When to see the doctor with the little ones

Children have a cold much more often than adults. Because your immune system still has to learn to cope with the onslaught of viruses. Coughs and sniffling are mostly harmless. But with some symptoms, a quick visit to the doctor is advisable.

The immune system of children is very busy, especially in the first years of life. Because there are many pathogens that can cause a cold. The good news for parents, who usually have to look after their offspring themselves later on: With every germ invasion, the body’s defense system learns, and the child gradually becomes  immune to many  viruses and bacteria. The older the children get, the better they are protected by their immune system and the fewer colds they have to go through.

When children are sick, it is often known as an upper respiratory cold . They sniff and cough particularly often in autumn and winter, but it also occurs in spring and summer. They often catch colds several times in a row, and small children up to ten times a year. Kindergarten children in particular often catch colds. Because the immune system of children is still maturing and must first learn to cope with the many germs. 

There are more than 200 different cold viruses

A cold is mainly triggered by viruses, especially rhinoviruses. There are more than 100 different types of these pathogens alone. But also adeno-, myxo-, paramyxo-, echo, coxsackie and parainfluenza viruses can cause the inflammation in the nose and throat. In total, more than 200 different viruses are known – but there are certainly many more that are not yet known today – that can cause colds . They are transmitted when speaking, sneezing, blowing your nose or cuddling, and are then found on toys, handkerchiefs or hands and are passed on cheerfully.

Respiratory syncytial viruses are not entirely safe for babies, especially premature babies , and younger children. They often lead to inflammation of the bronchi and lungs. Older children and adolescents, on the other hand, can no longer be affected by these pathogens, they only get a harmless cold.

Love and care

As a parent, there is very little you can actively do to protect your child. Make sure you have a regular daily routine and a healthy diet . Keep stress away from your child. And give him a lot of love. All of this strengthens the immune system – the most important protection against the pathogens. It is very controversial whether constant warm wrapping prevents the common cold. Of course children shouldn’t be cold, but it’s not the hypothermia that makes the children sick, it’s the pathogens. In this respect, the term common cold, which has become firmly established in everyday language, is actually wrong. The real flu toochallenges the immune system of children – even more than the common cold can. Because the flu pathogens can damage the tissue much more than cold viruses. Therefore, flu can make children seriously ill. Small children in particular often have to be hospitalized for serious complications.

The Standing Vaccination Commission of the Robert Koch Institute (STIKO) recommends parents to have children vaccinated against influenza if they are chronically ill. For example if you have chronic bronchitis, asthma, metabolic disorders, diseases of the cardiovascular system or the kidneys. In other countries, the flu vaccination is even recommended for all infants.


If the child is sick, it may not be noticed at first. Maybe it’s just quieter than usual or withdraws. They may also be crying or have no appetite. No wonder, because at the beginning of a cold you feel weak and depressed. The typical symptoms soon develop: fever, cough, headache and body aches. The nasal mucous membrane swells, the nose runny and initially produces watery-clear, then slimy-purulent mucus. That’s why breathing is difficult. The throat hurts and feels scratchy. The eyes are red and the lymph nodes are swollen.

You can tell the difference between a cold and the flu by how quickly and how severe the symptoms develop. A cold usually comes slowly and heals on its own. The flu usually starts suddenly and with a high fever of over 39 degrees Celsius, which then lasts for several days. Further symptoms of the real virus flu are: severe headache and body aches and a dry, strong cough.

With a normal cold, the viruses colonize the lining of the nose and throat. If the immune system is weakened, they may move on to the bronchi or paranasal sinuses. There they also cause inflamed tissue. The result: bronchitis or a sinus infection. In some cases, bacteria then colonize the inflamed areas. Such a mixed infection can cause further trouble.

If the cold spreads because the germs migrate, your child may suffer from further symptoms. The most common complications are:

  • An otitis media: when this happens, your child has a sharp, throbbing pain in the ear. However, small children often also feel it in the stomach. The pain occurs because the lining of the middle ear is inflamed.
  • sinusitis (sinus infection): This affects the lining of the sinuses. Classic complaints are a blocked nose, a purulent runny nose and headache .
  • bronchitis: In this infection, the child under cold, dry cough and fever suffers in infants often abdominal pain are added. In older children, acute bronchitis cannot be distinguished from a severe cold. Pneumonia rarely develops from it. If the finest branches of the bronchial tree are inflamed and swell, it can be life-threatening. Experts call this condition bronchiolitis.
  • laryngitis: It is noticeable by hoarseness, dry, tickly cough and itchy throat. Schoolchildren are mostly affected. A special form of laryngitis is more common in small children: pseudo croup.

To the doctor if it really hurts

Coughs and sniffling are mostly harmless. However, if you notice that your child seems seriously ill or is particularly suffering, you should go to the pediatrician with him – if the fever, pain or cough is very strong or if you discover a noticeable rash or even small bleeding into the skin. If the child seems apathetic and absent to you, this is also a reason to see the pediatrician. As a rule, everything that lasts longer than ten days is a case for the doctor.

If you have any of the following problems, you should go to a doctor’s office immediately:

  • The child is no longer drinking enough.
  • It has breathing problems.
  • She has a high fever and a severe headache.
  • It seems impassive.
  • It gets a stiff neck.
  • It’s sensitive to the touch.


The pediatrician will first ask you about your child’s symptoms and then examine the child.

With a glance into the wide open mouth and throat, the doctor examines the lining of the mouth and throat: it is often reddened when it is infected by viruses or bacteria. White deposits on the tonsils tend to suggest that bacteria have inflamed the tonsils. The doctor may then take a swab from the throat. With his hands he feels the neck down the sides below the jaw. Swollen lymph nodes can also indicate inflammation of the tonsils.

