Viral Upper Respiratory Illness with Wheezing (Child)

Your child has an upper respiratory illness (URI). This means a common cold. It's caused by a virus and is contagious during the first few days. It is spread through the air by coughing or sneezing, or by direct contact. This means by touching your sick child then touching your own eyes, nose, or mouth. Washing your hands often will decrease risk of spreading the virus. Most viral illnesses go away within 7 to 14 days with rest and simple home remedies. But, they may sometimes last up to 4 weeks. 

Illustration showing the position of the lungs and bronchial tubes, with a close up view of a bronchial tube and air sac.

Antibiotics will not kill a virus and are generally not prescribed for this condition. If there is a lot of irritation, the air passages can go into spasm and cause wheezing even in children who don't have asthma. Medicine may be prescribed to prevent wheezing.

Home care

  • Fluids. Fever increases water loss from the body. Encourage your child to drink lots of fluids to loosen lung secretions and make it easier to breathe.

    • For babies under 12 months, continue regular formula or breast feedings. Between feedings, give oral rehydration solution. This is available from drugstores and grocery stores without a prescription. For babies under 1 year old, continue regular formula feedings or breastfeeding. Between feedings, give oral rehydration solution. 

    • For children over 1 year old, give plenty of fluids, such as water, juice, gelatin water, soda without caffeine, ginger ale, lemonade, or ice pops.

  • Eating. If your child doesn't want to eat solid foods, it's OK for a few days, as long as they drink lots of fluid.

  • Rest. Keep children with fever at home resting or playing quietly. Encourage frequent naps. Your child may return to daycare or school when the fever is gone and they are eating well and feeling better.

  • Sleep.  Give your child plenty of time to sleep.

    • Children 1 year and older: Have your child sleep in a slightly upright position. This is to help make breathing easier. If possible, raise the head of the bed slightly. Or raise your older child’s head and upper body up with extra pillows. Talk with your healthcare provider about how far to raise your child's head.

    • Babies younger than 12 months: Never use pillows or put your baby to sleep on their stomach or side. Babies younger than 12 months should sleep on a flat surface on their back. Don't use car seats, strollers, swings, baby carriers, and baby slings for sleep. If your baby falls asleep in one of these, move them to a flat, firm surface as soon as you can.

  • Cough. Coughing is a normal part of this illness. A cool mist humidifier at the bedside may help. Clean the humidifier every day to prevent mold. Over-the-counter cough and cold medicines have not proved to be any more helpful than syrup with no medicine in it. They also can produce serious side effects, especially in babies under 2 years of age. Don't give OTC cough or cold medicines to children under 6 years unless your healthcare provider has specifically advised you to do so.

    • Keep your child away from cigarette smoke. It can make the cough worse. Don't let anyone smoke in your house or car.

  • Nasal congestion. Suction the nose of babies with a bulb syringe. You may put 2 to 3 drops of saltwater (saline) nose drops in each nostril before suctioning. This helps thin and remove secretions. Saline nose drops are available without a prescription. You can also use 1/4 teaspoon of table salt mixed well in 1 cup of water.

  • Fever. Use children’s acetaminophen for fever, fussiness, or discomfort, unless another medicine was prescribed. In babies over 6 months of age, you may use children’s ibuprofen or acetaminophen. If your child has chronic liver or kidney disease or has ever had a stomach ulcer or gastrointestinal bleeding, talk with your healthcare provider before using these medicines. Never give aspirin to anyone younger than 18 years of age who is ill with a viral infection or fever. It may cause severe liver or brain damage.

  • Wheezing. If a bronchodilator medicine (spray, oral, or via nebulizer) was prescribed, have your child takes it exactly at the times advised. If your child needs this medicine more often (especially of a handheld inhaler or aerosol breathing medicine), this is a sign that the bronchospasm is getting worse. If this occurs, contact your healthcare provider or return to this facility right away.

  • Preventing spread. Washing your hands before and after touching your sick child will help prevent a new infection. Good handwashing will keep the virus from spreading to you and to other children.

  • Education. In an age-appropriate manner, teach your children when, how, and why to wash their hands. Role model correct handwashing. Encourage adults in your home to wash hands often.

Follow-up care

Follow up with your child's healthcare provider, or as advised.

When to seek medical advice

Call your child's healthcare provider if any of these occur:

  • A fever (see Fever and children, below)

  • Your child is dehydrated, with one or more of these symptoms:

    • No tears when crying.

    • Sunken eyes or a dry mouth.

    • No wet diapers for 8 hours in infants.

    • Reduced urine output in older children.

  • Earache, sinus pain, stiff or painful neck, headache, repeated diarrhea, or vomiting

  • Unusual fussiness

  • A new rash appears

  • New symptoms develop or you are concerned about how your child is doing

Call 911

Call 911 if any of these occur:

  • Increased wheezing or difficulty breathing

  • Unusual drowsiness or confusion

  • Fast breathing:

    • Birth to 6 weeks: over 60 breaths per minute

    • 6 weeks to 2 years: over 45 breaths per minute

    • 3 to 6 years: over 35 breaths per minute

    • 7 to 10 years: over 30 breaths per minute

    • Older than 10 years: over 25 breaths per minute

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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