Coughs and Colds in Children
Coughs and colds are usually caused by infection with a germ called a virus. They normally clear away on their own, and antibiotic medicines are usually of no use. Paracetamol or ibuprofen may ease some of the symptoms. Make sure the child has enough to drink.
What causes coughs and colds and what are the symptoms?
Most coughs and colds are caused by germs called 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 preschool 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 may be sick (vomit) after a bout of coughing.
- A build-up of mucus behind the eardrums may cause dulled hearing or mild earache.
What are the treatments for coughs and colds?
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. Low body fluid (dehydration) may develop if a child has a raised temperature (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 a blocked nose in a baby is to put a few drops of salt water (saline) 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.
Inhaling steam can also help relieve congestion and coughing. The safest way to do this with children is to sit in the bathroom with a hot shower/hot taps running.
Sucking menthol sweets can help ease sore throats in older children.
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 convincing evidence that these cough and cold remedies work. Also, they may have side-effects such as allergic reactions, problems with sleeping or making you see or hear things that are not really there (hallucinations).
In March 2009 an important statement was issued by the Medicines and Healthcare products Regulatory Agency (MHRA). It said 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.
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. Zinc supplements may also help to prevent colds. However, there were possible side-effects such as unpleasant taste and feeling sick (nausea). The review concluded that it is not yet clear whether zinc should be recommended as treatment for colds. More studies need to be done to work out which dose should be taken and for how long. More details can be found under 'References' at the end of this leaflet.
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.
Echinacea (a herbal treatment) and garlic have traditionally been used for treating colds. However, recent reviews of research could not find any evidence that either is 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.
What symptoms should I look out for?
Most coughs and colds get better without complications. Sometimes a more serious infection develops from an initial viral infection. For example, an ear infection, chest infection (pneumonia), etc. Symptoms to look out for that may mean more than just a cold include:
- Breathing problems - wheeziness, fast breathing, noisy breathing or difficulty with breathing.
- Being unable to swallow (this may show up as excessive drooling).
- 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 3 months has a raised temperature (fever) higher than 38°C.
- Very bad (severe) 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. This is particularly important if your child has mucus or phlegm (sputum) which is green, yellow or brown, as it may indicate infection with other germs called bacteria.
- 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.
Further reading & references
- Over-the-counter cough and cold medicines for children; Medicines and Healthcare products Regulatory Agency (MHRA), 2009
- Singh M, Das RR; Zinc for the common cold. Cochrane Database Syst Rev. 2011 Feb 16;2:CD001364.
- Karsch-Volk M, Barrett B, Kiefer D, et al; Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2014 Feb 20;2:CD000530. doi: 10.1002/14651858.CD000530.pub3.
- Hemila H, Chalker E; Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013 Jan 31;1:CD000980. doi: 10.1002/14651858.CD000980.pub4.
- Kenealy T, Arroll B; Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Syst Rev. 2013 Jun 4;6:CD000247. doi: 10.1002/14651858.CD000247.pub3.
- Lissiman E, Bhasale AL, Cohen M; Garlic for the common cold. Cochrane Database Syst Rev. 2012 Mar 14;3:CD006206. doi: 10.1002/14651858.CD006206.pub3.
- Common cold; NICE CKS, November 2011 (UK access only)
- Secondhand smoke: the impact on children: Research report; ASH (action on smoking and health), March 2014
- Respiratory tract infections (self-limiting): prescribing antibiotics; NICE Clinical Guideline (July 2008)
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other healthcare professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Tim Kenny
Dr Mary Harding
Dr Helen Huins