Dr Phil Kieran: How can I ensure my baby does not get another respiratory infection?

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My baby is eight months old and was recently admitted to the hospital for a severe respiratory infection. She responded well to treatment and was home in a few days. Can I do anything to ensure that she does not get another infection?

Bringing a small child to hospital for a respiratory illness is one of the most terrifying experiences I know of. As you found out, one of the upsides is that once they start to get better, they bounce back quickly. The aftermath, however, is that for the next while, you tend to think that every sniffle or cough will mean another emergency.

Respiratory illnesses in children occur frequently, with the average rate for preschool kids being eight to 12 viral infections per year. This means they can have a cough or runny nose almost continuously.

However, most cases do not need intervention, let alone hospitalisation. There is no way to entirely prevent these viral infections (some research suggests they are important for normal immune system development). So, what can you do to avoid further hospital admissions? The single most significant risk factor for children getting frequent or severe respiratory infections is if someone in the family smokes. This applies even if they “never smoke in the house” or “only smoke rarely”. Cigarette soot, ash and other chemicals cling to skin, hair and clothes and can increase the rates and severity of chest infections, ear infections and other upper respiratory tract infections. If someone in the household smokes, this is yet another good reason to try and stop (look up quit.ie for support). This advice probably also applies to vaping as the breakdown products of the vapour can cause respiratory irritation.

The next step is to make sure the child has a good diet, which is something to establish as early as possible. Around the age of two to three, many children will start asserting more independence and one way this manifests is by restricting the range of foods they eat. The more variety of foods your child consumes by their first year, the wider their choice will likely be after this restriction happens, so encourage them to eat a wide variety of foods as soon as weaning starts.

I would also avoid letting anyone with a cold hold her where possible. This has gotten a lot better since covid, as has hand sanitising but still worth keeping in mind.

Sleep strengthens the immune system, so good bedtime habits are also essential. I know establishing a sleep routine can be tricky - If I had a sure way, I could write an international bestseller. But it is a good idea to keep trying to ensure they get enough sleep. Aim for 12-16 hours up to a year, dropping to the adult eight-10 hours in their late teens.

Unfortunately, you can’t prevent your daughter from getting another infection, but it’s unlikely to be as severe as the one you have just experienced as her immune system is getting stronger.

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