The common cold is a group of symptoms caused by a number of different viruses. There are more than 100 different varieties of rhinovirus, the type of virus responsible for the greatest number of colds. The signs and symptoms of a cold usually begin one to two days after exposure. In children, nasal congestion is the most prominent symptom. Children can also have clear, yellow, or green-colored nasal discharge; fever (temperature higher than 100.4oF or 38oC) is common during the first three days of the illness.

Other symptoms may include sore throat, cough, irritability, difficulty sleeping, and decreased appetite. The lining of the nose may become red and swollen, and the lymph nodes (glands) in the neck may become slightly enlarged.

The symptoms of a cold are usually worst during the first 10 days. However, some children continue to have a runny nose, congestion, and a cough beyond 10 days. In addition, it is not unusual for a child to develop a second cold as the symptoms of the first cold are resolving; this can make it seem as if the child has a single cold that lasts for weeks or even months, especially during the fall and winter. This is not a cause for concern, unless the child has any of the more serious symptoms, discussed below. Symptoms of allergies (allergic rhinitis) are slightly different than those of a cold, and may include bothersome itching of the nose and eyes.

Symptomatic treatment — The treatment of an infant or child with a cold is different than treatment recommended for adults. Antihistamines, decongestants, cough medicines, and expectorants, alone and in combinations, are all marketed for the symptoms of a cold. However, there have been few clinical trials of these products in infants and children, and there are no studies that demonstrate any benefit in infants or children.

The United States Food and Drug Administration (FDA) advisory panel has recommended against the use of these medications in children younger than six [1]. We agree with this recommendation because these medications are not proven to be effective and have the potential to cause dangerous side effects. Parents may give acetaminophen (sample brand name: Tylenol) to treat a child (older than three months) who is uncomfortable because of fever during the first few days of a cold. Ibuprofen (sample brand names: Advil, Motrin) can be given to children older than six months. Aspirin should not be given to any child under age 18 years. There is no benefit of these medications if the child is comfortable. Humidified air may improve symptoms of nasal congestion and runny nose

Antibiotics —CAntibiotics — Antibiotics are not effective in treating colds. They may be necessary if the cold is complicated by a bacterial infection, like an ear infection, pneumonia, or sinusitis. Parents who think their child has developed one of these infections should contact their child's healthcare provider. Inappropriate use of antibiotics can lead to the development of antibiotic resistance.