Pediatric respiratory infections every parent should know about

Pediatric respiratory infections typically spike during the winter months leading to “ cold and flu season”. This is when everybody spends more time indoors, where germs are quickly shared, especially in schools, daycares and other social settings. 

While these infections are often harmless and short-lived in older children, they can have dangerous consequences for infants or children with underlying medical conditions. Below are potentially serious pediatric respiratory infections every parent should be aware of, including common symptoms and prevention tips. 

1) Respiratory syncytial virus (RSV)/bronchiolitis

Almost all children get Respiratory Syncytial Virus (RSV) at least once before they are 2 years old. For most healthy children, RSV will be like a cold. However, some children can get very sick with RSV, particularly those who are very young or have underlying medical conditions.


RSV symptoms may include a runny nose, cough, and fever. Symptoms generally last an average of 5-7 days.  Symptoms are typically at their worst on days 3-5 of the illness and can quickly worsen for those who are high risk. RSV, along with other viruses, can cause another common respiratory illness called bronchiolitis. This develops when there is inflammation of the bronchioles, which are the smallest air passages in the lungs. Common symptoms of RSV and bronchiolitis in children can include: 

• Runny nose

• Cough

• Fever

• Brief pauses in breathing

• Irritability

• Decreased appetite

• Trouble breathing

• Wheezing (high-pitched whistling noise with breathing)

Seek prompt medical care if a child develops signs of increased work of breathing:

• Audible wheezing or grunting

• Lethargy

• Nostril flaring

• Rapid breathing

• Visible retractions of chest muscles when breathing (area under the ribs, between the ribs or in the neck sinking in/pulling in with breathing)


The best prevention is to teach children health hygiene habits at a young age, like hand-washing, covering their nose and mouth when coughing and sneezing, avoiding touching their faces with unwashed hands- and keeping their distance from others who are sick.

2) Pertussis

Pertussis is a pediatric respiratory illness caused by a bacteria called Bordetella pertussis. It’s referred to as “whooping cough” because of the sound made when inhaling between coughs.

This bacterial infection is treated with an oral antibiotic, however, the cough can continue. Infants and young children are at a high risk of developing life-threatening complications because of immature immune systems and narrow airways.


Symptoms of this respiratory infection often look like a cold with a runny nose, low-grade fever and cough for a week or two, but then symptoms worsen. Progressively, it can lead to these symptoms that require immediate attention:

• Blue lips or nails

• Exhaustion

• Increased work on breathing

• Lethargy

• Sudden, violent coughing attacks that can cause children to cough until they vomit, eat poorly and look ill


There is a vaccine that prevents pertussis infections and transmission and is effective in protecting your child from pertussis. The pediatric version is called DTaP (diphtheria, tetanus and acellular pertussis). The vaccine for older children and adults is called Tdap.

Most people need a Tdap booster every 10 years once they have completed their pediatric immunizations.

Parents and those who will be in close contact with children less than 1-year-old should receive a Tdap booster. This helps lower the risk of spreading Pertussis to infants. 

It is recommended that pregnant persons get a Tdap booster in each pregnancy since it allows mothers to pass along protection against this infection.

3) Croup

Croup is a predominantly viral infection that causes swelling of the larynx (voice box) and upper airway. The formal diagnosis is laryngotracheobronchitis. Children are most likely to get croup between 3 months and 5 years of age.


Symptoms of croup often begin like a cold and then more characteristic symptoms develop:

• A distinct-sounding barking cough

• Hoarse voice

• Stridor- which is a coarse noise heard with breathing in, especially when the child is crying or active. However, if this noise is heard when the child is resting, a medical evaluation is needed.

Children with croup are often treated with an oral steroid that decreases inflammation in their larynx and upper airway.

In young children or children with underlying medical conditions, croup can cause more serious symptoms, including respiratory distress and hypoxia. These children typically need more intensive, hospital-based treatments in addition to steroids that may include breathing treatments with a medication called epinephrine, oxygen and IV fluids. 


There is no croup vaccine. The best prevention is practicing health hygiene and avoiding contact with sick people.

4) Common Cold

This is caused by many different viruses and can affect adults and children alike. Unfortunately, there is no cure for the common cold. Antibiotics are not used to treat the common cold as they are used for bacterial infections, not viral ones. The majority of children will experience 6-8 colds a year and this can be even more frequent if enrolled in daycare. Usually, this will go away on its own and the body will fight off the infection. However, if a child experiences worsening or severe symptoms, it’s always best to speak with their pediatrician.


