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Children who are wheezing, have labored breathing or difficulty breathing, are a large and important group at the children’s emergency room. Many have asthma, others have croup. Some have pneumonia, others are just congested. Learn how to recognize and what to do when your child experiences breathing problems. Don’t forget to watch the YouTube videos as guidance. It’s very helpful!
As a rule, children who have difficulty breathing need help from health care professionals. At least if it’s the first time they have experienced this.
How do I know that the child has difficulty breathing?
- Undress the upper body of the child
and observe how they breathe.
- Undress the child and observe them.
- UNDRESS THE CHILD and observe!
No one can judge whether a child has difficulty breathing without undressing them first! At the children’s emergency room, when I come in to see the family, I always ask the parent to take off the child’s shirt as soon as I say hello. Then I can observe the child breathe while I talk to the parents and determine whether the child has difficulty breathing or not.
What am I looking for?
A healthy child breathes without even thinking about it. You’ll notice the child, and sometimes their chest, moving a few centimetres up and down at a steady, relaxed pace. The rest of the body and head are still. The nose wings are still. Watch your baby tonight to get an idea of how they breathe when they’re healthy.
1. Does the child struggle with every breath?
When you see a child with difficulty breathing, you immediately get the impression that the child needs to physically exert themselves with every breath. It may be more or less pronounced depending on the severity. The abdomen often goes in and out in a way that looks exhausting.
2. Is the child breathing faster than usual?
Don’t count the child’s respiratory rate at home! In my experience, this confuses parents more than it helps them. But feel free to look at how your child breathes when they’re healthy. You will notice that when the child is sick, they will breathe faster than usual. If the child has a high fever, they will breathe faster because of it. If the child does not have to struggle physically with breathing nor breathing stagnantly, you can give the child anti-pyretics and see if the breathing becomes normal again. If they breathe normally again, you can calmly continue to take care of them at home. But if the child breathes significantly faster than usual, even when the fever goes down, or if at the same time they struggle physically with breathing, then you should visit a doctor for assessment.
3. Does the child have retractions?
Children’s chests are much softer than adults’. When they have difficulty breathing, the skin between the ribs are pulled in between the ribs with each breath. If there is severe breathing problems, the entire chest can also move in and out. This is hard to explain in words, and therefore best if you watch a video.
Here is a YouTube video showing a child with heart disease and with retractions. This looks exactly the same as a child with asthma, except that a child with asthma is often more difficult compared to this calm baby. (The baby also breathes faster than normal for their age)
Another video of a child with croup having retractions. Here, both inhalation and exhalation are signs that there is swelling in the upper respiratory tract. I really hope the video was taken in a hospital, because a child with this much breathing problems needs to be cared for and monitored in hospital!
4. Are the exhalations high-pitched and whistling?
In asthma, it’s hard for the child to get air out of their lungs. In milder cases, it is easier to notice that the child’s exhalation takes longer than their inhalation. And in more severe cases, the exhalation is high-pitched. Refer to the YouTube video below, of someone’s child exhaling in a high-pitch. This child also has retractions, which is very common in asthma. He would need to be treated at the children’s hospital and I hope he received it!
5. Does your baby have terrible coughing attacks and whistles upon inhalation?
This could be whooping cough. Seek the children’s emergency room. Please film the coughing attack and insist that the child be tested and treated for whooping cough.
Read more about whooping cough
If the child is wheezing and it sounds slimy at every inhalation and exhalation, but the child does not seem to have difficulty breathing, eats well and is alert, then it is all right. What you hear is mucus in the airways and often it is mucus in the upper respiratory tract (pharynx) that sounds the worst.
What should you do when your child has difficulty breathing?
Welcome to the children’s emergency room! We are happy to help you and your child 24/7 🙂
If your child has asthma and you have treatment at home, try to increase the amount of puffs according to your asthma management guide. However, if this doesn’t help, visit the children’s emergency room. If you don’t have asthma medications at home, clear your child’s nasal passages with saline. If the child is all right, then you can stay at home. But, if they are still having difficulty breathing, visit the hospital. Often it is easier for the child to breathe in a sitting position than lying down. So let the child sit on your lap. Hold, caress and calm the child (maybe read a fairytale to them) until they have received treatment. The calmer the child, the less strenuous the breathing.
What about the medical center?
If you have a health center where doctors are used to, and good with children, most breathing problems can be treated there. If the child needs to be hospitalized, the doctor at the medical center can send the child there with a referral. Unfortunately, this isn’t the case for all health centers. So, if that’s the case, I think you and your child should go to a pediatrician’s office or a children’s emergency room.