Thank you to our friends at the Early Childhood Education Linkage System (ECELS) for this article.

Colds, coughs and runny noses are more common in the winter than in any other season. Poor circulation of air, dry heated air and crowded indoor spaces make it easier to share germs that make people sick.


The average child has three to ten colds a year. Children in their first couple of years of child care or school have one or two more colds than children their age who receive care only at home and who have no siblings to bring infection home.

After three years of age, children in child care for a year or more have fewer colds than those who have not built immunity by being in group care.

At least 100 different kinds of viruses can cause cold symptoms. The symptoms include runny nose, a scratchy or sore throat, headache, cough, sneezing, fussiness, muscle aches or tiredness. Some children may have a low-grade fever. A mild rise in temperature indicates that the body is working to fight a problem. A fever helps the body fight infection. These fevers do not need treatment as long as the child is not uncomfortable.

No medication cures the common cold. Multiple research studies confirm that over-the-counter cold medications are not helpful and may cause complications.


RSV (or respiratory syncytial virus) is one of the many viruses that cause respiratory illness―illnesses of the nose, throat, and lungs. This virus occurs in the late fall through early spring months.

Typically, RSV causes a cold, which may be followed by bronchiolitis (lower respiratory tract infection) or pneumonia. Symptoms of bronchiolitis may include cold symptoms, plus: fast breathing, flaring of the nostrils, head bobbing with breathing, rhythmic grunting during breathing, belly breathing, tugging between their ribs, and/or tugging at the lower neck, or wheezing.

Symptoms generally last an average of 5-7 days. RSV symptoms are typically at their worst on days three through five of illness. Fortunately, almost all children recover from an RSV infection on their own.

Infants with a higher risk for severe RSV infection include:

  • Young chronological age (≤12 weeks) at the start of RSV season
  • Premature or low birth weight infants (especially those born before 29 weeks gestation)
  • Chronic lung disease of prematurity
  • Babies with certain types of heart defects
  • Those with weak immune systems due to illness or treatments

Additional risk factors for severe RSV infections include low birth weight, having siblings, maternal smoking during pregnancy, exposure to secondhand smoke in the home, history of atopy (allergies/eczema), not breastfeeding, and being around children in a child care setting or living in crowded living conditions.

Contact a child’s health care provider right away if a child has any:

  • Symptoms of bronchiolitis (listed above)
  • Symptoms of dehydration (fewer than one wet diaper every eight hours)
  • Pauses or difficulty breathing
  • Gray or blue color to tongue, lips, or skin
  • Significantly decreased activity and alertness


The influenza (flu) virus is common and unpredictable. It can cause serious complications – even in healthy children.

Certain people are more at risk for serious flu-related complications. These include:

  • Children younger than five years of age, especially those younger than two years
  • Preterm infants
  • Children of any age with certain long-term health problems, for example, asthma or other lung disorders, heart disease, or a neurologic or neurodevelopmental disorder
  • Pregnant women
  • Older adults age 65 years and older: Immune systems decline as adults age.

The flu vaccine helps reduce serious illness and deaths that occur every year from influenza. For the 2020-2021 flu season, the national American Academy of Pediatrics advises any licensed, recommended, age-appropriate vaccine available can be administered.

Get flu vaccine now for the current season for children older than six months of age, parents and extended family members.

Coronavirus (COVID-19)

For information about keeping your child safe and healthy during the Coronavirus (COVID-19) pandemic, please visit the Resources for Families in Pennsylvania on COVID-19 page at on the PA’s Promise for Children website.



This article was prepared by Nancy Alleman, BSN, RN, CPNP, ECELS Lead Training/Technical Assistance Coordinator. ECELS is a program of the PA Chapter, American Academy of Pediatrics.two

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