5 Common Respiratory and Infectious Disorders
Learn how to assess common respiratory and infectious illnesses in children, recognize urgent warning signs, understand condition-specific care, and support families with prevention and follow-up.
Assess the whole child
Respiratory infections range from mild upper-airway illnesses to conditions that can quickly compromise a child’s breathing. Infants, children born prematurely, and children with chronic heart or lung disease or weakened immunity may be at greater risk of severe illness. Assess the whole child by considering age and medical history along with breathing effort, hydration, alertness, and caregivers’ observations.
Observe before disturbing the child
Begin by noting the child’s appearance, color, alertness, ability to speak or feed, and breathing pattern. Count respirations for a full minute while the child is calm, and interpret the rate according to age and clinical context.
Look for nasal flaring, grunting, chest retractions, noisy breathing, pauses in breathing, and reduced air movement. Check temperature, oxygen saturation when indicated, fluid intake, and urine output. Ask when symptoms began, whether they are worsening, and about exposures, vaccinations, medicines, allergies, and underlying conditions.
Recognize urgent warning signs
Seek emergency care for severe or worsening breathing difficulty, blue or gray lips or face, pauses in breathing, marked chest retractions, inability to drink or speak because of breathlessness, unusual sleepiness or difficulty waking, or signs of dehydration.
A rectal temperature of 100.4°F (38°C) or higher in an infant 3 months old or younger requires prompt medical evaluation. Reassessment is also needed if breathing worsens, the child drinks or urinates much less, fever persists, symptoms improve and then worsen, or a caregiver feels the child is becoming sicker.
Upper respiratory infections
and other viral upper respiratory infections
A commonly causes a runny or stuffy nose, cough, and sore throat. Most improve with time and supportive care. Encourage fluids and rest. Saline drops or spray and gentle nasal suction can help clear an infant’s nose, especially before feeds. Antibiotics do not treat viral infections. Over-the-counter cough and cold medicines are not recommended for children younger than 6 years, and honey should never be given to a child younger than 1 year.
and COVID-19
may cause fever, cough, sore throat, fatigue, headache, and muscle aches; some children do not develop a fever. Children younger than 5, especially those younger than 2, and children with certain chronic conditions are at increased risk of flu complications. Contact a clinician promptly if flu is suspected in a higher-risk child or the illness is severe. Prescription antivirals work best when started early, but may still be useful later for some children. Testing and treatment decisions depend on the child’s symptoms, risks, and local guidance.
Lower respiratory illnesses
RSV and
can begin like a cold and progress to cough, wheezing, fast breathing, or difficulty feeding. In young infants, irritability, reduced activity, poor feeding, or pauses in breathing may be prominent. is a viral infection of the small airways, most often affecting infants and children under 2.
Management is usually supportive: help keep the nose clear, offer appropriate fluids or feeds, and monitor breathing and hydration. Antibiotics do not treat viral . Routine bronchodilators and chest physiotherapy are not recommended for typical cases. A clinician may recommend hospital care for breathing support or fluids if needed.
causes a bark-like cough, hoarse voice, and sometimes stridor, a harsh sound when breathing in. Keep the child calm because distress can worsen noisy breathing. A clinician may prescribe a corticosteroid; nebulized epinephrine may be used for more severe symptoms, with observation afterward. Stridor at rest, increasing effort to breathe, bluish color, drooling, or difficulty swallowing needs urgent assessment.
is an infection of the lungs and may cause fever, cough, fast or difficult breathing, chest pain, low energy, or poor feeding. Viruses and bacteria can both cause it, so treatment depends on clinical assessment. Antibiotics are appropriate for suspected bacterial , not viral illness. Worsening breathing, dehydration, or a child who appears very ill warrants prompt care.
Ear infection and strep throat
can cause ear pain, fever, or ear tugging in a young child. A clinician diagnoses it by examining the eardrum. Some mild cases can be observed with follow-up rather than treated immediately with antibiotics.
For suspected , symptoms alone may not distinguish it from viral illness. Testing is used when appropriate. In children 3 years and older, a negative rapid test should be followed by a throat culture. Treat confirmed strep with prescribed antibiotics and complete the course as directed. Antibiotics do not help viral sore throats.
Prevention and family-centered care
Encourage routine handwashing, covering coughs and sneezes, cleaning frequently touched surfaces, avoiding tobacco smoke, and keeping sick children home while they are acutely ill. Keep recommended immunizations up to date, including seasonal vaccination. Ask the child’s clinician about current protection against RSV and other vaccine-preventable infections.
Partner with caregivers by listening to their concerns, explaining what changes to watch for, and agreeing on how to access follow-up care. Give medication instructions in plain language, based on the child’s age and weight, and use the supplied measuring device. Do not give aspirin to children with viral illness. Ask caregivers to repeat the home-care plan and urgent warning signs in their own words.