Viral Upper Respiratory Illness (Child)

Home care

• Fluids. Fever increases the amount of water lost from the body. Encourage your child to drink lots of fluids to loosen lung secretions and make breathing easier. 

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

  • For children older than 1 year, 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 until the fever is gone. Encourage frequent naps. Your child may return to daycare or school when the fever is gone and when they are eating well, don't tire easily, and are feeling better.

• Sleep. Periods of sleeplessness and irritability are common.

  • 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 with extra pillows. Talk with your child's health care 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 possible.

   

• 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 don't help better than syrup with no medicine in it. They also can cause serious side effects, especially in babies younger than 2 years of age. Don't give OTC cough or cold medicines to children younger than age 6 unless your child's 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 dissolved in 1 cup of water.

• Fever. Use children’s acetaminophen for fever, fussiness, or discomfort, unless another medicine was prescribed. In babies older than 6 months of age, you may use children’s ibuprofen or acetaminophen. If your child has chronic liver or kidney disease, talk with your child's provider before using these medicines. Also talk with the provider if your child has had a stomach ulcer or digestive bleeding. 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.

• Preventing spread. Washing your hands before and after touching your sick child will help prevent a new infection. It will also help prevent the spread of this viral illness to yourself and other children. 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 health care provider, or as advised.

When to call your doctor

For a usually healthy child, call your child's health care provider right away if:

• Your child has a fever (see Fever and children, below).

• Your child has an earache, sinus pain, stiff or painful neck, headache, repeated diarrhea, or vomiting.

• Your child is unusually fussy.

• Your child has a new rash.

• Your child is dehydrated, with 1 or more of these symptoms:

  • No tears when crying.

  • “Sunken” eyes or a dry mouth.

  • No wet diapers for 8 hours in infants.

  • Reduced peeing in older children.

Also call if your child has new symptoms or you are worried or confused by your child's condition.

Call 911

Call 911 if:

• Your child has increased wheezing or difficulty breathing.

• There's a blue, purple, or gray color or tint to your child's lips or fingernails.

• Your child is unusually drowsy or confused.

• Your child is unresponsive or has trouble awakening.

• Your child has 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

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the health care provider what type to use instead. When you talk with any provider about your child’s fever, tell them which type you used.

Below is when to call the provider if your child has a fever. Your child’s provider may give you different numbers. Follow their instructions.

When to call a provider about your child's fever

For a baby under 3 months old:

• First, ask your child’s provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher.

• Armpit: 99°F (37.2°C) or higher.

• A fever of ___________as advised by the provider.

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher.

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher.

• A fever of ___________ as advised by the provider.

• Armpit: 101°F (38.3°C) or higher

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age.

• Temperature of 104°F (40°C) or higher in a child of any age.

• A fever of ___________ as advised by the provider.