When to Take a Child to a Doctor for a Cold: When is it Serious

When to take your child to the doctor for a cold
It’s common for children to get colds, but how do you know if your child’s cold is serious enough for a doctor’s visit? Certain symptoms deserve medical attention. Learn when to see a doctor, when to go to the ER, and when telehealth or at-home care may be enough.

Signs you should take your child to a doctor for a cold

Call the doctor if your child has a high fever, trouble breathing, a cough or runny nose lasting over 7-10 days, ear pain, eye discharge, signs of dehydration, is very sleepy, or has a sore throat that makes swallowing hard.

Here are the details behind those warning signs:

• Fever. A fever is a sign that the body is fighting an infection.
  • For infants under 3 months, call your doctor immediately for a fever of 100.4°F (38°C) or higher. 
  • For children 3–6 months, call your doctor for a fever of 101°F (38.3°C) or higher. 
  • For children over 6 months, call your doctor for a fever of 103°F (39.4°C) or higher, or any fever lasting more than three days.
• Trouble breathing. Call your doctor right away or seek urgent care if your child experiences rapid or difficult breathing. Signs include wheezing and grunting, nasal flaring (widening of the nostrils during breathing), chest retractions, and blue lips or face. Trouble breathing may indicate more serious conditions, such as asthma,  bronchiolitis or pneumonia.
• Cold symptoms that don’t go away. Call if your child’s cold symptoms last more than 7- 10 days without improvement, Cold symptoms that last more than 7-10 days without improvement may signal a secondary infection, such as sinusitis or an ear infection. Note that thick yellow or green mucus is common with a  viral infection and does not always mean a bacterial infection unless it persists or worsens. 
• Ear pain or discharge. Call if your child has an earache, especially if it develops several days into a cold, is accompanied by fever or irritability, or there is fluid or discharge from the ear. These can be signs of an ear infection. 
• Eye redness or discharge. Call if your child has red eyes with yellow or green discharge or if their eyelids are stuck together after sleep. This may indicate conjunctivitis commonly known as “pink eye” or another secondary infection. 
• Unusual drowsiness or irritability. Call if your child is excessively sleepy, difficult to wake, or unusually irritable and not interested in playing. These may be signs of a more serious illness.
• Signs of dehydration. Call if your child has a dry mouth, no tears when crying, no urine output or wet diapers for eight hours or more, sunken eyes, or a soft spot on the head. 
• Sore throat with difficulty swallowing. Call if your child shows signs of a sore throat. A sore throat, especially if accompanied by fever, may be a sign of strep throat or another infection.

When to take your child to the doctor for a cold

Take your child to the doctor for a cold if symptoms get worse after several days, last more than 7-10 days, or include a high fever, persistent cough, or ear pain. You can manage mild colds at home, but you should see a doctor if your child is not improving.

When to take your child to their primary care doctor for a cold

Take your child to their primary care doctor for a cold if symptoms are not improving, they have recurring colds, or you’re concerned it might be something more serious. Your child’s primary care doctor knows your child’s health status best and can assess the illness, manage care and provide treatment, and provide follow-up if needed. Your primary care physician can also refer to the urgent care or emergency department if necessary. 

When to take your child to urgent care for a cold

Urgent care can help with moderate symptoms like a persistent cough or fever especially when your pediatrician isn’t available. However, for infants under 2 years old, choose a pediatric urgent care or pediatric ER, since general urgent care clinics and ERs may not have providers trained  to care for young infants and children.

When to go to the ER when your child has a cold 

Take your child to the ER for the following red-flag symptoms:

• A fever above 104°F (40°C) that does not go down with over-the-counter medicine. Children younger than 3 months should go to the ER with any level of fever. 
• Severe difficulty breathing (wheezing, grunting, retractions) or blue lips.
• Dehydration, with no urine output for eight or more hours, a dry mouth, no tears when crying, or a depressed fontanelle (soft spot on the head)
• Altered mental status or unresponsiveness — if you have trouble waking your child or they are confused.
• Seizures: Some children may have a febrile seizure when their fever rises quickly, often during a viral illness like a cold. Febrile seizures are typically brief and not dangerous, but a first-time seizure or one lasting over five minutes requires immediate medical attention.

