Does Cold Air Make Your Child Sick? (Pedcast)

Welcome to another edition of Thank you for joining me today I’m your host Dr. Paul Smolen; by day I’m a board-certified pediatrician practicing general pediatrics in Charlotte North Carolina for the past 32 years but by night I’m DocSmo, the blogger.  I’m recording this pedcast in December and it’s respiratory season here in Charlotte,  a time of year when a lot of kids come to the doctor with deep chest coughs. They usually have bronchitis; that is a really bad cough with lungs that sound clear and no fever. This condition is almost always caused by either a viral infection or allergy or both.  Part of my advice to  children with bronchitis about getting well is to give them the same advice that their grandmother’s would give them…  STAY OUT OUT COLD AIR UNTIL YOUR COUGH IS GONE,  I think it’s important that these kids not expose themselves to extremes of cold weather and in today’s podcast I’m going to try explain to you why I think this is good advice.  Long time listeners of my blog will know that I have a very healthy respect for the advice that grandma’s passed down from generation to generation, hence the  Doc’s Pearl;  “Grandma didn’t waste her time recommending things that weren’t important.”

So let’s get started talking about respiratory irritants, specifically cold air.


Now to get into a discussion about why cold air is an irritant to your child’s airways,  we  need to take a little trip down science lane. I love science lane. You remember from your high school and middle school science classes that air is mostly composed of nitrogen gas and a water. There’s actually a lot water in air.  We all intuitively know that because when we go outside on a cold day and exhale, the warm air from our lungs  immediately turns into rain  as it cools down to the cold outside temperature.  We can see that happen. Remember  cold air  can’t hold as much water as warm air can.   As the air cools down leaving your child’s lungs, it literally has the water squeezed out of it. That’s one of the reasons your child’s nose runs when they go out in the cold air. It is literally raining in your child’s nose when they are outside on a cold day. You can see that the cold air itself is causing a “weather event” in your child’s nose and lungs when they are outside for very long on a nippy day.


Additionally as the outside air dries out from being cooled, this lower humidity cool air  cools the surface of your child’s airways which can be very irritating to some children’s noses and bronchioles. You’ve probably heard about exercise asthma. Well this phenomenon occurs mainly because breathing large amounts of cool or cold air bathes the lining cells of your child’s airway and in some children, this triggers an asthma attack.  You can see that in some children, very cold air in large quantities is just not good for their airways especially when they’re sick. When they are sick, those delicate cells that line their nose and bronchioles have already been damaged by some respiratory virus and now here comes another irritant, dry, cold air.  This is why grandma was so upset when her children went out to play for a long time on a very cold day. She knew that this was just going to add to their troubles.  And sometimes there was so much trouble added,  that the child could not cough up a all their chest mucous, maybe with a little bronchospasm to boot, and before you know it they have…” pneumonia”, which is exactly what grandma feared the most, and she was right in saying that cold weather can cause pneumonia.   Remember that it wasn’t that long ago, before we had penicillin,  pneumonia frequently meant death even in young healthy children and adults.  That’s why grandmas, even today,  get such a pained expression on their face when a doctor mentions the word pneumonia. They remember what pneumonia could do to a child.  Fortunately in the modern era this rarely occurs.


So here’s some good advice that I give my patients who have bronchitis or even upper respiratory illness, when they come in to be examined and treated.  I think it’s fine for a child to be outdoors playing in cold weather when they’re well but when they have a deep bronchial-based cough, I ask them to stay out of cold air exercising until there cough has cleared.   For me, too cold is below 60 degrees Farenheit. Since Johnny is already suffering  from one respiratory irritant, probably a virus, I don’t think they need to have others like cold dry air adding to their problems. We don’t want him to suffer the perfect storm of bronchial irritants and come down with pneumonia, as Grandma feared do we?  Of course, as soon as his or her cough is gone, it’s back outside full tilt.


