It’s that time of year—viruses are among us and it seems everyone has some sort of cough, cold or sniffle! But how do you know when to be worried about your baby or child’s respiratory illness?
In general, the symptoms of a cold usually last for about 1 week, with days 3 to 5 being the worst. However, a cough can linger for over 2 weeks! Babies younger than 6 months old are most at risk for severe respiratory illness and can become a lot sicker, a lot faster than older children or adults. It is important to keep your infant away from others who have a cold, even if its “just mild” and ensure that everyone is washing their hands prior to touching or interacting with the infant. There are a variety of respiratory illnesses that are quite common in infancy and childhood. If you find yourself wondering which category your child’s symptoms fall into, continue reading to find out what the difference between them and how you can help. And remember to always consult a medical professional who is able to assess your family's medical needs through an individualized assessment, as these do not replace medical advice from your own healthcare provider.
Asthma is the most common activity-limiting condition in children. It is characterized by a wheezing sound (high pitched whistling noise) when a child is breathing. It is not formally diagnosed until after 2 years of age however, children under 2 years old may exhibit the classic signs of asthma. Children with eczema and allergies are more likely to have asthma. Treatment for asthma includes puffers. For younger children, using an aerochamber can deliver the medication needed much more effectively. Be sure that the child is taking at least 5-10 breaths for every press of the puffer.
Croup is common in children between 6 months and 2 1/2 years old. It is characterized by a seal bark-sounding cough or high-pitched sound when a child is inhaling, also known as stridor. Depending on the severity of the croup, your child may require vaporized epinephrine and oral steroids at the hospital. More mild croup symptoms can actually be resolved by breathing in cold moist air – try opening your freezer or taking your child outside briefly to breathe in the cold winter air.
Bronchiolitis is a virus that occurs most often in children younger than 2 years old, and is often mistaken for asthma. It is the leading cause of hospitalization in infants. Children with bronchiolitis will have an increased respiratory effort and an abundance of secretions! They may also have wheezing and/or a low grade fever. Eventually this infection can lead to difficulty breathing, a cough and trouble feeding. The treatment is mostly supportive care – try suctioning their nose (use either a bulb syringe or the Nose Frida Snot Sucker Nasal Aspirator!), Tylenol for irritability and fluids to maintain hydration. If these 3 things do not seem help or symptoms progress, the child may need oxygen support at the hospital.
Pneumonia can either have a bacterial or viral cause. It typically presents with a fever, a productive cough, chest or abdominal pain and congestion. In the very young, it may present with irritability, poor feeding and fever. If the pneumonia is caused by bacteria, antibiotics are needed. Your child may be ordered a chest X-ray to diagnose the pneumonia.
As a parent, you may recognize that your child is sick, but wonder when you should be worried about their respiratory illness and seek further assessment and treatment. The following are a list of respiratory red flags. If your child exhibits any of these symptoms you should seek medical care in a timely manner.
Respiratory red flags
o Breathing too fast or too hard (retractions or indrawing in the rib, sternum or lower neck area, using accessory muscles to breathe, head bobbing with each breath, nasal flaring)
o Abnormal sounds (e.g. grunting, wheezing, barking sound with coughing)
o Dehydration (e.g. dry lips and tongue), more irritable than usual, not sleeping well or inconsolable
o Decreased responsiveness (e.g. extremely sleepy or lethargic)
o Pale or blue around the lips
o Fever accompanied by productive cough for longer than 2 days
o Increased drooling (not related to teething)
Although you cannot prevent these illnesses, and I can almost guarantee that as soon as they go to daycare or their first year of school they will be bringing home one of these not so lovely respiratory bugs, you can provide supportive care and recognize when further care is needed!
o Position child in an upward position to assist with breathing.
o Provide Tylenol if child has a fever. Consult your healthcare provider for the most accurate dosage as children’s medications should be given by weight.
o Keep your child hydrated with small amounts of fluid, given often (instead of a large amount at once); however, if they are in respiratory distress, do not give anything by mouth as they are at a higher risk of choking.
o If they are not interested in eating, do not force them. Have snacks available for them to pick at.
o If child is breastfed, continue breastfeeding (even if you are sick too). For older infants who are currently breastfeeding and eating solids, they may resort to just breastfeeding while sick and this is okay!
o Try a humidifier in their bedroom while they are sleeping, this will keep the air moist and help to relieve a stuffy nose or dry cough.
o If they do have a stuffy nose and are unable to blow it – assist them to clear the secretions by sucking them out with a bulb syringe or the nose frieda.
o Finally, ensure you and your child take time to lay low, stay home and benefit from all the love and cuddles you can each provide! These moments pass by quicker than you could imagine!