After Care instructions for an Older Child with URI
Your child has a common cold (upper respiratory infection).
A cold is caused by a virus. Antibiotics do not help and are not needed. Colds get better on their own, usually within a week or two. A cough can linger the longest — sometimes up to 2 weeks. The goal of care is to keep your child comfortable while the body clears the virus.
Home care to help your child feel better
- Fluids: Offer plenty of water and other fluids. Staying well hydrated thins mucus and soothes the throat.
- Rest: Let your child rest as needed. They may return to school when fever-free for 24 hours (without fever medicine) and feeling well enough to participate.
- Humidified air: A cool-mist humidifier or sitting in a steamy bathroom can ease congestion. Clean the humidifier daily to prevent mold.
- Honey for cough: For a bothersome cough, 1-2 teaspoon of honey (plain, or in warm water/tea), or honey cough syrup such as Zarbee’s, can be given. Honey is safe at this age and works as well as or better than over-the-counter cough syrups.
- Fever and aches: Acetaminophen or ibuprofen can be used for fever, headache, sore throat, or aches. Follow the dosing on the package for your child’s weight and age. Never give aspirin to a child or teen with a viral illness.
- Sore throat: Warm liquids, cold treats (popsicles), or throat lozenges (only if your child is old enough to use them safely) can help.
Saline sinus/nasal rinses (NeilMed, neti pot, or squeeze bottle)
Rinsing the nose and sinuses with saltwater can loosen mucus, clear congestion, and make breathing easier. It is safe for children 6 and older who can cooperate.
How to do it safely:
- Use the right water — this is very important. Never use plain tap water straight from the faucet. Use one of the following:
- Distilled or sterile water (store-bought), OR
- Tap water that has been boiled for 3–5 minutes and then cooled to lukewarm.
- Use the premixed saline packets that come with the kit (such as NeilMed), mixed with the safe water above. Mix to lukewarm (body temperature) — not hot, not cold.
- Have your child lean over a sink, tilt the head to the side or forward, and gently squeeze or pour the solution into the upper nostril so it drains out the other nostril. Breathe through the mouth, not the nose.
- Gently blow the nose afterward.
- Use 1–3 times per day while congested.
Clean the device after every use: Wash with safe (distilled/boiled-and-cooled) water and soap, and let it air-dry completely. Do not share the device between family members.
Mild stinging, burning, or a small amount of leftover solution dripping out later is normal and harmless.
Medicines to avoid
- Over-the-counter cough and cold medicines (decongestants, antihistamine combinations, cough suppressants) offer little benefit for children and can cause side effects. They are not recommended under age 6 and are best avoided in young school-age children. Ask your child’s clinician before using any multi-symptom cold product.
- No aspirin — it can cause a rare but serious illness (Reye syndrome) in children with viral infections.
- No codeine-containing cough medicines.
- Medicines containing alcohol.
Call your clinician or seek care if your child has:
- Trouble breathing, fast breathing, or working hard to breathe (ribs pulling in, nostrils flaring)
- Bluish lips or face
- Fever lasting more than 5 days, or fever that goes away and then comes back
- Symptoms that last more than 10–14 days without improvement, or that suddenly get worse after starting to improve (may be a sign of bacterial infection)
- Ear pain, drainage from the ear, or pulling at the ears
- Severe sore throat, trouble swallowing, or drooling
- Signs of dehydration: no urine for 24+ hours, no tears when crying, dry mouth, unusual sleepiness
- A stiff neck, severe headache, or a new rash
- Not drinking, unusually drowsy, hard to wake, or acting very ill
Call 911 or go to the emergency room for severe breathing trouble, blue color, a seizure, or if your child is difficult to wake.
