Most babies and older children have several mild infections of the
respiratory system each year.
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:
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
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
is a less common bacterial
infection of the lower respiratory system.
Allergies are a common cause of
respiratory problems. Allergy symptoms in children include:
Babies and small children usually do not have
asthma. But the number of new cases of asthma
increases with age.
Besides asthma, allergies, and
infection, other possible causes of respiratory problems in children
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.
Symptoms of serious illness may
Based on your answers, you need
or other emergency services now.
Temperature varies a little depending on how you measure it.
For children up to 11 years old, here are the ranges for high, moderate, and
mild according to how you took the temperature.
Oral (by mouth), ear, or rectal temperature
Armpit (axillary) temperature
Note: For children under 5 years old, rectal temperatures are
the most accurate.
Symptoms of difficulty breathing can range from mild to severe. For example:
If you're not sure if a child's fever is high, moderate, or
mild, think about these issues:
With a high fever:
With a moderate fever:
With a mild fever:
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.
Symptoms of difficulty breathing in a baby or young child can range from mild to severe. For example:
Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:
You can use a small rubber bulb (called an aspirating bulb)
to remove mucus from your baby's nose or mouth when a
cold or allergies make it hard for the baby to eat, sleep, or breathe.
To use the bulb:
Don't do this more than 5 or 6 times a day. Doing it too often
can make the congestion worse and can also cause the lining of the nose to
swell or bleed.
Symptoms of serious illness in a baby
may include the following:
Sudden drooling and trouble swallowing can be signs of a
serious problem called epiglottitis. This problem can
happen at any age.
The epiglottis is a flap of tissue at the back
of the throat that you can't see when you look in the mouth. When you swallow, it closes to keep food and fluids out of the
tube (trachea) that leads to the lungs. If the epiglottis becomes inflamed or
infected, it can swell and quickly block the airway. This makes it very hard to
The symptoms start suddenly. A person with epiglottitis
is likely to seem very sick, have a fever, drool, and have trouble breathing,
swallowing, and making sounds. In the case of a child, you may notice the child
trying to sit up and lean forward with his or her jaw forward, because it's
easier to breathe in this position.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in children are:
A baby that is extremely sick:
A baby that is sick (but not extremely
Based on your answers, the problem may not improve without medical
Based on your answers, you may need care soon. The
problem probably will not get better without medical care.
Severe trouble breathing means:
Moderate trouble breathing means:
Mild trouble breathing means:
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.
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.
Call your child's doctor if any of the following occur during home
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
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:
May 9, 2013
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
& David Messenger, MD
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