When can you use telehealth for your child’s cold?

Use telehealth if your child has mild cold symptoms like a runny nose, low fever, or light cough — and is eating, drinking, and breathing normally. Do not use telehealth if they have ear pain, trouble breathing, signs of dehydration, or are under 3 months old.

Telehealth works well when your child’s symptoms are mild and they seem like their usual self. It’s okay to use it for things like a runny nose or a mild cough. But if your child is very young, has ear pain, trouble breathing, or signs of dehydration, see a doctor in person. Keep in mind that treating a child’s cold can differ greatly from treating an adult’s cold.

When to call 911 when your child has a cold

Call 911 if your child has the following emergency symptoms:

• Severe trouble breathing, with bluish lips or face, and unable to speak or cry.
• Signs of severe dehydration with no urine output for eight or more hours, a dry mouth, no tears when crying, or a soft spot on the head.
• Seizures.
• Altered mental state or unresponsiveness.
• For infants 3 months and under, a fever above 100.4°F (38°C).

Age-based considerations for when to take your child to the doctor for a cold

Infants (0–12 months). Colds present a high risk to infants, who have immature immune systems and smaller airways. Even mild colds can progress quickly in young infants. Infants under 3 months should see a doctor for any cold symptoms, especially if they develop a fever, breathing issues, feeding problems, or lethargy. Take your infant to the doctor for the following symptoms:

• Fever: Any fever over 100.4°F (38°C) in infants under 3 months requires immediate medical attention. For infants 3–12 months, a fever over 102°F (38.9°C) or lasting more than two days should be evaluated by a doctor.
• Trouble breathing, including flaring nostrils, grunting, chest retractions, or wheezing and coughing.
• Feeding issues: Refusal to eat or drink, or difficulty breastfeeding or bottle-feeding.
• Dehydration, with less than six wet diapers in 24 hours, a dry mouth, and no tears when crying; vomiting or diarrhea that leads to dehydration.
• Behavior changes, including excessive sleepiness, lethargy, or difficulty waking. 
• Mood changes, including persistent irritability or crying.
• Rash or any unusual skin changes.
• Cold symptoms lasting more than 7-10 days or worsening after five days.

Toddlers (1–3 years). Colds present less risk to toddlers because their immune systems are more developed than those of infants. Take your toddler to the doctor for a cold if they have the following symptoms:

• Fever: A fever over 102°F (38.9°C) lasting more than three days, or a fever over 104°F (40°C) at any time.
• Trouble breathing, including persistent wheezing, coughing, or labored breathing, or a high-pitched sound when breathing in.
• Dehydration, including refusal to drink fluids or significantly less urination; vomiting or diarrhea that leads to dehydration.
• Behavioral changes, including extreme fatigue, difficulty waking, or unusual irritability.
• Ear pain, including tugging at the ears or complaining about ear pain.
• Rash that spreads or is accompanied by fever.
• Cold symptoms lasting more than 10 days or worsening after initially getting better.

Preschool-aged children (3–5 years). Take your preschooler to the doctor for a cold if they have the following symptoms:

• Fever: A fever over 102°F (38.9°C) lasting more than three days, or a fever over 104°F (40°C) at any time.
• Trouble breathing, including persistent wheezing, coughing, or labored breathing, or a high-pitched sound when breathing in.
• Dehydration, including refusal to drink fluids or significantly less urination; vomiting or diarrhea that leads to dehydration.
• Behavioral changes, including extreme fatigue, difficulty waking, or unusual irritability.
• Ear pain, including tugging at the ears or complaining about ear pain.
• Rash that spreads or is accompanied by fever.
• Cold symptoms lasting more than 10 days or worsening after initially getting better.

