Sneezes and Wheezes

Childhood Respiratory Illnesses

By Donna Smith

Year round, hospital emergency rooms are filled with children suffering from respiratory tract infections. Many of these illnesses can be treated successfully at home, but it's important for parents to know when to seek more aggressive treatments. When is a cold just a cold – or something more?

Millions of people each year are affected by the common cold. Children seem to be more prone to getting "the sniffles" because of school and daycare settings, where germs get passed around as often as notes and toys.

"[The common cold] is caused by a variety of viruses in the rhinovirus family," says Dr. Stuart Abramson, assistant professor of pediatric immunology at Baylor College of Medicine and staff physician at Texas Children's Hospital in Houston, Texas. The symptoms, which can be one or all, include stuffy nose, runny nose, sneezing and cough.

Dr. Abramson says that in young infants, overmedicating should be avoided. "Sometimes just a bulb suctioning of the mucus to help open up the airway, so that [they] can breathe" is effective, he says. For older children, decongestants are often prescribed, such as Sudafed or topical sprays like Neosynephrine. "Those are short-term treatments for just a few days," says Dr. Abramson. "Sometimes just washing the nose with saline – an over-the-counter saline spray – can be helpful."

RSV is a virus that Dr. Abramson says almost everyone will eventually get, but the concern is for children under 2. Premature infants, infants with heart problems, such as congenital heart disease, and anyone with underlying immune deficiencies all need special attention to prevent RSV.

"The recommendation is that these patients should get an antibody injection that prevents RSV," he says. Synagis (palivizumab) is the medication that has been approved for preventing serious complications from RSV in high-risk infants.

The symptoms of RSV start by mimicking a cold, but then lead to increased coughing, difficulty breathing and lethargy. RSV can lead to pneumonia and cause other complications requiring hospitalization. "If the symptoms are severe and they have poor oxygenation from the pneumonia, that can be a complication," says Dr. Abramson.

Want to see more?

• Tackling Influenza: Making a Healthy Decision This Flu Season
• RSV: Battling the Wintertime Bug
• The Facts About RSV: What Every Parent Should Know
• Talk about it!