A cold in a child usually lasts one to two weeks, and the cough can linger for a few weeks more. What helps is simple: saline drops or spray, a raised head end at night, plenty to drink and rest. The child goes back to förskola (municipal preschool, from age one) when they are fever-free and have the energy to join in, not when the runny nose is gone. Seek medical advice for breathing difficulties, fever for more than four days, or if the child gets worse after getting better.
October, the third cold since preschool started in August. The one-year-old sleeps badly because her nose is blocked, the four-year-old coughs at bedtime, and you have already used more VAB days (paid leave to care for a sick child) than you planned for. Colds are the most common illness of the toddler years, and they are almost never dangerous. But they are hard work, and there are things that actually help and things that just cost money. Here is the difference.
How a cold runs its course
- Days one to two: under the weather, perhaps a slight fever, runny nose. The child eats less and wants to be close.
- Days three to five: blocked nose, thicker snot that turns yellow or green. That is normal and does not mean bacteria or antibiotics. Coughing at night from the snot running down the back of the throat.
- Days six to ten: the fever is gone, the mood is back, the runny nose easing.
- Weeks two to four: a lingering cough, especially at bedtime and in the morning. It is tiring but harmless if the child is otherwise well.
What should make you react is not the length of the cold but the direction. A child who gets better and then worse again, with a new fever, may have developed an ear infection or something else a doctor will want to look at.
What helps
- Saline drops or saline spray in the nose before breastfeeding, meals and sleep. For babies you can also suck out the snot with a nasal aspirator from the pharmacy. It sounds brutal and it works.
- A raised head end: a folded towel under the mattress, not a pillow in the cot for small children.
- Fluids. A child with a cold eats less, which does not matter for a few days, but they must drink. Water, välling (the Swedish milky cereal drink), soup, squash if nothing else goes down.
- Honey for children over one, a teaspoon at bedtime, soothes a cough as well as most things at the pharmacy. Never for children under one.
- Cool, moist air in the bedroom. Stockholm flats with the radiators on full get dry in winter, and dry air makes the mucous membranes worse. Air the room before bedtime.
- Rest without nagging. The child decides how much they can manage, and a three-year-old with a cold who is playing on the floor is usually fine.
Babies under one have it especially hard because they breathe through the nose while breastfeeding or taking a bottle. A blocked-up baby lets go of the breast after a few sucks, gets cross and falls asleep hungry. Saline drops and a nasal aspirator right before a feed often solve it, along with short, frequent feeds instead of few and long. If the baby is under three months and gets a fever, always call 1177 (the national healthcare helpline), however bright she seems.
Fever medicine and cough medicine
A fever in itself does not need to be brought down. If the child is miserable, in pain or sleeping badly, pain relief can help, but read the packaging, follow the instructions for age and weight and ask the pharmacy or 1177 if you are unsure. Cough medicines for children have no support in the research and are advised against for the smallest. Nasal sprays that shrink the lining are available for children from a certain age, but should be used for short periods only. The pharmacy will guide you, and they do it well.
Preschool: stay home or not?
| Can go to preschool | Stays at home |
|---|---|
| Fever-free for a day | Fever, however bright the child seems |
| Snuffly but playing and eating | Just wants to lie down and does not look up |
| Coughs a little, sleeps okay | Coughs so much it disturbs sleep and energy |
| Can manage a whole day indoors and out | Needs comfort and rest every ten minutes |
When to seek medical advice
| Seek medical advice | Wait at home |
|---|---|
| Child under three months with a fever | Child over one with a fever and in good spirits between peaks |
| Difficulty breathing, breathing fast, pulling in between the ribs | Snuffly breathing from a blocked nose that eases after saline |
| Fever for more than four days | Fever for two days that then goes down |
| Drowsy, hard to engage, not drinking | Tired but responsive, drinking little but often |
| Gets worse after getting better | Slowly gets better day by day |
| Earache, especially at night | A slightly sore throat when swallowing |
Can you get fewer colds?
Not much. Washing hands with soap when you get home and before meals reduces infection somewhat. The child should not share dummies, bottles and towels with siblings on the days you can see something is brewing. Vitamins, supplements and a woolly hat in August make no difference. What actually happens is that the child builds up an immune system during the first preschool years, and the colds become fewer by school age. That is a comfort, if a slow one.
How we do it with our families
A nanny who comes every week sees when a cold is starting: the one-year-old who does not want lunch on Tuesday, the three-year-old who is whinier than usual. She writes it on the note so you are not caught out in the night. She has saline spray in her bag and knows how you want her to handle a fever: ring you first, give nothing on her own initiative. If the child is home from preschool but too lively to lie still, and you have to work, the same nanny can take the day if she is free. A child with a cold wants someone they know.
This text is general information and does not replace advice from BVC (the child health clinic every family is enrolled in), your vårdcentral (local health centre) or 1177. If you are worried about your child, call 1177. In an emergency, call 112.
Would you like a nanny who knows your child, knows how they usually are and notices when something is different? Book a free first meeting with the nanny in your home.
Read more: Fever in children · Cough in children · A nanny when your child is sick · VAB
Frequently asked questions
How long does a cold last in a child?
Usually one to two weeks, with the worst days at the start. The cough can linger for three to four weeks after the runny nose has cleared, and that is normal. If the child gets worse after getting better, or has a fever for more than four days, call 1177.
How many colds are normal?
Preschool children often get six to ten colds a year, and more in their first year at preschool. It can feel as if the child is snuffly from October to April, and that is often true. It is not a sign of a weak immune system, it is a sign of a lot of new viruses.
Should the child stay home from preschool?
The child goes to preschool when they are fever-free and have the energy to take part, according to Folkhälsomyndigheten. A runny nose and a slight cough are not reasons to stay at home. A child who just wants to lie on the sofa should stay home, whatever the thermometer says, and that also applies to a sibling who seems bright but has a fever.
Does cough medicine help?
Cough medicines have no proven effect in children and are not recommended for small children. Honey from the age of one, a raised head end, fluids and saline drops in the nose help more. Ask the pharmacy before giving any medicine at all, and never give honey to a child under one.
When should we seek medical advice?
For breathing difficulties, if the child is under three months and has a fever, for a fever lasting more than four days, if the child is not drinking, is drowsy and hard to engage, or gets worse again after getting better. Call 1177, and 112 if the child is struggling badly to breathe.