The U.S. Food and Drug Administration (FDA) advises against the use of over-the-counter cough and cold medications in children under 2 due to safety concerns and the lack of proven efficacy.
When to See a Doctor About Cold and Flu Symptoms
Kristina Duda, BSN, RN, CPN, has been working in healthcare since 2002. She specializes in pediatrics and disease and infection prevention.
Updated on September 19, 2022
Sameena Zahoor, MD, is board-certified in family medicine and works at the Hope Clinic, which provides free primary medical care to uninsured and under-insured patients, as a physician.
Most people don’t go to the doctor when they have a cold or even the flu. In most cases, staying at home, resting, hydrating, and taking over-the-counter medications is all that’s needed. But there are also times when certain symptoms warrant a visit to a doctor or even the emergency room. Knowing when to act can help you potentially avoid progression of your illness, as well as serious complications.
This is especially true for people in high-risk groups, such as young children, pregnant women, adults 65 and older, and people with certain health conditions, in whom complications are more likely.
Fever
Surprisingly, the decision as to when to see a doctor about a fever often has little to do with how high the fever is—at least in adults. According to the Centers for Disease Control and Prevention (CDC), a flu-related fever that improves but suddenly returns or worsens is the key warning sign that you should seek medical attention.
The issue is different in kids. Any child who experiences fever above 104 degrees F should see a doctor as a matter of urgency. Moreover, babies less than 12 weeks old should be seen if there is any fever, no matter the temperature.
Never treat flu in children or teens (or any viral illness involving fever) with aspirin as this can lead to a potentially life-threatening condition known as Reye’s syndrome.
Congestion
Congestion is usually not a major concern when you have a cold or flu, but there are times when persistent or severe congestion needs to be looked at by a doctor. In adults or children, even a simple cold that doesn’t resolve can lead to a secondary infection such as sinusitis, acute bronchitis (chest cold), or pneumonia.
Most colds clear up in seven to 10 days. Those that last longer should be always a cause for concern, especially in children. With regards to congestion, runny nose and nasal congestion are more common with colds than with flu, both of which increase the risk of sinusitis.
According to the CDC, you should seek immediate medical attention if congestion persists for more than 10 days or is accompanied by any of the following symptoms:
- Fever over 104 degrees F
- Shortness of breath or trouble breathing
- Cough with bloody mucus
Children three months and under with a fever over 100.4 degrees F should be taken to the emergency room without exception or delay.
Even if symptoms are not severe, you should see a doctor if they persist for more than three weeks or recur. These include having a persistent cough (with or without discharge), chest pain or soreness, sore throat, body aches, or persistent fatigue.
Cough
Coughs from colds and flu tend to be annoying at best, but there are times when they are warning signs of something serious. Broadly speaking, you should be concerned if a cough:
- Is persistent or getting worse
- Is interfering with breathing
- Brings up excessive or abnormal mucus or phlegm
In children, you should seek immediate medical care if confronted with the following symptoms:
- A cough that improves but suddenly returns or worsen
- Fast breathing or labored breathing
- Chest pain
- Fever over 104 degrees F (or any fever in children under 12 weeks)
- Ribs that retract (pull in) with each inhalation
- Bluish lips, fingernails, or skin
- Coughing up bloody mucus
With adults, a cough warrants urgent medical care when there is:
- Coughing or fever that improves but suddenly worsens or returns
- Bloody mucus
- Difficulty breathing
- Shortness of breath
- Persistent pain or pressure in the chest
- Severe weakness
- Persistent dizziness or confusion
The U.S. Food and Drug Administration (FDA) advises against the use of over-the-counter cough and cold medications in children under 2 due to safety concerns and the lack of proven efficacy.
When Should I See a Doctor for a Cold or Flu?
You already know that a scratchy throat, annoying cough, and lots of sneezing are part of the game. You can also probably count on a stuffy nose and some aches and pains. But when is it time to put down the chicken soup and get some advice from a pro?
Take stock of your symptoms and see if they fit into one of these patterns:
Your cold or flu shouldn’t make you short of breath or cause your chest to hurt. If that’s happening to you, it could be a sign of a more serious problem, such as heart disease, asthma, or pneumonia.
Call your doctor or go to the emergency room.
Your fever doesn’t get better.
If it won’t go away it might mean you’ve got another infection in your body that needs treatment. Generally, a fever for an adult is a temperature over 100.4 degrees F.
You can’t keep anything down.
Your body needs fluids to work right. If you can’t drink anything without vomiting, you may need to go to your doctor’s office or the hospital to get fluids through an IV.
It hurts to swallow.
That’s not normal. Although a sore throat can make it hurt a little to swallow, severe pain can be a sign of an infection or injury that needs to be treated by a doctor.
You can’t get rid of your cough.
If it doesn’t go away, it’s likely due to postnasal drip — mucus that moves from your nose into your throat. It can be treated with antihistamines. But it could also be related to asthma or GERD (gastroesophageal reflux disease). Your doctor can tell you what to do for it.
A lasting, severe cough is also the main symptom of whooping cough, a disease that’s become more common in many parts of the U.S. So, if you’ve been hacking away for more than 2-3 weeks, your doctor may give you a test to see if you’ve got it.
Your congestion and headache won’t go away.
Colds and allergies that block your nose with mucus can lead to a sinus infection. If your cold medicine doesn’t give you relief, see your doctor for more treatment.
Show Sources
CDC. “Pertussis (Whooping Cough).”
National Institute of Allergy and Infectious Diseases: “Common Cold.”
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