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
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.
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
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
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.
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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.
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.
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.
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.
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.
How this information was developed to help you make better health decisions.