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Is it a Cold or the Flu?
Many parents wonder, “What’s the difference between a cold and the flu? How can I tell which illness my child has? Do I treat each illness differently?” Here’s an overview to help you understand the distinguishing characteristics of colds and the flu.

How colds and the flu are similar
Both colds and the flu are respiratory infections—contagious illnesses of the nose, sinuses, throat and breathing passages. For this reason, they share some similar symptoms, including a stuffy/running nose, sore throat and cough. You catch them the same way, too: breathing air with germs that someone has coughed into, kissing or sharing food or utensils with an infected individual, or touching your nose or mouth after touching someone’s hands or an object they’ve touched, such as a toy, doorknob or telephone.

In addition, colds and flu are both caused by viruses. Although colds can be caused by hundreds of different types of viruses, “the flu” is short for “influenza” which has three types (A, B and C) and slightly different strains every year. However, most people give the name “flu” to the general symptoms caused by influenza, which can also be caused by other viruses. Because colds and flu are caused by viruses, they usually get better on their own. Antibiotics, which treat bacterial infections, are not helpful.

How colds and the flu are different
The main difference between colds and flu are that colds are considered mild illnesses, and the flu can cause more severe symptoms. Colds are also known as head colds or upper respiratory infections since they tend to affect mostly the nose, sinuses and throat. They cause mild symptoms like stuffy and runny nose, sneezing, sore throat and a mild cough, and they usually get better within a week. The flu can be considered a lower respiratory infection since it is more likely to affect the lungs and total body. It causes symptoms like severe cough, fever, headache, shaking chills, body aches, vomiting, diarrhea and extreme fatigue. It can take two weeks to recover.

How to treat colds and flu
The basic treatment for both colds and flu is to help make your child feel comfortable and help his own body fight off the viral infection. The most important things you can do at home are:
  • Give your child tender loving care and plenty of rest. If your child’s energy level is high enough to participate in activities, it’s OK to let him go to childcare or school. If his energy level is down, it’s best to relax at home, cuddle in bed, stroke his forehead, read books, sing songs and play quiet games for a day or two until he feels better.
  • Keep up good nutrition and plenty of fluids. If your child has a good appetite, it’s fine to continue with her regular diet. But if her appetite is down, encourage her to eat light snacks and drink lots of fluids. Frequent breastfeeding or formula is good for infants. Older children can also drink juice, suck on frozen juice pops or sip warm chicken soup and no-caffeine tea with honey. Try light foods such as soup, noodles, rice, crackers, toast, applesauce and gelatin.
  • Stock up on tissues. When your child has a runny nose, you’ll need to wipe it frequently. Use soft tissues and wipe gently. Teach your child how to blow her nose gently, too. If the skin under her nose starts getting irritated and raw, dab on petroleum jelly or A&D ointment to help protect the skin.
If your child is uncomfortable with a congested nose, the following may help:
  • Run a cool-mist humidifier or vaporizer in your child’s room. The water vapor can help loosen your child’s nasal mucus. Be sure to empty, clean and dry the vaporizer each day to prevent the growth of bacteria or mold. Don’t use a hot water vaporizer because it can cause burns.
  • Try saline solution nose drops or spray. These are available at the pharmacy without a prescription. Tilt your child’s head back gently and squeeze a couple of drops of saline into each nostril to loosen the mucus. For infants, use a soft rubber infant suction bulb to suck out nasal mucus. If your baby’s nose is too congested to feed comfortably, you can use the saline nose drops and suction bulb before feedings.
If your child is uncomfortable with a fever, headache, sore throat or body aches:
  • Give him medicine to reduce his pain and fever: Acetaminophen or ibuprofen (for children older than 6 months) can help reduce pain and fever. Be sure to check the appropriate dose for your child’s age. Do not give your child aspirin because this can cause a serious illness called Reye Syndrome.
Be cautious about giving your child other medications. Most medicines labeled “for coughs and colds”—such as antihistamines, decongestants and cough suppressants—have not generally been found to relieve children’s symptoms or help them recover quicker. They can also have harmful side effects such as increased drowsiness or difficulty sleeping, nervousness and irritability. Experts now recommend not to give these "cough and cold medications" to children under 2 years of age, and many discourage giving them to children up to 6 years of age.

Also, beware alternative medicine treatments used in adults such as zinc, echinacea, goldenseal and large doses of vitamin C. These have not been studied enough in children to know whether they’re safe or effective. It’s always best to consult your doctor before giving your child any medication.

When to call the doctor
Most children recover from a cold or flu within a week or two without any problems. But sometimes a child might have a more severe case of the flu, or the cold or flu might progress to another illness such as an ear infection, sinus infection, tonsillitis, croup, bronchiolitis, pneumonia or asthma attack. In these cases, additional medical treatment such as anti-viral medication, antibiotics and asthma medications may be necessary.

Children younger than 2 and children with chronic illnesses such as lung, heart or immune system problems are more likely to get sicker with the flu. If your child has any of these conditions and you think he might have influenza, call your doctor right away. The doctor may prescribe an antiviral drug that can treat influenza, but it must be taken within 48 hours of the first symptoms to be effective.

Be sure to call your child’s doctor for any of the following signs of concern:
  • Persistent cough, wheezing, difficulty breathing, rapid breathing, flaring nostrils, skin pulling in around her ribs when she breathes or lips turning blue
  • Severe vomiting and/or diarrhea, and signs of dehydration: sunken eyes, dry mouth, skin that doesn’t spring back when gently pinched and no urination
  • Severe ear pain or pulling at ears, severe sore throat or difficulty swallowing and severe headache or stiff neck
  • Excessive fussiness, difficulty sleeping or excessive sleeping
  • Seizures or convulsions
  • Any fever greater than 101 degrees F. (38.3 degrees C.) rectally in an infant younger than 3 months. For older children, a persistent fever greater than 102 degrees F. (38.9 degrees C.) for more than three to five days, where the child is not feeling better or feeling better then getting worse after five days.
Preventing colds and flu in the future
Try to prevent both colds and the flu by making sure that you and your children eat well and get enough rest. Don’t share food, cups, utensils or tissues. Cough and sneeze into your elbow instead of into the air or your hands. Wash your hands and your children’s hands with soap and water, especially after wiping noses and using the bathroom. When a sink isn’t available, use an alcohol-based hand sanitizer.

In addition, protect yourself and your children from the flu by getting the annual flu vaccine every October or November. It’s now recommended for all children starting at 6 months of age and all adults to get the annual flu vaccine. It's especially important for children 6 months to 5 years of age, pregnant women, adults caring for young children, adults 50 years and older, and children and adults with chronic medical conditions, who are more susceptible to serious complications from the flu. Be sure to ask your doctor about the flu vaccine.

For more information about colds and flu, visit the Centers for Disease Control website at www.cdc.gov .

Article updated: January 2011
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician