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Signs of Respiratory Distress in Children

Learning the signs of respiratory distress

Children having trouble breathing often show signs that they are having to work hard to breathe or are not getting enough oxygen, indicating respiratory distress. Below is a list of some of the signs that may mean your child is not getting enough oxygen. It's important to learn the signs of respiratory distress to know how to respond appropriately:

  • Breathing rate. An increase in the number of breaths per minute may mean that a child is having trouble breathing or not getting enough oxygen.

  • Increased heart rate. Low oxygen levels may cause an increase in heart rate. 

  • Color changes. A bluish color seen around the mouth, on the inside of the lips, or on the fingernails may happen when a child is not getting as much oxygen as needed. The color of the skin may also appear pale or gray.

  • Grunting. A grunting sound can be heard each time the child exhales (breathes out). This grunting is the body's way of trying to keep air in the lungs so they will stay open.

  • Nose flaring. The openings of the nose spreading open while breathing may mean that a child is having to work harder to breathe.

  • Accessory muscle use/retractions. The chest appears to sink in just below the neck, under the breastbone, or between the ribs with each breath as a way of trying to bring more air into the lungs. The muscles in the neck may also appear to be moving when your child breathes in.

  • Sweating. There may be increased sweat on the head, but the skin doesn't feel warm to the touch. More often, the skin may feel cool or clammy. This may happen when the breathing rate is very fast.

  • Wheezing. A tight, whistling, or musical sound heard with each breath can mean that the air passages may be smaller, making it harder to breathe.

  • Stridor. An inspiratory A whistling or wheezing sound heard in the upper airway neck during inhalation (breathing in).

  • Changes in alertness. Low oxygen levels may cause your child to act very tired and may indicate respiratory fatigue.

  • Body positions. Low oxygen and trouble breathing may force your child to thrust their head backward with the nose up in the air (especially if lying down). Or they may lean forward while sitting. A child automatically uses these positions as a last attempt to improve breathing. 

The signs of respiratory distress may resemble other problems or health conditions. Always consult your child's healthcare provider for a diagnosis, but if your child is having trouble breathing, call 911 or go to the closest emergency room right away.

Online Medical Reviewer: Liora C Adler MD
Online Medical Reviewer: Ronald Karlin MD
Online Medical Reviewer: Tara Novick BSN MSN
Date Last Reviewed: 1/1/2023
© 2000-2023 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.