School-aged children (6–12 years). Take your school-age child to the doctor for a cold if they have the following symptoms:

• Fever: A fever over 102°F (38.9°C) lasting more than three days, or a fever over 104°F (40°C) at any time.
• Trouble breathing, including persistent wheezing, coughing, or labored breathing, and complaints of chest pain or tightness.
• Dehydration, including refusal to drink fluids or significantly less urination; vomiting or diarrhea that persists or leads to dehydration.
• Behavioral changes, including lethargy, confusion, or difficulty waking.
• Ear pain or complaints of ear discomfort.
• Rash that spreads or is accompanied by fever.
• Cold symptoms lasting more than 10 days or worsening after initially getting better.

Adolescents (13+ years). Adolescents can better communicate their symptoms, but complications from a cold can still occur. Take your teen to the doctor for a cold if they have the following symptoms:

• Fever: A fever over 102°F (38.9°C) lasting more than three days, or a fever over 104°F (40°C) at any time.
• Trouble breathing, including persistent wheezing, coughing, or labored breathing, and complaints of chest pain or tightness.
• Dehydration, including refusal to drink fluids or significantly less urination; vomiting or diarrhea that persists or leads to dehydration.
• Behavioral changes, including lethargy, confusion, or difficulty waking.
• Severe sore throat, with difficulty swallowing or white patches in the throat.
• Ear pain or complaints of ear discomfort.
• Rash that spreads or is accompanied by fever.
• Cold symptoms lasting more than 10 days or worsening after initially getting better.

How to recognize the signs of breathing issues in children

It’s important to know what to look for when a child is experiencing respiratory distress or having trouble breathing. Catching problems early can prevent further complications. According to Dr. Ashley Kelley, a pediatrician with Included Health, it is important for caregivers to quickly recognize the signs and symptoms of difficulty breathing in order to intervene quickly. “When I am evaluating a child with a cold, I talk to the caregiver about the signs of trouble breathing they can watch for, so they can act quickly if needed to seek additional medical attention.  Caregivers should watch for fast breathing or signs that the child is working hard to breathe. Look for grunting sounds when they breathe, flaring nostrils, or retractions. Retractions are when the skin pulls in around the ribs as the child is breathing. 

Other sounds they can listen for are wheezing, which is a whistling sound made when breathing indicates the lungs are narrowed or obstructed. Wheezing is often associated with reactive airway disease or asthma but can have other causes too so it’s important to get it evaluated.  Another common breathing sound caregivers can listen for is stridor, which is a different high-pitched whistling noise, harsher sounding than wheezing, often associated with the viral illness, croup. 

If your child has a bluish color around the lips or face, this can indicate low oxygen levels and is a serious sign. Apnea (pauses in breathing) and altered mental status (such as confusion or excessive sleepiness) are also critical signs to watch for. If you notice any of these signs, it’s important to seek medical help right away. Early recognition and treatment can make a big difference in your child’s health.”

Here’s a summary of the signs and symptoms to look out for:

• Gasping for air – The child appears to be struggling to breathe, often opening their mouth wide and taking quick, shallow breaths as if they can’t get enough oxygen.
  
• Child can’t cry – In severe breathing difficulty, a child may not be able to make sounds or cry out because their airflow is too limited.
  
• Child can’t talk – A child who is unable to speak or form full sentences may not be getting enough air to support normal speech.
  
• In infants, difficulty breathing may cause them to stop feeding or struggle to suck and swallow – Babies may refuse to nurse or take a bottle because breathing issues make it hard to coordinate sucking, swallowing, and breathing.
  
• Ribs or pulling in with each breath – Also called “retractions,” this is when the skin around the ribs, neck, or stomach visibly pulls in with each breath, showing that the child is working very hard to breathe.
  
• Wheezing, whistling, stridor – These are abnormal breathing sounds: wheezing is a high-pitched sound when exhaling, whistling can occur with both inhale and exhale, and stridor is a harsh, raspy sound typically heard when inhaling.
  
