First Aid Course

How to check for breathing difficulty in children

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The flu and cold season can be a hard time for both children and parents. In most cases, children can suffer from 8-10 colds in a year, thus parents spend a lot of time listening to the coughing. Oftentimes, a common cold can progress into something different or affect the child severely that eventually leads to breathing issues.

How can you determine if a child is plainly congested or has breathing issues? Take note that the signs can be both subtle and observable. Once a child has common cold or upper respiratory conditions, there are symptoms to watch out for that might indicate breathing issues.

Central cyanosis

This causes bluish or grayish coloring of the skin in the chest or face. A child that turns blue is quite obvious and it clearly indicates breathing difficulty. On the other hand, central color change is essential to check for, not just momentary changes in the toes or fingers.

Once this condition is confirmed, call for emergency assistance right away. If there is central discoloration, it is not safe to drive the child to the emergency room since he/she could stop breathing while on the way. Calling for an ambulance will ensure that the child will receive care quickly.


Wheezing or the high-pitched whistling sound produced during exhalation can indicate that a child is having breathing issues. Even though congestion can also be heard while breathing, actual wheezing is a whistling sound.

Wheezing or the high-pitched whistling sound produced during exhalation can indicate that a child is having breathing issues.

If the child does not have a history of wheezing, seek medical care right away. Remember that wheezing will not go away on its own and not safe to wait for hours. Wheezing can rapidly progress and the oxygen level of the child can drop dangerously.

If the child has a history of wheezing and there is an on-hand fast acting nebulizer or inhaler, use it as directed. If this stops the wheezing, consult the doctor and ask if further treatment is needed.


When examining the chest of a child with retractions, there is a skeletal appearance. Take note that the skin pulls in and out amidst every rib with each breath and you might be able to count the ribs.

In case the child is overweight, it might be hard to determine if there is retraction around the chest wall. Another way to check for retractions is to look at the neck and collarbone. If the skin is pulled down to the collarbone or the child seems to strain the neck muscles with every breath, it clearly indicates breathing problems.

Once significant retraction is observed, call for emergency assistance. This indicates severe respiratory distress and calling for help is the quickest way to ensure that the child will receive proper care.

Nasal flaring

If congested, the nostrils of the child flare in and out with every breath. Nasal flaring can be seen among children with cold and may or may not indicate breathing issues.

Once you notice the child’s nostrils are flaring, the initial step is to suction the nose out using saline drops and a bulb syringe. If the child is old enough, instruct him/her to blow the nose.

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