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Respiratory illness in under 3-year-olds: what it is and how to help your child

Posted on: 16 December 2021

For parents of young children, a worrying effect of the COVID-19 pandemic is a predicted surge in respiratory illnesses in under three-year-olds this winter 2021/22.

Due to our mask wearing, social distancing and regular hand washing (in themselves all good, effective and appropriate infection control measures), there has been a minimised spread of other usual infections too. Jenny Gilmour our 0-19 Service Development Lead, explains how this affects babies and what parents should know and how they can help their little ones. 

Babies normally develop their immunity to colds and viruses during their first one or two years of life through regular contact with others, however, this hasn’t been the case for babies born just before and during the pandemic lockdowns over the past 20 months.

This means that parents may not have seen the usual level of respiratory infections in their infants, which typically present as one different cold or infection a month for the first two years of life, as their immunity develops. 

The result is that this winter 2021/22, we are likely to see more babies and young children become poorly with respiratory illnesses and particularly Bronchiolitis which is a viral infection and in most cases is caused by Respiratory Syncytial Virus (RSV).

RSV is a very common seasonal winter virus and almost all children are infected with it by the time they are two years old. In older children and adults, RSV may cause a cough or cold but in young children it can cause bronchiolitis.  

Bronchiolitis is usually mild and can be managed at home but infants under two months old, those born prematurely, those with identified congenital health disease or chronic lung disease are more at risk. Also, babies who are breastfed for less than two months or not at all, those exposed to smoke, for example if their parents/carers smoke) and having siblings who attend school or nursery as they are more likely to come into contact with the virus, are also more likely to develop the infection. 

It is important that parents learn more about all of this to safely identify minor respiratory illnesses and when their babies and infants are more likely to be poorly with self-limiting respiratory conditions which can safely be managed at home. 

Access to appropriate information and support will help parents and carers to confidently manage those respiratory infections appropriately at home this winter and to help parents and carers know when to seek advice and help if their baby, infant or small child becomes more seriously unwell, or their conditions worsens after an initial health consultation. 


Where to seek help? 

There is a lot of information available to help inform and advise parents on how to manage these symptoms and when to seek professional help. 

In the first instance, parents can speak to a Health Visitor, Pharmacist or GP. Also know when and how to use NHS 111. Especially if your infant is too unwell to attend A&E. 

There are also some great resources online. You will find really good clear information on the Healthier Together Website which has specific information on respiratory illnesses in younger children.

The information typically consists of a short video to watch and also has a ‘when should you worry’ section in a Red/Amber/Green coloured format to help parents identify stages and changes in their infant’s condition and particularly to support decisions on managing their illness and what to do. 

There is also advice on ‘what you can do to help your child’. This is also presented as a Bronchiolitis advice sheet to print. 

Google translation is available on this website. Work is being done to translate some of this information and will be hosted as PDFs in the near future plus some translated voice overs for the relevant videos.

View and download the information via the links below. 


Bronchiolitis and RSV – read the Bronchiolitis Advice Sheet

Fever/high temperature – read the information specifically for babies

Wheeze and breathing difficulties - read the information specifically for babies


As mentioned above, Bronchiolitis affects premature babies. There is special advice and care for premature babies through the Hospital Paediatric departments and a lot of useful additional support from BLISS, a charity that works to support parents of premature and sick babies. The charity is working to increase awareness of RSV, its symptoms and how to manage it/when to seek health support.  

Access the BLISS website for further RSV support particularly for premature babies and watch their short animation here.