• Faster than normal breathing – Breathing that is noticeably quicker than usual, even at rest, may signal that a child is trying to compensate for reduced oxygen intake.

Possible complications from colds in children

Most colds in children go away on their own, but complications can sometimes develop, especially in babies, toddlers, and children with underlying health conditions. A common cold may lead to ear infections, sinus infections, or more serious respiratory illnesses, such as bronchiolitis and pneumonia. For children with asthma, a cold can trigger wheezing or an asthma flare-up. Another potential complication is croup, an infection of the throat and windpipe that causes a harsh, barking cough. Young children may experience febrile seizures (convulsions caused by fever) during a cold-related fever, though these are rare and usually harmless. Call your child’s doctor if symptoms worsen, last more than 10 days, or include trouble breathing, high fever, or ear pain.

What is the timeline of a cold in a child?

The timeline of a cold in a child usually follows a predictable pattern that lasts about 7-10 days, though some symptoms (like a lingering cough) may persist longer. The exact duration and severity can vary depending on the child’s age, immune system, and the specific virus causing the cold.

Here’s a breakdown of the typical timeline of a cold in children:

Day 1–2: Incubation period (before symptoms appear)

After exposure to a cold virus, the virus begins to replicate in the body. During this time, the child may not show any symptoms, but can already be contagious. The virus is spreading in the respiratory tract.

Day 2–4: Onset of symptoms (early stage)

Symptoms begin to appear as the immune system responds to the virus. This is when the child is most contagious. Common symptoms include:

• Runny or stuffy nose, with clear mucus that may thicken over time
• Sneezing
• Mild sore throat
• Fatigue or feeling “off”
• Low-grade fever (more common in younger children)
• Mild cough may begin

What to do:

• Encourage rest and drinking lots of liquids.
• Use a saline nasal spray and suction for infants or toddlers to relieve congestion.
• Monitor for fever and other symptoms.

Day 4–6: Peak of symptoms (middle stage)

Symptoms are at their worst as the immune system fights the virus. The child may still be contagious, especially if coughing or sneezing frequently. (For more, see How long is a cold or flu contagious?) Common symptoms include:

• Nasal congestion or runny nose (mucus may turn yellow or green, which is normal as the immune system clears the infection)
• Persistent cough that may worsen at night
• Sore throat 
• Mild headache or body aches
• Low-grade fever (or no fever at all in older children)
• Fatigue or irritability

What to do:

• Drink lots of liquids, rest, and use saline spray and a humidifier.
• Use fever-reducing medications, such as acetaminophen or ibuprofen, if needed.
• Watch for signs of complications, such as ear pain, difficulty breathing, and high fever.

Day 6–10: Recovery stage

The immune system is clearing the virus, and symptoms begin to improve. The child is less contagious as symptoms subside. Common symptoms include:

• Nasal congestion and runny nose improve, but mucus may still be present
• Cough may linger, especially at night
• Energy levels start to return to normal

What to do:

• Encourage your child to continue resting and drinking liquids
• Use a humidifier or warm fluids to soothe a lingering cough
• Monitor for any symptoms that worsen or fail to improve

Day 10+: Lingering symptoms (if any)

Most cold symptoms go away by this point, but some children may experience lingering effects, including:

• Cough: A dry or mild cough may persist for 1–2 weeks as the airways heal.
• Fatigue: Some children may feel tired for a few extra days.

What to do:
If significant symptoms persist beyond 10 days or worsen after they have improved, such as a fever returning or cough developing, call your child’s doctor to rule out complications like sinus infections, ear infections, or pneumonia.

At-home treatments for children with colds that doctors recommend

There is no cure for the common cold, but there are a number of at-home remedies that can ease children’s symptoms.

1. Keep Your Child Hydrated

Why it helps: Staying hydrated helps thin mucus, making it easier to clear from the nose and throat, and prevents dehydration caused by fever or reduced fluid intake.

