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Patient Education

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Respiratory Problems, Age 11 and Younger

Overview

Most babies and older children have several mild infections of the respiratory system, Opens dialog 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 include:

  • A runny or stuffy nose. It may lead to blocked nasal passages that cause the child to breathe through the mouth.
  • Feeling cranky or restless, having a poor appetite, and being less active than usual.
  • Coughing, especially when lying down.
  • Fever.

Lower respiratory system

The lower respiratory system includes the bronchial tubes and lungs. These types of problems are less common than ones in the upper respiratory system. But they are usually more severe. They are more likely to need a doctor's care.

Symptoms of lower respiratory system infections include:

  • Coughing that lasts through the day and night.
  • Fever. It may be high with some infections, such as pneumonia.
  • Feeling cranky or restless, having a poor appetite, and being less active than usual.
  • Difficulty breathing, Opens dialog. You may notice:
    • Rapid breathing.
    • Grunting, which is heard when the child breathes out (exhales). Most babies grunt now and then when they sleep. But grunting that occurs with rapid, shallow breathing may mean a lower respiratory system infection.
    • Wheezing, Opens dialog. (This is a different sound than croup, Opens dialog.)
    • Using the neck, chest, and belly muscles to breathe. This causes a "sucking in" between or under the ribs (retractions).
    • Flaring the nostrils when breathing.

Respiratory problems may have many causes.

Viral infections

Viral infections cause most upper respiratory infections. Sore throats, colds, croup, and influenza (flu), Opens dialog are common viral illnesses in babies and older children. These infections are usually mild and go away in 4 to 10 days. But sometimes they can be severe.

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 aren't used to treat viral illnesses. They don't change the course of viral infections. Using an antibiotic when it's not needed exposes your child to the risks of an allergic reaction, Opens dialog and antibiotic side effects. These side effects include nausea, vomiting, diarrhea, rashes, and yeast infections. Antibiotics also may kill helpful bacteria and encourage the growth of dangerous antibiotic-resistant, Opens dialog 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, Opens dialog. Up to 10% of babies and children with viral infections of the lower respiratory system, such as those caused by respiratory syncytial virus, Opens dialog (RSV), may have severe blockage of the air passages. They need treatment in a hospital.

Bacterial infections

The most common sites for bacterial infections in the upper respiratory system are the sinuses and throat.

Bacterial pneumonia may follow a viral illness as a secondary infection, Opens dialog. Or it can appear as the first sign of a lower respiratory infection. In babies and small children, the first sign of infection often is rapid breathing, crankiness, being less active than usual, and poor feeding. Antibiotics work well against bacterial infections.

Allergies

Allergies are a common cause of respiratory problems. The 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").
  • Crankiness and loss of appetite.

Asthma

Babies and small children usually don't have asthma, Opens dialog. 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 gets worse, symptoms may include wheezing and shortness of breath after exercise or at nighttime.
  • In severe asthma, the most common symptoms are trouble breathing (using the neck, chest, and belly muscles to breathe) and a high-pitched sound when breathing (wheezing).
  • Allergies and asthma often occur together.

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 this 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.
  • Problems that have been present from birth (genetic causes), such as cystic fibrosis, Opens dialog.

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. What type of symptoms your child has and how severe they are will help you know if your child needs to see a doctor.

Current as of: July 31, 2024

Author: Ignite Healthwise, LLC Staff

Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.