URTI = Upper Respiratory Tract Infection.

Occur above the vocal cords, e.g: ears, nose, throat and sinuses.

The common cold and croup (which are viral) are usually the main causes of URTI’s in paediatrics.

LRTI = Lower Respiratory Tract Infection.

Occur below the vocal cords, e.g:  trachea, bronchi and lungs. 

The most common LRTI’s for infants is bronchiolitis, which is also viral, along with Pneumonia (caused by virus or bacteria) which affects the tissues of the lungs. 

Children are more susceptible to respiratory tract infections as their little bodies are still growing and maturing. As your child gets older their ability to fight infection will improve and they will become more resilient as they grow. 

It is VITAL that you are aware of the signs of respiratory distress. Please note, a paediatric has an uncanny ability to compensate for a period of time, however, if the signs are not recognised, the child can become gravely ill. Just because the fast breathing slows down and the rib retraction / recession (‘sucking in’) disappears, doesn’t mean they are getting better, generally it is indicative that they require urgent medical assistance.

Respiratory Distress image – click here

Here are a list of signs that indicate your child maybe in that ‘danger zone’ of falling into respiratory distress:


  • Increased breathing rate, indicating your child is not getting enough oxygen.
  • Colour changes, your child may appear to have a bluish tinge to their lips, mouth and fingernails, again indicative of lack of oxygen. The skin can also appear gray or pale.
  • Noisy breathing – Grunting may be heard when your child exhales. It’s the body’s attempt to try and keep air in the lungs.
  • Nasal-flaring – Nostrils flaring in paediatrics is indicating the child is working very hard at breathing. 
  • Retractions / recession – ribs ‘sucking in’ when they are breathing is another way of trying to bring more air into their lungs.
  • Wheezing (whistling, musical sounds) – is indicating that your child’s air passages are becoming narrower and smaller.
  • Tripod position – child will adopt this position to try and draw in as much air as possible to their lungs. 
  • Observing your child’s behaviour and the level of consciousness is important.