Symptoms of the common cold can be similar to other illnesses and can include the following: 

• Congestion

• Cough

• Sore throat

Runny nose

• Fever

• Mild headache

• Overall tiredness

• Slight body aches

• Sneezing

Newborns under 12 weeks old should receive medical attention if they develop a fever of 100.4°F (38°C) or if children have difficulty breathing ear pain, decreased drinking or urination (wet diapers), extreme drowsiness or fussiness.


There is no vaccine for the common cold. The best prevention is practicing health hygiene and avoiding contact with sick people.

5) Sinusitis

Sinusitis is inflammation of the sinus cavities, which are air-filled spaces in the bones of the face around the nose and eyes. The nasal cavities become inflamed and infected. This common infection is often caused by a virus or bacteria.


Symptoms of sinusitis can be similar to a common cold. However, there are a few specific patterns and certain symptoms that can help diagnose sinusitis including:

• Cold symptoms lasting at least 10 days without improvement

• Onset of thick yellow/green nasal discharge with fever for at least 3-4 days 

• Significant pressure or pain in the face around the sinus cavities that worsens with bending forward.  

Other potential symptoms can include: 

• Bad breath

• Cough

• Fever

• Draining sensation down the back of the throat (postnasal drip)

• Headaches


There is no specific sinusitis vaccine, however, some bacteria that can cause sinusitis are protected against with other recommended pediatric immunizations.  In addition to health hygiene, avoid exposure to cigarette smoke. Using a humidifier during drier months can help reduce the risk of sinusitis. Nasal rinses can also be used among children who are at least 2 years old. 

6) Epiglottitis 

The epiglottis is a flap of tissue that is at the base of the tongue in the back of the throat. Epiglottitis is an infection caused by bacteria—most commonly Haemophilus influenzae type b, also known as Hib—which can ultimately become a rare but life-threatening respiratory illness in children. With this illness, the epiglottis becomes swollen and inflamed and can affect breathing by blocking the airway.  Children with this condition should be kept calm and evaluated in the emergency room. 


Children can develop symptoms of epiglottitis quickly, within a matter of hours, including: 

• Sore throat

• Breathing through the mouth

• Drooling

• Fever (usually higher than 101)

• Hoarse voice

• Stridor/noisy breathing

• Painful or trouble swallowing

• Restlessness

Symptoms can worsen when lying down and the child may refuse to do so. Children are often more comfortable sitting upright and leaning forward.


Hib vaccination has become routine for infants, which has made epiglottitis rare in children.

7) Bronchitis

Bronchitis is when there is inflammation of the bronchi, which are the larger air passages that connect your trachea (windpipe) to your lungs. Viruses are the most common cause of bronchitis in children, therefore antibiotics are usually not needed for treatment. Symptoms often last 1-2 weeks but can persist for 3-4 weeks. 


Bronchitis symptoms can include: 

• A dry or mucous-containing cough 

• Rhinorrhea

• Shortness of breath 

• Wheezing

• Gagging or vomiting when coughing

• Chest tightness 

• Fever


There is no bronchitis vaccine. The best prevention is practicing health hygiene and avoiding contact with sick people.

8) Pneumonia

Pneumonia is an infection in the lungs that causes the air sacs in one or both of the lungs to fill with pus and other fluid.  This can be due to viruses or bacteria. Pneumonia can be diagnosed based on signs, symptoms and physical exam, but sometimes a chest X-ray is used


Initial pneumonia symptoms can look like a cold, but it can progress to include:

• Chest pain when breathing and coughing

• Stomach pain

• Fatigue

• Fever

• Nausea, vomiting and diarrhea

• Productive cough

• Shortness of breath

• Signs of increased work of breathing


The most common cause of bacterial pneumonia is a bacteria called Streptococcus pneumonia.  It is recommended that all healthy children receive 4 doses of the pneumococcal vaccine (PCV13 or PCV15) between the ages of 2 and 15 months. 

Visit urgent care for pediatric care

Pediatric respiratory infections can be concerning, but we are here for you!  Our urgent care centers are open seven days a week, and we see children ages 6 months and older (our designated pediatric sites can evaluate children of all ages). We can provide many treatments and preventive flu shots too! You can walk in without an appointment, or you can check in online. We’ll have you back to feeling better in no time.