Kids’ Respiratory Illnesses 101

December 21, 2023

Providence Children's Health Team

[5 MIN READ]

There are many different types of respiratory illnesses that can afflict children, including the common cold, asthma, allergies and neuromuscular lung diseases.
The experts at Providence can help parents know the difference between these illnesses and how to treat them, so they can have healthy children once again.
Not sure whether you should take your child to their health care provider? It’s better to take them early, rather than letting an unknown illness progress.

If you have a child, they are most likely to suffer from at least one respiratory illness this winter. In fact, most children battle four to six respiratory viruses in any given year, according to Stanley Lee, M.D., a pediatric pulmonologist at Providence Sacred Heart Medical Center in Spokane, Washington.

Most of those illnesses will just be temporary and go away on their own. But how do you know when your child has a respiratory infection that’s bad enough to need a doctor’s care, and whether they are suffering from a serious problem?

Here’s a primer on the different kinds of respiratory illnesses that afflict children, and what you can do to help your own little ones recover.

The common cold

While a cold is usually harmless, it can still cause your child to feel miserable. Colds are highly contagious, and children are highly susceptible because they are in close contact with other children nearly every day in daycares and at school.

The most common symptoms include:

Cough.
Sneezing.
Stuffed or runny nose.
Scratchy or sore throat.
Low-grade fever (if your child has a high fever, there’s probably something else going on).

The best treatment for cold-like symptoms in young children, according to Dr. Lee, is over-the-counter medications such as ibuprofen (Advil) or acetaminophen (Tylenol) and lots of fluids. “I try to stay away from cough medicine because when we use it, we’re just putting a bandage on the symptoms,” he said. “We’re not giving the body a chance to get rid of the virus by coughing up mucus.”

Dr. Lee said he never prescribes antibiotics for a cold. “Antibiotics will not do anything for a viral infection,” he said. “Instead, they are used to treat bacterial infections. We minimize the use of antibiotics because we want to avoid antibiotic resistance in children.”

Asthma

Asthma is a chronic lung disease whose symptoms can often mimic those of a cold. However, Dr. Lee said, while colds eventually disappear, asthma lingers. If your child has not been diagnosed with asthma, but their “cold” is persisting and they’re having trouble breathing while the rest of their classmates are healthy again, it’s time to see their primary care provider.

Although asthma is a genetic disease, there is an environmental component to it. According to Dr. Lee, the top five asthma triggers are:

A virus.
Allergies.
A change in temperature.
Exercise.
Smoke.

While there are several different ways to treat asthma symptoms, both Dr. Lee and Alma Chavez, M.D., another pediatric pulmonologist at Providence Sacred Heart, recommend using an albuterol inhaler with a spacer. A spacer suspends the particles of the medicine in the inhaler until the child breathes in, making it easier for the medicine to get into all parts of the lungs.

“With an inhaler, the medication is coming out at more than 100 miles an hour,” said Dr. Chavez. “By using the spacer, you’re slowing that medicine and controlling it. With a spacer, you get about 30% of the medication in your respiratory tract. If you don’t use a spacer, you get less than 10%, and your child may continue to have difficulty breathing.”

Seasonal allergies

Seasonal allergies, also called hay fever, are so common that you likely either suffer from them yourself or have a family member who does. Children are most likely to experience severe allergy symptoms in the spring or fall — or both.

In many cases, children who have asthma often also suffer from allergies and eczema, a condition that causes skin to become dry, itchy and bumpy. “I call them the unholy trinity,” said Dr. Lee.

“If allergies are flaring, that can lead to asthma exacerbation,” added Dr. Chavez. “If a child has allergies, experiences bad weather, or is sleep deprived and gets a cold, they can wind up with symptoms of asthma and be quite sick.” If they don’t get proper treatment, it can even be life-threatening.”

Neuromuscular lung diseases

While children need healthy lungs, they also need a healthy “pump” for the lungs — diaphragm, ribs and muscles to help the lungs expand and contract. When there’s a problem with one of these body parts, that can lead to neuromuscular lung diseases.

Some of the most common neuromuscular diseases that can cause breathing problems include muscular dystrophy, spinal muscular atrophy and congenital myopathies, which are muscle disorders that appear at birth or earlier than 12 months of age.

In most cases, there is no cure for these diseases — rather, parents do the best they can at treating their children’s symptoms, such as mucus accumulation in the lungs. “Children with neuromuscular disease need to have their airway cleared at least once or twice a day,” said Dr. Chavez. “We help parents find the best way to do this with their children.”

When to call the doctor

If your child is having respiratory symptoms such as shortness of breath and you’re unsure whether you should take them to the doctor, watch them closely. For children in severe respiratory distress, their skin sinks in when they are trying to breathe and they flare their nostrils. If they start grunting when they breathe, the situation has become much worse.

“If a baby is grunting, they’re about to stop breathing, and you should call 911 or go to the emergency department right away,” said Dr. Chavez.

In general, if you are in doubt, call your doctor. It’s better to treat a disease or illness in its early stages than it is when it has already progressed to something serious.

Contributing caregivers

Stanley Lee, M.D., pediatric pulmonologist at Providence Sacred Heart Medical Center in Spokane, Washington

Alma Chavez, M.D., pediatric pulmonologist at Providence Sacred Heart Medical Center in Spokane, Washington

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