Breathing problem (noisy breathing)
It is extremely scary if your child has any sort of breathing problem. Use your instincts – if your child appears well and their breathing difficulty improves after a short period, there is normally no need to worry.
Wheeze is extremely common in young children and is most often triggered by a viral infection. Most pre-school children with wheeze do not have asthma.
Children under two years of age with breathing difficulties may have bronchiolitis. This is an extremely common condition that usually starts as a runny nose and cough, but their breathing may get worse over the next two or three days. Respiratory syncytial virus (RSV) is a common cause of bronchiolitis. Watch this video explaining more.
If your child is struggling to breathe, they need to be seen urgently by a medical practitioner and are likely to need treatment. If your child has croup (hoarse voice, barking cough, noisy breathing), they will also need to be seen by a medical practitioner.
Most chest infections are caused by viruses and do not usually need treatment with antibiotics.
Babies normally breathe at a faster rate than adults and older children. It is normal for a newborn baby to take slight pauses in their breathing for a few seconds, or to breathe rapidly for a short period. By six weeks of age, they should have a more regular breathing pattern.
Sometimes your baby’s breathing rate may increase for a longer period of time if they are unwell and you may also notice they are working harder to breathe. For babies, the most tiring thing they do is feeding, so this can be the first time you notice them struggling to breathe. If they are too breathless to feed, they need to be seen urgently by a healthcare professional.
It can be very scary watching your child having difficulty breathing and below are some signs to look out for if you are worried.
Check if your child has any red symptoms:
- Your child shows signs of working hard to breathe. These signs include constantly breathing fast, flaring the nostrils, drawing in the muscles below the ribs or making a grunting noise every time they breathe out.
- Your child has laboured / rapid breathing or they are working hard to breathe – drawing in the muscles below their lower ribs, at their neck or between their ribs (recession).
- Going blue on or around the lips or tongue.
- Long pauses in their breathing (more than 10 seconds), an irregular breathing pattern or grunting noises.
- A harsh breath noise as they breathe in (stridor) present all the time (even when they are not upset).
- Too breathless to talk, feed or drink.
- Becomes pale, mottled and feels abnormally cold to touch.
- Becomes extremely agitated (crying inconsolably despite distraction), confused, floppy or very lethargic (difficult to wake).
- Develops a rash that does not disappear with pressure (the ‘Glass Test’).
- Is under three months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features are present) – how to take your child’s temperature.
Actions to take if your child has any red symptoms
- Your child may require emergency treatment.
- You should call 999 or take them to your NEAREST Emergency Department where they can be assessed.
If there are no red symptoms, check if your child has any amber symptoms:
- A harsh breath noise as they breathe in (stridor) present only when they are upset.
- Seems dehydrated (sunken eyes, drowsy or not passed any urine for 12 hours).
- Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with cuddles, toys, TV or snacks) – especially if they remain drowsy or irritable despite their fever coming down.
- Extreme shivering or complains of muscle pain.
- Is three to six months of age with a temperature of 39°C / 102.2°F or above (please note fever is common in babies up to two days after they receive vaccinations) – how to take your child’s temperature.
- Continues to have a fever of 38.0°C or above for more than five days.
- Is getting worse or if you are worried.
Options if your child has any amber symptoms
Your child does not need to be taken to the Emergency Department immediately, but you should seek medical advice today.
- ring your GP surgery during their usual opening hours
- contact the out of hours GP if the surgery is closed
If symptoms continue for four hours or more and you have not been able to speak to your GP or the out of hours GP, consider going to your nearest Emergency Department.
If your child develops any of the red symptoms above, go to your nearest Emergency Department.
If no red or amber symptoms are present:
- your child does not seem to have any symptoms of serious illness or injury
- you can get general advice on the NI Direct website or from your local pharmacy
If your child develops any of the red or amber symptoms above, follow the advice in these sections.
How you can help manage your child’s breathing difficulties at home
- Make sure your child stays well hydrated by offering them lots of fluids. Closely monitor them for any signs of deterioration by looking out for any red or amber features.
- If your child is interacting with you normally and is able to drink as normal, you can watch them closely at home. If your child is not feeding as well as normal, you should offer smaller feeds but more frequently.
- If they become more breathless or start struggling to drink, they will need to be seen urgently by a medical practitioner. Call your GP surgery, out of hours GP or take them to your nearest Emergency Department.
- If your child has a fever, their breathing may become more rapid. You should try to lower their temperature using paracetamol (Calpol).
Advice leaflet for coughs / breathlessness in children under one year old – please note NHS 111 is not available in Northern Ireland.
Advice leaflet for coughs / breathlessness in children over one year old – please note NHS 111 is not available in Northern Ireland.
Although your child’s cough is likely to last for two to three weeks, they should not be breathless or wheezy for more than three or four days.
- If it is non-urgent, speak to your local pharmacist or health visitor.
- Alternatively, you can contact your GP practice and a qualified member of the clinical team will check whether your child needs to be seen urgently. Out of hours GP details are available here.
- You should only call 999 or go your nearest Emergency Department in critical or life-threatening situations.
- See our section: How does the Children’s Emergency Department Work?