Upper Respiratory Infection, Infant

An upper respiratory infection (URI) is a common infection of the nose, throat, and upper air passages that lead to the lungs. It is caused by a virus. The most common type of URI is the common cold.

URIs usually get better on their own, without medical treatment. URIs in babies may last longer than they do in adults.

What are the causes?

• Breathing in droplets from an infected person's cough or sneeze.
• Touching something that has been exposed to the virus (is contaminated) and then touching the mouth, nose, or eyes.

What increases the risk?

• Your baby is exposed to tobacco smoke.
• Your baby has close contact with other children, such as at child care or daycare.
• Your baby has:
  • A weakened disease-fighting system (immune system). Babies who are born early (prematurely) may have a weakened immune system.
  • Certain allergic disorders.

What are the signs or symptoms?

• Runny or stuffy (congested) nose. This may cause difficulty with sucking while feeding.
• Cough or sneezing.
• Ear pain.
• Fever.
• Decreased activity.
• Sleeping less than usual.
• Poor appetite.
• Fussy behavior.

How is this diagnosed?

This condition may be diagnosed based on your baby's medical history and symptoms, and a physical exam. Your baby's health care provider may use a swab to take a mucus sample from the nose (nasal swab). This sample can be tested to determine what virus is causing the illness.

How is this treated?

URIs usually get better on their own within 7–10 days. You can take steps at home to relieve your baby's symptoms. Medicines or antibiotics cannot cure URIs. Babies with URIs are not usually treated with medicine.

Follow these instructions at home:

Medicines

• Give your baby over-the-counter and prescription medicines only as told by your baby's health care provider.
• Do not give your baby cold medicines. These can have serious side effects for children younger than 6 years of age.
• Talk with your baby's health care provider:
  • Before you give your child any new medicines.
  • Before you try any home remedies such as herbal treatments.
• Do not give your baby aspirin because of the association with Reye's syndrome.

Relieving symptoms

• Use over-the-counter or homemade saline nasal drops, which are made of salt and water, to help relieve congestion. Put 1 drop in each nostril as often as needed.
  • Do not use nasal drops that contain medicines unless your baby's health care provider tells you to use them.
  • To make saline nasal drops, completely dissolve ½–1 tsp (3–6 g) of salt in 1 cup (237 mL) of warm water.
• Use a bulb syringe to suction mucus out of your baby's nose periodically. Do this after putting saline nose drops in the nose. Put a saline drop into one nostril, wait for 1 minute, and then suction the nose. Then do the same for the other nostril.
• Use a cool-mist humidifier to add moisture to the air. This can help your baby breathe more easily.

General instructions

• If needed, clean your baby's nose gently with a moist, soft cloth. Before cleaning, put a few drops of saline solution around the nose to wet the areas.
• Offer your baby fluids as recommended by your baby's health care provider. Make sure your baby drinks enough fluid so he or she urinates as much and as often as usual.
• If your baby has a fever, keep him or her home from daycare until the fever is gone.
• Keep your baby away from secondhand smoke.
• Make sure your baby gets all recommended immunizations, including the yearly (annual) flu vaccine if older than 6 months.
• Keep all follow-up visits. This is important.

How to prevent the spread of infection to others

URIs can be passed from person to person (are contagious). To prevent the infection from spreading:

• Wash your hands with soap and water for at least 20 seconds, especially before and after you touch your baby. If soap and water are not available, use hand sanitizer. Other caregivers should also wash their hands often.
• Do not touch your hands to your mouth, face, eyes, or nose.

Contact a health care provider if:

• Your baby's symptoms last longer than 10 days.
• Your baby has difficulty feeding, drinking, or eating.
• Your baby eats less than usual.
• Your baby wakes up at night crying.
• Your baby pulls at one ear or both ears. This may be a sign of an ear infection.
• Your baby's fussiness is not soothed with cuddling or eating.
• Your baby has fluid coming from one ear or eye, or both ears or eyes.
• Your baby shows signs of a sore throat.
• Your baby's cough causes vomiting.
• Your baby is younger than 1 month old and has a cough.
• Your baby develops a fever.

Get help right away if:

• Your baby is younger than 3 months and has a fever of 100.4°F (38°C) or higher.
• Your baby is breathing rapidly.
• Your baby makes grunting sounds while breathing.
• The spaces between and under your baby's ribs get sucked in while your baby inhales. This may be a sign that your baby is having trouble breathing.
• Your baby makes high-pitched whistling sounds when breathing, most often when breathing out (wheezes).
• Your baby's skin or fingernails look gray or blue.
• Your baby is sleeping a lot more than usual.

These symptoms may be an emergency. Do not wait to see if the symptoms will go away. Get help right away. Call 911.

Summary

• An upper respiratory infection (URI) is a common infection of the nose, throat, and upper air passages that lead to the lungs.
• URI is caused by a virus.
• URIs usually get better on their own within 7–10 days.
• Babies with URIs are not usually treated with medicine. Give your baby over-the-counter and prescription medicines only as told by your baby's health care provider.
• Use over-the-counter or homemade saline nasal drops to help relieve stuffiness (congestion).