Respiratory Distress (Child)

Respiratory distress is when a child has a problem getting enough oxygen into his or her body. This is because the child has trouble breathing. It can be caused by a cold or flu, asthma, allergies, cough, or pneumonia. Anything that blocks air passages can also be a cause. This includes extra mucus or large tonsils. An injury that makes it painful to take a deep breath can lead to respiratory distress. Bruised or broken ribs are an example of this type of injury.

A child in respiratory distress will breathe faster than normal. He or she may grunt or wheeze. Wheezing is a whistling sound caused by breathing through narrowed airways. Your child’s nostrils may flare and his or her chest may pull in. The lips and skin around your child’s mouth may have a blue tint. Your child may also sweat or drool.

In the hospital, steps are taken to calm the child and help him or her get enough oxygen. Then the cause of the respiratory distress is assessed and treated. It can be scary to watch your child struggle to breathe. But keeping your child calm will help. Breathing will go back to normal when the underlying problem gets better.

Home care

Your child’s healthcare provider may prescribe medicines for cough, pain, fever, or infection. You may be advised to use saltwater (saline) nose drops to help with breathing. Use these before your child eats or sleeps. Your child may be prescribed bronchodilator medicine. This is to help open the airways. It may come as a spray, inhaler, or pill to take by mouth. Have your child use the medicine exactly at the times advised. Follow all instructions for giving these medicines to your child.

The healthcare provider may also prescribe an oral antibiotic for your child. This is to help stop an infection. Follow all instructions for giving this medicine to your child. Have your child take the medicine every day until it is gone. You should not have any left over.

If your child has pain, you can give him or her pain medicine as advised by the healthcare provider. Don’t give your child any other medicine without first asking the provider. Never give aspirin to anyone younger than 18 years of age who is ill with a viral infection or fever. It may cause severe liver damage or brain damage.

General care

  • Follow all instructions you are given to care for your child’s cold, flu, or other condition.

  • Wash your hands well with soap and warm water before and after caring for your child. This is to help prevent spreading infection. In an age-appropriate manner, teach your children when, how, and why to wash their hand. Role model correct handwashing. Encourage adults in your home to wash hands often.

  • Give your child plenty of time to rest. Trouble sleeping is common with this condition.

    • Children 1 year and older: Have your child sleep in a slightly upright position. This is to help make breathing easier. If possible, raise the head of the bed slightly. Or raise your older child’s head and upper body up with extra pillows. Talk with your healthcare provider about how far to raise your child's head.  

    • Babies younger than 12 months: Never use pillows or put your baby 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 blow his or her nose correctly. Check that they throw away the tissue. For younger children, suction mucus from the nose with saline nose drops and a small bulb syringe. This can help make breathing easier. Squeeze the bulb first, gently place the rubber tip into one nostril. Slowly release bulb. The suction will draw the mucus out of the nose. Wash your hands after this.

  • For toddlers and children over 1 year: To prevent dehydration and help loosen lung mucus, have your child drink plenty of liquids. Children may prefer cold drinks, frozen desserts, or ice pops. They may also like warm chicken soup or drinks with lemon and honey. Don’t give honey to a child younger than 1 year old.

  • For babies younger than 12 months: To prevent dehydration and help loosen lung mucus, have your child drink plenty of liquids. Use a medicine dropper, if needed, to give small amounts of breastmilk, formula, or clear liquids to your baby. Give 1 to 2 teaspoons every 10 to 15 minutes. A baby may only be able to feed for short amounts of time. If you are breastfeeding, pump and store milk to use later. Give your child oral rehydration solution between feedings. This is available from drugstores and grocery stores without a prescription.

  • Don’t smoke around your child. Don’t let anyone else smoke around them either. Tobacco smoke can make your child’s symptoms worse.

Follow-up care

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

Special note to parents

Don’t give cough and cold medicines to any child younger than 6 years old. These don'thelp young children, and they may cause serious side effects.

When to seek medical advice

In a usually healthy child, call your child's healthcare provider right away if any of these occur:

  • Fever (see Fever and children below)

  • Wheezing, coughing, or trouble breathing that doesn’t get better within 24 hours

  • New symptoms develop or you are concerned about how your child is recovering

Call 911

Call 911 if any of these occur:

  • Confusion or excessive tiredness

  • Wheezing, coughing, or trouble breathing that gets worse

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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