Respiratory tract infections in children

A respiratory tract infection is an infection in the parts of the body that help us breathe.

The respiratory tract can be grouped into the:

• upper respiratory tract – this is the nose, sinuses and throat
• lower respiratory tract – this is the windpipe, airways and lungs.

Respiratory tract infections are very common in children because their immune systems are still developing.

Respiratory tract infections are contagious. This means that they can spread easily, for example when someone coughs or sneezes. If your child is unwell, try to prevent the infection from spreading to others as much as possible.

Most respiratory tract infections get better on their own so you can look after your child at home. It’s common for symptoms to get worse for 2 to 3 days before getting better.

Sometimes you may need to see a healthcare professional.

• common cold
• respiratory syncytial virus (RSV)
• tonsilitis

Sometimes, having an upper respiratory tract infection can affect the ears and lead to an ear infection.

• bronchitis
• bronchiolitis
• chest infections
• pneumonia.

COVID-19 and flu (influenza) can be either upper or lower respiratory tract infections.

Lower respiratory tract infections are usually more serious than upper respiratory tract infections. This means that it might take your child a bit longer to get better.

Lower respiratory tract infections are also sometimes called chest infections.

• being irritable or finding it hard to stay still – some children might be less social than usual
• a runny or blocked nose – blocked noses can sometimes make it difficult to breathe, so you might notice your child breathing through their mouth more
• sneezing – this is mainly a sign of upper respiratory tract infections
• coughing – some children might cough up mucus, or vomit after coughing a lot
• a sore throat, headache, earache or other aches and pains – some babies and small children do not complain about aches and pains but they might be more irritable than usual
• problems with eating, drinking or sleeping, for example if your child’s nose is very blocked – some children may not want to eat or drink if they have a very sore throat
• being more tired than usual
• a high temperature (fever).

Your child may have more than one of these symptoms.

In more serious cases, some children may have signs of breathing problems like: 

• a tight chest or chest pain
• difficulty breathing and breathlessness – you might notice your child is breathing faster than usual
• noisy chest sounds, like wheezing.

Find out more about the signs of breathing problems to look out for in children, including when to call 999 and 111.

In most cases, you can look after your child at home if they’re breathing as usual. Make sure you check on them often and know the signs that mean you may need to see a healthcare professional.

Most respiratory tract infections clear up by themselves within 1 to 2 weeks.

Looking after your child at home

If your child has a respiratory tract infection, make them more comfortable by:

• encouraging them to drink water regularly but in small amounts and continue to feed your baby as usual – this can help prevent dehydration, make mucus easier to cough up, and help their throat feel less dry.
• raising their head up slightly when they’re sleeping – this can help your child’s breathing and makes mucus easier to cough up
• following NHS advice on how to look after your child if they have a high temperature (fever)
• encouraging them to get lots of rest if they feel tired
• making sure they avoid passive smoking and passive vaping as much as possible by not smoking in your home
• giving them healthy food. It’s common for children to lose their appetite for a few days when they’re unwell. If your child has a very sore throat, they also may not want to eat or drink. It’s a good idea to give them soft and nutritious foods that will be easier to swallow. Try offering them food in smaller amounts but more often.
• avoiding air pollution hot spots like busy road junctions if your child is well enough to go outside.

Find out more about how to look after your child at home from the NHS.

When should I see a healthcare professional?

Always seek urgent medical help if your child is struggling to breathe.

Find out when to see a healthcare professional, when to call 111 or book an urgent GP appointment, and when to call 999 about your child’s breathing.

Can my child still go to school or nursery?

If your child seems generally well enough to go to school or nursery and they do not have a high temperature, it’s fine for them to go to in. 

If your child has a high temperature, keep them off school or nursery until the temperature has gone.

The NHS has more information to help you decide whether your child is too ill for school or nursery. 

Always talk to your pharmacist or another healthcare professional if you’re not sure what medicine to give your child or you have any questions. Remember that you do not need an appointment to speak to a pharmacist.

The NHS has information about medicines for babies and children.

Children’s painkillers

Your child can have children’s paracetamol or ibuprofen if:

• they’re 5 years old or older and they have a high temperature or they’re in pain
• they’re under 5 years old, they have a high temperature and they’re distressed.

Take care not to give more than the recommended dose and follow the instructions on the patient information leaflet that comes with the medicine.

If your child has asthma, speak to a pharmacist before giving them painkillers. This is because ibuprofen is not always recommended for people with asthma.

Cough medicine

Cough medicines do not stop your child from coughing, but they might help them cough less often.

Coughs can sometimes last up to three weeks, even after the infection is gone. It can be upsetting to hear your child cough, but coughing can help the body fight against infection by clearing mucus.

It’s best to speak to a pharmacist if you’re not sure how to help your child with their cough because:

• cough medicines are not always suitable for children under 12 years old
• over the counter cough or cold medicines are not recommended for children under six years old.

If your child is over one year old and has a cough, try giving them a warm drink of water with honey and lemon. This can help soothe their throat. Do not give honey to babies under 12 months old because it can contain bacteria that may produce toxins in their intestines.

The NHS has more advice on coughs in children.

Saline nose drops

If your child is over six years old and has a blocked or runny nose, you could try giving them saline nose drops or other decongestants. Speak to your pharmacist if you’re not sure what to give your child.

• making sure they get their annual flu vaccine
• having good hygiene
• sharing ideas with their school about how to help children have good hygiene – for example the e-Bug programme, run by the UK Health Security Agency, teaches children how to reduce the spread of viruses that cause infections.