Cold, Flu, or RSV? How to Tell and What to Do

Runny noses. Stubborn coughs. Sleepless nights filled with tissues and steamy showers. If you’ve got little ones, you know that cold and flu season can feel never-ending. And with RSV making headlines, parents often wonder: how do I know what’s what?

I know how unsettling it can be to hear your child wheeze or cough through the night. The good news is, most colds and even RSV infections can be managed at home. The key is knowing the difference between a typical course of illness and red flags that need medical attention.

The Usual Suspects

• Colds: Usually mild, with a runny or stuffy nose, mild cough, and sometimes a low fever. Symptoms often last 7–10 days.

• Flu: Comes on suddenly with high fever, body aches, chills, cough, and exhaustion. Kids often look “wiped out.”

• RSV: Starts like a common cold but can progress, especially in infants, to wheezing, rapid breathing, or difficulty feeding.

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The RSV Timeline (Typical)

• Days 1–3: Mild cold symptoms—runny nose, mild cough, low-grade fever.

• Days 3–5: Symptoms peak—worsening cough, wheezing, fast breathing, feeding issues.

• Days 5–7: Breathing may still be hard, but symptoms begin to stabilize.

• Days 7–10: Slow recovery, lingering cough and congestion.

Knowing this pattern helps parents feel less blindsided by the mid-week “worsening” that RSV often brings.

When to Manage at Home

It’s usually safe to ride things out with comfort measures if your child:

• Is drinking fluids and making wet diapers or urinating normally.

• Is breathing comfortably without chest retractions or rapid rate.

• Seems tired but still responds to you or perks up between naps.

• Has a fever that responds to medicine.

  
  

When to Call the Doctor

Call right away if you see:

• Rapid or labored breathing (chest sucking in, flaring nostrils).

• Blue lips, pauses in breathing, or extreme sleepiness.

• Dehydration signs—very few wet diapers, dry mouth, no tears when crying.

• Fever in any infant under 3 months old.

Trust your gut: if your child looks worse than you expect, don’t wait.

What You Can Do at Home

• Use saline and suction for stuffy little noses.

• Run a cool-mist humidifier in the bedroom.

• Offer frequent fluids—breast milk, formula, or water if age-appropriate.

• Keep them comfortable with fever medicine if needed.

• Elevate the crib mattress slightly (under the mattress, never in the crib) to ease congestion.

  
  

Parent Takeaway

Most of the time, colds, flu, and RSV don’t require emergency care. But as parents, it’s natural to worry especially when breathing sounds rough or fevers spike in the middle of the night. The key is to focus on how your child looks and acts, not just the thermometer or cough sound or runny nose color. And remember: you are not alone in this. Every parent has sat by the crib listening to coughs and counting breaths, waiting for morning light. With comfort, rest, and a watchful eye, your child will recover.

-Dr.O💛

Disclaimer:

The information provided on Dr. O on Demand is for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your child’s pediatrician or qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it. If you think your child may have a medical emergency, call your pediatrician or 911 immediately.