Most babies and older children have several mild infections of the
respiratory system each year.
Upper respiratory system
The upper respiratory
system includes the nose, mouth, sinuses, and throat. A child with an upper
respiratory infection may feel uncomfortable and sound very congested. Other
symptoms of an upper respiratory infection include:
- A runny or stuffy nose. This may lead to blockage of the nasal
passages, causing the child to breathe through his or her mouth.
- Irritability, restlessness, poor appetite, and decreased activity
- Coughing, especially when lying down.
- Fever that occurs suddenly and may reach
Lower respiratory system
The lower respiratory
system includes the bronchial tubes and lungs. Respiratory problems are less
common in the lower respiratory system than in the upper respiratory
Symptoms of a lower respiratory (bronchial tubes and
lungs) problem usually are more severe than symptoms of an upper respiratory
(mouth, nose, sinuses, and throat) problem. A child with a lower respiratory
problem is more likely to require a visit to a doctor than a child with an
upper respiratory problem.
Symptoms of lower respiratory system
- Shallow coughing, which continues throughout the day and
- Fever, which may be high with some lower respiratory system
infections, such as pneumonia.
- Irritability, restlessness, poor appetite, and decreased activity
- Difficulty breathing. You may notice:
- Rapid breathing.
- Grunting, which is heard during the breathing out (exhaling)
phase of breathing. Most babies grunt occasionally when they sleep. But
grunting that occurs with rapid, shallow breathing may mean lower
respiratory system infection.
- Wheezing (which is a different sound than
- Flaring the nostrils and using the neck, chest, and abdominal
muscles to breathe, causing a "sucking in" between or under the ribs (retractions).
Respiratory problems may have many causes.
Viral infections cause most upper
respiratory infections. Sore throats, colds, croup, and
influenza (flu) are common viral illnesses in babies
and older children. These infections are usually mild and go away in 4 to 10
days, but they can sometimes be severe. For more information, see the topics
Influenza (Seasonal Flu).
Home treatment can help
relieve the child's symptoms. The infection usually improves on its own within
a week and is gone within 14 days.
Antibiotics are not used to
treat viral illnesses and do not alter the course of viral infections.
Unnecessary use of an antibiotic exposes your child to the risks of an
allergic reaction and antibiotic side effects, such as
nausea, vomiting, diarrhea, rashes, and yeast infections. Antibiotics also may
kill beneficial bacteria and encourage the development of dangerous
lower respiratory system infections may be mild, similar to upper respiratory
system infections. An example of a possibly serious viral infection is
bronchiolitis. Up to 10% of babies and children with
viral infections of the lower respiratory system, such as those caused by
respiratory syncytial virus (RSV), may develop severe
blockage of the air passages and require hospitalization for treatment. For
more information, see the topics
Acute Bronchitis, Pneumonia, and Respiratory Syncytial Virus (RSV) Infection.
The most common sites for
bacterial infections in the upper respiratory system are the sinuses and
sinus infection is an example of an upper respiratory
pneumonia may follow a viral illness as a secondary infection or appear as the
first sign of a lower respiratory infection. In babies and small children, the
first sign of infection often is rapid breathing, irritability, decreased
activity, and poor feeding. Antibiotics are effective against bacterial
Tuberculosis is a less common bacterial
infection of the lower respiratory system.
Allergies are a common cause of
respiratory problems. Allergy symptoms in children include:
- Clear, runny drainage from the nose or a stuffy nose. Children
often rub their noses by pushing the tip upward with the palm of the hand
- Sneezing and watery eyes. Often there are dark circles under the
eyes ("allergic shiners").
- Irritability and loss of appetite.
Babies and small children usually do not have
asthma. But the number of new cases of asthma
increases with age.
- In babies and small children, a hacking cough may be the only
symptom of mild asthma.
- If asthma worsens, symptoms may include wheezing and shortness of
breath after exercise or at nighttime.
- In severe asthma, difficulty breathing (using the neck, chest,
and abdominal muscles to breathe) and a high-pitched sound when breathing
(wheezing) are the most common symptoms.
- Allergies and asthma often occur together. For more information,
see the topic
Asthma in Children.
Besides asthma, allergies, and
infection, other possible causes of respiratory problems in children
- Exposure to cigarette smoke. Tobacco smoke impairs lung growth
and development. Children who are exposed to tobacco smoke, even before birth
(prenatal), are more likely to have asthma and other respiratory
- Blockage of the airway by an
inhaled object, such as food, a piece of a balloon, or
a small toy. For more information, see the topic
Swallowed or Inhaled Objects.
- Problems that have been present from birth (genetic causes), such
Babies and children younger than age 3 may have more
symptoms with respiratory problems than older children, and they may become
more ill. For this reason, younger children need to be watched more closely.
The type and severity of the symptoms helps determine whether your child needs
to see a doctor.
Check your child's symptoms to decide if
and when your child should see a doctor.
Most children have 7 to 10 mild upper
respiratory infections each year. Your child may feel uncomfortable and have a
stuffy nose. The infection is usually better within a week and is usually gone
within 14 days.
Home treatment is appropriate for mild symptoms
and can help your child feel better.
- Keep the room temperature comfortable for you and your child. A
hot, dry environment will increase nasal congestion.
- Raise the head of your baby's bed about
1 in. (2.5 cm) to
2 in. (5 cm) by placing blocks
under the crib. Do not raise just the mattress because it may leave a gap for
your baby to roll into. Do not raise the head of the bed
if your baby is younger than 6 months.
- Let your baby breast-feed more often or give your baby extra
bottles. Liquids may help thin the
mucus and also reduce fever (if present).
