Diagnostic Findings of a Cold (Upper Respiratory Infection [URI])

  • Runny or stuffy nose
  • Usually associated with fever and sore throat
  • Sometimes associated with a cough, hoarseness, red eyes, and swollen nodes in the neck

Similar Conditions

  1. Vasomotor rhinitis. Many children and adults have a profusely runny nose in the winter when they are breathing cold air. This usually clears within 15 minutes of coming indoors. It requires no treatment beyond a handkerchief and has nothing to do with infection.
  2. Chemical rhinitis. Chemical rhinitis is a dry stuffy nose from excessive and prolonged use of vasoconstrictor nose drops (more than one week). It will be better within a day or two of stopping the nose drops.

A cold or upper respiratory infection is a viral infection of the nose and throat. The cold viruses are spread from one person to another by hand contact, coughing, and sneezing -- not by cold air and drafts. Since there are up to 200 cold viruses, most healthy children get at least six colds each year

Expected Course
Usually the fever lasts less than 3 days, and all nose and throat symptoms are gone in one week. A cough may last 2 to 3 weeks. The main thing to watch for are secondary bacterial infections such as ear infections, yellow draining from the eyes, thick pus from the nose (often indicating a sinus infection), or difficulty breathing (often caused by pneumonia). In young infants a blocked nose can interfere so much with the ability to suck that dehydration can occur.


Not much can be done to affect how long a cold lasts. However, we can relieve many of the symptoms. Keep in mind that the treatment for a runny nose is quite different from the treatment for a stuffy nose.

Treatment for a Runny Nose with Profuse Clear Discharge: Suctioning or Blowing.
The best treatment is clearing the nose for a day or two. Sniffing and swallowing the secretions are probably better than blowing because blowing the nose can force the infection into the ears or sinuses. For younger babies, use a soft rubber suction bulb to remove the secretions gently. Nasal discharge is the nose's way of eliminating viruses. Medicine is not helpful unless your child has a nasal allergy.

Treatment for a Dry or Stuffy Nose with Only a Little Discharge
Warm-Water Nose Drops and Suctioning. Most stuffy noses are blocked by dry mucus. Blowing or suctioning alone cannot remove most dry secretions. Nose drops of warm water are better than any medicine you can by for loosening mucus. If you prefer normal saline nose drops, mix 1/4 teaspoon of table salt in 8 ounces of water. Make up fresh solution every few days and keep it in clean bottle. Use a clean dropper to insert drops. Water can also be dripped or splashed in using a wet cotton ball.

  • For the younger child who cannot blow his nose: Place three drops of water in each nostril. After 1 minute use a soft rubber suction bulb to gently suck out the loosened mucus. To remove secretions from the back of the nose, you will need to seal off both nasal openings with the tip of the suction bulb and your fingers. Suction bulbs are inexpensive and you can get one at your drugstore.
  • For the older child who can blow his nose: Use three drops as necessary in each nostril while your child is lying on his back on a bed with his head hanging over the side. Wait 1 minute for the water to soften and loosen the dried mucus. Have your child blow his nose. This can be repeated several times in a row for complete clearing of the nasal passages.
  • Errors in using warm-water nose drops: The main errors are not putting in enough water, not waiting long enough for the secretions to loosen up, and not repeating the procedure until the breathing is easy. The front of the nose can look open while the back of the nose is all gummed up with dried mucus.
Naturally, putting in warm-water drops without suctioning or blowing the nose afterward is of little or no value.

The Importance of Clearing the Nose in Young Infants.
A child can't breathe through the mouth and suck on something at the same time. If your child is breast- or bottle-feeding, you must clear his nose so he can breathe while he's sucking. Clearing the nasal passages is also important before putting your child down to sleep.

Treatment for associated Symptoms of Colds

  • Fever: Use acetaminophene for aches or mild fever (over 1020 F [38.90 C]).
  • Sore throat: Use hard candies and saltwater gargles for children over 4 years old.
  • Cough: Use cough drops for children over 4 years old and corn syrup for younger children. Run a humidifier.
  • Red eyes: Rinse frequently with wet cotton balls.
  • Poor appetite: Encourage fluids of the child's choice.
Prevention of Colds.
A cold is caused by direct contact with someone who already has one. Over the years, we all become exposed to many colds and develop some immunity to them. Since complications are more common in children during the first year of life, try to avoid undue exposure to other children or adults with colds, to day-care nurseries, and to church nurseries. A humidifier prevents dry mucus membranes, which may be more susceptible to infections. Vitamin C, unfortunately, has not been shown to prevent or shorten colds. Large doses of vitamin C (for example, 2 grams) cause diarrhea.

Common Mistakes in Treating Colds.
Most over-the-counter cold remedies or tablets are worthless. Nothing can shorten the duration of a cold. If the Nose is really running, consider a pure antihistamine (such as chlorpheniramine products). Especially avoid drugs that have several ingredients because they increase the risk of side effects. Avoid oral decongestants if they make your child jittery or keep him from sleeping at night. Use acetaminophen for a cold only if your child has a fever, sore throat, or muscle aches. Leftover antibiotics should not be given for uncomplicated colds because they have non effect on viruses and may be harmful.

Call Your Doctor Immediately If

  • Breathing becomes difficult and no better after you clear the nose.
  • Your child starts acting very sick.

During Regular Hours If

  • The fever lasts more than 3 days.
  • The discharge lasts more than 10 days.
  • The discharge becomes thick and yellow for more than 24 hours.
  • The skin under the nose becomes raw or scabbed over.
  • The eyes develop a yellow discharge.
  • You can't unblock the nose enough for your infant to take adequate fluids.
  • There is any suggestion of an earache or sinus pain.
  • The throat becomes quite sore (get a throat culture).
  • You feel your child is getting worse.
  • You have other questions or concerns.