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Health condition · Clinically reviewed

Colds in babies, how to help feeding and sleep, and when to seek urgent help.

Most infant colds settle at home with saline, feeds and rest. This guide covers exactly what helps, what to avoid, and the red flags that mean you need to be seen the same day.

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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a UK registered paediatric clinician before publication.

  • 02

    Sourced from guidance

    Checked against NICE, RCPCH and NHS sources listed at the end of the guide.

  • 03

    Current for 2026

    Reflects modern UK guidance including nirsevimab (Beyfortus), maternal RSV vaccination and MHRA cough medicine restrictions.

Key facts

Baby colds at a glance.

The essentials in plain English - what causes them, how long they last, and what really helps.

  • What it is

    A viral upper respiratory tract infection - rhinovirus is the most common, followed by RSV, parainfluenza, influenza, COVID and adenovirus.

  • How often

    Babies typically catch eight or more colds in the first year, especially those in nursery or with older siblings.

  • Key infant issue

    Infants are obligate nose breathers - a blocked nose can stop feeding, disturb sleep and cause distress out of proportion to the illness.

  • Usual duration

    Symptoms peak at days 3 to 5 and settle over 7 to 14 days. Cough can linger for weeks in under 2s.

  • Mainstay of care

    Feeds, fluids, saline nasal drops, gentle suction and age-appropriate paracetamol or ibuprofen. No cough or decongestant medicines.

  • When to worry

    Any baby under 3 months with a fever, poor feeding, drowsiness, grunting, chest recession, apnoea or a non-blanching rash needs urgent review.

Why this guide matters

Simple care at home, clear rules for when to escalate.

Colds in babies are common but not always harmless. These three points shape everything else on this page.

  • The nose is the whole story

    Babies are obligate nose breathers - clearing the nose with saline is often the difference between a baby who feeds and one who cannot.

  • Age changes the threshold

    A baby under 3 months with a fever is not treated like a toddler with a fever - the younger the baby, the lower the threshold for assessment.

  • Cough medicines are not the answer

    Since 2008 MHRA guidance has been clear - do not use over-the-counter cough or decongestant medicines in children under 6 years.

How a baby with a cold is assessed

From first sniffle to a clear plan.

The steps a UK GP, paediatric nurse or paediatrician will normally follow, so you know what to expect and why.

  1. 01

    Assessing

    History and red-flag screen

    Age, feeding volumes, wet nappies, alertness, breathing, temperature, immunisations and household contacts.

  2. 02

    Assessing

    Examination

    Vital signs, weight, hydration, chest auscultation, work of breathing, fontanelle, skin and neurological status.

  3. 03

    Assessing

    PEWS or NEWS2 scoring

    A paediatric early-warning score puts a number on how unwell the baby looks and guides escalation.

  4. 04

    Confirming

    Investigations only if needed

    Most viral colds are a clinical diagnosis - bloods, urine or a chest X-ray are only for red flags or diagnostic doubt.

  5. 05

    Confirming

    Consider differentials

    Bronchiolitis, pneumonia, whooping cough, croup, meningitis and sepsis can all start looking like a cold.

  6. 06

    Safety-net

    Safeguarding and parental wellbeing

    A quick check on how parents are coping - sleep deprivation and postnatal mental health matter alongside the baby.

  7. 07

    Safety-net

    Safety-net advice

    Clear written advice on what to watch for and when to come back - the single most useful thing a parent can leave with.

Typical assessment: a full paediatric review in one visit, with clear written safety-net advice to take home.

Symptoms

What a cold looks like in a baby.

The classic mix of a blocked nose, runny nose, mild fever and disrupted feeding - and the features that mean it is more than a cold.

  • Nasal congestion

    The dominant feature - a blocked nose disrupts feeding and sleep in babies who cannot breathe well through the mouth.

  • Runny nose and sneezing

    Clear or yellow-green rhinorrhoea. Colour change does not mean bacterial infection.

  • Mild fever and irritability

    Low-grade fever, fussiness and unsettled behaviour - especially at night.

  • Poor feeding and disturbed sleep

    Shorter, more frequent feeds. Broken sleep for baby and parents is very common.

  • Cough and hoarse cry

    Dry or moist cough, occasional hoarseness. Cough often lingers longest.

  • Typical course

    Symptoms build over 2 to 3 days, peak at day 3 to 5 and settle over 7 to 14 days.

  • Reduced wet nappies

    A useful marker of hydration - fewer than the baby's usual number is a warning sign.

  • Red flag - breathing or feeding

    Grunting, chest recession, nasal flaring, blue lips, apnoea, or less than half of normal feeds - seek urgent help.

Management

How infant colds are managed in the UK.

Feeds, fluids and saline first. Age-appropriate pain and fever relief when needed. Antibiotics only where a bacterial infection is suspected.

  • Feeds and fluids

    Offer breast or formula more often in smaller amounts. Older babies can have small sips of water. Track wet nappies.

  • Saline nasal drops

    A few drops before feeds and sleep loosens mucus. Products like Snufflebabe or Calpol Snotty Sniffles saline are widely used in the UK.

  • Gentle nasal suction

    A soft aspirator such as the NoseFrida, used gently after saline, clears the nose enough for feeding and sleep.

  • Paracetamol (2 months and older)

    For fever, irritability or pain. Use the correct age and weight-based dose on the bottle and never exceed four doses in 24 hours.

  • Ibuprofen (3 months and 5 kg or more)

    An alternative or additional option. Do not routinely alternate with paracetamol - only if response to one is inadequate.

