Respiratory Distress in Babies and Toddlers

Respiratory distress refers to difficulty breathing. It is scary watching your child struggle for breath.

Difficulty breathing can occur for various reasons but usually it occurs because of a problem in the lungs.

Most cases of difficulty breathing are caused by respiratory tract infections and are short-lived and resolve completely.

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Signs of Respiratory Distress

Signs of breathing difficulty to look out for include: 

  • grunting noise when your child breathes
  • flaring of the nostrils as your child breathes
  • the trachea pulling in as your child breathes (look at the soft spot above the breast-bone)
  • the ribs looking more prominent as your child breathes
  • the bottom of the ribs becoming very prominent as your child breathes - as if sucking the tummy under the ribs
  • the abdomen (tummy) pushing out as your child breathes out
  • lips looking blue or dusky in color
  • wheeze (a whistling noise as your child breathes out)
  • stridor (a whistling noise as your child breathes in)
  • breathless or sweating with feeding in a baby

When there is difficulty breathing, the pulse and the respiratory rate (breaths per minute) will be higher than normal. To read about normal values for age for pulse and breathing rates, click here.

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Conditions causing difficulty in breathing in infants and toddlers include the following:

For more information on any of the conditions, follow the links.

  • viral infections. Viral respiratory tract infections are one of the most frequent causes of difficulty breathing in infants and toddlers. Read more.
  • cough. Cough is one of the commonest reasons children see doctors. Read more.
    to read about how to stop a cough in a child, click here.
  • croup. This causes children to have a hoarse croaky voice, a barking cough and stridor.
    It is usually caused by a virus. Read more
  • wheeze - transient or viral induced.This commonly occurs, especially in infants less than 24 months of age. Infants have narrow airways to begin with and they get narrower with a virus, causing obstruction to air flow and wheeze (a whistling noise as your child breathes out) often accompanied by other signs of respiratory distress as well. Read more
  • asthma. Commonly, this runs in families. Children get respiratory distress and wheeze. A common trigger for an attack is a viral infection, like a cold. Read more.
    You can also read about medications used in asthma - click here.
  • bronchiolitis. This occurs in epidemics in the winter months and affects babies, causing respiratory distress and difficulty feeding. Read more
  • pneumonia. If your child is unwell with a fever and has difficulty breathing, she may have pneumonia, which may be bacterial or viral. Read more
    If your child is very unwell, see your doctor.
  • congenital heart disease. If you have a baby who is getting breathless and sweaty with feeds, she may have congenital heart disease. This would be especially true if she occasionally looks blue or dusky around the lips or is not gaining weight. See your doctor.

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See your doctor if:

  • your child is struggling hard for breath
  • your child is having difficulty feeding because of breathlessness
  • your child is going blue or dusky, especially around the lips
  • your child is not as responsive as normal
  • your child is breathing faster than 60 breaths per minute
  • your child has stridor (a whistling noise as your child breathes in) and is struggling for breath
  • your child has wheeze (a whistling noise as your child breathes out) and is struggling for breath
  • your child is not growing and has signs of difficulty breathing sometimes
  • you are really worried about your child's breathing

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To go to the top of the respiratory distress page, click here

To go to the Serious Illness page, click here

To read about normal respiratory and heart rates, click here

To return to the Home page, click here


Last reviewed 17 May 2011

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Dr Maud MD

Dr Maud MD (MBChB, FRACP, FRCPCH), a specialist pediatrician, provides health information and medical advice for parents of babies and toddlers. Read more about Dr Maud.



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