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 level.
Coughing, especially when lying down.
Fever that occurs suddenly and may reach
105
°F (41
°C).
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
system.
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
infections include:
Shallow coughing, which continues throughout the day and
night.
Fever, which may be high with some lower respiratory system
infections, such as pneumonia.
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 indicate lower
respiratory system infection.
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
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
Croup or
Influenza.
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
antibiotic-resistant bacteria.
Viral
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 and
Pneumonia.
Severe acute respiratory
syndrome (SARS) is caused by a type of coronavirus, a family of
viruses that often cause mild to moderate upper respiratory illness, such as
the common cold. For more information, see the topic
Severe Acute Respiratory Syndrome (SARS).
Bacterial infections
The most common sites for
bacterial infections in the upper respiratory system are the sinuses and
throat. A
sinus infection is an example of an upper respiratory
bacterial infection.
Bacterial
pneumonia may follow a viral illness 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
infections.
Tuberculosis is a less common bacterial
infection of the lower respiratory system.
Allergies
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
("allergic salute").
Sneezing and watery eyes. Often there are dark circles under
the eyes ("allergic shiners").
Irritability and loss of appetite.
Asthma
Babies and small children usually do not
have
asthma. However, 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.
Other causes
Besides asthma, allergies, and
infection, other possible causes of respiratory problems in children
include:
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
problems.
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 Objects.
Problems that have been present from birth (genetic causes),
such as
cystic fibrosis.
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.
Review the Emergencies and Check Your Symptoms
sections to determine if and when your child needs to see his or her
doctor.
Breathing stops for longer than 10 to 20 seconds.
Note: If breathing has stopped, after calling
911 or other emergency services, begin
rescue breathing. Go to the topic
Dealing With Emergencies to see Rescue
Breathing.
Difficulty breathing and choking on an object in the
windpipe. Note: If choking is present, go to the topic
Choking Rescue Procedure. For babies under 1 year of
age, use back blows rather than the Heimlich maneuver. Do not perform the
Heimlich maneuver if the child is still coughing or able to speak.
Wheezing that lasts for longer than 1 hour in a baby
younger than 3 months old who appears sick
Drooling with trouble breathing occurs, or the child is not able
to cry or make sounds. This can be caused by
epiglottitis.
Check Your Symptoms
If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.
Review
health risks that may increase the seriousness of your
child's symptoms.
If your child has any of the
following symptoms, evaluate those symptoms first.
Smoke or chemical
fume inhalation: Go to the topic
Burns.
Note:
If your child has been diagnosed with a respiratory disease,
such as
asthma or
cystic fibrosis, and your child's doctor has given you
a plan for handling your child's respiratory problems, seek medical care
according to the plan.
Does your child have an occasional streak of blood in his or her sputum
(bloody mucus from the lungs, not bleeding from the nose or the back of the
throat)?
You may wait to see if your child's symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to
any of the following questions.
Does your child have a recurrent or ongoing fever without an obvious
cause after traveling outside your own country in the last 6 weeks?
You may wait to see if your child's symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to
any of the following questions.
Did your
child's symptoms begin after taking a
medicine?
Note:
Call the doctor who prescribed the medicine the same
day (before the next dose) to determine whether your child should stop taking
the medicine or take a different one. An appointment may not be
necessary.
If your child is taking a nonprescription medicine,
do not give your child another dose. If you feel your child needs to continue
taking the medicine, call your child's doctor.
If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.
Breathing stops for longer than 10 to 20 seconds.
Note: If breathing has stopped, after calling
911 or other emergency services, begin
rescue breathing. Go to the topic
Dealing With Emergencies to see Rescue
Breathing.
Difficulty breathing and choking on an object in the
windpipe. Note: If choking is present, go to the topic
Choking Rescue Procedure. For babies under 1 year of
age, use back blows rather than the Heimlich maneuver. Do not perform the
Heimlich maneuver if the child is still coughing or able to speak.
Wheezing that lasts for longer than 1 hour in a baby
younger than 3 months old who appears sick
Drooling with trouble breathing occurs, or the child is not able
to cry or make sounds. This can be caused by
epiglottitis.
Check Your Symptoms
If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.
Review
health risks that may increase the seriousness of your
child's symptoms.
If your child has any of the
following symptoms, evaluate those symptoms first.
Smoke or chemical
fume inhalation: Go to the topic
Burns.
Note:
If your child has been diagnosed with a respiratory disease,
such as
asthma or
cystic fibrosis, and your child's doctor has given you
a plan for handling your child's respiratory problems, seek medical care
according to the plan.
Does your child have an occasional streak of blood in his or her sputum
(bloody mucus from the lungs, not bleeding from the nose or the back of the
throat)?
You may wait to see if your child's symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to
any of the following questions.
Does your child have a recurrent or ongoing fever without an obvious
cause after traveling outside your own country in the last 6 weeks?
You may wait to see if your child's symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to
any of the following questions.
Did your
child's symptoms begin after taking a
medicine?
Note:
Call the doctor who prescribed the medicine the same
day (before the next dose) to determine whether your child should stop taking
the medicine or take a different one. An appointment may not be
necessary.
If your child is taking a nonprescription medicine,
do not give your child another dose. If you feel your child needs to continue
taking the medicine, call your child's doctor.
If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.
If your child has other symptoms with his or her
respiratory symptoms, such as nausea, diarrhea, or dehydration, evaluate those
symptoms also.
If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.
Home Treatment
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
fluids.
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
damp.
Use a shallow pan of water to provide moisture in the air
through evaporation if you do not have a humidifier. Place the pan where no one
will trip on it or fall into it.
Use an
aspirating bulb 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 an aspirating bulb.
Do not give your child oral
antihistamines or
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 cold and 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's doctor prescribes decongestant nose drops for
your child's stuffy nose, put 1 or 2 drops in one side of the nose only.
Use only when needed, such as before feeding or
sleep.
Alternate the side of the nose that you put the drops
in.
Don't use nose drops for longer than 3 days.
Don't share the nose drops with other members of the
family.
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.
Don't give cough and
cold medicines to your young child unless you've checked with the doctor first.
They can be harmful to children. Experts say not to give them to children
younger than 2.
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:
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.
Safety tips
Be sure to follow
these safety tips when you use a nonprescription medicine:
Carefully read and follow all labels on the medicine
bottle and box.
Give, but do not exceed, the maximum recommended
doses.
Do not give your child a medicine if he or she has had an
allergic reaction to it in the past.
A sore throat lasts for longer than 2 to 3 days. A sore throat
that improves as the day goes on is commonly caused by dryness from breathing
through the mouth or drainage down the back of the throat during sleep.
Signs of an ear infection develop, such as pulling at
the ears, crying when sucking, unable to sleep lying down, or being extremely
fussy.
Cold symptoms last longer than 14 days.
Symptoms become more severe or frequent.
Prevention
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
problems:
If you have a respiratory infection, such as a cold or the
flu, or if you are caring for someone with a
respiratory infection,
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
Immunizations.
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
sleep.
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.
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 the topic
Swallowed Objects.
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