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When a child has trouble breathing

One of the most frightening experiences for any parent is when a child has difficulty breathing. Understanding the causes of breathing emergencies and the steps to take to restore breathing will help you do the right thing for any child in your care. If a child has trouble breathing, breathes rapidly or is wheezing, the best first step is usually to call his or her physician. Here are some of the most common causes of breathing difficulty in infants and children.


The American Lung Association estimates that 6.2 million children under age 18 suffer from asthma. Medications called bronchodilators and corticosteroids help reduce the inflammation associated with asthma and open the airways. If your child has asthma and has been prescribed these medications, always keep them on hand. Also, be on the alert for the common “triggers” of an asthma attack, such as pollen, house dust, pet dander, and exercising in cold air. Control or avoid these triggers when you can; be prepared for an attack when you can’t.


No parent can forget the barking cough that accompanies this viral infection. Children age 4 and younger are most at risk. The virus, which infects the voice box (larynx), wind pipe (trachea) and bronchial tubes, narrows the airways and causes a cough that sounds like the barking of a seal. Croup usually lasts five to six days. Steam from a shower can help open airways, as can moist night air or mist from a humidifier. It’s a good idea to sleep in the same room with a child who has croup so that you’ll know if his or her condition is getting worse. Seek immediate medical care for children who show any of the following symptoms:

  • unconsciousness
  • excessive drooling or difficulty swallowing
  • blue or dusky lips
  • high-pitched noises that occur when the child inhales
  • inability to bend neck forward
  • heart rate faster than 160 beats per minute

Whooping cough (pertussis)

This extremely infectious disease causes bouts of coughing followed by a deep inhalation with a high-pitched whooping sound. It begins with symptoms similar to those of a common cold and lasts for about four weeks.

Antibiotics are used to treat whooping cough. Children who have it should drink plenty of fluids and eat several small meals a day. If the child’s lips turn blue, he or she is having difficulty breathing. Seek medical treatment immediately.


Choking occurs when food or a small object gets stuck in the throat or windpipe and blocks the flow of air to the lungs. The face of a child who is choking may turn purple, his eyes may bulge and he may wheeze or gasp, with a look of terror on his or her face. If you can see an object in the mouth, reach a finger to the back of the mouth and try to remove the object with a sweeping motion. Be careful not to poke the object farther back into the throat.

If the finger sweep fails or if no object is visible, place the child stomach down on your lap with his head and upper body off to the side of your knees. Your arm should be underneath the child, supporting the upper body and chin, while keeping the head lower than the rest of the body. Thump the child up to five times on the middle of the back using the heel of your hand. The combination of back thumps and gravity should free the object.

For an older child, kneel or stoop behind the child, wrapping your arms around him or her. Make a fist with one hand and hold the other hand against the center of the abdomen, between the navel and ribs. Provide abdominal thrusts until the object is expelled.

Breathing problems can happen for a number of other reasons, including pneumonia and allergic reactions, such as bee stings. Learning the signs of breathing difficulty and taking a class in cardiopulmonary resuscitation of infants and children are the best ways to prepare for potentially life-threatening situations. Knowing how to recognize and handle breathing emergencies could even one day enable you to save a child’s life.