There’s nothing scarier for a parent than seeing your child gasp for breath. It’s normal to worry and even panic, so learning how to handle this situation ahead of time is key.
To help, here’s what labored breathing looks like, its causes and treatment, plus when you should seek immediate medical help.
What is considered labored breathing?
The medical term for labored breathing is respiratory distress, which is defined as shortness of breath or struggling to breathe.
Normal breathing, of course, is just that — gentle breathing that isn’t difficult in the least and doesn’t interrupt your tot’s activity.
What causes labored breathing in a toddler?
The causes of labored breathing in a toddler can be varied, ranging from illnesses to an allergic reaction. Here’s a rundown of what could be behind your tot’s shortness of breath:
A cold. Congestion and runny nose are among the symptoms of the common cold, and both can contribute to labored breathing.
Bronchiolitis. Breathing is restricted with this illness due to a viral infection and the swelling of the small breathing tubes called bronchioles.
Croup. This viral infection in the voice box and windpipe can cause a seal-like bark as your tot struggles for air. And severe croup may lead to stridor, a harsh breathing noise while inhaling.
Asthma and allergies (including food allergies). Both of these can leave kids wheezing, coughing or gasping. If it's a food allergy, labored breathing can be a sign of a serious allergic reaction and warrants at-home treatment and a 911 call.
Choking hazards. Toddlers and foreign objects, such as coins, pen caps, nuts and popcorn, are a bad mix as the two can result in a blocked airway and labored breathing.
Pneumonia. The flu and other viral, bacterial and fungal conditions may lead to pneumonia, a lung infection that can cause troubled breathing.
- Other causes. There are a number of other potential reasons for respiratory distress in little ones, so be sure to seek medical attention right away if your child is experiencing it.
What are signs of labored breathing in a toddler?
Labored breathing symptoms can be both seen and heard. Here are the most common ones:
- Shortness of breath, struggling to breathe, faster breathing or unusually slower breathing
- Ribs visibly pulling in or chest retracting with each breath (look for the skin pulling in above the clavicles, between the ribs and under the ribs, and for belly-breathing, where the abdomen noticeably pulls in forcefully with breathing)
- Loud breathing, wheezing, grunting or coughing
- Noisy or high-pitched sounds with breathing (like stridor)
- A child who is unusually quiet or speaking in short phrases or words (if your toddler is old enough to speak in full sentences)
- A bluish tinge around the mouth, lips and fingernails or pale, ashen skin
- Nostril flaring or neck muscles that move (which can cause the head to bob and skin to pull in above the collarbone), indicating extra effort needed to breathe
When should you go to the hospital for labored breathing?
Any time you’re concerned about your child’s breathing, you should get immediate help. Some things like colds, mild cases of asthma and bronchiolitis may be managed at your pediatrician's office or pediatric urgent care.
But if your toddler can’t catch his breath or his lips, fingertips or face turn blue, he’s not getting enough oxygen and needs help ASAP. Go straight to the ER or call 911 and get an ambulance.
You should also go to the ER immediately or call 911 if your child has passed out or stopped breathing, has choked on something or an object is lodged in his throat, or the labored breathing came on suddenly, such as after an insect sting, new medicine or food.
If your child is older than 1, has an object stuck in his throat and you’re trained in first aid, perform the heimlich maneuver on him while someone else calls 911. If your little one is a baby under age 1, alternate between giving him five back blows and five chest thrusts to dislodge the item causing the choking (again, while someone calls 911).
And seek medical care quickly if his ribs or chest are pulling in or the trouble breathing is accompanied by loud wheezing or stridor.
How is labored breathing diagnosed in toddlers?
Once you’re in the exam room, the ER doctor will likely put your child on a monitor to check his oxygen levels and heart rate, and he may be given oxygen if his levels are too low. Oxygen levels are checked with a pulse oximeter, a device that attaches to your tot’s finger, toe or earlobe.
The doctor will do a physical exam. He or she will ask you questions about your child’s medical history, symptoms and events that led up to the trouble breathing to figure out the cause of the labored breathing. The doctor may also ask about family medical history, travel or other details. Tests and X-rays may also be done to get a proper diagnosis.
How is labored breathing treated in toddlers?
If the physician suspects your child’s breathing trouble is due to croup, he may be given steroids, like Prednisone, to clear his airways and reduce inflammation. If it's because of a bacterial infection, he may be given antibiotics. For a viral respiratory illness, antibiotics won't help.
If asthma is the cause of the labored breathing, your toddler will probably be treated with a nebulizer, an electric or battery-powered machine that turns asthma medication into a fine mist so it can more easily reach the lungs. Depending on the severity of the difficulty breathing, your child may be given steroids to reduce swelling and help your child breathe better, or other medications either by mouth or through an IV.
Once treatment begins, the doctor will periodically reevaluate your toddler’s breathing to determine the next steps. In more serious cases, the physician may decide that hospitalization is necessary before the child is well enough to go home.
What the doctor will tell you to do at home
Depending on the diagnosis, you may be sent home with an OTC medication, a prescription, an asthma inhaler or nebulizer, or in the case of a virus, no medication at all (which may be the appropriate course of treatment, since toddlers and babies shouldn't take cough or cold medicine).
If it’s determined that your child is prone to severe allergic reactions, your doctor may give you a prescription for an epinephrine auto-injector (EpiPen Jr.).
A follow-up with your toddler’s pediatrician is the next step, and you’ll probably be given a list of warning signs for breathing problems in children that could land your little one back in the ER.
The doc may also suggest installing a humidifier or standing near a hot shower so warm mist can relax your tot’s airway and ease his breathing in cases of croup or a bad cold. The doctor may suggest helping your child clear his nose by giving him saline spray or drops and suctioning out mucus, either with a bulb suction or a NoseFrida.
Cigarette smoke can cause coughing and breathing trouble, so strictly avoid it at home and around your toddler.
Do the best you can to remain calm during a case of labored breathing. With any luck, this will be a one-time incident, but the more you know about the condition, the better prepared you’ll be should your tot experience this scary situation in the future.
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