Common Cold and URTI

This page answers the following questions about the common cold and upper respiratory tract infections (URTI):


What is an upper respiratory tract infection (URTI)?

An upper respiratory tract infection is one where the upper respiratory tract is involved, so this means the nose, throat and ears. The common cold is an example of an URTI.

Most upper respiratory tract infections (URTI) in toddlers, like the cold, are caused by viruses. A virus is an organism that is small and it incorporates itself into the body's own cells. Unlike bacteria, which are larger and attach to the body's cells but do not incorporate themselves within the cells, viruses do not respond to antibiotics.

This page deals mainly with viral upper respiratory tract infections like the cold. To read about other ear nose infections, like ear infections, tonsillitis etc, hit on the links on the Ear Nose Throat main page - go there now.

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How many upper respiratory tract infections (URTI) do children get?

On average, toddlers get 8-10 viral infections per year so you can see that frequent upper airways infections are the norm for toddlers. That is how they develop their immunity, so it's a good thing. But it does mean that some children will have less than 8-10 infections per year and some children will have more than 8-10 infections per year and so if your child is the latter, it can mean he seems to have a constant runny nose. Don't worry, though. It's normal

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What causes the common cold?

The common cold is caused by a virus. The most common viruses that cause cold symptoms in children are:

  • RSV (or Respiratory Syncitital virus)
  • Parainfluenza
  • Rhinovirus

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What are the symptoms of a cold?

Children get a runny, snotty nose. This excess mucus (snot) can block their nose and make breathing noisy. Children often get a mild fever which can make them feel miserable and grumpy.They can also be off their food.

About 25% of children will have an ear infection at the same time as a cold - these often settle by themselves and don't require any antibiotics. Ear infections are more likely if your child has glue ear (otitis media with effusion). To read more on ear infections, click here.

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What is the treatment for the common cold?

  • Treatment is what we call supportive - so making your child comfortable while their body does the work of clearing the virus causing the cold.
  • If your child has a fever and is miserable with it, give some Paracetamol (Acetaminophen for those in the United States), which should make your child comfortable - read more
  • Give your child plenty to drink. Don't worry if she doesn't eat much.
  • If you have a baby and the blocked nose is interfering with breathing, normal saline nose drops put in each nostril before a feed can help.

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How long does a common cold last?

Viruses last about 7-10 days, so your child can have symptoms for that long. Generally, the cold starts off with only minor symptoms, reaches a peak when things are worst about day 3 or 4 and then by 7-10 days your child should be back to normal.

If the snotty nose is getting worse after 7 days then see your doctor as occasionally the common cold will be complicated by sinusitis.

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Are there any complications from a common cold?

Usually, children get through a cold with no problems. Sometimes, having a cold will make a child more susceptible to getting a bacterial infection. The child's immunity is lowered so it is easier for the bacteria to take hold. Bacterial infections generally require antibiotics, so if you are worried that things are not improving, you need to see your doctor.

However, frequent upper airway infections in toddlers are very common and mostly do not lead to complications. If things are not returning to normal by 7 days after the start of a cold, then see your doctor.

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Does Day Care affect the number of common colds a child gets?

Yes. When children start daycare they do tend to get more infections than children who are not in daycare. However, the number of upper respiratory tract infections (also known as the common cold) equalizes out in the long run, so when these children reach elementary school they are having less infections than their classmates who didn't have early daycare. So if you have to use Day Care for your child, don't feel badly when they get a cold - it just means they won't get one later on.

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When should I see my doctor?

You should see your doctor any time you feel really worried about the health of your baby or toddler.

If you have a baby, see your doctor if he:

  • is very irritable
  • is feeding poorly
  • is more drowsy than usual when awake (it doesn't matter so much if he's sleeping more as long as he's alert when he's awake)
  • is working very hard at breathing
  • has any colour change (looks grey or blue)
  • is unusually floppy
  • is making you really concerned
  • is not starting to get better by day 7

For toddlers, see your doctor if she:

  • is drowsy when awake
  • is not drinking
  • is working very hard with breathing
  • is very irritable
  • has a high fever for more than 5 days
  • is making you really concerned
  • is not starting to get better by day 7

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  • Côté SM, et al "Short- and long-term risk of infections as a function of group child care attendance: An 8-year population-based study" Arch Pediatr Adolesc Med 2010; 164: 1132-1137.
  • Armengol CE, Hendley JO, Winther B. Occurrence of acute otitis media during colds in children younger than four years. Pediatr. Infect. Dis. J. 2011 Jun; vol. 30(6) pp. 518-20

To go to the top of the Common Cold page, click here

To read about signs of Serious Illness, click here

To go to the main Ear Nose Throat page, click here

To return to the Home page, click here

Last reviewed 11 June 2011

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Dr Maud MD

Dr Maud MD (MBChB, FRACP, FRCPCH), a specialist pediatrician, provides health information and medical advice for parents of babies and toddlers. Read more about Dr Maud.

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