Children who have frantic breathing, strained breathing or who find itdifficult to breathe are a large and important group for the paediatric nurse to care for. Many have a cold or asthma, others have croup. Some have pneumonia, others are just suffering with nasal congestion. Here you will find out how you recognize these and what to do when your child has breathing difficulties. Don't miss the links to youtube videos where parents posted videos on their poor kids struggling with breathing. Very educational!
As a rule, children who are finding it difficult to breathe need help from the medical service. At least the first few times, before getting an inhalation aid at home.
How do I notice that a child has difficulty breathing?
- Undress the baby on the upper body
and look at how it breathes.
- Undress the baby and watch it.
- UNDRESS THE BABY and watch it!
No one can judge if a child has difficulty breathing without undressing that sweater! When I work on the nursery and come in to a family, I always ask the parent to remove the baby sweater as soon as I greet. Then I can look at how the child breathes while talking to the parents and decide whether the child has difficulty breathing or not.
What am I looking for?
A healthy child breathes without even thinking about it. Watching the baby move, the chest and sometimes the stomach move a few inches in and out at a slow pace. The rest of the body and head are still. The nostrils are still. Watch your baby tonight when you put it down for the evening, to get a picture of how your baby is breathing when it is healthy.
1. Does the child have to fight physically with each breath?
When you see a child who is having difficulty breathing, you immediately get the impression that the child has to fight physically with each breath. It can be more or less pronounced depending on how severe breathing problems are. The abdomen often goes in and out in a way that looks strenuous.
2. Does the baby breathe faster than usual?
Do not count the baby's breathing rate at home! My experience is that it confuses more than it helps. But look at your baby when it is breathing when it is healthy, and you will notice the baby when it is sick, by breathing faster than usual. If the child has a high fever, it will breathe faster due to the fever. If the child does not have to fight physically with the breath or breath stutters, you can give the child a fever reducer and see if breathing becomes normal then. In that case, you can calmly continue to take care of the child at home. But if the child breathes significantly faster than usual even when the fever goes down, or if it simultaneously struggles physically with breathing, then you should come to the doctor for assessment.
3. Does the child have contractions?
Children's chests are much softer than adults. When they are finding it difficult to breathe, the skin between the ribs will be pulled in between the ribs in each breath. The entire chest can also move in and out for more laboured breathing problems. This is difficult to explain in words, and is best seen on film.
Here is a video on youtube that shows a heart-sick child having retractions. They look exactly the same as when the children have a cold or asthma, for example, but then the children are often sleepier than this lovely baby! (Baby also breathes faster than normal for its age)
One more video of a child having inhalations, and body cough. Here, too, the breath of both inhalation and exhalation indicates that there is swelling in the upper airways. I really hope the video is taken in a hospital, for a child with this much of a breathing problem needs to be looked after and monitored in hospital!
4. Does it sound squeaky and laboured when the baby exhales?
In the case of asthma, it is difficult for the child to get the air out of the lungs. It is easier to notice that exhalation takes longer than inhalation, and in more severe cases exhalation whistles. Here too, youtube helps with video, and even here I would be grateful to have a video posted on someone's child with a wheeze. This child also has retractions, which is very common in asthma. This child would also need help at the children's hospital and I hope he got it!
5. Does your baby have terrible cough attacks and beeps after the inhalation?
It may be whooping cough. Watch the child cough, feel free to film an attack and insist that the child be tested and treated for whooping cough.
If the child has frantic breathing, where it sounds slimy at every inhale and exhale, however no seems to have difficulty breathing, eats well and is well-heeled, then there is no danger. What you hear is mucus in the airways, and often it is mucus in the upper airways (throat) that sounds worst.
What should I do when my child has difficulty breathing?
Welcome to the ER! We are happy to help you and your child around the clock 🙂
Of course, if your child has asthma and you have treatment at home, try to increase the dosw and come in if it doesn't help. What you can do at home if you do not have asthma drugs at home is to clean your baby's nose. If the baby is perfectly well then you can stay calmly at home, but if they still have difficulty breathing, you must come to the hospital. Often it is easier for the child to breathe while sitting than lying down, so let the child sit on your lap, hold them and read stories, caress and calm until the child has received treatment, because the calmer the child is, the less strenuous the breathing.
The health centre then?
If you have a health centre where doctors are accustomed to and good at checking children, most breathing problems can be treated at the health centre. If the child needs to be admitted to hospital, the health care doctor can then send the child via referral there. Unfortunately, it does not work that way at all health centres and if it does not work that at your health centre I think you should go with the child to a paediatrician or a paediatric emergency room.