Difficulty breathing and wheeze
It is extremely scary if your child has any sort of breathing difficulty. Use your instincts; if your child appears well and their breathing difficultly 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 2 years of age with breathing difficulty 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 2-3 days.
If your child is struggling to breathe, they need to be urgently seen by a medical practitioner. 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.
If your child has a salbutamol (blue inhaler) then follow your personalised action plan.
When should you worry?
If your child has any of the following:
- Is going blue around the lips
- Has pauses in their breathing (apnoeas) or has an irregular breathing pattern or starts grunting
- A harsh breath noise as they breathe in (stridor) present all of the time (even when they are not upset)
- Too breathless to talk / eat or drink
- Becomes pale, mottled and feels abnormally cold to touch
- Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
- Develops a rash that does not disappear with pressure (the 'Glass Test’)
- Is under 3 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)
- Has laboured / rapid breathing or they are working hard to breathe – drawing in of the muscles below their lower ribs, at their neck or between their ribs (recession)
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has any of the following:
- A harsh breath noise as they breathe in (stridor) present only when they are upset
- Seems dehydrated (sunken eyes, drowsy or not passed urine for 12 hours)
- Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
- Has extreme shivering or complains of muscle pain
- Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
- Continues to have a fever of 38.0°C or above for more than 5 days
- Is getting worse or if you are worried
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS 111 - dial 111
If none of the above features are present
- Make sure that your child stays well hydrated by offering them lots of fluids. And closely monitor them for any signs of deterioration by looking out for any red or amber features.
- Additional advice is also available for families for help cope with crying in otherwise well babies here
Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111
What should you do?
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 or are struggling to drink, they will need to be seen urgently by a medical practitioner. Please call your GP surgery (or call NHS 111 if your GP surgery is closed).
If your child has a fever, their breathing may become more rapid. You should try to lower their temperature using paracetamol (calpol and/or ibuprofen). For further advice on a fever, please see fever high temperature.
How long will your child’s symptoms last?
Although your child’s cough is likely to last for 2 to 3 weeks, they should not be breathless or wheezy for more than 3 or 4 days.
The charts below show how long croup or bronchiolitis last in children. The faces represent 10 children who have croup or bronchiolitis. Green faces are those children who have recovered within that time period
The diagrams above are taken from www.whenshouldiworry.com