What do I need to know about respiratory infections in children?
- They are very common, particularly in children in daycare or school or in children with siblings.
- Having six respiratory infections per year is normal.
- Some uncomplicated respiratory infections can last up to two weeks.
- Many respiratory symptoms overlap and make differentiating the illnesses difficult, especially for parents and teachers.
What are the common symptoms in uncomplicated respiratory illnesses?
What are the symptoms that may cause you to seek medical advice?
- Breathing fast
- Retractions (seeing a deeper outline of the ribcage or ribs than what is normal)
- Coughing (frequent; vomiting may occur with it)
- Activity (not playing or being usual self)
- Talking (infants and toddlers are quiet, not making normal sounds. Older children are unable to talk normally, having to catch breaths between words)
- Wheezing (a high-pitched whistling sound heard when breathing out)
- Stridor (a harsh, raspy vibrating sound heard when breathing in. As it progresses, it can sound like a seal, particularly with coughing)
- Fever (keep track of the number of diapers an infant/toddler is using or when the last time your potty trained child went to urinate)
What is bronchiolitis?
- It is most common around six months of age and is rarely seen after age two.
- The main symptom is wheezing. The wheezing generally lasts about seven days with 14 days of cough.
- The most common cause is from a respiratory virus (usually RSV, which is present in the winter and spring months).
- It is spread by direct contact with respiratory secretions like a cough or sneeze.
- There is no specific treatment and antibiotics are not used when illnesses are caused by viruses. A bulb suction should be used on infants to help clear nasal passages, especially before feedings. A vaporizer in the bedroom is helpful.
- Common complications include ear infections.
What is the common cold? Is there a cure for it yet?
There are at least 200 separate viruses that can cause colds, so unfortunately no cure is on the horizon.
- Colds can occur at any age.
- There is a wide range of cold symptoms, depending on how severe the cold is.
- Colds are spread through direct contact with respiratory secretions.
- Colds last about seven to 10 days on average, though the cough can last three weeks. Fever shouldn't last more than three days.
- Complications include ear infections, sinus infections, pneumonia, and eye infections.
Treatment is symptomatic only:
- Nasal suctioning as needed and before feeding is helpful in infants.
- Acetaminophen (such as Tylenol®) is only for pain and fever.
- Fluids are always important, even if the child's appetite is poor.
- Most over-the-counter cold medications are not helpful and should be avoided.
- Never give leftover antibiotics from a prior illness or from another child.
What is croup?
- Croup is a disease seen mostly in toddlers. It is caused by a virus, and lasts about five to six days.
- The classic symptom is hoarseness with a cough that sounds like a seal or a dog. It is usually part of a cold. Stridor develops later. Symptoms are generally worse at night.
- Children are quite contagious.
- There is no specific treatment. The child should be kept calm. Cough medicines are not helpful. Mist, cool or warm, can be quite helpful.
What causes ear infections?
Children commonly get middle ear infections, which means that there are bacteria behind the ear drum. Pain is the main symptom. Ear infections are not contagious.
Antibiotics are generally quite helpful. Tylenol can help with pain.
Complications can include a small tear in the ear drum, which causes drainage to come out of the ear. The tear heals quickly.
What is pink eye?
Pink eye is generally considered a contagious bacterial infection of the eye. Pink eye can also be caused by viral infections and allergies or irritants. In general, when the infection is bacterial, the discharge is thick and yellow and the eyelids stick together.
- The eye discharge is contagious.
- The viral form usually accompanies a cold and lasts about a week. If it is bacterial, the discharge generally stops after 3 days of antibiotics.
- Warm compresses are useful.
- Antibiotic drops or ointment may be prescribed.
What causes sore throat?
Most sore throats, including the sore throat found in mononucleosis, are caused by viruses and accompany a cold. Strep (the Streptococcus bacterium) causes about 10% of cases, and the resulting infection of the throat and tonsils can look exactly like viral sore throat.
Viral sore throats generally last about three to five days. Strep usually responds to antibiotics within 24 hours. Mononucleosis generally lasts about a week but can cause symptoms for two to four weeks.
Treatment for symptoms includes:
- Gargling with salt water
- Corn syrup or hard candies
- A soft bland diet
Antibiotics are useful for strep throat only. Never give leftover antibiotics from a prior illness or from another family member.
Complications of strep include a rash known as scarlet fever, and more seriously, rheumatic fever, which can be prevented with proper treatment. Mononucleosis may cause difficulty breathing if the tonsils get large enough. The liver and spleen may become enlarged; contact sports should be avoided for about four weeks.
Will my children get pneumonia if they are exposed to someone who has it?
Pneumonia generally presents with a cough, which is likely to bring up sputum. There may be some difficulty with breathing, such as rapid, labored, or painful respirations. There is often fever.
Other facts about pneumonia:
- It is an infection of the lung that causes fluid to collect in the air sacs. About 80% of infections are viral and milder. Twenty percent are bacterial. It is not contagious.
- Bacterial pneumonia is usually more sudden and can improve significantly within 24 to 48 hours of taking antibiotics. Viral pneumonia is milder but can last two to four weeks.
- Cough suppressants should be avoided. Antibiotics are prescribed if indicated.
Hospitalization is very rarely necessary in otherwise healthy people.
When is a runny nose a sinus infection?
Sinus infections are often signaled by:
- Pain and pressure in the face
- Thick nasal discharge
- Post-nasal drip
- Bad breath
- Nausea, and
- Chronic (long-lasting) cough.
Sinus infections are not contagious. Saline nasal sprays are helpful for opening sinus passages. Antibiotics may be prescribed if indicated. Consult your child's physician before giving any medication to your child.
How high should I let my child's temperature get before I panic?
The normal body temperature is 98.6° F, but this changes throughout the day.
- Temperature can be taken by rectum, by mouth, under the arm, or in the ear. Rectal is best.
- Fevers are not harmful--they are a sign that the immune system is working. Your child's behavior is far more important than the actual temperature. Never wake a child to take his or her temperature.
- Most fevers range from 101° F to 104°F and last about three days.
- Your health care provider needs to see all babies younger than six weeks of age if they have elevated temperature. Acetaminophen (Tylenol®) is the safest medication to use to reduce fevers; consult your child’s physician to be sure you are giving the correct amount. Liquid ibuprofen (such as Liquid Advil®) is available by prescription and may be suggested. Never use aspirin without consulting your health care provider. Consider a sponge bath, using room-temperature water, if the fever hasn't come down after 30 minutes.
- Lots of extra fluids are necessary with fevers. Keep track of the number of diapers your infant/toddler is using or when the last time your potty-trained child went to the bathroom to urinate.
Febrile seizures may develop in 4% of children. While it is scary to watch, they are generally quite harmless. Consult your child’s doctor if your child has a seizure.
How can I help keep my child from getting ill?
- Wash your hands, especially before meals. Set the example for your family.
- The entire family should keep up with routine medical checkups and immunizations.
- Beginning at an early age, teach your children to sneeze into their sleeves or to use a tissue, and how and when to wash their hands.
- Make sure that everyone is getting enough sleep and drinking plenty of fluids.
- Avoid contact with ill people.
- Have a concern? Call your child’s physician.
- Always consult your child's physician before giving any medication to your child.