More than likely, if your child is sick with a respiratory virus, it's a cold. The American Lung Association reports that young children suffer from an average of six to eight colds yearly.

Still, as a parent, it's important to stay vigilant to keep your children healthy. Because colds are so common, many parents assume their child has a cold instead of the flu. The cold and flu put your child at risk for secondary infections - like otitis media (ear infections) or pneumonia - but the risk for secondary infections is slightly higher with the flu, so it’s important to know the signs to provide an adequate level of care.

So, how do you tell the difference between the cold and the flu, and if your child does have the flu, what should you do? Keep reading to get answers to these questions and more.

Key Takeaways:

• The cold and flu are both common respiratory viruses with a few similar symptoms, such as fever, cough, and sore throat.
• Cough symptoms typically appear more gradually, while flu symptoms appear suddenly.
• While upper respiratory infections are generally limited to the nose, sinuses, ears, and throat, the flu can affect multiple systems in the body, including the respiratory system (cough, congestion), GI tract (nausea, vomiting, diarrhea), and musculoskeletal systems (body aches).
• Rest, hydration, and over-the-counter medications are recommended  for both colds and flu.
• Establish good hygiene habits and stay up-to-date with vaccines to minimize the risk of your child catching colds or the flu.

How are colds and flu similar?

The cold and flu are both caused by viruses spread through respiratory droplets. Both illnesses are characterized by fever, cough, and sore throat. The common cold and the flu can lead to secondary infections such as ear infections or pneumonia, so it’s important to look out for changes or worsening of symptoms if your child has been diagnosed with either illness.

What's the difference between the common cold and flu?

The biggest differences between the cold and the flu are the severity of symptoms and the speed at which those symptoms show up. While a cold and flu look similar, flu symptoms usually come on more abruptly and can last slightly longer. While colds can take a few days for symptoms to appear after infection, flu symptoms may appear within hours after exposure to an influenza virus.

Common cold symptoms 

The Centers for Disease Control reports that more than 200 viruses can cause a cold, with the rhinovirus being the most common culprit. Close contact with an infected person is the main way to catch a cold. Seasons and age can also impact your child's susceptibility to catch a cold, as colds are more common in fall and winter, hitting babies and young children especially hard.

Symptoms

Colds usually last 7-10 days, with the peak of symptoms occurring on days 2 and 3. Common symptoms include:

• Sneezing
• Stuffy nose
• Runny nose
• Sore throat
• Coughing
• Post-nasal drip (mucus dripping down one’s throat)
• Watery eyes
• Fever

What should I do if my child has a cold?

Rest and hydration are important remedies for treating a cold. You can also administer over-the-counter medications, such as decongestants or pain relievers, to help ease your child's symptoms. Many of these medications are age-dependent, so check with a doctor if you aren’t sure what is safe to give.

Common flu symptoms

The flu is a highly contagious viral upper respiratory infection caused by influenza viruses. The virus infects the nose, throat, and lungs but may cause symptoms in multiple body systems.  Infection rates are highest among children (roughly 20-30 percent annually) and occur seasonally, most often during the fall and winter months (but can occur at any time of year). Influenza can cause mild to severe illness. 

Symptoms

Many flu symptoms are similar to the common cold, such as fever, cough, runny or stuffy nose, and sore throat. Some symptoms, however, are also seen with  flu, including:

• Headache
• Chills or sweats
• Body aches
• Tiredness or fatigue
• Nausea
• Vomiting
• Diarrhea 

Additionally, influenza generally causes higher fever than what is seen with the common cold.  - Although it is possible that a regular cold could push your child's fever above that point, it is not uncommon for influenza to cause a fever above 101F. In general, we expect the fever to last up to 4 days. If your child still has a fever on day 5 of illness, we recommend making an appointment for an in-person evaluation. While the fever is expected to resolve by day 5,  other symptoms tend to resolve by day seven, and the cough may linger for up to 21 days. 

Causes

The flu is caused by the influenza virus and is spread by respiratory droplets containing the virus. Those droplets enter the body through mucous membranes - nose, mouth, or eyes. Your child might get the flu if an infected person coughs or sneezes near them, or your child may touch a surface with droplets and infect themselves by touching their face afterward. For this reason, hand hygiene and mask use, when possible, can help prevent the spread.

Home Testing for Flu

The FDA recently approved an at-home flu test that can detect influenza A and B and COVID-19. This test is available at many pharmacies and does not require a prescription. 

What should I do if my child has the flu?

Just like a cold, the most important thing is for them to stay well-hydrated and well-rested. Dehydration is the most common reason a child is hospitalized with the flu, so keep pushing those fluids! We also recommend tracking how often your child is peeing to get a sense of how hydrated they are. We generally like to see a minimum of 4 episodes of urine output per 24 hours. If your child develops vomiting or diarrhea, and you are worried about dehydration, it’s important to reach out to your doctor for an assessment, and possibly a medication to help the vomiting stop. 

What other signs should I look out for?

If your child develops increased work of breathing, signs of dehydration, or severe fatigue, please seek medical attention right away. In general, fevers can be high with influenza, but should not last more than 4 days. If your child has a fever for more than 4 days, they will need to be seen in person for an evaluation to make sure a secondary bacterial infection has not developed. 

Keep sick children away from other people

The  flu is very contagious, so kids should stay home from daycare, school, and other activities while they are sick. Clean the surfaces in your house well, especially kitchen counters and tables, and ensure everyone in your household washes their hands well; it can make a difference! 

Administer over-the-counter meds as needed

Your child will probably be pretty miserable and cranky if they have the flu, and for general discomfort, you may use Tylenol, Motrin, and/or a nasal saline spray as needed. If you give your child over-the-counter medicines, remember to focus not on the number of temperatures that your child has (which is an easy trap to fall into)- focus on treating the symptoms.

