New Delhi, Nov 7 (PTI) As respiratory infections become a concern with the onset of colder weather, paediatricians are urging parents to distinguish routine coughs and colds from warning signs of pneumonia, worsening asthma and other conditions that may require prompt medical attention.
While most uncomplicated upper respiratory infections in children are caused by viruses and improve with supportive care, fast or laboured breathing, chest indrawing, poor feeding and unusual drowsiness should not be dismissed as symptoms of a seasonal illness, doctors say.
A runny nose, mild fever, sore throat and cough are common features of viral respiratory infections in children, said Dr Manish Mannan, Senior Director and Head of Department, Pediatrics at Paras Health, Gurugram.
However, the duration of symptoms alone does not establish whether an infection is serious; the child's breathing, activity, hydration and overall condition are equally important, he said.
"Parents should look at the child as a whole rather than judge illness severity by temperature or cough intensity. A child with a viral infection may have a runny nose, mild fever and cough but remain active, drink fluids and breathe comfortably. Concern should arise with changes in breathing or behaviour," Mannan said.
Rapid breathing, skin pulling in between or below the ribs, flaring nostrils or difficulty speaking, crying or feeding due to breathlessness need medical assessment.
"Parents should also watch for unusual sleepiness, refusal of fluids or reduced urine. Babies and children with underlying heart or lung conditions need particular attention as they can deteriorate faster. If breathing is laboured or the child appears seriously unwell, parents should not wait for fever to rise or home remedies to work before seeking care," he stated.
Respiratory viruses can trigger wheezing and breathing difficulties in children with asthma. Repeated episodes of cough, particularly at night or during physical activity, may also warrant an assessment for asthma or other airway conditions, experts said.
Dr Jitendra Jain, senior consultant, Neonatology, Cocoon Hospital, Jaipur said that one of the common challenges is that parents may assume every episode of cough and wheezing is simply another cold.
"In children with asthma, a viral infection can trigger inflammation and narrowing of the airways, causing persistent cough, wheezing, chest tightness or difficulty breathing. A child who has repeated episodes, wakes up coughing at night or develops symptoms while running or playing should be evaluated rather than repeatedly treated for individual infections," Jain said.
Parents of children already diagnosed with asthma should follow the treatment plan prescribed by their doctor and know when to use the recommended reliever medication and when emergency care is needed.
"They should not independently stop controller medicines or change doses. If the child is struggling to breathe, cannot speak or drink comfortably, or does not improve with the prescribed rescue treatment, urgent medical attention is necessary," he emphasised.
Most uncomplicated viral respiratory infections do not require antibiotics. These medicines act against bacteria, not viruses, and their unnecessary use contributes to antimicrobial resistance, said Dr Navin Bhatia, consultant and Head of Department, Paediatrics and Paediatrics Intensive Care, PB Health, Gurugram.
However, when a doctor diagnoses or strongly suspects a bacterial infection such as pneumonia, appropriate antibiotics may be necessary, he said
"Antibiotics should not be started simply because a child has fever, persistent cough or coloured nasal discharge. Many respiratory infections are viral, and antibiotics will not shorten their course. The decision should be based on symptoms, clinical examination and likelihood of bacterial infection," Bhatia said.
Parents should not assume every cough is harmless or delay consultation to avoid antibiotics. When pneumonia or another bacterial infection is suspected, timely assessment and treatment are important.
"Do not use leftover antibiotics, share medicines prescribed for another child or stop a prescribed course without consulting the doctor. Cough and cold preparations should not be given indiscriminately, particularly to young children. Supportive care, fluids, rest and monitoring can help many children recover, but worsening breathing, poor feeding or reduced alertness requires prompt medical review," Bhatia said.
Pneumonia affects the lungs and may cause fever, cough and fast or difficult breathing. In young children, the illness can sometimes progress quickly, Dr Suresh Shah, Director, Sparsh Children's Hospital, Mumbai stated.
Visible chest indrawing, grunting, bluish lips, inability to drink or breastfeed, and reduced alertness are important danger signs.
"Pneumonia should be suspected when a child with cough or fever develops fast breathing or visible effort while breathing. Parents may notice the lower chest pulling inward, nostrils flaring or grunting with each breath," he said.
"A child who is unable to drink or breastfeed, becomes unusually lethargic or develops bluish discolouration of the lips needs immediate medical attention. Fever coming down does not, by itself, establish that the illness is resolving. The child needs to be assessed on the basis of breathing, hydration, alertness and other clinical findings," Shah said.
(This story has not been edited by THE WEEK and is auto-generated from PTI)