Upper Respiratory Infections
Common Health Issues

Upper Respiratory Infections

Upper respiratory infections are a group of illnesses that includes the common cold and viral and bacterial infections of the ear, nose and throat—are the most common afflictions of youngsters.


Children are usually far more susceptible to these infections than adults, and, unfortunately, can build up resistance to them only through repeated exposure. As most parents know, a child seems to be sick as often as he is well during his first year or two of school—usually his initial experiences with crowds of children in close quarters.



Below are the common types of upper respiratory infections and their treatment options



Colds are not much of a problem in themselves, but they can lead to more serious respiratory infections. If a child’s cold is persistent or suddenly gets worse, consult the doctor. Be especially alert for earaches, sore throat, persistent cough, increased or recurrent fever, swollen eyes, a thick or greenish nasal discharge, or a stiff neck. Any of these symptoms may mean that a more serious infection is also present.

You can help reduce the frequency or severity of colds by not letting your child get overtired or chilled. However, it is a mistake to put too much clothing on him or to keep him indoors in an overheated room. Not only is hot, dry air irritating to the nasal passages, but the ability to adjust to temperature changes decreases when a child spends most of his time in an overheated house.


In general, a good indoor temperature is 20°C to 21°C in the daytime and 15°C at night. All healthy children, except very young infants, should be outdoors several hours a day in good weather so that their bodies become accustomed to colder air.


Treating a Cold

Keep a child with a cold in a comfortably warm, draft-free room, in bed if possible, at least for the first day.



A vaporizer or humidifier (safely out of reach) will help him breathe more comfortably. If he is feverish, make sure that you encourage him to drink small quantities of fluid often.



Older children with colds usually respond well to the simple routine of rest, plentiful fluids, and aspirin for fever and discomfort. Unless fever is present, the child need not be confined to bed. Consult your doctor before administering decongestants or nose drops to shrink swollen mucous membranes. Drops can be severely irritating to nasal passages.


With older children, too, you must watch for signs—such as high fever and persistent coughing—which may mean secondary infections.


Colds in Infants

An infant with a cold is especially uncomfortable because he breathes primarily through his nose. He snorts, gasps, and has considerable difficulty feeding. Two simple measures will relieve a baby’s mucus-plugged nose:

  1. Set up a vaporizer. It works best in a small room with the windows closed
  2. Loosen the mucus by putting in the nostrils a few drops of warm sterile water


After a few minutes, gently draw out the mucus with a rubber-tipped nasal syringe: compress the bulb of the syringe, insert it into the nostril and then slowly release it.


Infants with colds may be so fretful that their parents rush them to the doctor. While the trip may be unnecessary, it is usually prudent to let the doctor take at least a brief look at the baby. And be sure to see the doctor if there are any signs of a secondary infection, such as fever over 38°C, persistent vomiting, high-pitched fretful crying (which may indicate earache), a severe cough, unusual pallor or listlessness, or rapid heavy breathing.



A sore throat may be caused by either a virus or by streptococcal bacteria. Sore throats accompanied by other respiratory symptoms, such as nasal congestions, are likely to be viral; whereas an uncomplicated sore throat with fever is more likely to be caused by strep bacteria. The only way to be sure of the cause, however, is for the doctor to make a throat culture. 


If persistent, even the mildest sore throat should be so tested, as should the more painful cases and those in which fever or swollen glands are present. If there is a strep infection, the doctor will probably prescribe penicillin or another antibiotic.


If you give your child the entire dosage for the prescribed number of days, the infection should readily clear up. The doctor may then want to take another culture to be sure that the infection has been cured. Early diagnosis and prompt treatment of strep throats are vital because the possible complications, rheumatic fever and nephritis, are extremely dangerous.




The tonsils, located in the back of the mouth at either side of the entrance to the throat, have the same purpose as lymph glands—to waylay and destroy germs. But sometimes the tonsils get overloaded by a heavy invasion of germs and become infected.


When this happens, the tonsils may cause a high fever that may last for several days, vomiting and headache, and a throat so sore that the child can hardly swallow. Like other sore throats, tonsillitis can be caused by either bacteria or viruses and must be treated by a doctor.


Adenoidal Infection

The adenoids, located in the throat behind the nasal passages, guard these passages against germs as the tonsils do the throat. When adenoids become infected and enlarged, they partially block the outlet from the nose and child is forced to breathe chiefly through his mouth.