• Infants: Continue breastfeeding or formula feeding. Offer small, frequent feedings if they’re congested.
• Toddlers and older children: Water, diluted fruit juice, or oral rehydration solutions (e.g., Pedialyte).
• Warm fluids: Warm water, broth, or herbal teas (for older children) can soothe a sore throat and loosen mucus.

Tip: According to Dr. Kelley, hydration is key but can be difficult to maintain in a sick child. “As a pediatrician, I often advise parents that when their child is sick with a cold, the usual rules about feeding routines or having your child eat their vegetables at dinner time go out the window.  The focus during the illness is on hydration and comfort.  For some children, a popsicle might be the only way to get fluids into them, so popsicles it is! For toddlers and older children, food options like yogurt, smoothies, watermelon, and broths are excellent choices because they are hydrating.  I recommend watering down fruit juice to help reduce the sugar content.  For infants who are breast- or bottle-fed, they may want to take in smaller quantities more frequently, and may veer off their usual feeding routine as a result.  I recommend monitoring wet diapers or urine output in infants and children as a good indicator of the hydration status and follow up with your primary care provider, know right away if you start to notice signs of dehydration.” 

2. Use a Humidifier or Vaporizer

Why it helps: Adding moisture to the air can ease nasal congestion, soothe irritated airways, and reduce coughing.

• Use a cool-mist humidifier in your child’s room, especially at night.
• Clean the humidifier daily to prevent mold and bacteria buildup.
• Alternatively, sit with your child in a steamy bathroom for 10-15 minutes to help loosen mucus.

3. Saline Nasal Spray and Suction

Why it helps: Saline spray or drops can loosen mucus in the nose, making it easier to clear.

• For infants and toddlers: Use saline drops followed by a bulb syringe or nasal aspirator to gently suction out mucus.
• For older children: Encourage them to use saline spray and blow their nose gently.

Tip: Use saline before feedings or bedtime to help your child breathe more easily.

4. Elevate the Head

Why it helps: Keeping the head elevated can reduce nasal congestion and make breathing easier.

• For infants: Place a rolled towel or wedge under the crib mattress to slightly elevate the head (never place pillows directly under the baby).
• For older children: Use an extra pillow to prop up their head while sleeping.

5. Honey for Cough Relief (For Children Over 1 Year Old)

Why it helps: Honey can soothe a sore throat and reduce coughing.

• Give 1/2 to 1 teaspoon of honey before bedtime or as needed.
• Mix honey with warm water or herbal tea for added relief.

Important: Do not give honey to children under 1 year old due to the risk of botulism.

6. Warm Compress for Sinus Pain

Why it helps: A warm compress can relieve sinus pressure and reduce discomfort.

• Soak a clean washcloth in warm water, wring it out, and place it over your child’s sinuses (around the nose and eyes) for a few minutes.

7. Rest and Sleep

Why it helps: Rest allows the body to focus on fighting the infection and recovering.

• Create a calm, quiet environment.
• Offer comforting activities like reading, watching a favorite movie, or cuddling.

8. Over-the-Counter Medications (Use with Caution)

Why it helps: Certain medications can relieve symptoms like fever, pain, or congestion.

• Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for fever or pain relief (always follow dosing instructions based on your child’s age and weight).
• Avoid aspirin in children due to the risk of Reye’s syndrome.
• Avoid cough and cold medications in children under 6 years old unless directed by a doctor, as they can have serious side effects and are not proven effective for young children.

Important: Always consult your pediatrician before giving any medication, especially to infants or toddlers.

9. Soothe a Sore Throat

Why it helps: A sore throat can be painful and make swallowing difficult.

• Warm fluids: Offer warm water, broth, or herbal tea with honey (for children over 1 year old).
• Saltwater gargle: For older children, have them gargle with warm saltwater (1/2 teaspoon of salt in 8 ounces of water) to reduce throat irritation.
• Popsicles or cold drinks: These can numb the throat and provide relief.
• Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help with sore throat pain relief (always follow dosing instructions based on your child’s age and weight).

