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Breathing difficulties in children.

Children can have breathing problems at any time of the year, but A & E departments tend to see a rise of cases in the Autumn and Winter months. Cold weather can cause issues for those who have chronic conditions like Asthma. Furthermore, viral conditions such as Croup and Bronchiolitis tend to increase around this time.

Most children usually recover well from infections at home, but some may require medical attention. Knowing when to seek help can be tricky with little ones. I always emphasise on courses the importance of trusting your instincts, but to help you further I have put together this aid to guide you on how to recognise signs of respiratory distress in a child.

What is normal breathing?

It is important to note what is normal for your child. It is a good idea to expose their chest when they are settled and healthy and take a short video. Then, if you do have any concerns about their breathing when unwell, you have a point of comparison. Babies and Children do breathe faster than adults so the video will also be a useful tool for gauging the normal rate. If they have a fever, the rate will increase slightly, but keep a close eye on them. If your child becomes too breathless to feed, drink or talk, they will certainly need help quickly.

Breathing sounds

Can you hear any unusual noises as they breathe, for example, a wheeze? This presents as a high-pitched whistling sound indicating the child’s airways may be narrowing. Regular grunting, usually when breathing out, can also be a concern especially if coupled with fast, shallow breathing.

Colour changes

The skin may appear pale or grey in colour if they are struggling to breathe and it could be cool and clammy to touch. Sometimes you may see a bluish colouration of the skin, often most notable around the lips which can indicate that they do not have sufficient Oxygen in the body. For those with a darker complexion, look for a grey/white tone around the eyes and the lips.


Initially, the child could be restless and irritable. The longer they struggle to breathe they will become lethargic and confused indicating a lack of Oxygen in the body.

Physical signs

The child may change position to make breathing easier. Typically, this is sitting upright, perhaps with the head tilted backwards. Flaring of the nostrils and bobbing of the head can also be signs of respiratory distress in Babies and young children.

Use of accessory muscles

Recession or retractions are medical terms used when the muscles we use to breathe are visibly pulled in and is an indicator that the child is working very hard to breathe. This exaggerated sucking in of the muscles can be seen in between or below the ribs, below the breastbone, and in the neck.

What can you do?

The above signs could be mild, moderate, or severe, but remember to trust those instincts and if it appears your child is working hard to breathe seek medical help quickly. I understand this would be alarming, but it is crucially important to stay calm as panicking can make the situation worse.

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