Colds, Congestion and Cough

Colds, Congestion and Cough in Children


  • Most children will have 4-6 colds (viral infections of the nose and throat) each year in their first few years (maybe more if in childcare). Once they reach school age they may have one or more colds per month in the fall and winter months.
  • Expect the cold to last 7-10 days and usually have some combination of runny nose, stuffiness, sneezing and cough. Some children develop a fever for the first few days with a cold.
  • Cough in young children is often a result of post-nasal drip caused by colds or allergies. A typical post-nasal drip cough is worse at night because gravity is pulling the mucous from the nose into the back of the throat. It also often sounds worse just after your child wakes up and gets better as he or she becomes more active.
  • Post-nasal drip coughs are typically ‘wet’ sounding but can occasionally be ‘barky.’ Infants and toddlers may have mucous in their nasal passages accompanying this cough. This often leads to a vibration as they breathe, leaving parents to feel ‘there is a rattling in the chest’.  If your child displays these symptoms, then most likely it is your child’s nose and upper airway (not the lungs) that are the source of the cough.

Managing Cold Symptoms

  • If your child’s symptoms are not interfering with sleep or daily activities, ‘treatment’ is not necessary.
  • Cough and cold medicines for children have been off the pharmacy shelves for several years due to lack of evidence that these medicines do anything to ease the symptoms and often have undesirable side effects.
  • We do not recommend giving any over the counter medications for cough unless directed by our office. The following are alternatives to cold and cough medicines:

Saline Solution

  • This is a perfectly safe and gentle way to clear noses—after all, our bodies are made of salt water!
  • You may purchase it at the pharmacy or may make it yourself (combine ½ teaspoon of table salt with 1 cup of warm tap water).
  • Put two to three drops in each nostril; older children can spray into their own noses.  Use this as often as your child sounds congested, especially before nursing or bedtime!
  • You may notice a grimace as your child tastes the salty water, or sometimes a sneeze.


  • Honey is an effective cough reliever for children older than 12 months.
  • DO NOT give honey to an infant younger than 1 year old, as they could develop Botulism.
  • Honey works well on dry, irritant coughs and coats and soothes sore throats, too!
  • Medical studies have shown time and time again that honey is more effective than cough syrups in head-to-head studies.
  • Try ½ tsp for children aged 12 months to 5, 1 tsp for 5-12 year olds and 2 tsp for children 12 and over.
  • In recent years Zarbee’s cough syrup has become extremely popular. Though it is a good and safe product (honey is the base ingredient), there is no evidence it is more effective than plain honey.
  • Many parents ask about the benefit of local honey. For runny nose, congestion and cough caused by cold viruses, local honey is unlikely to be more beneficial than non-local honey.
  • Chicken soup and other warm liquids are also wonderful ways to quiet coughs, as well as to relieve congestion and soothe sore throats.  Your grandmother was right!
  • Also remember to drink lots of liquids, especially water, as this helps keep irritated nasal passages hydrated.

Vapor Rubs

  • For children aged 2 years and older, vapor rubs are made for application on the skin and may soothe stuffy noses and help a congested child sleep.
  • Rub onto your child’s chest to ease congestion.
  • Do not give by mouth or rub these on the face, as they may be irritating to the eyes or mucous membranes.


  • Humidifiers may be helpful. However, they often do not provide an adequate amount of humidity and can be a pain to clean and keep clean.
  • A warm, steamy bathroom is a good alternative to running a humidifier.
  • Steam up the bathroom, then give your child a warm bath or shower. This is especially helpful before bed.

Remind your family that the best way to stay healthy during cold season is to wash hands frequently with soap and water, to avoid touching your face, and to stay home when sick to avoid making others ill!

Please contact our office if:

  • If your child has a fever that lasts 2-3 days accompanied by a cough, ear pain or sore throat.
  • Your child has a history of wheezing or asthma and a cough that is worsening over 24 hours, or shows any signs of trouble breathing.
  • Your infant or toddler has a cough that is affecting appetite, play or activity, or cough accompanied by trouble breathing.
  • Your child has a cough or congestion lasting beyond 10 days without improvement or with worsening symptoms.

Signs of trouble breathing include belly sucking underneath the ribs with each breath, skin sucking in between each rib with every breath, or skin sucking underneath the collarbones (clavicles) or breastbone (sternum) with every breath.