Dr Mark Rosenthal
MD MB ChB FRCP FRCPCH BSc
Consultant in Paediatric Respiratory Medicine
also specialist in Food Allergies & Disorders of Sleep
T: 0207 351 8832
A:The Royal Brompton Hospital, London, SW3 6NP
0207 351 8832
0207 349 7754
Viral infection in children is the most common respiratory (chest) problem in children less than 4 years old, affecting 1 out of every 6 children in London. It typically starts after the age of 9 months and the first symptom of viral infection is that the infant gets a cold (runny nose, fever etc) then one or two days later starts coughing severly at night. They may also wheeze which is a breathing out sighing or whistling sound and they may also suck the skin under and between the ribs and one can also see sucking in of the skin with breathing in the throat just above the breast bone.
There is another sound that infants and toddlers make between the ages of 6 and 24 months that is often confused with wheezing. This is stertor, which is a kind of gargling sound in the throat during both breathing in and out. Parents are often worried about it because it can be felt when putting ones hand on the chest but actually it is not coming from the chest. Why it starts at about 6 months and goes when older is one of life's many unsolved mysteries but is another common symptom of viral infection in kids.
Once the coughing starts (one of the first viral infection in children) it is usually at a peak near the beginning and slowly fades away over 1-3 weeks quite often just in time to get another cold and the whole cycle to begin again. Did you know that the average number of viral infections in children between a child's first and second birthday is 11 (yes eleven!) and the range is 5 to 20 so a cold every 3-4 weeks is normal although I realise that is little comfort when you have to wake up to see your child suffer from viral infection at 3am!
Viral infection symptoms in children are more common between October and March and much more common if the mother smoked in the last third of her pregnancy and continues smoking after the baby is born. 85% children suffering from viral infections especially boys, grow out of this by the age of 6 years and each succeeding winter is generally less tortuous than the previous one.
This condition is often called asthma and while the symptoms may indeed be very similar to the symptoms of viral infection in a child, the molecular mechanisms of its occurrence are different and the treatment is not the same as viral infection treatment. Antibiotics do not help and unlike in asthma, steroids also do not generally help. Montelukast acts as an anti-inflammatory agent and has been shown to reduce hospital admissions by a third, salbutamol (ventolin) often also helps in reducing the acute infection symptoms in babies.
Clearly a child too breathless to feed or speak properly or is otherwise distressed and not consolable needs to be at a hospital.
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