Respiratory Problems, Age 11 and Younger

Topic Overview

Most babies and older children have several mild infections of

therespiratory 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 level.
 Coughing, especially when lying down.
 Fever that occurs suddenly and may reach 41 °C (105 °F).

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 system.
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 infections include:
 Shallow coughing, which continues throughout the day and night.
 Fever, which may be high with some lower respiratory system
infections, such as pneumonia.
 Irritability, restlessness, poor appetite, and decreased activity level.
 Difficulty breathing. You may notice:
o Rapid breathing.
o 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.
o Wheezing (which is a different sound than croup).
o 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.

Fever
 Children with a fever often have an infection caused by a virus, such as a
cold or the flu. Infections caused by bacteria, such as bacterial
pneumonia, also can cause a fever. Babies younger than 6 months should
be seen by a doctor anytime they have a fever because they can get
extremely sick quickly.
Temperature varies depending on how you take it. The most common
methods to measure it are:
 Under the tongue.
 In the armpit.
 In the rectum.
 In the ear.
To convert a temperature from one method to another, use the Interactive
Tool: How Do Temperatures Compare?

Viral infections
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 Croup and 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 anallergic 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 antibiotic-resistant 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. Up to 10% of babies and children with viral
infections of the lower respiratory system, such as those caused
by respiratory syncytial virus (RSV), may develop severe blockage of the
air passages and require hospitalization for treatment. For more
information, see the topics Acute Bronchitis, Pneumonia, and Respiratory
Syncytial Virus (RSV) Infection.

Bacterial infections
The most common sites for bacterial infections in the upper respiratory
system are the sinuses and throat. A sinus infection is an example of an
upper respiratory bacterial infection.
Bacterial 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 infections.
Tuberculosis is a less common bacterial infection of the lower respiratory
system.

Allergies
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
("allergic salute").
 Sneezing and watery eyes. Often there are dark circles under the
eyes ("allergic shiners").
 Irritability and loss of appetite.

Asthma
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 topicAsthma in Children.

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 tobacco 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. For more information, see the topic Swallowed
or Inhaled Objects.
 Problems that have been present from birth (genetic causes), such
ascystic fibrosis.
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.
Check your child's symptoms to decide if and when your child should see
a doctor.