Infants and children will experience a variety of types of breathing difficulty from several different illnesses. Determine which situation below applies to your child’s situation, and read the accompanying information to determine if you should page your doctor after hours:
Newborn to 2 months – the first step in evaluating a newborn with breathing trouble is to assess what body part is the main problem:
- Nasal congestion – many newborns will have a stuffy nose for several weeks. This can interfere with sleeping and feeding, but is harmless. This is virtually never a reason to page your doctor after hours. Simply squirt nasal saline (from the drug store) or breast milk into the nose, and suction with a bulb syringe. Steam in the bathroom also helps. Call your doctor during normal business hours for more help.
- Chest congestion – most young infants have chest congestion and “junky breathing” from time to time due to saliva and regurgitated milk. This is virtually never a reason to page your doctor after hours. Holding baby upright and sleeping upright in arms or a carseat can help until you call your doctor during normal business hours.
- Rapid breathing or panting is common in newborns. If there is no other sign of illness, it comes and goes and your baby is breathing comfortably most of the time, there’s no need to worry.
- Wheezing – most cases of newborn wheezing are simply due to “junky breathing” due to saliva and regurgitated milk, and are not a worry. TRUE WHEEZING with labored breathing and “caving in” of the chest that persists for hours despite steam, upright positioning, and gentle clapping on the chest and back does warrant a page to your doctor.
- Labored breathing with “caving in” of the chest. This can indicate a serious respiratory illness and warrants a page to your doctor if it persists for hours despite steam, upright positioning, and gentle clapping on the chest and back.
Infants and children – there are several different types of BREATHING DIFFICULTY that infants and toddlers experience. Decide which situation describes your child, and follow the instructions:
- Raspy labored breaths with a hoarse voice, croupy cough that sounds like a seal barking, and possible fever probably means your child has croup, a viral respiratory illness that is not treatable with antibiotics, and usually does not require an urgent page to your doctor. Follow the instructions in our croup article first, and then page the doctor according to the guidelines indicated.
- Asthmatic wheezing describes labored breathes with high-pitched or squeaky sounds when your child breathes out, and sometimes in. Your child may also have some sucking in of the ribs, abdomen, or neck area with each breath. If your child is a known asthmatic, you can probably treat this without paging your doctor. Read What To Do During An Asthma Attack.
- Rapid labored breathing without audible wheezing and without the signs of croup above may be pneumonia. Click here for information on treating pneumonia and deciding when to page your doctor.
IF YOUR CHILD IS NOT A KNOWN ASTHMATIC then you can try treating this by letting your child breathe steam (turn on the hot shower and sit in the steamy bathroom) for 20 minutes every couple hours, clap on the back and chest for several minutes during the steam, and give your child an expectorant (click here for dosing). If your child’s breathing remains labored and difficult despite this, you should probably go to an ER or urgent care because your doctor won’t be able to do much over the phone.