Parenting

Flu vs. Cold in Kids: 12 Ways to Tell the Difference

ParentingUpdated Aug 1, 2022
By Judy Dutton
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Sooner or later, all parents end up with a sick kid ... only how sick is the big question. That's because colds and the flu have such similar symptoms, it's hard to tell one from the other. "Sometimes it's hard to tell if your child has a cold or the flu for parents and doctors alike," says Kathryn Boling, MD, a family medicine practitioner at Mercy Medical Center. "Colds and the flu not only have many of the same symptoms, but another complicating factor is that the worst of the 'cold season' is September through April -- pretty much the same time as the flu season."

Still, it's important to be able to distinguish colds from the flu because the latter can cause serious health problems. "Influenza can cause complications such as pneumonia, a bad asthma exacerbation, or other complications like dehydration in hosts who aren't as healthy to fight off infections easily," says Cheryl Wu, MD, a pediatrician in New York.

"Parents should contact their physician if they think their child has the flu," says Deena Blanchard, MD, a pediatrician at Premier Pediatrics NY. "There are tests available for diagnosis." To help you figure out what you're dealing with, here's a look how symptoms differ with the cold and the flu so you can tell which is which.

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Fever

Colds: "Colds generally have mild fevers that really don't reach above 101 and are fleeting over one to two days," says Amesh Adalja, MD, an infectious disease physician at the University of Pittsburgh.

Flu: "Fevers can range from 100.4 and up and often last five or even up to seven days with the flu," says Deena Blanchard, MD, a pediatrician at Premier Pediatrics NY.

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Headache

Colds: Rare.

Flu: May come on suddenly and be intense. "Headaches are a hallmark of flu," says Hannah Chow-Johnson, MD, a pediatrician at the Loyola Center for Health. Plus, rather than just pounding at the temples, they're felt all over the head.

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Eye Pain

Colds: Almost never.

Flu: Can crop up on its own or as part of a headache, says Dr. Boling.

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Body Aches
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Body Aches

Colds: Rare. "Symptoms stay mostly above the neck rather than generalized aches or pains," says Dr. Chow-Johnson.

Flu: Frequent and intense. "Muscle aches and pain are a prominent feature of influenza but not the common cold," says Dr. Adalja. "This is one of the biggest distinguishing features."

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Loss of Appetite
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Loss of Appetite

Colds: Rare. "Kids will more likely experience a lack of taste; things won't taste quite right," says Dr. Chow-Johnson.

Flu: Frequent and extreme.

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Vomiting

Colds: Almost never.

Flu: A definite possibility. "Since young children often swallow their phlegm, they may cough and vomit afterward," says Dr. Blanchard. "Often, kids feel better once that happens."

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Chills

Colds: Rare.

Flu: Frequent. "Having chills is also more common with the flu," says Dr. Blanchard.

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Weakness/Exhaustion

Colds: Occasional but mild.

Flu: May be intense, last for weeks. "Patients often feel terrible with the flu while just uncomfortable with a cold," says Dr. Chow-Johnson.

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Stuffy/Runny Nose and Sneezing

Colds: Frequent. "With colds children tend to have a lot of nasal discharge," says Dr. Blanchard.

Flu: Occasional.

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Cough

Colds: "Cough associated with colds typically starts a few days after the cold starts: typical colds start with sore throat for the first day, progress to nasal congestion and runny nose for two to three days, then an increased cough," says Kristine Wake, MD, a pediatrician in Sheboygan, Wisconsin, at Aurora Health Care. "Cough with cold typically doesn’t cause difficulty breathing or chest pain."

Flu: "Coughs associated with the flu are usually frequent and dry, meaning it doesn’t produce much mucous," says Dr. Wake.

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Sore/Scratchy Throat

Colds: Frequent.

Flu: Occasional.

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Symptom Onset

Colds: "Most symptoms gradually develop over 24 to 48 hours," says Dr. Chow-Johnson.

Flu: Appear quickly within three to six hours.

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