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Parent’s Guide

Parent’s Guide: Breathing Trouble

It is scary to hear your child struggle to breathe. This guide will help you distinguish between a simple stuffy nose (which is noisy but safe) and "Respiratory Distress" (which requires medical help).

1

How to Check for “Distress”

Strip your child down to their diaper or underwear. Watch their chest and belly while they breathe. Look for “Work of Breathing”:

Nasal Flaring

Nostrils widen/flare out with every breath.

Retractions

Skin sucking in between ribs, above collarbone, or below ribs with each breath.

Grunting

A grunting noise happens every time they breathe out.

Rate & Color

Breathing much faster than normal (panting). Bluish tint around lips/nails.

2

When to Get Help

Call 911 Now

  • Severe struggle to breathe.
  • Can barely speak or cry.
  • Blue/Gray/Purple lips or face.
  • Passed out or hard to wake.
  • Stops breathing > 10 secs.

Call Doctor Now

  • Retractions (skin pulling in).
  • Stridor (harsh sound breathing IN).
  • Wheezing (whistle breathing OUT).
  • Fast breathing (>60/min in babies).
  • Fever > 104°F or ANY fever < 12 weeks.

Contact in 24hrs

  • Breathing slightly fast but playing/smiling.
  • Constant cough disrupting sleep.
  • Fever lasting more than 3 days.
3

What Does That Sound Mean?

SoundWhat It IsWhat It Usually Means
StridorHarsh, raspy sound when breathing IN.Croup Swelling in upper windpipe. Often “barking seal” cough.
WheezingHigh-pitched whistle when breathing OUT.Asthma or Bronchiolitis. Lower airways are tight.
GurglingWet, bubbling sound.Mucus Usually just a cold. Typically not dangerous.
GruntingShort “uugh” sound when breathing OUT.Severe Distress Body trying to keep lungs open.
4

Common Causes

Croup (Viral)

Signs: Barking cough, hoarse voice, Stridor.

Action: Cool night air or steamy bathroom helps.

Bronchiolitis (RSV)

Signs: Wet cough, fast breathing, wheezing.

Action: Suction nose, fluids. Watch for retractions.

Asthma

Signs: Wheezing, tight chest, night cough.

Action: Follow Asthma Plan (Albuterol).

Croup (Viral)

Signs: Barking cough, hoarse voice, Stridor.

Action: Cool night air or steamy bathroom helps.

5

Home Care for Mild Symptoms

Clear the Nose

Babies are “nose breathers.” Use saline drops and suction (bulb syringe) before feeds and sleep.

Humidify

Use a cool-mist humidifier in the bedroom. Dry air makes coughs worse.

Hydration & Honey

Fluids thin mucus. For children over 1 year, 1 tsp of honey can calm a cough.

⚠️ No honey for babies < 1 year (Botulism risk).

Avoid Cough Meds

Do not give OTC cough syrups to children under 6 years. They are often ineffective and unsafe.

Medically Reviewed by Dr Michael Villadelgado
Disclaimer: This information is for educational purposes only. You assume full responsibility for how you use it. If you are unsure, always call your doctor.