Does my child need prescription medication if they have the flu?

Medication is not usually prescribed for flu infections. Sometimes, if a doctor diagnoses your child with the flu within the first 48 hours of symptoms, they might prescribe Tamiflu (Oseltamivir), an antiviral medication specifically used to treat and prevent the flu.

Not all doctors prescribe Tamiflu, however, because research shows that it doesn't cut the flu's symptoms short by that long (only about a day) and because it can have side effects such as nausea and vomiting, which can make an episode of flu even more miserable! Some reserve it for high-risk patients, such as those under age 2 or those with asthma. Using Tamiflu varies case-by-case, so don't worry if your doctor doesn't write your child a prescription.

How do I prevent my child from getting a cold or flu?

It's natural for children to contract both the common cold and flu as they are exposed to more people and their immune systems are developing. Despite this, there are ways to help minimize their chances of getting sick. Here are some tips to keep your child healthy during cold and flu season:

Establish good hygiene habits

Cold and influenza viruses are easily spread by close contact with an infected person or touching an infected surface. Help your child build a hand-washing habit by washing their hands with soap and warm water before eating, after using the restroom, and when coming home from school or other public places. If water isn't readily available, use an alcohol-based hand sanitizer.

Remind them to cover their mouth and nose by coughing firmly into the crook of their elbow. Covering a cough with their hands does not do much to prevent the spread (unless hands are washed immediately), because their hands can spread the virus onto surfaces they touch. Good hygiene practices can greatly reduce the risk of your child catching a cold or flu or spreading it to others. If someone in your home requires special immune protection, using a mask can also help keep them protected.

Ensure a balanced diet

A well-balanced diet is crucial for maintaining a strong immune system. Ensure your child is getting plenty of fruits and vegetables rich in vitamins and antioxidants. These nutrients help boost the body's natural defense against infections. In addition, limit sugary treats as they can weaken the immune system and make it more susceptible to viruses.

Stay up-to-date with vaccines

Annual flu vaccines can also help protect your child from getting sick. Talk to your child's doctor about when they should get their flu shot and other recommended vaccinations.

Get enough sleep

Sleep plays an important role in keeping the immune system strong. Ensure your child gets enough sleep each night, as lack of sleep can make them more vulnerable to illnesses.

Encourage outdoor  activity

Encourage your child to participate in sports or outdoor activities that keep them active. Regular physical activity helps strengthen the immune system, decreases the chances of getting sick, and improves overall health. Vitamin D is obtained largely from sun exposure and plays an important role in boosting the immune system. 

Need help telling the difference between cold and flu? Chat with a Blueberry pediatrician

The common cold and flu are just two respiratory viruses Blueberry pediatricians treat. If you’re unsure which virus your child has, have questions, or want additional guidance, you can chat with a board-certified pediatrician through Blueberry Pediatrics.

Blueberry offers on-demand virtual healthcare for kids ages 0-21, right from the comfort of home. Blueberry's pediatricians are available 24/7/365 through text, video, or phone call. We treat most childhood symptoms or illnesses; no question is too big or small.

The best part? An entire year of Blueberry membership costs less than the typical copay of a single urgent care visit, and one membership covers all children in your household! It's like a doctor's office in your house. Sign up here.

Sources:

• Facts About the Common Cold. (2023, March 27). Www.lung.org. https://www.lung.org/lung-health-diseases/lung-disease-lookup/facts-about-the-common-cold
• Flu and Children - NFID. (n.d.). Https://Www.nfid.org/. https://www.nfid.org/infectious-diseases/flu-and-children/
• Sur, M., Lopez, M. J., & Baker, M. B. (2021). Oseltamivir. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK539909/

Frequently Asked Questions

Is a sore throat a symptom of a cold?

A sore throat is a common symptom of both colds and the flu.

What are the symptoms of a cold versus flu?

The cold and flu present similar symptoms such as fever, cough, runny or stuffy nose, and sore throat. However, flu symptoms generally involve the entire body, are more severe, and come on more abruptly. 

Should my child get a flu vaccine?

It is recommended that your child gets a flu shot every year. The influenza vaccine protects against the four most common circulating strains of influenza each year. Still, because the virus is continually changing, the vaccine does not provide 100% protection against the virus. While flu immunization does not necessarily prevent your child from getting the flu, it significantly reduces the risk of severe illness. 

Can my child get the flu more than once?

Yes, there are different strains of the flu (strains A and B are the most common in humans, but there are also subtypes of each strain that continually change over time). Strains A and B typically have peaks at different times during the flu season. It is possible to contract multiple strains. 

Are colds contagious?

The common cold is contagious and can be spread through close contact with infected people or surfaces. Coughing, sneezing, or rubbing watery eyes are all means of spreading the common cold.

Is the flu contagious?

The flu is highly contagious, and requires special precautions to prevent the spread. This includes staying home from school or activities where other children could be exposed, using a mask if possible, and practicing good hand hygiene. 

Do you need antibiotics for the flu?

No. Influenza A and Influenza B are viral infections, and antibiotics are only for bacterial infections. The typical recovery method for the flu is rest and hydration, with the administration of over-the-counter medicine for specific symptoms, as needed.

Do you need antiviral medications for the flu?

Not necessarily. Sometimes, your child's doctor may prescribe an antiviral like Tamiflu within 48 hours of onset of flu symptoms. In many cases, no medication is prescribed, although over-the-counter medications, such as ibuprofen or acetaminophen can be administered to make your child more comfortable, and help bring their fever down.