10. Encourage Gentle Nose Blowing

Why it helps: Clearing mucus from the nose can reduce congestion and prevent secondary infections like sinusitis. How to teach:

• Show your child how to blow their nose gently, one nostril at a time.
• Use tissues or soft wipes to avoid skin irritation.

11. Avoid Irritants

Why it helps: Reducing exposure to irritants can prevent symptoms from worsening.
What to avoid:

• Cigarette smoke.
• Strong odors (e.g., perfumes, cleaning products).
• Dry air (use a humidifier to keep the air moist).

12. Provide Comfort and Reassurance

A sick child may feel anxious or uncomfortable, and your care can help them feel better emotionally.

• Offer cuddles, read stories, or watch a favorite movie together.
• Reassure your child that they’ll feel better soon.

How Doctor On Demand can help with your child’s cold

A virtual visit with Doctor On Demand is quick and convenient. Following the steps below can make it even easier for your child to get the care they need.

• Take your child’s temperature, noting the time and method used.
• Write down any other symptoms your child is experiencing (runny nose, cough, rash, etc.).
• Note how long your child has had the symptoms and any changes in severity.
• List any medications given, with dosage and timing.
• Keep your child’s medical history and medication list handy.
• Be ready to describe exposures, such as recent travel, sick contacts, etc.

 Doctor-answered FAQs on kids’ colds

• When to take an infant to a doctor for a cold​?
  Call your doctor if your baby under 3 months has cold symptoms — especially a fever over 100.4°F (38°C). For babies 3 to 12 months, see a doctor if they have trouble breathing, feed poorly, seem very sleepy or irritable, or don’t get better after a few days.
  
• When to take a toddler to a doctor for a cold?​
  Take your toddler to the doctor for a cold if they have a fever for more than three days, are breathing fast or struggling to breathe, are not drinking enough fluids, have ear pain, or seem unusually drowsy or irritable. Also, contact your doctor if the cold symptoms last more than 10 days or get worse.
  
• How long is too long for a child to have a cold?
  If a child’s cold lasts more than 10 days or worsens after about five days, seek medical care.
  
• What are the stages of a cold in a child?
  A cold in a child usually begins with sneezing and a mild sore throat. Fever may follow and last 2 to 3 days. Next comes a runny or stuffy nose and nasal itching. A cough often appears last and can linger after other symptoms improve.
  
• When should I be concerned about my child’s cold?
  Be concerned if your child has a high fever, trouble breathing, wheezing, or signs of dehydration like dry mouth or fewer wet diapers. Also, call your doctor if symptoms get worse after a few days or your child is very sleepy, irritable, or not eating.
  
• When is a child no longer contagious with a cold?
  A child is most contagious in the first few days of a cold, when symptoms like a runny nose and sneezing are at their peak. They can continue to shed the virus for up to two weeks, but the risk of spreading it drops sharply once they’re fever-free, feeling better, and symptoms are improving.
  
• Why is my child’s cold not going away?
  Your child may have a secondary infection, such as a sinus infection, ear infection, or pneumonia. If the cold does not improve after seven days or lasts more than 10 days, take your child to the doctor.
  
• Should you let your child go swimming with a cold​?
  It’s usually okay for a child to swim with mild cold symptoms like a runny nose or a light cough. If they feel well enough and have the energy to swim, it’s a good sign. Pool humidity may also help ease congestion and loosen mucus.
  
• Should you send your child to school with a cold​?
  You can send your child to school with a mild cold if they have no fever and have enough energy to go to school. Your child should stay home from school with a fever of 100.4°F (38°C) or higher until they are fever-free for at least 24 hours without medication. 
  
  If your child has a chronic condition, such as asthma, diabetes, or a weakened immune system, check with your doctor about whether to send your child to school.