Fort Worth, Texas,
16:21 PM

What Are Signs of Difficulty Breathing for Children?

"He's having difficulty breathing" is a statement that can mean a million things, including something as simple as a stuffy nose...because it can be difficult to breathe through a stuffy nose. But when I call  a nurse to help me because this child is having difficulty breathing it means something different.

So what is difficulty breathing? How do you tell if your baby or child is having it?

In babies there are 3 main considerations to look for difficulty breathing:

  1. The nose - When babies are having difficulty breathing, their nostrils will flare open and closed with each breath.
  2. The area below the rib cage - Babies will begin to use their bellies to help them breathe when they are having trouble, this will look like sucking in and out of the area below the ribs.
  3. Rapid breathing - Babies already breathe fast and they can breathe at a really unpredictable rates. But if you feel like the rate is faster over a sustained period, it could mean that they are having difficulty breathing.

In older children, there are some similar and some different ways you can assess difficulty breathing:

  1. Watching - Just like babies, you can watch an older child under their ribs to see if they are breathing harder than normal.
  2. Assessing activity - Are they able to go about their normal activities or are they getting short of breath?
  3. Say the alphabet - Can they say the alphabet without breathing? How far can they get?

Obviously these aren't perfect assessments and children should be seen if you are worried. Any change in alertness or change in color (blue or duskiness) is an emergency.

Get to know Justin Smith, M.D.

Justin Smith, M.D., is a pediatrician in Trophy Club  and the Medical Advisor for Digital Health for Cook Children's in Fort Worth, Texas. Dr. Smith is an experienced keynote speaker for a variety of topics including pediatric/parenting topics, healthcare social media and physician leadership. If you are interested in having Dr. Smith present to your conference or meeting, please contact him at

He has an active community on both Facebook and Twitter as @TheDocSmitty and writes weekly for Cook Children's He believes that strategic use of social media and technology by pediatricians to connect with families can deepen their relationship and provide a new level of convenience for both of their busy lifestyles. Dr. Smith’s innovative pediatric clinic, a pediatric clinic “designed by you,” open now. Click to learn more. To make an appointment, call 817-347-8100.


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