Respiratory Infections in Children
Airway and lung infections in children
Quick Facts
- Type: Childhood infectious conditions
- Most common cause: Viruses
- Range: Colds and croup to bronchiolitis and pneumonia
- Emergency: Fast or labored breathing, blue lips
Overview
Respiratory infections are among the most common illnesses in childhood. They affect the parts of the body used for breathing, including the nose, throat, ears, airways, and lungs. Young children catch them frequently because their immune systems are still developing and they are often in close contact with others at home, childcare, and school.
Most childhood respiratory infections are caused by viruses, are mild, and clear up with rest and supportive care at home. Some, such as bronchiolitis, croup, and pneumonia, can affect breathing and need closer attention. Knowing the warning signs of breathing trouble helps parents and caregivers respond quickly.
Symptoms
Symptoms depend on the child's age and which part of the airway is affected. Common ones include:
- Runny or blocked nose and sneezing
- Cough, which may be dry or wet
- Sore throat
- Fever and fussiness
- Reduced appetite and lower energy
- Noisy breathing, wheezing, or a barking cough in some infections
- Trouble feeding in infants
Warning signs that need urgent care include fast or labored breathing, the skin pulling in around the ribs or neck, grunting, blue or gray lips, or a baby who is very sleepy or refusing to feed.
Causes
Most respiratory infections in children spread through droplets and contact and are caused by viruses, though some involve bacteria.
- Cold viruses cause the majority of upper respiratory infections.
- Respiratory syncytial virus (RSV) is a common cause of bronchiolitis in infants.
- Influenza can cause more severe illness.
- Parainfluenza viruses often cause croup.
- Bacteria can cause some ear infections, strep throat, and pneumonia, sometimes after a viral illness.
Risk Factors
- Young age, especially infants and toddlers
- Attending group childcare or having school-age siblings
- Exposure to tobacco smoke or air pollution
- Being born prematurely or having chronic lung or heart conditions
- A weakened immune system
- Not being up to date on recommended vaccines
Diagnosis
Most childhood respiratory infections are diagnosed by symptoms and a physical exam. Additional tests are used when needed:
- Listening to the chest for wheezing or abnormal breath sounds.
- Checking oxygen levels with a pulse oximeter.
- Nasal or throat swabs to identify specific viruses or bacteria.
- Chest X-ray when pneumonia is suspected.
Treatment
Care depends on the type and severity of the infection.
- Rest and fluids to keep the child comfortable and hydrated.
- Fever and pain relief with acetaminophen or ibuprofen as appropriate for age.
- Saline drops and gentle suction to relieve a blocked nose in infants.
- Antibiotics only for bacterial infections, not for viral colds.
- Hospital care, oxygen, or breathing support for severe infections such as serious bronchiolitis or pneumonia.
Cough and cold medicines are generally not recommended for young children. Always follow age-appropriate dosing and a clinician's advice for medications.
Prevention
- Wash hands often and teach children good hand hygiene
- Keep children away from tobacco smoke
- Stay up to date on recommended vaccines, including influenza
- Keep sick children home and away from vulnerable infants when possible
- Clean shared surfaces and toys regularly
- Breastfeed when possible, which supports infant immunity
When to See a Doctor
Contact a doctor if your child has a high or persistent fever, symptoms that worsen, ear pain, or a fever in an infant under 3 months. Seek emergency care immediately if your child:
- Is breathing fast or struggling to breathe
- Has skin pulling in around the ribs or neck, or is grunting
- Has blue or gray lips or face
- Is very drowsy, hard to wake, or refusing to drink
- Shows signs of dehydration
Frequently Asked Questions
How many colds are normal for a young child each year?
Young children commonly catch many colds a year, sometimes six to eight or more, especially in childcare or with older siblings. Frequent mild colds are usually a normal part of a developing immune system, but worsening or breathing symptoms should be checked.
Do children's respiratory infections need antibiotics?
Most are caused by viruses, and antibiotics do not help viral infections. Antibiotics are used only for bacterial infections such as strep throat, some ear infections, or bacterial pneumonia. Rest, fluids, and fever relief are the mainstays for viral illness.
What are the breathing warning signs in a sick child?
Seek emergency care if a child is breathing fast or struggling to breathe, has skin pulling in around the ribs or neck, is grunting, has blue or gray lips, is very drowsy or hard to wake, or is refusing to drink. These can signal a serious infection.
Are cough and cold medicines safe for young children?
Over-the-counter cough and cold medicines are generally not recommended for young children and can be harmful. Saline drops, fluids, rest, and age-appropriate fever relievers are safer. Always follow your clinician's guidance on any medication and dosing.
References
- Centers for Disease Control and Prevention (CDC).
- American Academy of Pediatrics. Respiratory infections in children.
- Mayo Clinic. Common cold in children and bronchiolitis.
- MedlinePlus, U.S. National Library of Medicine. Respiratory tract infections.