Seasonal sicknesses come with a lot of upper respiratory tract infections (URIs), from the common cold to more serious illnesses like the flu, RSV and COVID-19. Many URIs have similar symptoms which can make it hard for parents with sick kids to know when to go to the doctor and where to go.
The symptoms of these respiratory viruses can include:
- Congestion and runny nose
- Body aches
- In some cases, vomiting
MaryBeth Bernardin, MD, a pediatric emergency doctor at MU Health Care, offers three main signs to look for: oxygen level, breathing and hydration.
1. Oxygen level
Oxygen level, also called blood oxygen level or blood oxygen saturation, is a measurement of how well your lungs are passing oxygen into the blood and removing carbon dioxide. It is one of the first vitals a doctor checks during a visit and can be measured on a device called a pulse oximeter. Most healthy people will show between 95% and 100% blood oxygen saturation, but respiratory infections can lower this number. Reduced oxygen levels, when left untreated, can damage vital organs and become life-threatening, especially in young kids, older adults and people who have preexisting heart and lung conditions.
“Sometimes children need to stay in a hospital because a viral infection has lowered their oxygen level,” Dr. Bernardin said. “If they need extra oxygen to keep their oxygen level at a normal place, then they need to stay in the hospital.”
Another sign doctors look for is distressed breathing, or when your child is working extra hard to breathe. Signs of difficult breathing include:
- Sucking in the belly (belly breathing)
- Flared nostrils
- Visible neck muscle strain
- Visible ribs when breathing in
There are a few things parents can do at home to relieve labored breathing, such as using nose suction with a bulb or NoseFrida and putting your child in a steamy room for 30 minutes. Fevers can also cause faster breathing, so if they have a fever, try reducing it with over-the-counter medications such as children’s Tylenol, or ibuprofen in kids older than six months. If none of that is working, it’s time to see a doctor.
“If children and babies are having a really hard time breathing, sometimes they need to stay in the hospital where we have lots of different options and different tools we can use to help them breathe easier,” Dr. Bernardin said.
Hydration goes hand-in-hand with feeding in babies and young children, so if they aren’t eating or drinking enough, they may be at risk of dehydration. When healthy, most babies and infants will urinate every six to eight hours, or three to four wet diapers per day. Dr. Bernardin tells families it’s OK if your kid isn’t eating well for a few days, as long as they’re still drinking fluids, taking bottles or nursing. Vomiting or not being able to keep anything down is a concern for young kids, as it can easily lead to dehydration.
Common signs of dehydration in infants include:
- Dry lips and tongue
- Dry and wrinkled skin
- No tears when crying
- Sunken eyes
- Blotchy, cool skin on the hands or feet
“If your child or your baby is having a hard time keeping themselves hydrated at home, or if they're vomiting so much that they can't keep down fluids, especially if you're seeing a decrease in their urine output, that can be a sign of dehydration,” Dr. Bernardin said. “Sometimes that can be a reason why children need to stay in the hospital or need to be assessed in the emergency department.”
When and Where Should I Seek Care?
Understanding the severity of your child’s sickness is just one piece of the equation. Knowing where to seek care is equally important. Dr. Bernardin lays out the following recommendations:
If your child is sick, but still breathing well and eating or taking bottles without issue, Dr. Bernardin recommends caring for them at home and monitoring their symptoms. In many cases, URIs can pass without your child needing to see a doctor.
If your child has additional symptoms of ear pain, sore throat or rash— or if you want to have them tested for an infection, you can visit your child’s regular doctor’s office to see if they have a same-day clinic, do a virtual visit or go to a quick care (for kids over the age of 2) or urgent care.
If your kid is sick and has difficulty breathing, difficulty feeding or staying hydrated, or has had a fever for more than five consecutive days, go to the emergency room.