Respiratory infections: When to take your child to the doctor

If you’re the parent of young children, you’re well acquainted with the snotty nose and cough that seems to return each fall and winter. In most cases, your child has caught a cold and will get better with time and perhaps some over-the-counter medicine to help ease symptoms. But there are other respiratory viruses that may cause more severe symptoms.

This fall, healthcare providers are seeing more cases of respiratory syncytial virus (RSV) than in previous years. To make things more complicated, providers are concerned there may be a tri-demic among children this fall, with higher levels of flu and COVID as well as RSV.

As a parent or caregiver, it’s important to know the symptoms of these three illnesses and which symptoms mean you should seek medical care for your child.

In children, the symptoms all three viruses share include:

• Congestion
• Runny nose
• Sore throat
• Cough
• Muscle aches
• Fever
• Headache
• Irritability, increased crying
• Decreased appetite

There are tests for all three illnesses to help your healthcare provider reach an accurate diagnosis and develop an appropriate approach to treatment.

Some babies and young children are at higher risk for a more severe case of RSV. If your child is 12 weeks old or younger, was born prematurely or had a low birth weight, has a chronic lung condition related to being premature, has a weakened immune system, has some types of heart defects, or has a neuromuscular disorder like muscular dystrophy, he or she is at higher risk of severe RSV. For babies in the high risk category, your healthcare provider may recommend a medication called palivizumab, which is given as an injection once a month for five months during RSV/cold and flu season.

Most children with mild RSV symptoms won’t need to be seen by a healthcare provider. You can help manage mild symptoms by using a nasal saline spray and suction bulb to clear nasal passages, a cool mist humidifier to help break up mucus, and offering more liquids to help your baby or child to stay hydrated. If your child has a fever, ask her or his pediatrician if you should give acetaminophen or ibuprofen to bring the fever down.

Does your child need medical attention?

How do you know if your child needs medical attention? These symptoms should prompt a call to your healthcare provider:

• Your baby isn’t eating or drinking as much as usual and has fewer wet diapers. This can be a sign of dehydration.
• Your child has a fever of more than 100.4 degrees for 72 hours.
• Your child is wheezing or breathing more rapidly than usual.

Seek immediate medical attention if:

• Your baby or child is struggling to breathe, is breathing very rapidly, or their breathing is shallow
• Their tongue, lips, fingernails, or skin has a blue or gray tinge (a sign they’re not getting enough oxygen)
• Your child is much less alert and active than usual
• Your child has a high fever

You can lower your child’s risk of contracting RSV, as well as the flu and COVID, by washing everyone’s hands frequently, keeping your child away from people if they’re ill, keeping your baby away from large gatherings and crowds, not letting people smoke in your home or near your baby, and washing your child’s toys and bedding frequently.