In my mind, I think there is good science behind grandma’s recommendation to stay at a cold air with really bad cough. As I have said, I give this advice to my patients to this day and I think it’s good advice. So now, if your coughing child is giving you a hard time about not letting them outside on really cold day to play, I think maybe you can explain to them why you feel this way.  Kids are amazingly logical when you take a few minutes to explain things to the.  Here’s another DocSmo pearl to remember; When you treat your children like adults,  one day they are likely to act like one! 


Thanks for tuning in today. I hope I added to your parenting knowledge base. Portable, practical, pediatrics is always our goal here at the DocSmo blog.   If you enjoy this educational format, take a moment to write a review on iTunes or leave a comment at my blog, and maybe subscribe and be weekly listener. My staff has  made it very easy to send podcasts to friends and family so take advantage of that feature, won’t  you.  This is Dr. Paul Smolen broadcasting from studio 1E, that’s the first child’s bedroom on the east side of my house… Reminding you that when the temperature takes a dip, don’t forget DocSmo’s tip… Keep those little coughing babes in a nice warm place, won’t you?  Until next time.



  1. Hendrik Crafford says:

    Good day Docsmo. Our daughter (21 monhts old) was not sick, but we took her home from grandma’s at around 9pm in the cold weather. The next day she started coughing and this cough get worse ar night. My questions to you:
    1. Can that 1 minute of cold air from house to car cause her to get sick?
    2. How do we treat this cough at home. We try cough syrup, heating the room, pain meds, but does not seem to be effective. Her milk seems to make it worse.

    Hendrik Crafford
    South Africa

    • DocSmo says:

      Dear Ms Crafford,

      South Africa. I don’t get many questions from South Africa! Brief exposure to extremes in temperature are unlikely to make a child ill unless they have cold exposure bronchospasm, something that is very unlikely in a 21 month old. It is likely that she was recently exposed to a respiratory virus and this is what has made her sick. Fall in south Africa now? As for your child’s cough, I think you need to understand that a strong cough, while not normal and a sign of illness, is keeping your child’s lungs clear of pneumonia and shouldn’t be suppressed. If you daughter has a fever, wheezing, seems ill, or has any trouble breathing, she should be seen by her pediatrician. I think you can ease her cough with honey and a vaporizer.

  2. Gigi says:

    I am so sorry my comment is in pieces but for some reason posting them has been very tough, maybe it was the name of the medication in there, I don’t know?
    – PART 3-
    He started breaking out into a rash (raised and extremely itchy) which seemed like an allergic reaction because they would disappear after a little Ben adryl or Zyr tec, but an allergy to what we don’t know. He just got diagnosed with asthma, and that’s when the pred nisone was prescribed. I told one pulmonary doctor of my sons exposure to cold, and she said to me that it couldn’t have caused him Asthma and that he had asthma already, so It was just triggered by playing in the cold. I didn’t understand or agree; this article makes more sense to me. Based on the info I’ve provided what is your take on this? And how can we consult with you? My baby has been coughing since 31st December 2018, today is April 4, 2019, and to hear him coughing in his sleeping again is heartbreaking. Please help ??

    • DocSmo says:

      Dear Gigi,
      I am very sorry to hear that both you and your son have been suffering so much this winter. First let me say that I cannot practice medicine via a blog but I may have some suggestions and insights that may be helpful. It sounds like you have gotten to pulmonary specialists that hopefully, with time, will help your son. I have seen children who develop a severe bronchitis, and for a while, act as though they have asthma. But it passes. Their bronchial hypersensitivity is based on an injury (like a severe viral illness or whooping cough) to their airways not allergies. For a while after the injury, any bronchial irritants, like cold air, can set them off into fits of coughing. For a while (time frame variable) they react to bronchiole irritants like an asthmatic would but I believe the mechanism is different. The fire fighters during 9/11 are a good example of this.
      Anyway, I think there is a chance that this will all pass. I would however, do what the pulmonary doctors recommend. Make sure that he avoids things that irritate his bronchioles like cigarette smoke, indoor cleaners, chemical vapors, cold air, etc. You may think about getting him allergy tested to see if he has pollen sensitivities. This may be very helpful direct his future care.
      I am just making suggestions for you to think about but I don’t know enough about his history and health to give you more specific advise. I am sorry that I cannot consult on his condition since I am retired from full time practice. However,I am sure that between his pediatrician and pulmonary specialists, they will return him to good health.

