How to Tell If Your Baby Has an Upper Respiratory Infection

An upper respiratory infection is an illness that leads to symptoms in the upper respiratory tract.

You can think of this as any symptoms above the chest, such as those in the ear, nose, and throat. Influenza, for example, is not considered a URI because it affects both the upper and lower respiratory tracts.

Both viruses and bacteria can cause URIs. Since babies have smaller nasal passages than older kids and adults, they may deal with different symptoms.

They include:

• stuffy nose (congestion)
• runny nose
• cough
• sneezing
• hoarseness
• low grade fever
• rash
• loss of appetite
• fussiness
• fatigue

When you observe these symptoms all clustered together, you may be inclined to call it a cold — and you may be right. However, there are actually a number of different URIs. Each has its own unique set of symptoms or progression of symptoms.

URIs include but are not limited to the following conditions:

Rhinitis

Also referred to as the common cold, rhinitis makes up between 25 and 30 percent of all URIs. Babies and young children are more likely to have a fever with colds than adults, according to 2017 research.

Other symptoms include:

• sore throat
• runny nose
• cough
• sneezing

Sinusitis

Sinus infections (sinusitis) may develop as a complication of the common cold. Children younger than 15 years old are at higher risk than teens and young adults.

Symptoms include thickened nasal mucus, which may block the sinuses and create pain and pressure.

Epiglottitis

While uncommon due to the HIB vaccine, epiglottitis is an upper respiratory infection caused by the bacteria H. influenzae, per 2021 research.

Symptoms include:

• sudden onset of sore throat
• trouble swallowing
• difficulty breathing

Tonsillopharyngitis

Also called tonsillitis, this infection affects the tonsils.

Symptoms include:

• swollen tonsils
• redness or pain in the tonsils or throat
• fever

It’s important to note that the related pharyngitis (strep throat) is uncommon in children under 5 years old, per a 2006 overview.

Laryngitis

Acute laryngitis is caused by a viral infection that affects the larynx. Symptoms in babies and children include:

• sore throat
• loss of voice
• hoarseness
• dry cough

Croup

The classic sign of croup is a barking cough that tends to develop in the overnight hours, according to 2018 research.

Researchers note that this viral infection primarily affects the larynx and trachea, but it may also travel to the bronchi in some cases.

Ear infections

Ear infections may accompany up to 30 percent of URIs.

Symptoms may include pain and fluid in the ear, which can lead to eardrum rupture or trouble with hearing. Between 2 and 6 percent of kids may deal with chronic ear infections.

Respiratory syncytial virus (RSV)

If you had your baby in the fall, winter, or spring, you’ve probably heard of RSV. It stands for respiratory syncytial virus. This URI is of particular concern for babies younger than 6 months old or those with weakened immune systems or other health concerns.

While RSV generally causes mild cold symptoms, including runny nose and cough, the Centers for Disease Control and Prevention (CDC) reports that 1 or 2 out of every 100 babies with RSV may be hospitalized with the virus, due to complications and trouble breathing.

RSV can become more serious, causing a baby to be irritable, lose their appetite, or have episodes of apnea (paused breathing). It may lead to bronchiolitis or even pneumonia.

If a baby is hospitalized, the outcome is generally good after treatment with oxygen or mechanical ventilation, per the CDC.

Many URIs will self-resolve, which means they will go away on their own without medical treatment, per 2021 research.

That said, you know your baby best. If your child is inconsolable or not taking in feeds, it may be a sign to call your doctor.

Other worrisome signs include high temperatures or symptoms that just won’t go away.

URIs generally get better with time, rest, and fluids. The common cold, for example, may last anywhere between 10 and 14 days before resolving on its own. If your baby’s symptoms last longer than this period of time or seem to get worse, you should consider making an appointment with your pediatrician.

Diagnosis may include listening to your child’s symptoms and conducting a physical exam to look at the ears, nose, and throat. Your doctor may be able to see things like swollen tonsils, inflamed nasal passages, or fluid behind the eardrums, indicating an infection that may need treatment with medication.

If there’s a question about exactly what virus or infection is causing your little one’s symptoms, your pediatrician may order further testing. For example, a throat or nasal swab test can help identify specific strains of virus or bacteria, like RSV.

Treatment may include:

• rest and fluids for viruses that haven’t turned into bacterial infections
• over-the-counter (OTC) fever-reducing medications for comfort
• prescription medications for bacterial infections

Home remedies

There are also a number of things you can do at home to keep your baby comfortable when they’re sick, including:

• Add moisture to the air with a humidifier to help with sniffles and cough. If you don’t own a humidifier, you may also try something similar by running a hot shower and holding your baby in the bathroom while it steams up.
• Offer plenty of breast milk, formula, or water as directed by your pediatrician to prevent dehydration.
• Use saline drops and a bulb syringe to remove excess mucus from your child’s nose.
• Skip using OTC cold medications with infants, per the CDC, and call your pediatrician regarding the correct dosages to use with other meds, like acetaminophen or ibuprofen.

Whether this is your baby’s first cold or fifth, pay attention to the symptoms, their duration, and their severity.

In many cases, upper respiratory infections will get better with time, rest, and fluids. If your baby’s symptoms are progressing or if you have any other questions about how to make them comfortable, call your pediatrician.

Depending on the URI, your child may need prescription medication or a bit more time to recover.