How to Recognise Breathing Difficulties in Babies and Young Children
Breathing difficulties in babies and young children can be frightening for any parent. A blocked nose, cough or mild chest infection can sometimes make children sound noisy when they breathe, but there are certain signs that may show a child is working harder than normal to get enough air.
Because babies and young children have smaller airways, their symptoms can change quickly. Knowing what to look for can help parents respond earlier and seek medical care when needed.
Dr Lerissa Pillay, Specialist Paediatrician, provides warm, evidence-based care for infants, children and adolescents, including support for respiratory concerns, acute childhood illnesses, newborn care and chronic conditions such as asthma and allergies.
Breathing Difficulties in Children: Why Parents Should Pay Attention
Children breathe faster than adults, especially when they are active, crying or have a fever. However, breathing that looks strained, unusually fast, noisy or tiring may be a sign that your child needs medical attention.
Breathing difficulties can be caused by several conditions, including viral infections, RSV, bronchiolitis, croup, pneumonia, asthma, allergies or choking. In babies, even a common cold can sometimes affect feeding and breathing because their nasal passages and airways are still small.
The most important thing is to recognise when breathing does not look normal and to seek help if you are concerned.
Common Signs of Breathing Difficulties in Babies and Young Children
Breathing difficulties can look different depending on your child’s age. Some signs are easy to notice, while others can be more subtle.
Watch for the following warning signs:
Breathing faster than usual
Chest or ribs pulling in when breathing
Nostrils flaring with each breath
Grunting sounds when breathing out
Wheezing or whistling sounds
Pauses in breathing
A baby who is too tired to feed properly
Poor feeding or drinking
Fewer wet nappies than usual
Unusual sleepiness, weakness or irritability
Pale, blue or grey colour around the lips, tongue, face or nails
If your child has any of these symptoms, especially if they are worsening, they should be assessed by a healthcare professional.
What Does “Working Hard to Breathe” Look Like?
One of the most important signs parents should understand is increased work of breathing. This means your child’s body is using extra effort to move air in and out.
You may notice the skin pulling in between the ribs, under the ribs, above the collarbone or at the base of the neck. This is often called recession or retractions. It can look as if the chest is sucking inward with each breath.
In babies, you may also notice head bobbing, grunting, flaring nostrils or difficulty feeding because breathing is taking so much effort.
In older children, signs may include struggling to speak in full sentences, needing to sit upright to breathe, becoming unusually tired, or stopping play because they are short of breath.
Noisy Breathing: When Is It a Concern?
Noisy breathing can happen for many reasons. A blocked nose may cause snuffling sounds, while mucus in the chest may make a child sound congested. However, certain breathing sounds should be taken seriously.
Wheezing is a high-pitched whistling sound that often happens when breathing out. It may be linked to conditions such as viral infections, bronchiolitis or asthma.
Stridor is a harsh, high-pitched sound that usually happens when breathing in. It may be heard with croup or swelling around the upper airway.
Grunting is a sound babies and young children may make when they are struggling to keep air in the lungs. This can be a serious sign and should not be ignored.
If your child’s breathing sounds unusual and they are also breathing fast, working hard to breathe, feeding poorly, looking tired or changing colour, seek medical care urgently.
Breathing Difficulties in Babies: Feeding and Hydration Signs
In babies, breathing and feeding are closely linked. A baby who is struggling to breathe may not have enough energy to feed well. This can lead to dehydration, especially if symptoms continue for several hours.
Parents should watch for:
Shorter or weaker feeds
Refusing feeds
Vomiting after coughing
Fewer wet nappies
Dry mouth or no tears when crying
Unusual sleepiness
A baby who wakes less often to feed
If your baby is feeding much less than usual or has fewer wet nappies, it is important to seek medical advice.
When to Seek Urgent Medical Help
Seek urgent medical care immediately if your child:
Is struggling to breathe
Has ribs, chest or neck pulling in with each breath
Has pauses in breathing
Has blue, grey or very pale lips, tongue, face or nails
Is floppy, unusually drowsy or difficult to wake
Is grunting with breathing
Cannot feed or drink because of breathing difficulty
Has severe wheezing or noisy breathing
Appears very weak or not like themselves
For babies, especially newborns and young infants, it is safer to seek help early. If you are unsure whether your child’s breathing is normal, rather have them assessed.
When to Book a Paediatric Consultation
You should consider booking a paediatric consultation if your child has:
Ongoing coughing
Repeated chest infections
Wheezing that comes and goes
Breathing problems during sleep
Breathing symptoms with exercise or play
A history of asthma, allergies or eczema
Poor growth or feeding concerns
Symptoms that are not improving as expected
A paediatrician can assess your child’s breathing, listen to the chest, review their symptoms and guide the next steps.
Dr Lerissa Pillay provides specialist paediatric care for children from birth to adolescence. Her practice supports families across the North Coast with respiratory concerns, acute illnesses, newborn and infant care, chronic condition care, developmental assessments and parent guidance.
How Parents Can Monitor Breathing at Home
Helpful things to observe include:
Is your child breathing comfortably?
Are they feeding or drinking normally?
Are they alert and responding normally?
Are they having wet nappies or passing urine?
Is the cough or breathing getting better, staying the same or worsening?
Is there any chest pulling, grunting or colour change?
Avoid giving cough mixtures or medication to babies and young children unless recommended by a healthcare professional. If your child has prescribed medication, such as an inhaler, follow the instructions provided by your doctor.
Trust Your Instincts as a Parent
Parents often notice small changes before anyone else does. If your child’s breathing seems different, if they are more tired than usual, or if something does not feel right, it is always reasonable to ask for medical advice.
Breathing difficulties in babies and young children should never be ignored. Early assessment can help identify the cause, support your child’s recovery and give parents clear guidance.
If you are concerned about your child’s breathing, book an appointment with Dr Lerissa Pillay, Specialist Paediatrician.
FAQs About Breathing Difficulties in Children
What are the signs of breathing difficulties in babies?
Signs may include fast breathing, chest pulling in, flaring nostrils, grunting, poor feeding, fewer wet nappies, unusual sleepiness, wheezing or changes in colour around the lips, tongue or nails.
How do I know if my child is breathing too fast?
Children may breathe faster when they have a fever, are crying or have been active. However, breathing that stays fast while resting, especially with chest pulling, wheezing, poor feeding or tiredness, should be assessed by a healthcare professional.
Is wheezing always serious in children?
Wheezing can happen with viral infections, bronchiolitis, asthma or allergies. It should be checked if it is new, severe, recurring or linked to breathing difficulty, tiredness or colour change.
When should I take my baby to the doctor for breathing problems?
You should seek medical care if your baby is breathing fast, working hard to breathe, feeding poorly, having fewer wet nappies, grunting, pausing in breathing or looking unusually sleepy.
Can a blocked nose cause breathing problems in babies?
A blocked nose can make feeding and sleeping more difficult for babies. However, if your baby is struggling to breathe, feeding poorly, becoming dehydrated or showing chest pulling, they should be assessed.
Where can I find a paediatrician for breathing difficulties?
Dr Lerissa Pillay is a Specialist Paediatrician in KwaDukuza, offering paediatric care for infants, children and adolescents, including respiratory symptoms, acute illnesses and chronic childhood conditions.
Disclaimer
This blog is for general educational purposes only and does not replace medical advice, diagnosis or treatment. If your child is struggling to breathe, has blue or grey lips, is unusually sleepy, feeding poorly, or you are worried about their symptoms, seek medical care urgently.
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