  • Cool humidifier or steamy bathroom

    Humid air can ease congestion. Keep the baby out of direct steam and clean humidifiers thoroughly.

  • Oseltamivir for influenza

    Considered for confirmed or suspected influenza in high-risk infants when started within 48 hours of symptoms.

  • Urgent paediatric assessment

    Neonates and young infants with fever, poor feeding or any red flag need same-day review, often with admission for observation.

Neonates

A very low threshold for admission.

In the first 4 weeks of life, any fever, poor feeding or unusual behaviour warrants a full septic screen and, usually, intravenous antibiotics until infection is excluded.

Vaccination

Keep up with the routine UK schedule, plus seasonal flu from 2 years, maternal RSV vaccination in pregnancy, and nirsevimab (Beyfortus) introduced in the UK from 2024.

Prevention

Regular handwashing, keeping the home smoke-free, breastfeeding where possible, and limiting close contact with unwell adults and older children lowers the frequency of colds.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP, health visitor or paediatrician knows your baby and can tell you which parts of this guide apply. If in doubt, always seek advice.

  • NICE CKS. Common cold.

  • NICE NG143. Fever in under 5s: assessment and initial management.

  • RCPCH. Feverish illness and the unwell child guidance.

  • MHRA. Over-the-counter cough and cold medicines for children (2008 advice, still current).

  • UK Health Security Agency. Green Book - immunisation against infectious disease.

  • NHS. Coughs, colds and ear infections in children.

Red flags

When a cold needs urgent attention.

Most baby colds settle at home. These are the situations where you need to be seen the same day - or call 999.

  • Any fever in a baby under 3 months

    A temperature of 38 degrees C or higher in a baby under 3 months needs same-day assessment - the threshold is lower than at any other age.

  • Fever above 39 degrees C under 6 months

    High fever in a baby under 6 months warrants urgent review even if they otherwise look well.

  • Poor feeding or dehydration

    Less than half of normal feeds, fewer wet nappies, dry mouth, sunken fontanelle or no tears - seek help the same day.

  • Drowsy, floppy or hard to wake

    Reduced responsiveness, weak cry or unusual lethargy is never normal in a baby with a cold.

  • Breathing difficulty

    Grunting, subcostal recession, nasal flaring, head bobbing, fast breathing, blue lips or pauses in breathing (apnoea) - call 999.

  • Oxygen saturation below 92%

    If home pulse oximetry shows readings below 92% in air, the baby needs urgent hospital assessment.

  • Bulging fontanelle or non-blanching rash

    Meningitis and sepsis can present with cold-like symptoms - either sign needs an immediate 999 call.

  • Seizure

    Any first seizure, or one lasting more than 5 minutes, needs emergency assessment.

  • Symptoms getting worse or lasting over 10 days

    Prolonged or worsening symptoms may point to bronchiolitis, pneumonia, whooping cough or a secondary bacterial infection.

Important differentials

A cold in a baby can look very similar to more serious illness. Consider bronchiolitis, pneumonia, whooping cough, croup, meningitis and sepsis in any baby whose symptoms are worsening or unusual.

At home

Small things that make a real difference.

Four practical habits that get most babies (and parents) through a cold with feeding, hydration and sleep more or less intact.

A quiet reminder

Trust your instincts.

If your baby looks or behaves differently from how they usually do, it is always reasonable to ask for a review. Parents notice changes before anyone else.

  1. 01 Feeds

    Little and often

    Small, frequent breast or formula feeds are easier for a congested baby than large ones. Try an upright position.

  2. 02 Nose care

    Saline before every feed

    A few saline drops and gentle suction before feeds and sleep is the single most useful thing you can do.

  3. 03 No syrups

    Skip cough and decongestant medicines

    MHRA advice since 2008 is not to use over-the-counter cough or decongestant medicines in children under 6 years.

  4. 04 Prevention

    Handwashing and vaccination

    Hand hygiene, keeping the home smoke-free and staying up to date with routine and RSV vaccines lowers the risk of the next one.

Frequently asked

Everything parents ask us about baby colds.

Quick answers on medicines, honey, when to go to A and E, and how to prevent the next one.

  • How many colds is normal for a baby?

    It is completely normal for a baby to have eight or more colds in the first year, particularly if they are in nursery or have older siblings. Each one lasts around 7 to 14 days, so it can feel almost continuous through winter.

  • Can I give my baby cough or decongestant medicine?

    No. Since 2008 the MHRA has advised against over-the-counter cough and decongestant medicines in children under 6 years because of safety concerns and lack of evidence. Saline drops, feeds and paracetamol or ibuprofen are the mainstays.

  • Is honey safe for a cough?

    Honey can help cough in older children but must not be given to any baby under 1 year old because of the risk of infant botulism.

  • When can I give paracetamol or ibuprofen?

    Paracetamol can be used from 2 months and ibuprofen from 3 months, provided the baby weighs at least 5 kg. Use only for fever that is upsetting the baby, pain or irritability - and follow the dose on the bottle. Do not routinely alternate them.

  • When should I take my baby to A and E?

    Call 999 or go straight to A and E for grunting, severe breathing difficulty, pauses in breathing, blue lips, a seizure, a non-blanching rash, a bulging fontanelle or if the baby is drowsy and hard to wake. Any baby under 3 months with a fever needs same-day assessment.

  • How can I prevent the next cold?

    Regular handwashing, keeping the home smoke-free, breastfeeding where possible, avoiding contact with unwell adults and older children, and staying up to date with routine immunisations, seasonal flu, maternal RSV and nirsevimab (Beyfortus) all lower the risk.

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