- Do not awaken your child during naps or at night to take
- Do not force your child to take fluids, which may cause your
child to vomit.
- Give your child extra cuddling and distraction.
- Let your child get extra rest to fight the infection.
- Do not give your child leftover antibiotics or antibiotics or other
medicines prescribed for someone else.
- Put a
vaporizer or humidifier in your child's room if he or
she is breathing through the mouth.
- Lukewarm mist may help your child feel more comfortable by
soothing the swollen air passages. It may also help with your child's
hoarseness. But do not let your child's room get uncomfortably cold or very
- Use a shallow pan of water to provide moisture in the air
through evaporation if you don't have a humidifier. Place the pan where no one
will trip on it or fall into it.
- If your child has a stuffy nose:
saline nose drops to help with nasal
- Use a
rubber bulb to suction the nose sparingly. It will help reduce nasal
drainage if your baby is having difficulty breast-feeding or bottle-feeding or
seems to be short of breath. Babies often do not like having their noses
suctioned with a rubber bulb.
- Do not give your child oral
decongestants unless directed to do so by your child's
doctor. Antihistamines and decongestants can cause your child to behave
differently, making it harder to tell how sick he or she really is. Studies
show that over-the-counter cough medicines do not work very well. And some of
these medicines can cause problems if you use too much of them. It is important
to use medicines correctly and to keep them out of the reach of children to
prevent accidental use.
- If your child has a cough:
- Honey or lemon juice in hot water or tea may
help a dry cough. Do not give honey to a child younger than 1 year old. It may
have bacteria that are harmful to babies.
- Be careful with cough and cold medicines, including any products with menthol. They may not be safe for young children, so check the label first. If you do give these medicines to a child, always follow the directions about how much to give based on the child's age and weight. For more information, see Quick Tips: Giving Over-the-Counter Medicines to Children.
- If your child has a barking cough during the night, you can
help him or her breathe better by following the
home treatment for a barking cough.
Medicine you can buy without a prescription
| Try a nonprescription
medicine to help treat your child's fever or pain:|
- Acetaminophen, such as Tylenol
- Ibuprofen, such as Motrin or Advil
Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.
| Be sure to follow these
safety tips when you use a nonprescription medicine:|
- Carefully read and follow all labels on the medicine bottle
- Give, but do not exceed, the maximum recommended
- Do not give your child a medicine if he or she has had an
allergic reaction to it in the past.
- Do not give aspirin to anyone younger than age 20 unless directed to do so by your child's doctor.
- Do not give naproxen (such as Aleve) to children
younger than age 12 unless your child's doctor tells you to.
Symptoms to watch for during home treatment
Call your child's doctor if any of the following occur during home
- Difficulty breathing develops.
- Increased drooling develops.
- Cough gets worse or a persistent cough develops.
- Symptoms become more severe or frequent.
It is common for children to develop
respiratory problems (such as viral infections) because they are often exposed
to other people who have infections and have not built up immunity. There is no
sure way to prevent many respiratory illnesses in babies and children. Very
young babies are at greater risk for developing complications from respiratory
illnesses, so it is important to do what you can to protect them from exposure.
The following may help reduce your child's risk for respiratory
- If you have a respiratory infection, such as a cold or the
flu, or if you are caring for someone with a
wash your hands before caring for your child. Hand-washing eliminates the
germs on your hands and the spread of germs to your child when you touch your
child or touch an object he or she might touch.
- If your child goes to a day care center, ask the staff to wash
their hands often to prevent the spread of infection.
- Make sure that your child gets all of his or her vaccinations,
especially for diphtheria, tetanus, and pertussis (DTaP) and for
Haemophilus influenzae type b (Hib). For more
information, see the topic
- Breast-feed your baby for at least the first 6 months after birth,
if possible. Breast-fed children develop fewer respiratory problems than those
who are not breast-fed.
- If one of your children is sick, separate him or her from other
children in the home, if possible. Put the child in a room alone to
- Do not smoke or use other tobacco products. If you smoke, quit. If
you cannot quit, do not smoke in the house or car. Secondhand smoke irritates
the mucous membranes in your child's nose, sinuses, and lungs and increases his
or her risk for respiratory infections. For more information, see the topic Quitting Smoking.
- Avoid giving young children food or objects that may be improperly
swallowed and inhaled, such as nuts, popcorn, small candies, or small toys. An
inhaled object can lead to a respiratory infection. For more information, see
Swallowed or Inhaled Objects.
- For information on preventing allergies or asthma, see the topic
Allergic Rhinitis or
Asthma in Children.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your child's
doctor diagnose and treat your child's condition by being prepared to answer
the following questions:
- Did the symptoms start as a cold but now appear to be worse than
you would expect from a cold?
- What home treatment have you tried? Did it help?
- What nonprescription medicines have you used? Did they help?
- What prescription and nonprescription medicines does your child
- Does your child seem to have any symptoms that indicate an
infection in one area, such as pain in one ear?
- Has your child had any other recent illnesses?
- Has your child had his or her routine immunizations?
- Does another member of your family have similar symptoms?
- Has your child been eating, sleeping, and playing normally?
- Have you, your child, or another member of your family recently
traveled, either inside or outside of the country?
- Does your child have any
- Coughs, Age 11 and Younger
- Ear Problems and Injuries, Age 11 and Younger
- Nausea and Vomiting, Age 11 and Younger
- Nausea and Vomiting, Age 12 and Older
- Sore Throat and Other Throat Problems
|By: ||Healthwise Staff ||Last Revised: May 9, 2013|
|Medical Review: ||William H. Blahd, Jr., MD, FACEP - Emergency Medicine|
David Messenger, MD