  3. Hala says:

    Dear Docsmo,
    My 2.5 year old was taken outside by his daycare to “play with water” on a windy 60 degree sunless day. I was told he drenched himself (head and chest) with the water sprinkler and became very cold. I do not know how long it took them to dry and warm him up. Same night he developed an infrequent cough (“barking” sound maybe?) with some raspiness/roughness from somewhere in his throat or chest-can’t tell. Multiple night wakings but no pain according to him, with a mild fever of 99 degrees but breathing and talking normally. Is there a concern for severe bronchitis or pneumonia?

    • DocSmo says:

      Dear Hala,

      It sounds like your son developed some croup, either the allergic type or infectious type ( mechanisms are very different). I think the exposure to cold may have contributed to this as I spoke about in my podcast “Does Cold Air Make Your Child Sick?” I think you are right but other factors may be at play as well. Common sense tells me that getting wet and having an extended exposure to cold is not good for anyone’s health. Please ask the daycare to be extra cautious not to let this happen again.

  4. Pingback: Grandma Right? Can Cold Weather Cause Pneumonia? (Pedcast) |

  5. Jackie says:

    Hello, super curious my two year old daughter had rsv back in February and had a couple Summer colds that kind of got deep. And then at her 3 year check up she was still a bit wheezy and that was in august so they wanted to do a X-ray and she still had inflammation on her left lower lobe. And now she has prolly gotten sick with a cold 3 times already and it’s so deep, meaning wheezy, terrible deep cough, runny nose. Will she ever heal? Will this cause asthma ? And I’m afraid to even let her outside at all this winter already. Any help or suggestions would be greatly appreciated ! Thank you.

    • DocSmo says:

      Jackie, I can’t give you specific advice as to your child’s health, only their doctor can do that. But, you bring up an interesting question; does an RSV infection cause asthma or are asthmatic children just more sensitive to RSV infections? I believe that RSV causes a particularly severe injury to a young child’s bronchioles, that takes time to heal. Sometimes, a very long time. At times years. Avoiding other bronchiole irritants (cold air, cigarette smoke, dust, inhaled fumes, dusts etc.) while things heal seems prudent to me. You will have to use your judgement about that with the help of your child’s doctor(s). I hope that helps.

  6. Shilpi says:

    Dear DocSmo,

    My 5-year old is having very bad cough which gets worse in early mornings (around 4 AM ) and he just keeps on cough for nearly half an hour or more and also throws up mucus, and keeps coughing.Whenever he is out to play, starts coughing. I can hear wheezing while he is sleeping.
    He is also complaining of sore tummy while walking fast or running (not sure if it is related).
    He is also complaining of tiredness these days and is not eating well.

    Do you think it is bronchitis or something else? His doctor has given him asthma inhalers (preventer and reliever), however I am a bit skeptical about asthma (no one in our family have asthma). He doesn’t ever seem breathless.

    Please advise.

    P.S. We are based in Northern Ireland where currently the temperature is under 10 degree Celsius.


    • DocSmo says:

      Dear Shilpi, While, I cannot give you specific medical advice for your son, but I can speak some to his symptoms. If you and his doctor are hearing wheezing, that means restricted airflow in his lungs, usually in the bronchioles. I assume he has not choked on any food or toy, an obvious reason to wheeze. Something else to think about is gastric reflux and aspiration given his early morning worsening. There are other reasons that children wheeze but the most common is asthmatic bronchitis. The definition of asthma involves two factors; recurrent (meaning multiple episodes which your son has not had to date) and reversibility with inhalers (still be determined). Cold air is a known bronchial irritant and often makes coughs worse in children with inflamed bronchioles. Sore tummy likely from severe cough and tiredness likely from disrupted sleep due to cough. I think your son’s doctor is on the right path to getting him back to good health. Oh, and by the way, genetics is just one factor in producing asthma in a child. Air pollution, early viral infections, exposure to cigarette smoke, prematurity, etc are also factors.

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