Respiratory Distress (Child)
Respiratory distress means a child isn't getting enough oxygen into their body. This is because the child has trouble breathing. It can be caused by a cold or flu, asthma, allergies, cough, or pneumonia. Anything else that blocks air getting into the lungs can also be a cause. This includes extra mucus or large tonsils. An injury that makes it hurt to take a deep breath can cause it. Bruised or broken ribs are an example.
A child in respiratory distress breathes faster than normal. They may grunt or wheeze. Wheezing is a whistling sound caused by breathing through narrowed airways. Your child’s nostrils may flare and their chest may pull in. The lips and skin around your child’s mouth may look blue. Your child may also sweat or drool.
In the hospital, steps are taken to calm the child and help them get enough oxygen. Then the cause of the respiratory distress can be found and treated. It can be scary to watch your child struggle to breathe. But keeping your child calm will help. Breathing will go back to normal when the problem that's causing the distress gets better.
Home care
Your child’s doctor may give your child medicines for cough, pain, fever, or infection. You may be advised to use saltwater (saline) nose drops to help with breathing. Use these before your child eats or sleeps. Your child may get bronchodilator medicine. This is to help open the airways. It may come as a spray or inhaler, or liquid medicine to put in a nebulizer machine. The machine creates a mist to breathe in. Have your child use the medicine exactly at the times advised. Follow all instructions. Always give your child their bronchodilator or other medicines correctly.
The doctor may also give your child an oral antibiotic. This is to help stop an infection. Follow all instructions for giving this medicine to your child. Have your child take the medicine every day until it's gone. You should not have any left over.
If your child has pain, you can give them pain medicine as advised by the doctor. Don’t give your child any other medicine without first asking the doctor. Do not give aspirin to children or teens unless your child’s doctor says it is safe. Aspirin can put your child at risk for Reye syndrome, a rare but serious condition.
General care
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Follow all instructions you are given to care for your child’s cold, flu, or other conditions.
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Wash your hands well with soap and clean, running water before and after caring for your child. This is to help prevent the spread of infections. Teach your children when, how, and why to wash their hands. Be a role model for good handwashing. Urge adults in your home to wash their hands often. Help teach everyone in the home to not touch their eyes, nose, or mouth. This helps prevent germs from entering the body.
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Give your child plenty of time to rest. Trouble sleeping is common with this condition.
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Children 1 year and older: Have your child sleep in a slightly upright position. This is to help make breathing easier. If possible, raise the head of the bed slightly. Or raise your older child’s head and upper body up with extra pillows. Talk with your doctor about how far to raise the head.
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Babies younger than 12 months: Never use pillows or put your baby to sleep on their stomach or side. Babies younger than 12 months should sleep on a flat surface on their back. Don't use car seats, strollers, swings, baby carriers, and baby slings for sleep. If your baby falls asleep in one of these, move them to a flat, firm surface as soon as you can.
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Help your child blow their nose correctly. Make sure they throw away the tissue. For younger children, suck mucus from the nose with saline nose drops and a small bulb syringe. This can help make breathing easier. Squeeze the bulb first and gently place the rubber tip into one nostril. Slowly release the bulb. The suction will draw the mucus out of the nose. Wash your hands after this.
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For toddlers and children over 1 year: Have your child drink plenty of liquids. This prevents dehydration and helps loosen lung mucus. Children may prefer cold drinks, frozen desserts, or ice pops. They may also like warm chicken soup or drinks with lemon and honey. Don’t give honey to a child younger than 1 year old.
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For babies younger than 12 months: Have your child drink plenty of liquids. This prevents dehydration and helps loosen lung mucus. Give small amounts of breast milk, formula, or clear liquids to your baby. Use a medicine dropper, if needed. Give 1 to 2 teaspoons every 10 to 15 minutes. A baby may only be able to feed for short amounts of time. If you are breastfeeding, pump and store milk to use later. Give your child an oral rehydration solution between feedings. You can get it at drugstores and grocery stores without a prescription.
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Don’t smoke around your child. Don’t let anyone else smoke around them either. Tobacco smoke can make your child’s symptoms worse.
Follow-up care
Follow up with your child’s doctor, or as advised.
Special note to parents
Don’t give cough and cold medicines to any child younger than 6 years old. These don't help young children. They may cause serious side effects.
When to seek medical advice
In a child that's usually healthy, contact your child's doctor right away if:
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Your child has a fever (see Fever and children below).
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Your child has wheezing, coughing, or trouble breathing that doesn’t get better within 24 hours.
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New symptoms develop or you are concerned about how your child is recovering.
Call 911
Call 911 if:
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Your child is confused or too tired.
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Your child has wheezing, coughing, or trouble breathing that gets worse.
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The lips, fingernails, or skin has a blue, purple, or gray color or tint.
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Your child is dizzy.
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Your child is unresponsive or loses consciousness.
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Your child is unable to talk.
Fever and children
Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:
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Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
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Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The doctor may want to confirm with a rectal temperature.
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Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
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Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The doctor may want to confirm with a rectal temperature.
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Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.
Use the rectal thermometer with care. Follow the instructions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel okay using a rectal thermometer, ask the doctor what type to use instead. When you talk with any health care provider about your child’s fever, tell them which type you used.
Here are guidelines to know if your young child has a fever. Your child’s doctor may give you different numbers for your child. Follow your doctor’s specific instructions.
Fever readings for a baby under 3 months old:
Fever readings for a child age 3 months to 36 months (3 years):
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Rectal, forehead, or ear: 102°F (38.9°C) or higher.
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Armpit: 101°F (38.3°C) or higher.
Contact the doctor in these cases:
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Repeated temperature of 104°F (40°C) or higher in a child of any age.
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Fever of 100.4° F (38° C) or higher in baby younger than 3 months.
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Fever that lasts more than 24 hours in a child under age 2.
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Fever that lasts for 3 days in a child age 2 or older.