The doctor uses a stethoscope to listen to the lungs: this is how he can diagnose pneumonia. He also looks at the skin all over his body to identify rashes. If the doctor suspects a serious illness after the physical examination, he will recommend further examinations for your child, such as an X-ray of the lungs or a blood test , because the blood values ​​can provide information about serious disorders or diseases of certain organs.

When an allergy looks like a cold

Often there are other illnesses behind the symptoms of the common cold. A cough or runny nose also occurs with:

  • real flu virus . It usually begins suddenly and is accompanied by a high fever of over 39 degrees. But it can also be milder and look like a cold .
  • Whooping cough or measles . These classic teething troubles also begin like a cold. The symptoms typical of the disease appear later.
  • bronchiolitis. These are inflamed bronchi, especially in the very small branches of the lungs. The risk of confusion is particularly high with infants. Severe shortness of breath, rapid breathing, sometimes coughing and wheezing are the consequences of bronchiolitis.
  • an allergic runny nose . It is often confused with a cold at first.


If your child has a cold, all you can do is alleviate the symptoms. You cannot fight the cause – the viruses. In general, you should make sure that your child drinks a lot. When you have a fever, your body uses up a lot of fluids. Herbal teas and still mineral waters are suitable. Do not wrap your child too warm, especially if they have a high fever. Offer your child food that they like and that is high in vitamins.

Ventilate the children’s room regularly or take your child out into the fresh air. Refrain from smoking, as it irritates the mucous membranes. Provide your child with a cold regularly with fresh handkerchiefs and do not put used handkerchiefs on the table, but throw them away.

Drink, gargle, wrap

There are many herbal remedies available for cold symptoms . The empirical knowledge about it is passed on from generation and generation.

  • Steam inhalations with a water-table salt solution make the nasal mucous membranes swell and make breathing easier. Thyme, chamomile or angelic root balm are also suitable against colds. But remember to never leave your child alone with the hot water! You can also try nasal rinsing with salt, but only for children aged four and over.
  • If your child has a sore throat, gargle with salt water, sage or chamomile tea, or give them linden blossom tea to drink. Neck wraps can also be beneficial, for example a warm potato or onion wrap or a cold quark wrap. A humidifier or damp cloths in the nursery soothe the scratchy throat.
  • Quench the cough with herbal teas that contain thyme or ivy extracts, elderflower, sage or marshmallow. Warm milk with honey in children from two years of age acts as an expectorant.
  • Onion compresses have anti-inflammatory and pain-relieving effects for earache.

Medicines only in consultation with the pediatrician

There are plenty of medicines for colds in the pharmacy. But be careful: some substances are not suitable for children, for example acetyl salicylic acid (ASA). Others cause additional problems with prolonged use, such as nasal drops that cause the mucous membranes to swell. Before giving any medication to your child, it should be discussed with your pediatrician.

  • Ibuprofen or paracetamol lower the fever and relieve the pain. The dosage depends on the weight of the child.
  • Nasal drops , which have a decongestant effect, make it easier to breathe through the nose. However, the drops should not be used for more than five days, as they can damage the nasal mucosa if used continuously. Sea-based or salt-based nasal drops or sprays are suitable for children.
  • Expectorant cough suppressants such as acetylcysteine, ambroxol or bromhexine do not do any harm, but there is no evidence that they work.
  • You should only give your child cough suppressants , so-called antitussives, in exceptional cases in the event of an excruciating dry cough and after consultation with the pediatrician, as these usually contain substances that are chemically related to morphine. In addition, it usually doesn’t make sense to block the cough, as it is the body’s natural mechanism for removing mucus from the bronchi.

Antibiotics are often pointless for bronchitis

Antibiotics can only be useful if your child has a severe otitis media or if they are very small . If, on the other hand, your child drinks enough and the earache is only moderate, you can wait two to three days. You can give him mild pain relievers like ibuprofen for as long. Warmth, for example from red light or a hot water bottle, or herbal remedies such as an onion or chamomile sachet also help. You should decide together with the doctor whether an antibiotic is really necessary. Ear drops should only be instilled after the doctor has examined the eardrum.

If you suspect that your child has bronchitis, you can try to relieve the cough with the help of herbal cough teas, thyme breast compresses or – for children from two years of age – the tried and tested honey milk. Antibiotics are pointless because the symptoms are mostly caused by viruses . But antibiotics only kill bacteria.


Viruses can survive on the surface of the skin for several hours. Therefore, encourage your child to wash their hands thoroughly every time they blow their nose.

Strengthen your child’s immune system with exercise, fresh air and a healthy diet .

expert advice

Stern.de expert Professor Reinhard Berner from the University of Freiburg answers your questions:

How can I strengthen my child’s immune system?

At birth, an infant’s immune system is not yet fully developed. However, if you breastfeed your child for the first six months, they will receive certain antibodies from you through their breast milk and are thus at least partially protected. Later on, a balanced diet and lifestyle best support your own defenses.

Can vitamins strengthen the immune system?

With a balanced diet, vitamin tablets are completely superfluous. Instead, make sure that your child gets fresh air and exercise regularly – even in bad weather.

What do you think of flu drugs in children?

The market for cough suppressants , nasal drops , flu medication and immune strengthening agents is vast. However, most of the preparations do not keep what they promise. For example, the effect of so-called expectorant drugs has not been proven. They don’t do any harm, but they don’t do any good either. Echinacea preparations can also be saved. They do have an effect on the immune system. However, they do not influence the course of the disease in a relevant way: they neither shorten the disease nor alleviate the symptoms.

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