Atelectasis (Child)

Front view of infant showing respiratory system.

The lungs’ job is to get air into and out of the body. Inside the lungs, air travels through a network of branching tubes (airways) made of stretchy tissue. If something blocks these airways, or if there is too much pressure on a lung, the lung may collapse. Partial or full collapse of a lung is called atelectasis.

Atelectasis can be caused by a child swallowing a foreign object. The object then blocks the airways. Atelectasis may also be caused by a long bed rest such as after surgery. It may also be caused by not taking full breaths. This might be because of a broken rib, for example. It's also more likely in children with lung conditions such as cystic fibrosis.

Atelectasis is often not life-threatening in a healthy child. The condition is more serious in small children and those with other health conditions. Atelectasis may cause no symptoms. Or it may cause shallow breathing, low oxygen levels, coughing, or wheezing. The condition is often diagnosed with a chest X-ray or a CT of the chest. It can also be seen during a bronchoscopy. This is a procedure to look at the airways in the lungs. A thin, lighted tube is put in the mouth and down the throat and windpipe into the airways. The goal of treatment for atelectasis is to re-expand the lung. If a foreign object is in the lung, it's removed. Moving the child into different positions and gently tapping the chest may help reinflate the lung. The child may also use a special device called an incentive spirometer. This helps them to breathe deeply. If pain is contributing to the atelectasis, pain medicines may be given. These make it easier for the child to breathe deeply and to cough. If atelectasis isn't treated, it may lead to pneumonia or trouble breathing.

Home care

Medicines

Your child's healthcare provider may prescribe medicines called mucolytics. These help break up your child's secretions. Or your child may be prescribed bronchodilators. These help open up (dilate) your child's small airways. Follow the healthcare provider’s instructions for giving these medicines to your child.

General care

  • Allow your child time to rest as needed. They may go back to normal activities when able.

  • For children older than 1 year, use extra pillows to keep your child’s head and upper body upright while lying down. This may make breathing easier. Talk with your healthcare provider about how far to raise your child's head.

  • Never use pillows with a baby younger than 12 months. Also never put a baby younger than 12 months to sleep on their stomach or side. Babies younger than 12 months should sleep on a flat surface on their back. Don't use car seats, strollers, swings, baby carriers, and baby slings for sleep. If your baby falls asleep in one of these, move them to a flat, firm surface as soon as you can.

  • Help your child with breathing exercises as instructed by their provider.

  • If coughing is painful, have your child hold a pillow to their stomach to cough. This may help ease the pain.

  • Help your child eat a healthy diet and drink plenty of fluids.

  • If your child was given an incentive spirometer, use it as directed.

  • Don't smoke around your child. And don’t let anyone else smoke around them either. This includes guests in your home and passengers in your car.

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

When to get medical advice

For a usually healthy child, call the healthcare provider right away if any of these occur:

  • Symptoms continue or get worse

  • A fever (see "Fever and children" below)

  • Cough gets worse

  • Your child has other symptoms that concern you, or your child isn't getting better as you think they should be

Call 911

Call 911 if your child has:

  • Trouble breathing

  • Confusion or dizziness

  • No response when you talk to them, or they become unconscious

  • Lips, skin, or nails look blue, purple, or gray in color

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° F (38° C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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