paediatric Centre of HK Medical Consultants and serves as Infection Control Officer at the Hong Kong Adventist Hospital.

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This article was independently written by Healthy Matters and is not sponsored. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.

Dr. Cheung Wai Yin Eddie
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