Difficulty breathing and wheeze

  • It is extremely scary if your child has 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.
  • 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. If you are concerned about asthma please visit our asthma pages. We also have local leaflets on Croup, Wheeze, Chest Infection, and Bronchiolitis.
  • 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 next 2-3 days.
  • If your child is struggling to breath, they need to be urgently seen by a medical practitioner and are likely to need treatment. If your child has croup (hoarse voice, barking cough, noisy breathing), they will also need to be seen by a medical practitioner.
  • Most chest infections are caused by viruses and do not usually need treatment with antibiotics.

When should you worry?

If your child has any of the following:

  • Is going blue around the lips
  • Has pauses in their breathing (apnoeas) or has an irregular breathing pattern or starts grunting
  • A harsh breath noise as they breathe in (stridor) present all of the time (even when they are not upset)
  • Too breathless to talk / eat or drink
  • Becomes pale, mottled and feels abnormally cold to touch
  • Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
  • Develops a rash that does not disappear with pressure (the ‘Glass Test’)
  • Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features) 

You need urgent help

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

If your child has any of the following:

  • Has laboured/rapid breathing or they are working hard to breathe – drawing in of the muscles below their lower ribs, at their neck or between their ribs (recession)
  • A harsh breath noise as they breathe in (stridor) present only when they are upset
  • Seems dehydrated (sunken eyes, drowsy or not passed urine for 12 hours)
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
  • Has extreme shivering or complains of muscle pain
  • Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
  • Continues to have a fever of 38.0°C or above for more than 5 days
  • Is getting worse or if you are worried

You need to contact a doctor or nurse today

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

 

If none of the above features are present

Make sure that your child stays well hydrated by offering them lots of fluids. Closely monitor them for any signs of deterioration by looking out for any red or amber features

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

Self care

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

What should you do?

  • 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 (calpol)

How long will your child’s symptoms last?

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. Most children with croup should improve in 2 to 3 days time. Children with bronchiolitis may take longer to recover. A bronchiolitic cough can last up to six weeks.

Where should you seek help?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance

Page last updated on: 04th September 2023