Every winter brings colds, influenza and other respiratory ailments that can spread quickly, particularly among children.

Laura Santos, MD, associate division director of pediatric critical care at Hassenfeld Children’s Hospital at NYU Langone, offers some reassurance for parents, including how to care for children with respiratory illnesses, signs that may indicate more serious illness and tips for helping your child recover at home.

My kids have had recurring respiratory symptoms off and on since the holidays. Is it too late to get them the flu shot?

It’s not too late to vaccinate: Influenza (flu) activity can occur as late as May, and most often peaks in February, so getting your child vaccinated at any time during the season can keep them from becoming ill and missing school.

Generally, it’s safe for children to get most vaccines even if they have a fever or a mild illness. Getting vaccinated may also protect those around you who aren’t eligible for the flu vaccine, like babies younger than 6 months and people with certain health conditions.

How do I know if it’s the common cold, the flu, respiratory syncytial virus or COVID?

Respiratory illnesses can look alike because the symptoms are similar: runny nose, sneezing, cough and fever. It can be difficult to differentiate between them based on symptoms alone, but there are a few key differences. 

In general, flu symptoms are more intense, begin more suddenly and tend to include chills and muscle or body aches. If you suspect that your child has the flu, check in with your pediatrician. There are special tests that can detect flu viruses, and treatment options are available that work best when started within 48 hours of the first symptoms. 

In most children, RSV is a mild illness that resembles the common cold. It tends to be more significant for children under the age of 2, and it can cause severe illness in infants younger than 6 months as well as children with chronic medical conditions. Wheezing can be a symptom of RSV in older children. Any breathing difficulties need to be checked out by a doctor or pediatrician immediately.

If you suspect COVID-19, at-home tests can be safely used on children. It’s important to know if your child has the COVID-19 virus so you can help limit the spread in your home and your community. Whatever respiratory illness it is, you should keep your child at home to recover and prevent others around your child from getting sick.

When should I consult a pediatrician, and what can I do at home?

While not every sniffle or sneeze requires a pediatrician, it’s wise to watch for more serious symptoms. If your child is having trouble breathing, cannot eat or drink, is not urinating due to dehydration or is unresponsive, seek immediate medical care. 

The good news is that many kids get better with remedies you can easily provide at home. If your child has a stuffy nose, there are lots of things you can try.

First, make sure your child is hydrated, which can help thin out mucus. Use a bulb syringe to extract excess mucus from the child’s nostrils, or try an over-the-counter saline nasal spray. Clearing out mucus can help your child breathe, but never insert anything deep into the nasal cavity.

If a nighttime cough is keeping your child from getting a good night’s rest, try a cool mist humidifier in their room along with acetaminophen to reduce muscle pain that can occur from coughing. Avoid over-the-counter cough and cold medicines for babies and young children, as they are not effective and may pose serious side effects. 

Lastly, encourage your child to rest and drink plenty of fluids. Give an over-the-counter infant or children’s fever reducer to ease pain and break a fever. Dressing your child in light clothing can help keep them comfortable — and snuggles from a loved one or a favorite blanket or sweater never hurt!

NYU Langone can help you find a pediatrician close to home, and Virtual Urgent Care is available for children ages 5 and older by calling 929-455-6409. Our experienced team is ready to help your family get through this winter season of respiratory illnesses. 


Laura Santos, MD, is associate director for the Division of Pediatric Critical Care at Hassenfeld Children’s Hospital at NYU Langone. She is also a professor of Pediatrics at NYU Grossman School of Medicine. As a critical care expert, Dr. Santos specializes in providing care for children with a wide variety of serious health problems, from infancy through young adulthood.

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