How to Know If Your Child's Breathing Trouble Is Life-Threatening

Child using a breathing treatment
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Cold and flu season can be a tough time for kids. Typically, kids will get between 8 and 10 colds a year, so you will probably spend a lot of time wiping runny noses and listening to coughs. But sometimes a cold can turn into something more or affect a child more severely and he can develop breathing problems.

How can a parent know when their child is just congested or when he or she is actually having breathing problems? The signs can be both obvious and subtle.

Signs and Symptoms of Breathing Problems in Children

The next time your child has a cold or upper respiratory illness, review this list to see if your child may have any of these symptoms that may be signs of breathing problems.

Central Cyanosis

Central cyanosis is blue or gray coloring to the skin of the face or chest.

It is pretty obvious to most parents that if their child turns blue, they are probably having breathing problems. But central color change is the most important thing to look for, not just brief changes in fingers or toes.

What to Do: Call 911 immediately. If there is central discoloration to the child's skin, it is not safe to drive them to an emergency room, the child could stop breathing on the way and he or she will get care more quickly if you call an ambulance.


Wheezing, or a high-pitched whistling sound made when a person exhales is a significant sign that a child is having breathing problems. Although congestion may be heard when a person is breathing, true wheezing is a whistling noise.

What to Do: If your child has no history of wheezing, seek medical attention right away. Wheezing is not something that will go away on its own and it is not safe to wait several hours. Wheezing can progress quickly and your child's oxygen levels can become dangerously low.

If your child does have a history of wheezing and you have a fast-acting inhaler or nebulizer, you may try using it as directed by the prescribing healthcare provider. If that eliminates the wheezing, you may then contact the healthcare provider and ask what he or she recommends for further treatment.


When looking at the chest of a child with retractions, you may notice a skeletal appearance. The skin pulls in and out between each rib with each breath and you may be able to "count ribs."

If the child is overweight, it may be difficult to determine if there is retracting around the chest wall. Another way to determine if the person is retracting is to look at the neck and collarbone. If you can see the skin pulling down to the collarbone or it looks like the child is straining their neck muscles with each breath, they are probably having significant breathing problems.

What to Do: If there is significant retracting—you can see nearly all of the child's ribs from a few feet away—and the child is not fully alert, you should call 911. This is a sign that the child is in severe respiratory distress and calling 911 is the fastest and safest way to get help.

If there is minimal retracting, but your child has no history of wheezing or using inhalers or nebulizers, you should seek medical attention immediately. If the child is awake and alert, it is most likely safe to drive the child yourself, but always have someone else in the car and a cell phone in case the situation changes.

If there is minimal retracting and your child has an inhaler or nebulizer available, giving a breathing treatment is reasonable to see if the retracting resolves. If it does, you can then call your child's healthcare provider to get instructions for further treatment.

Nasal Flaring

When a child is congested, you may notice their nostrils flaring in and out with each breath. Nasal flaring may be seen in children with colds and may or may not be a sign that he or she is having breathing problems.

What to Do: The first thing you should do if you notice your child's nostrils flaring is to try suctioning the nose out with saline drops and a bulb syringe. Or, if the child is old enough, have him blow his nose.

Using a drop or two of saline in one nostril, gently suction the congestion out, then repeat these steps in the other nostril. This may help clear up the nasal flaring. If it does not, contact your doctor or seek medical attention right away.

Important Note

If your child has any of these symptoms and also has a rash or facial swelling, these could be signs of a severe, life-threatening allergic reaction.

If you notice these signs or think this may be a possibility, call 911 immediately.

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Article Sources

  • Nasal Flaring. Medical Encyclopedia 10 May 06. Medline Plus National Library of Medicine. National Institutes of Health.

  • Wheezing. Medical Encyclopedia 02 Jan 08. National Institutes of Health.

  • Skin discoloration - bluish. Medical Encyclopedia 02 Jan 08. National Institutes of Health.

  • Intercostal retractions. Medical Encyclopedia 10 May 06. Medline Plus. National Library of Medicine. National Institutes of Health.