How to Recognize Respiratory Distress in Children

By learning more about how doctors treat breathing issues and how to identify an emergency situation, you can get your child the care he needs in a more timely manner.

Watching your child struggle to breathe is scary and upsetting. As a parent, you may not know immediately know if it's a manageable respiratory issue or one that requires immediate medical attention.

When Your Child Can’t Get Air Into Their Lungs

Respiratory distress is usually caused by one of three things: chronic illness, infections, or blocked airways. By learning more about how to treat these breathing issues and how to identify an emergency situation, you can get your child the care he needs in a more timely manner.

parent administering rescue medication to boy

What Are the Signs of Respiratory Distress?

Indicators of respiratory distress include one or more of the following symptoms.

1. Breathing Rate

If your child has experienced an increase in the number of breaths per minute, this may indicate that they are not getting enough oxygen. Tachypnea, or abnormally rapid breathing, is defined by the World Health Organization criteria as the following:

  • Newborn to 2 months: 60 breaths per minute
  • Infant 2 months to 1 year: 50 breaths per minute
  • Preschool Child 1 to 5 years: 40 breaths per minute
  • School-age Child: 20-30 breaths per minute
  • Adults: 20 breaths per minute

2. Increased Heart Rate

Low oxygen levels may cause an increase in heart rate. 

3. Color Changes

When a person is not getting enough oxygen, they may present a bluish color seen around the mouth, on the inside of the lips, or on the fingernails. The color of their skin may also appear pale or gray.

4. Grunting 

Listen for a grunting sound when your child exhales. This grunting is the body's way of trying to keep the air in the lungs so they will stay open.

5. Nose Flaring

The openings of the nose spreading open while breathing may indicate that a person is having to work harder to breathe.

6. Retractions

The chest appears to sink in just below the neck and/or under the breastbone with each breath. This is the body's method for trying to bring more air into the lungs. Asthmatics often experience retraction during the onset of an asthma attack.

7. Sweating

There may be increased sweat on the head, but the skin does not feel warm to the touch. More often, the skin may feel cool or clammy. This may happen when the breathing rate is very fast.

8. Wheezing

A tight whistling or musical sound heard with each breath may indicate that the air passages may be smaller, making it more difficult to breathe.

9. Changes in alertness

Low oxygen levels may cause your child to act more tired and may indicate respiratory fatigue.

How to Monitor Your Child’s Breathing Rate

Monitoring your child's breathing rate can be done simply and easily. Set a timer for 30 seconds, and count the number of times the child’s chest rises. Simply double this number to get their respiratory rate. Respiratory rate is typically reported as “respirations per minute.” 

It is important to remember that taking extra precautions can help you avoid some breathing problems, but it will not prevent all of them. There are things that can be done proactively to help keep your loved ones safe. Some tips for doing so are as follows:

  • Do not smoke around your child. Children who are around smokers get twice as many respiratory infections and colds as those who are not. Smoke residue can build up on surfaces in rooms and in cars, so be aware of the environmental pollutants your child may be exposed to. 
  • Do not use powders on your child, including baby powder or cornstarch, as they can irritate small lungs.
  • Keep your child in dust-free environments.
  • Always practice good hand washing to prevent the spread of germs and other colds.

When Should You Take Your Child to the ER?

Many signs of respiratory distress may also resemble other medical conditions and problems. We at Aluna want to remind parents to seek medical attention if your child shows any of the above symptoms.

Additionally, seek medical help if your child is unable to speak more than short phrases due to shortness of breath, or if they are having to strain their chest muscles to breathe. In the event that your child is having any difficulty breathing, call 911 or go to the closest emergency room. 


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