What symptoms do children with breathing difficulties have?
The common symptoms caused by breathing (respiratory) difficulties in children include:
- A runny nose, stuffy nose, blocked nose and sneezing. These symptoms are often caused by a cold but may also be caused by an allergy.
- Most coughs clear up within a few days and are caused by a viral infection.
- Sometimes the cough may go on for a few weeks after the infection has gone but there are no other symptoms and this is also harmless.
- If a cough is really bad, occurs with severe breathing problems or won't go away then there may be a more serious cause.
- As well as common viral infections, a cough may be caused by other conditions such as croup, bronchiolitis or whooping cough.
- A cough that won't go away may be due to asthma or another long-term condition such as cystic fibrosis.
- Coloured mucus: yellow, green or brown mucus usually means there is a respiratory tract infection.
- A high temperature (fever): can be a sign of infection. A high temperature can make your child irritable or drowsy. Often getting their temperature down will make them feel much better.
- Wheezing: this is a high-pitched sound that comes from the chest when your child is breathing out. This is most often caused by respiratory infections or asthma.
- Aches and pains: children with respiratory tract infections often complain of aches and pains in their arms and legs and they often have a headache.
How do I know when my child is really unwell?
The signs of your child being very unwell with breathing (respiratory) difficulties that might need urgent medical treatment include:
- Breathing rate. An increase in the rate of breathing may be the first symptom of breathing difficulty. Count the number of breaths in one minute. The breathing rate is too fast if it is more than:
- 60 breaths per minute for a baby aged 0-5 months.
- 50 breaths per minute for an infant aged 6-12 months.
- 40 breaths per minute for a child aged 1-5 years.
- 20-30 breaths per minute for children of school age. The normal breathing rate gets gradually less as a child gets older. So, for example, a breathing rate above 30 would be too high for a child aged 6 years but a breathing rate above 20 would be too high for a teenager aged 16 years.
- Increased effort of breathing. This includes the chest sinking in below the neck and below the breastbone (sternum).
- Flaring of the nostrils. The nostrils widen when breathing. This also shows that more effort is needed for breathing.
- Grunting. A grunting sound is made when breathing out. This is the body trying to get more air into the lungs.
- Colour. The skin may seem pale or a bluish colour. The lips and tongue may also appear blue. These changes mean your child isn't getting enough oxygen from breathing.
- Drowsiness. Low oxygen levels may cause your child to become very tired and difficult to keep awake.
- Stridor. This is a high pitched noise when your child breathes in. It is caused by an obstruction to the flow of air in the upper airway. The causes for this include croup or epiglottitis.
Although most children get better quickly from respiratory infections, occasionally the infection overwhelms the body's defences and causes sepsis, which needs emergency treatment in hospital.
Further reading and references
Feverish illness in children - Assessment and initial management in children younger than 5 years; NICE Guideline (Updated August 2017)
British Guideline on the management of asthma; Scottish Intercollegiate Guidelines Network - SIGN (2016)
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