At some point in their young lives, just about all children develop respiratory infections. They tend to be more susceptible at earlier ages, particularly in the first few months of life as their immune systems begin to develop and encounter the world.
The vast majority of respiratory illnesses are mild and self-limiting.
Those children who do not get better in seven days or more or those who develop signs and symptoms of respiratory distress should always be taken for medical evaluation.
If your child seems to be more ill than expected, they probably are. Don’t hesitate to have the child seen by a healthcare provider sooner than later.
Children may improve or deteriorate rapidly and without warning during respiratory illnesses.
Parents, especially mothers, have a sixth sense. Call it instinct. Mothers learn to know their children and how their child reacts to illnesses. They become adept at figuring out what is wrong and what will or will not work. If they have older children, that experience plays into the equation.
One of the most important aspects of taking a history and physical in the clinic or emergency room comes from what the mother or father describes. When it comes to knowing when it is safe to treat the child at home versus bringing them to the doctor, instinct does play a role, but there are also sure signs and symptoms that every parent should look for.
In medicine, there is a saying every clinician learns early on in his or her training: “If you think about a possibility with a patient, it is more likely than not that you should consider it.”
This dictum holds especially true when dealing with pediatrics, as children tend to have less inherent reserve in dealing with illness than adults.
In other words, if a child seems sick and is not getting better with home remedies, don’t delay. It is better to be safe than sorry even if only a small percentage of children with upper respiratory illnesses need medical attention.
Why do children get so many respiratory?
Upper respiratory illnesses (URIs) are by far the most common presentation of acute illness seen in the outpatient setting. URIs can range from mild and self-limited to severe and even life-threatening. Viruses account for most URIs.
URIs are caused by a direct invasion of the mucosa lining of the upper airway. Viruses, bacteria, or other pathogens must pass through several barriers including physical, mechanical, and immune defenses, but in children, those barriers are much smaller, weaker, or are still developing.
Along the same lines, children tend to develop more severe signs and symptoms because their bodies are naïve to the onslaught of these pathogens. Children often encounter certain illnesses for the very first time. And they may be in environments such as schools where other children are sick, so the pathogens can spread more easily.
In addition, if your child does have persistent upper respiratory signs and symptoms, it is because their airway is smaller. This is particularly true in infants younger than six months of age. Some illnesses can cause swelling and airway narrowing in children, which can cause alarming signs and symptoms which should always be taken seriously.
What warrants a visit to the clinic or hospital?
In most cases, if the following signs or symptoms are not present, children can be cared for at home. There should be a heightened concern if any of these conditions are present:
This may seem obvious since all children with respiratory illnesses seem to complain about a stuffy nose or chest congestion. There are signs there may be something more going on, though. If the child starts wheezing when breathing out or making rattling sounds with breathing in, there may be cause for concern. The sounds with difficulty breathing are called stridor and they can be associated with paradoxical movements of the chest wall, accessory muscle use in the neck and face, and nasal flaring. These signs can lead to decreased breath sounds and pauses in breathing. These signs can be indicative of something more serious, and the child should be taken to the clinic or hospital.
If your child is not eating or drinking, dehydration can develop without much warning. Less than one wet diaper every eight hours can be a sign that a child is becoming dehydrated. It may be difficult to get the child to drink because of throat discomfort or difficulty breathing. In these cases, children will need supplemental fluids, such as with an IV before they develop more problems.
Almost all children develop fevers during respiratory illnesses. What raises concerns are the fevers of 100.4oF or more that do not respond to conservative measures and persist even with acetaminophen or ibuprofen. Fevers that exceed 104oF should always be taken seriously, as there are increased risks of seizures or other neurological problems.
Children can develop tachycardia (fast heart rate) and hypertension when they are entering into respiratory distress or failure. Sometimes there are signs of a heart gallop or an irregular heartbeat or even progression to bradycardia (slow heart rate) and shallow breathing. It is important to be able to recognize these potential changes in a heartbeat in children with a respiratory illness, as they almost always indicate a need for the child to be taken for medical care.
If the child begins showing signs of grayness or blue color to their tongue, lips, or skin, it may mean they are not getting sufficient oxygen. The technical term for low oxygenation is cyanosis and it can be very serious, particularly if the child has pauses in breathing, decreased activity or alertness, and signs of gasping for air in distress.
Other telltale signs your child should be taken to the clinic or hospital include:
- Poor sleep.
- Chest pain.
- Unrelenting cough.
- Difficulty or pain with swallowing.
- Tugging at the ears.
- Ear drainage or bleeding from the ears.
A healthcare provider should evaluate all children if symptoms continue to worsen despite home remedies, or if the illness lasts seven or more days.
What are the basic home remedies?
- Nasal saline or mist.
- Cool mist humidifier.
- Frequent feedings, and soft foods.
- Acetaminophen or ibuprofen (in children over six months of age). Avoid aspirin and cold and cough medicines.
Prevention includes hand washing, cleaning linens, avoiding others who are also ill, and appropriate vaccinations.
Respiratory illnesses are highly contagious and can affect young children more as their immune systems are still developing. Parents, particularly mothers, are adept at administering home remedies to their children. However, if your child’s symptoms worsen, it’s best to have your child treated by a healthcare professional.