15 July 2025 · Little Rei
Surviving Cold and Flu Season With Kids
Eight to twelve colds a year is normal for a preschooler. Not concerning, not a weak immune system, not a badly run nursery.
It's simply what happens when somebody with no prior exposure to two hundred-odd respiratory viruses is put in a room with thirty other people in exactly the same position.
The number comes down as they get older. Knowing that in November instead of working it out in March makes the season a lot easier to sit through.
What reduces how often it happens
Six things with evidence behind them. The first one does more than the other five combined.
- Hand washing, done properly and often. This is the intervention with the best evidence behind it, and it's unglamorous.
- Teaching the elbow cough early. Children pick it up faster than adults expect.
- Flu vaccination, where offered for children. It reduces both illness and onward transmission in the household.
- Not sharing cups, bottles and towels between siblings.
- Keeping a unwell child at home, which is easier said than done and is still the right call.
- Ventilation. Opening a window for a few minutes clears a room more effectively than any spray.
What doesn't
Vitamin C doesn't prevent colds. That's not a hedge, the Cochrane review pooled 29 placebo-controlled trials covering 11,306 people taking between 0.2 and 1g a day and found no significant reduction in how often they caught one. There's one genuine exception, and it isn't you. In five trials of people under heavy acute physical stress, three of them marathon runners, vitamin C halved the incidence. Unless your toddler is running marathons, the shelf of orange chewables is doing nothing. The rest of the list: antibacterial surface sprays do little against viruses that travel person to person. Antibiotics do nothing at all for a cold and aren't a shortcut. And going out with wet hair doesn't cause anything.
The specifics
Treating a cold in a small child
There's no cure, so the aim is comfort and hydration while it runs its course, typically seven to ten days, with a cough that can outlast everything else by a fortnight.
- Fluids, in small amounts and often. Watch nappies or trips to the toilet as the hydration check.
- Saline drops and, for babies, gentle suction before feeds.
- Paracetamol or ibuprofen for discomfort or fever, at the correct dose for age and weight.
- Honey for cough in children over one. The Cochrane review found it probably relieves cough better than no treatment or placebo, and about the same as dextromethorphan, with the caveat that most children in those trials were treated for a single night, and the evidence is rated low to moderate. Never under one, because of the infant botulism risk.
- Steam from a hot shower in a closed bathroom.
- Upright when awake. For sleep, keep babies flat on the back, don't prop or incline the cot.
What not to give
Five things, and the first is on sale in every pharmacy with a picture of a child on the box.
- Over-the-counter cough and cold medicines, which aren't recommended under six and offer little benefit under twelve.
- Aspirin, at any age in childhood, because of the risk of Reye's syndrome.
- Decongestant drops or sprays in young children unless a doctor has advised them.
- Antibiotics for a viral illness, which is nearly all of them.
- Vapour rubs on babies, and never under the nose.
Fever, in proportion
Fever is a response, not the illness, and the number matters far less than how the child looks and behaves. A child with 39°C who's drinking, alert between naps and grumbling at you is usually less concerning than a child with 38°C who's limp and won't drink. Treat for discomfort instead of to chase a reading.
The exception is age. Any temperature of 38°C or above in a baby under three months needs same-day medical assessment, and under one month it is urgent.
| Age | Temperature | Action |
|---|---|---|
| Under 3 months | 38°C or above | Same-day assessment, always |
| 3-6 months | 39°C or above | Same-day assessment |
| Any age | Any, with breathing difficulty | Urgent |
| Any age | Any, with a non-fading rash | Urgent |
| Any age | Lasting more than five days | See a doctor |
| Any age | Hard to rouse, or not drinking | Urgent |
The signs that mean this isn't just a cold
Everything above assumes an ordinary cold in an ordinary week. These are the things that aren't that.
- Difficulty breathing: fast breathing, grunting, nostrils flaring, or skin sucking in under the ribs or at the throat.
- Blue, grey or mottled skin, or lips that change colour.
- Very hard to wake, floppy, or not responding normally.
- A rash that doesn't fade when pressed with the side of a glass.
- No wet nappy for 12 hours, or no urine for eight hours in an older child.
- Getting better and then clearly worse again, or a fever lasting more than five days.
- Any temperature of 38°C or above under three months.
Surviving it as the adult
A house with small children in it is often ill for weeks at a stretch, and the wearing part is never any one illness. It's the sequence.
Lower the standard on purpose for the season. Fewer commitments. Easier meals. Earlier bedtimes for everybody, adults included.
Get your own flu vaccination, because an ill parent nursing an ill child is the hardest version of that week by a distance.
When the nursery closes for the third time, let the day go. That plan was never going to survive anyway.
Sources
- Hemila & Chalker (2013), Cochrane Database Syst Rev CD000980: Vitamin C for preventing and treating the common cold
- Oduwole et al. (2018), Cochrane Database Syst Rev CD007094: Honey for acute cough in children
- NHS. Coughs, colds and ear infections in children
- NICE. Fever in under 5s: assessment and initial management
This guide is general information, written to help you understand a topic and ask better questions. It is not medical advice and does not replace your own doctor, midwife or paediatrician. Anything that worries you about your baby belongs with them.