It’s that time of year again when you’re reminded nearly every day to “get your flu shot.” Certainly, it is important to protect yourself and your family against the flu. We also suggest becoming aware of other winter illnesses that can affect children, including how to recognize and treat these illnesses.


Respiratory syncytial virus (RSV) causes infections of the lungs and respiratory tract. It's so common that most children have been infected with the virus by age 2. In fact, about 150,000 children a year are hospitalized due to RSV, according to the Centers for Disease Control and Prevention.

RSV is a viral illness that affects both the upper (nose and throat) and lower (lungs) respiratory tracts. It is especially known to cause inflammation in the lungs that leads to a bad cough, lots of mucus production and wheezing. Infants are most severely affected by RSV. Some children develop enough lung inflammation that they have trouble breathing. You may notice your child's chest muscles and skin pull inward with each breath. This is a sign that he or she is struggling to breathe and your child should be seen by a doctor. Other symptoms include:

  • Short, shallow and rapid breathing
  • Cough
  • Poor feeding
  • Unusual tiredness
  • Fussiness

Most children and adults recover in one or two weeks, although some might have repeated wheezing. Severe or life-threatening infection requiring a hospital stay may occur in premature babies and infants as well as older individuals who have chronic heart or lung problems. If you have any concerns, see your doctor. It is especially important to seek immediate medical attention if your child is having trouble breathing, has a high fever, a blueish tint to the skin, lips or nail beds, is breathing very fast or is not drinking fluids well.

RSV is a viral infection so antibiotics don’t help. However, RSV does increase the risk of bacterial infections such as pneumonia or ear infections so it is important to check with your doctor if there are any signs of complications. It is important to suction the nose of younger children to assist them in clearing the mucus. This will help with feeding and breathing. Treatment for RSV involves self-care measures to make your child more comfortable and but hospitalization is needed in serious cases.

Croup and laryngitis

Croup is a viral infection that affects the upper airways, and especially the larynx (voice box). Due to their size, children’s airways are narrower than adults and, therefore, when a virus causes inflammation in this area they develop a characteristic barky cough.

In more severe cases, a high-pitched sound can occur when breathing in, called stridor. Stridor indicates that the airway is swollen and narrowed. This is a reason to see a doctor right away.

This illness is most common in children under the age of 6 years due to their small airway size. Older children and adults would manifest this illness more like a common cold with stuffy nose and a hoarse voice (laryngitis).

For mild symptoms, a cool-mist humidifier or trip outside into the cold air can help. For stridor or trouble breathing, see your doctor right away. This illness often requires a breathing treatment and steroid medication. Signs it’s time to see your doctor include the following:

  • Stridor
  • The child is breathing very fast or labored
  • There is a noticeable pulling in of the neck and chest muscles (retractions)
  • Child is too out of breath to talk or walk. He/she may also drool or have trouble swallowing.
  • Child is very sleepy and even hard to wake up
  • Child is dehydrated
  • A pale or bluish color around the child’s mouth

A doctor will asses your child to determine if he or she needs hospitalization to prevent complications from croup. A steroid medicine may also be given to reduce swelling in the airway. However, antibiotics are not given to children with croup or laryngitis as it is a viral, not bacterial, infection.

Common (or not so common) cold

As a parent, you can expect up to five colds per year for your child. We all know the signs: a runny nose, mild fever, slight cough, irritability, etc. Most kids bounce back from a cold in five to seven days. So, how do you know if your child’s cold is progressing past the normal phase? The serious symptoms are similar to those for RSV and croup. For example, it’s time to see the doctor if:

  • The cough just won’t go away (it lasts more than one week)
  • Nasal mucus lasts for longer than 10 to 14 days
  • The openings of the nose (nostrils) are get larger with each breath, the skin above or below the ribs sucks in with each breath (retractions), or your child is breathing fast or having any trouble breathing
  • Child has developed ear pain
  • Temperature is above 102 degrees F (38.9 degrees Celsius)