Breathing difficulties and wheeze

It is extremely scary to see your child with any sort of breathing difficulty.

Use your instincts, if your child:

  • appears well and their breathing difficultly improves after a short period, there is normally no need to worry
  • is struggling to breath and not improving after a short period, they need to be urgently seen by a medical practitioner and are likely to need treatment.
  • has croup (hoarse voice, barking cough, noisy breathing), they will also need to be seen by a medical practitioner

Wheeze is extremely common in young children and is most often triggered by a viral infection. Most pre-school children with wheeze do not have asthma

  • Children under 2 years of age with breathing difficulty may have bronchiolitis. This is an extremely common condition that usually starts as a runny nose and cough, but their breathing may get worse over the first 2-3 days
  • Children over 4 years of age with breathing difficulty may have asthma
  • Most chest infections are caused by viruses and do not usually need treatment with antibiotics

If your child has any of the following:

  • Breathing very fast or breathing that stops or pauses
  • Working hard to breathe, drawing in of the muscles below the rib, unable to talk or noisy breathing (grunting)
  • A harsh breath noise as they breathe in (stridor) present all of the time (even when they are not upset)
  • Having symptoms of cough/wheeze or breathlessness which are getting worse despite 10 puffs blue (salbutamol) inhaler every 4 hours via a spacer

  • Becomes pale, blue, mottled and/or unusually cold to touch
  • Difficult to wake up, very sleepy or confused
  • Weak, high-pitched, continuous cry or extremely agitated
  • Has a fit (seizure)
  • A temperature less than 36oC or temperature 38oC or more if baby is less than 3 months
  • Develops a rash that does not disappear with pressure and seems unwell (see the 'Glass Test')

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Blue (salbutamol) inhaler 2-5 puffs via a spacer is not lasting 4 hours
  • Cough or wheeze/tight chest during the day and night
  • Too breathless to run/play/do normal activities
  • Breathing a bit faster than normal or working a bit harder to breathe
  • A harsh breath noise as they breathe in (stridor) present only when they are upset
  • Dry skin, lips, tongue or looking pale
  • Not had a wee or wet nappy in last 12 hours
  • Sleepy or not responding normally
  • Crying and unsettled
  • Poor feeding (babies) or not drinking(children)
  • A temperature 39oC or above in babies 3-6 months
  • Temperature of 38oC or above for more than 5 days or shivering with fever (rigors)
  • Getting worse or you are worried about them

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

If your child has none of the above

Watch them closely for any change and look out for any red or amber symptoms

Additional advice is also available for families for help cope with crying in otherwise well babies


Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

This guidance has been reviewed and adapted by healthcare professionals across North East and North Cumbria with consent from the Hampshire development groups.

  • If your child is interacting with you normally and is able to drink as normal, you can watch them closely at home. If your child is not feeding as well as normal, you should offer smaller feeds but more frequently
  • If they become more breathless or are struggling to drink, they will need to be seen urgently by a medical practitioner. Call your GP surgery or NHS 111
  • If your child has a fever, their breathing may become more rapid. You should try to lower their temperature using paracetamol
  • If your child feels or looks breathless and sounds wheezy, give up to 10 puffs of salbutamol (blue inhaler) via a spacer device. Whilst unwell, you may need to give this every 4 hours for the first few days
  • Consider contacting your child’s GP early on in the illness to see if your child would benefit from any other medicines such as a steroid (taken by mouth) to help their breathing.
  • If your child becomes too breathless to speak or drink, or they need 10 puffs of their blue inhaler more often than every 4 hours, please go directly to your nearest Hospital Emergency Department or phone 999

Although your child’s cough is likely to last for 2 to 3 weeks, they should not be breathless or wheezy for more than 3 or 4 days

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