How Long Does a Cold Last in Kids?

Few things in life are more miserable than watching your child suffer from an illness, even when it's mild. When your children are down for the count with a runny nose, sore throat, fever, and cough, you want to make them feel better as quickly as possible. But even when their energy returns, it can be hard to know if they've kicked their symptoms for good.

So how long does a cold typically last, how do you treat it, and when should you see a doctor if your child isn't improving? Experts weigh in on what parents need to know.

Symptoms of a Cold in Kids

Each year, hundreds of viruses can lead to an infection, but the ones most health care providers treat are RSV, influenza, COVID, and the common cold. A cold is a viral infection of the upper respiratory tract, which includes the nose, mouth, and throat, explains Bernadette Sapienza, a certified pediatric nurse practitioner at Newton Pediatrics in Boston.

Colds are contagious, especially in the first two to four days after symptoms begin. Your kid can catch a cold through person-to-person contact, breathing in virus particles, or touching a contaminated surface and then touching their mouth or nose.

Typical symptoms of a cold include:

• Sneezing
• Runny nose
• Congestion
• Coughing
• Sore throat
• Fever
• Headache

Some kids may also experience the following symptoms of a cold, though they are less common:

• Fatigue
• Crankiness
• Loss of appetite
• Diarrhea
• Vomiting
• Eye discharge or redness
  

How Long Does a Cold Last?

Experts say most common colds begin one to three days after exposure to a virus and last seven to 14 days, regardless of a person's age. The worst of the symptoms typically peak in the first few days and then slowly improve. Not all viruses are the same though. For example, RSV peaks around five days.

According to Sapienza, younger children may feel sick longer because they struggle to clear congestion. Older kids may experience a lingering cough that lasts up to a few weeks. "Parents often worry when they're in our office frequently, but kids, especially those under 2, can get up to eight colds per year, mostly in the fall and winter," says Sapienza.

How To Treat a Cold

There's no cure for the common cold or other viruses that cause cold-like symptoms. "Treatment is all about supportive care," says Emily Wisniewski, M.D., a pediatrician at Mercy Family Care in Baltimore.

She advises parents to provide plenty of fluids and to use saline drops, suctioning, humidifying air, and/or shower steam to help with nasal symptoms. Dr. Wisniewski says you can give acetaminophen or ibuprofen (the latter for 6 months and older only) for pain or fever, but always talk to your child's health care provider first.

Over-the-counter cough and cold medications are not approved for children younger than 6 and aren't recommended, says Dr. Wisniewski. Often they don't work, and they usually contain several different medications which can confuse parents. For instance, a parent may give Tylenol for a fever and cough medicine that also includes acetaminophen (Tylenol's active ingredient), which can be too much, she says.

Children older than 1 can take 2 to 5 mL of honey for cough as needed. According to the American Academy of Pediatrics (AAP), research has proven honey is better than store-bought cough syrup for reducing the severity and frequency of a cough. Additionally, methylated rubs may soothe coughing in children over 2. Place the rub over the chest and throat and keep the container out of reach when not in use.

How To Know if Your Child's Cold Is Getting Better

When kids start to turn the corner, you'll see their energy return, nasal symptoms decrease, fever dissipate, and appetite return. Older kids will want to return to sports and activities and go back to school, says Sapienza.

Check with your school about guidelines for returning. Most require children to be fever-free without using fever-reducing medication for at least 24 hours. If your child tested positive for COVID, the Centers for Disease Prevention and Control (CDC) recommends isolating for five full days after their symptoms began.

When To Call the Doctor for a Cold

The AAP recommends calling your child's provider at the first sign of illness in children younger than 3 months. For children older than 3 months, call a provider when:

• Their nostrils get larger with each breath, the skin above or below the ribs sucks in with each breath, or there are any changes in breathing
• Lips or nails turn blue
• Nasal mucus lasts longer than 10-14 days
• The cough lasts more than a week
• They have ear pain
• Their temperature is over 102 degrees Fahrenheit (38.9 degrees Celsius)
• They are too sleepy or cranky

Sapienza advises parents to watch for dehydration if kids are not wetting their diapers or going to the bathroom and if their energy doesn't return and they don't seem like themselves.

Occasionally a cold can develop into a sinus infection, ear infection, or pneumonia. That's why it's important to call your child's provider if they begin to feel worse instead of better after day five, adds Sapienza.