If you think your child is in respiratory distress, is not breathing, or is struggling to breathe, call 911 and start CPR immediately.

Sometimes moisturized air can make breathing more comfort­able. You can try using steam (such as a steamy bathroom) or cool mist (such as a vaporizer). Try this only when the breathing difficulty is mild, in conjunction with other treatments, and on the advice of your doctor.

If an irritant has triggered the breathing difficulty, remove the irritant. If you are indoors, go outside. A cigarette smoker can trigger an asthma attack in a bystander just by wearing a sweater or shirt saturated with smoke. Cats shed large amounts of dander, so even if a cat is removed from the room, the dander lingering on the carpet can cause the irritation to continue.

If your child is known to have RAD or asthma, your doctor may have already advised you about a medication regimen.

 

When does my doctor need to be involved?

If your child is struggling to breathe or appears not to be breath­ing at all, call 911 and start CPR immediately. Anytime you suspect difficulty breathing, call your doctor. It can be difficult for you to tell whether a child’s breathing is worri­some.

 

Your child will use certain techniques to get extra oxygen into her lungs, however. Call your doctor if your child displays two or more of these symptoms or if you have any doubt.

 

Flaring the nostrils with each breath. This allows more air to flow into the airway and lungs.

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Visible flexing or contracting of the long muscles at the neck, between the jaw and shoulders. This pulls on the tops of the lungs, increasing the size of the lungs and their air capacity. The notch between the collarbones, called the sternal notch, may also be pulling in with each breath.

 

Visible flexing or contracting of the muscles between the ribs. This pulls on the lungs to open them horizontally. It also increases lung size and capacity. To see these muscles pulling, draw an imaginary line from your child’s armpit to her hip. Halfway along that line, look for the ribs moving with each breath. They will look like a row of bucket handles moving up and down.

 

Moving the belly up and down in an exaggerated way with each breath. This forces the diaphragm down, increasing the depth of the lungs and their air capacity.

 

Breathing fast. This increases the flow of air into the lungs simply by speeding it up. Remember that a child who has a fever will breathe fast to “blow off” the fever. This is a very good way to help cool down the body; it is not a sign that she is having difficulty breathing.

 

In the absence of a fever, the normal rate of breathing is age dependent: young toddlers may breathe 25 to 35 times a minute, while children over two years old breathe 20 to 30 times a minute. (Adults typically breathe 12 to 14 times per minute.) If your child has a fever, give her a fever-reducing medicine. When her temperature has returned to normal, recheck her respiratory rate.

 

These symptoms are helpful in assessing a (relatively) calm child. However, in a crying child, they are not necessarily accu­rate indicators of difficulty breathing. This is because a crying child will flare her nostrils, open her mouth, and breathe fast as part of crying.

 

When in doubt, call your doctor or 911 immediately. When your child is having difficulty breathing, you should never put anything into her mouth, including food or drink.