Signs of breathing problems in children

Breathing problems to look out for in children

Breathing problems in children can have a number of different causes. This page tells you what signs to look out for and what they might mean, from coughing or a runny nose to wheezing, fast breathing or coloured mucus.

Call 999 now if your child has any of these breathing-related symptoms:

  • Severe breathing difficulties
  • Grunting with the effort of trying to breathe
  • The muscles under their ribs are sucking in with each breath
  • Fast breathing
  • Your child won’t wake up, or won’t stay awake
  • Breathing stops for more than 20 seconds
  • Regular shorter pauses in their breathing while they are awake
  • Very pale or blue skin, or the inside of their lips and tongue are blue
  • Fitting, if they have never had a fit before

What signs and symptoms are linked with breathing problems?

The following signs and symptoms can all make it difficult for your child to breathe.


Runny nose, blocked nose and sneezing

A runny nose is usually caused by a cold.

Sometimes it’s caused by an allergy – this is often called hay fever.

If your child’s runny nose is caused by allergies, they may be more likely to have asthma and problems sleeping too.

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Coughing

Everyone coughs from time to time. A cough helps clear the airway of mucus and things like dust and smoke. An occasional cough is not usually a sign of anything serious.

More persistent coughs are due to a cold or viral infection that usually clears up in a few days. Some coughs carry on for a few weeks after the infection has cleared. Common cough medicines do not stop coughing and are not recommended. If your child is older than 1 year, you could give them honey to help soothe their throat. Honey must not be given to infants under 12 months.

Visit your doctor if:

  • your child is vomiting after they cough
  • has bouts of coughing that last over a minute several times a day, or
  • has a cough that lasts for longer than 3-4 weeks

It is very helpful to doctors and nurses if you can video the cough on your mobile phone. This is because different coughs are signs of different conditions:

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Breathing problems

It’s important to seek help if your child is breathing in a different way than usual. Check out when to call 999 and when to go to the doctor.

Fast breathing can be a sign of an infection of the lower airways, such as bronchiolitis or pneumonia. All children are different, but as a rough guide, fast breathing can be defined as:

  • more than 50 breaths per minute for infants (2 months to 1 year)
  • more than 40 breaths per minute for children (1-12 years)
  • more than 20 breaths per minute for children over 12 and adults.

The main thing to watch out for is if your child is breathing persistently faster than usual.

Wheezing is a high-pitched sound that comes from the chest when your child is breathing out. Wheezing is a common symptom of asthma. However wheezing can have many causes, so it does not necessarily mean your child has asthma. 

We know that different doctors, nurses and parents all mean something different by wheeze. If your child is well enough, a video on your mobile phone is a very helpful way of showing the nurse or doctor what happens.

Breathlessness or difficulty breathing that becomes worse over a few hours could be a sign of an asthma attack.

Pneumonia and chest infections can also cause breathlessness. Children usually have a fever with these conditions.

Sudden and unexpected breathlessness or difficulty breathing could mean your child has something blocking their airway and is choking.

Difficulty breathing during exercise can be a sign of asthma

What do breathing difficulties look like?

  • Breathing may be faster than usual, or irregular
  • Your child’s nostrils may flare (get wider) when they breathe
  • They may wheeze when breathing out
  • They may make a high-pitched sound when breathing in (stridor)
  • They may make a grunting sound when breathing out. Call 999 if this happens
  • The muscles under their ribs may suck in with each breath. Call 999 for urgent medical help.

Find out when to call 999 about your child’s breathing difficulties

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High temperature

A fever is a high temperature. In children, a temperature of over 38C (100.4F) is a fever.

What’s causing my child’s fever?

A high temperature can be a sign of infection – including infections in the upper respiratory tract and lungs. Fever helps children and adults to fight infection.

Your child’s fever could also be caused by other illnesses, or by vaccinations.

In itself, a fever is not dangerous. It is the cause of the fever that is the concern. Always seek medical advice if you are worried.

NHS advice on fever

The NHS website has more information on temperature and fever.

They recommend that you seek urgent help if your child:

  • is under 3 months and has a temperature of 38C (101F) or over
  • is 3-6 months and has a temperature of 39C (102F) or over

Contact your GP for an urgent appointment. Out of hours, call NHS 111 (in England and Scotland), 0845 46 47 (in Wales) or your local out-of-hours service in Northern Ireland.

The NHS also suggests you should always get medical help for your child of any age who has a high temperature if:

  • you think your child may be dehydrated
  • your child develops a red rash that doesn’t fade when a glass is rolled over it
  • your child has a fit
  • your child doesn’t stop crying
  • the fever lasts for more than 5 days
  • your child’s health is getting worse
  • you’re concerned about looking after your child at home

Treating a fever in hospital

A high temperature will make your child feel poorly, have a faster breathing rate and a faster pulse. Children who are becoming severely ill will also have faster breathing and a faster pulse.

Health care professionals may treat a temperature to see if the pulse and breathing are slower without the fever.

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Drowsiness

If your child has a high temperature (fever) they may also be drowsy or confused.

Children with a temperature often lack interest or are more sleepy or irritable than usual. They usually improve after taking children’s paracetamol or ibuprofen to bring their temperature down.

Seek urgent help from your GP or health visitor if your child is drowsy and:

  • has other symptoms of breathing difficulty
  • doesn’t improve after taking paracetamol or ibuprofen

Out of hours, call NHS 111 (in England and Scotland), 0845 46 47 (in Wales) or your local out-of-hours service in Northern Ireland.

Call 999 if you're unable to wake your child or, if woken up, they are very drowsy and don't stay awake.

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Problems with feeding and drinking

Problems with feeding and drinking can be a sign of a problem with the lungs and airways.

Your child may not be feeding or drinking if:

  • they have an infection and a high temperature
  • they are struggling to feed and breathe at the same time

Seek help if your child is having difficulty breastfeeding or they are drinking half, or less than half, the amount they usually would. They may need to go to hospital to make sure they get enough food and fluid.

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Aches and pains

Chest pain, headaches and other aches and pains can be symptoms of a chest infection.

A tight, sore chest can be a sign of asthma.

Babies and small children do usually not complain about aches and pains.  But they might be irritable if you pick them up.

If your child is older they might say, ‘My chest’s hurting’ or ‘I’ve got a tummy ache’.

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Coloured mucus

Mucus protects your child’s airways. It traps unwanted particles and carries them away.

Mucus can be a problem if it doesn’t work properly or if there’s too much of it. A build-up of mucus in your child’s airways is called catarrh.

Young children usually swallow their mucus so you may not know what colour it is.

But if you are able to see it, yellow, green or brown mucus is a sign of infection or allergy. It might not be serious or need treatment. For example, green mucus running from their nose can be caused by mild infections that don’t need antibiotics.

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A change in skin colour

A change in your child’s skin colour may mean they do not have enough oxygen in their blood or their circulation is poor.

Call 999 if:

  • your child’s skin is very pale and they have other symptoms of an infection or difficulty breathing
  • your child’s skin looks blue
  • the inside of their lips and tongue are blue.

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Next: information on respiratory tract infections >

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Last medically reviewed: September 2019. Due for review: September 2022

This information uses the best available medical evidence and was produced with the support of people living with lung conditions. Find out how we produce our information. If you’d like to see our references get in touch.