Difficulty breathing

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Difficulty breathing

The following descriptions can help you identify the severity level of a child's problem breathing.

Severe difficulty breathing is a medical emergency. Signs that a child is having severe difficulty breathing may include:

• Breathing very fast or grunting with each breath.
• Appearing very tired during feeding. Rapid breathing can make a child unable to nurse or take a bottle.
• Using the neck, chest, and abdominal muscles to breathe, causing a "sucking in" between the ribs (retractions).
• Needing to sit up and lean forward (“tripod position”) or sit with the nose tilted up, as if sniffing the air. The child may fight any attempts to change this position.
• Appearing persistently pale, gray, bluish, or mottled (blue and white patches of skin), especially on the tongue, lips, earlobes, and nail beds.
• Listlessness and not wanting to talk or play as usual. Sometimes the child may instead act scared, hyper, and unable to sit still.

Signs that a child is having moderate difficulty breathing may include:

• Rapid breathing. A child who has moderate difficulty breathing generally breathes 40 to 60 times per minute.
• Tiring quickly during feeding. The child either stops eating or sucks in air to catch a breath. The effort needed for breathing and eating exhausts the child.
• Using the stomach muscles to breathe.
• Slightly gray, or lacelike purple and pale (mottled) appearance on the face, hands, and feet. However, the tongue, gums, and lips remain pink.

Signs that a child is having mild difficulty breathing may include:

• Breathing slightly faster than normal. Most healthy children breathe less than 40 times per minute.
• Using his or her stomach muscles to breathe.
• Normal skin color.

Credits

Last updated:	August 09, 2006
Author:	Debby Golonka, MPH
Reviewed By:	Michael J. Sexton, MD - Pediatrics, W. David Colby, MSc, MD, FRCPC - Infectious Disease
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman