Discusses respiratory problems that babies and children can have. Covers viral and bacterial infections, allergies, and asthma. Offers home treatment tips. Includes interactive tool to help you decide when to call a doctor.
Respiratory Problems, Age 11 and Younger
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.
Taking a rectal temperature is the only way to be sure that a baby this age does not have a fever. If you don't know the rectal temperature, it's safest to assume the baby has a fever and needs to be seen by a doctor. Any problem that causes a fever at this age could be serious.
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:
Diseases such as diabetes, cystic fibrosis, sickle
cell disease, and congenital heart disease.
which are used to treat a variety of conditions.
after organ transplant.
Chemotherapy and radiation therapy for
Not having a spleen.
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:
Put a few saline nose drops in each side of the
baby's nose before you start.
Position the baby with his or her
head tilted slightly back.
Squeeze the round base of the
Gently insert the tip of the bulb tightly inside the baby's
Release the bulb to remove (suction) mucus from the
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.
Severe trouble breathing means:
The child cannot eat or talk because he or she is
breathing so hard.
The child's nostrils are flaring and the belly
is moving in and out with every breath.
The child seems to be
The child seems very sleepy or confused.
Moderate trouble breathing means:
The child is breathing a lot faster than
The child has to take breaks from eating or talking to
The nostrils flare or the belly moves in and out at times
when the child breathes.
Mild trouble breathing means:
The child is breathing a little faster than usual.
The child seems a little out of breath but can still eat or talk.
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
104°F (40°C) and
100.4°F (38°C) to
100.3°F (37.9°C) and
Armpit (axillary) temperature
High: 103°F (39.5°C) and higher
99.4°F (37.4°C) to
Mild: 99.3°F (37.3°C) and lower
Note: For children under 5 years old, rectal temperatures are
the most accurate.
A baby that is extremely sick:
May be limp and floppy like a rag
May not respond at all to being held, touched, or talked
May be hard to wake up.
A baby that is sick (but not extremely
May be sleepier than usual.
May not eat
or drink as much as usual.
If you're not sure if a child's fever is high, moderate, or
mild, think about these issues:
With a high fever:
The child feels very hot.
It is likely
one of the highest fevers the child has ever had.
With a moderate fever:
The child feels warm or hot.
sure the child has a fever.
With a mild fever:
The child may feel a little warm.
think the child might have a fever, but you're not sure.
Symptoms of difficulty breathing in a baby or young child can range from mild to severe. For example:
The child may be breathing a little faster than usual (mild difficulty breathing), or the child may be having so much trouble that the nostrils are flaring and the belly is moving in and out with every breath (severe difficulty breathing).
The child may seem a little out of breath but is still able to eat or talk (mild difficulty breathing), or the child may be breathing so hard that he or she cannot eat or talk (severe difficulty breathing).
Symptoms of difficulty breathing can range from mild to severe. For example:
You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).
Symptoms of serious illness may
A severe headache.
Mental changes, such as feeling confused or much less
Extreme fatigue (to the point where it's hard for you to
Symptoms of serious illness in a baby
may include the following:
The baby is limp and floppy like a rag doll.
The baby doesn't respond at all to being held, touched, or talked
The baby is hard to wake up.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.
Try home treatment to relieve the
Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:
Your age. Babies and older
adults tend to get sicker quicker.
Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
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.