Enlarged adenoids may also block the Eustachian tubes to the middle ear, causing swelling, pain and middle-ear infection, as well as a temporary interference with hearing.


Tonsillectomy and Adenoidectomy

The popularity of these operations—usually performed simultaneously and known as a “T&A”—was at its height several decades ago when it was thought that such surgery would prevent recurrent colds and other respiratory infections. 


Today, however, doctors are aware that any operation, no matter how simple, carries with it a certain risk. Also, they recognize that removal of the tonsils or the adenoids cures only those problems directly related to them, such as recurrent tonsillitis and middle-ear infections.


Neither procedure prevents respiratory infections. Therefore, doctors usually recommend surgery only for children who have serious and recurrent infections in the tonsils and adenoids.



Earaches in young children are both common and extremely painful. Germs from colds, sore throats and infected adenoids or tonsils can travel from the throat region through either Eustachian tube to the middle ear, just behind the eardrum. 

Infections in the middle-ear chamber, in turn, produce pressure on the eardrum, causing the pain. Because the Eustachian tube in the young child is relatively short, the infection doesn’t have far to go in order to reach this chamber.


Any child who has had a cold or other respiratory infection followed by acute pain in, or discharge from the ear (often accompanied by fever, vomiting and headache) should see a doctor immediately. Treatment may include aspirin and/or eardrops for the relief of pain, decongestants to reduce inflammations and antibiotics to combat the infection itself, if it is bacterial.


Children who experience recurrent or chronic middle-ear infections sometimes suffer a temporary hearing loss because of them. In such cases, the doctor may recommend surgical draining of the ear (myringotomy) to rid the middle-ear chamber of fluids.


A baby or young child with an ear infection often cannot tell the parents where the pain is coming from. Therefore, notify the doctor if the boy or girl cries without letup or shows other signs of acuter or prolonged discomfort, of if the child experiences loss of appetite, vomiting, and diarrhea.


Swimmer’s Ear

Another type of infection, common in summer, is ‘swimmer’s ear.’ It affects the external canal and can be fungal, bacteria or both. The warmth and wetness of the ears of children who swim a great deal give such infections an ideal breeding ground.


Consult the doctor if your child complains of a persistent sensation of water in her ear, or if her ear hurts when you gently wiggle it.


Swollen Glands

Swelling of glands in the neck often accompanies other kinds of viral or bacterial infections. If the swelling comes and goes, if the glands are not tender and do not make the child uncomfortable, there is likely to be no immediate problem.


But if the glands are large and firm, or if the area is painful and the child has fever, notify the doctor. In the case of mumps, for instance, the parotid glands—lying in the areas beneath the earlobes—become swollen and acutely painful. Swollen glands that persist for a week or more, even if they cause no discomfort, should be checked by the doctor.



The nasal sinuses are air-filled hollows in the skull near the nose. They are tiny in a very young child, but enlarge as he or she grows. The sinuses are highly subject to infection, although less so in children than adults. 


A small opening connects each sinus with the inside of the nose. During a cold, infection may spread from the nose to the sinuses, which become clogged with mucus that can drip down from the back of the nose into the throat.


This postnasal drip may cause a dry, hacking cough, especially when the child is lying down. Severe sinusitis may result in fever and a headache, which is often felt just behind the eyes and which may respond better to the use of decongestants than to aspirin. Ask your doctor for the better treatment.



Young children like to experiment, and many of them push foreign objects—bits of crayons, buttons, anything—into their noses, ears and other body openings without telling their parents about it. If your child discharges pus from one nostril or ear, take him to the doctor. If the cause is a foreign object, it is risky to try to get it out yourself



Nosebleeds are quite common in children whose nasal passages have been irritated by infection or by dry, hot air. A poke of the finger into the irritated nostril may set off the bleeding. Nosebleeds can usually be stopped by simple pressure.



Have the child sit up, with his head thrown back, and gently but firmly hold his nostrils pinched shut for at least 10 minutes (preferably 20) while he breathes through his mouth.


Repeat if necessary, and if the treatment does not work the second time, call the doctor. A doctor should examine a child who has frequent, severe nosebleeds with no apparent cause.


Rich Health Editorial Team

Health Research

Rich Health Editorial Team is made up of medical practitioners and experienced writers who provide information for dealing with health issues in a simple and easy-to-understand manner