Patient education: Upper respiratory infection in children – Discharge instructions (The Basics)

What are discharge instructions? — Discharge instructions are information about how to take care of your child after getting medical care for a health problem.

What is an upper respiratory infection? — An upper respiratory infection ("URI") is an illness that can affect the nose, throat, ears, and sinuses. Almost all URIs are caused by a virus. The common cold is an example of a viral URI. Some URIs are caused by bacteria, but this is much less common.

URIs spread easily from person to person, most often through coughing or sneezing. A URI will almost always get better in a week or 2 without any treatment. Because most URIs are caused by viruses, antibiotics do not usually help.

If your child does have a bacterial infection, the doctor might prescribe antibiotics.

How is a URI treated? — Doctors do not recommend over-the-counter cough and cold medicines for children younger than 6 years. For children older than 6 years, these medicines might help with symptoms. But they can't cure the URI, or help the child get well faster.

Medicines such as acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin) can help bring down a fever. But these medicines are not always needed. For instance, a child older than 3 months who has a temperature less than 102°F (38.9°C), and who is otherwise healthy and acting normally, does not need treatment.

Never give aspirin to a child younger than 18 years old. Aspirin can cause a dangerous condition called Reye syndrome.

How do I care for my child at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for your child. Ask questions if there is anything you do not understand.

You should also:

●Wash your hands and your child's hands often (figure 1).

●Teach your child to cough or sneeze into a tissue. If they do not have a tissue, teach them to cough or sneeze into their elbow instead of their hands.

●Offer your child lots of fluids (water, juice, or broth) to stay hydrated. This will help replace any fluids lost through a runny nose or fever. Warm tea or soup can also help soothe a sore throat.

●Use a cool mist humidifier to add moisture to the air. This can help a stuffy nose and make it easier to breathe. You can also use saline nose drops or spray to relieve stuffiness.

●Use a bulb suction for babies to help keep their nose clear.

●Follow the directions on the label carefully if you decide to give your older child over-the-counter cough or cold medicines. Do not give them more than 1 medicine that contains acetaminophen.

●Keep your child away from smoke. Avoid places where people are or have been smoking as much as you can.

How can I prevent my child from getting another URI? — The best way to prevent a URI from spreading is to keep your child's hands and your hands clean. Wash hands often with soap and water or alcohol gel rubs.

Some other ways to prevent the spread of infection include:

●Always wash hands with soap and water after coughing, sneezing, or blowing the nose.

●Clean surfaces and objects that are touched a lot. These include sinks, counters, tables, door handles, remotes, and phones. Use a bleach and water mixture. The germs that cause a URI can live on surfaces for at least 2 hours.

●Do not share cups, food, towels, bed linens, or other personal items.

●Keep children out of school or day care and away from other people when they are sick. If the child is old enough, consider having them wear a face mask when they do need to be around people.

When should I call the doctor? — Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●You can't wake your child up.

●Your child has trouble breathing, and has 1 or more of the following:

•Can only say 1 or 2 words at a time or cannot talk in a full sentence, or your baby has trouble crying

•Needs to sit upright at all times to be able to breathe, or cannot lie down because their breathing is worse

•Is very tired from working to catch their breath

•Is making a grunting noise when they breathe

•Their skin pulls in between their ribs, below their ribcage, or above their collarbones

Call the doctor or nurse for advice if your child:

●Has trouble breathing

●Has a fever of 100.4°F (38°C) or higher that lasts more than 3 days

●Cannot do their normal activities because of their breathing

●Is having trouble feeding normally

●Has a stuffy nose that gets worse or does not get better after 10 days

●Has red eyes or yellow drainage from their eyes

●Has ear pain, is pulling on their ear, or becomes fussier

●Has new or worsening symptoms

More on this topic

Patient education: Cough, runny nose, and the common cold (The Basics)
Patient education: COVID-19 overview (The Basics)
Patient education: Flu (The Basics)
Patient education: Fever in children (The Basics)
Patient education: What you should know about vaccines (The Basics)
Patient education: What you should know about antibiotics (The Basics)

Patient education: Allergic rhinitis (Beyond the Basics)
Patient education: Acute sinusitis (sinus infection) (Beyond the Basics)
Patient education: Ear infections (otitis media) in children (Beyond the Basics)
Patient education: Influenza symptoms and treatment (Beyond the Basics)
Patient education: Nonallergic rhinitis (runny or stuffy nose) (Beyond the Basics)