Quick Assessment
Answer these questions — we'll tell you what to do.
Call 911 Immediately
Signs of severe breathing distress
- Blue or grey lips, tongue, or fingernails
- Cannot speak, cry, or make sounds
- Gasping or struggling to get air in
- Ribs or neck muscles pulling in with each breath (retractions)
- Stridor (high-pitched sound) at rest — not just when crying
- Sudden onset with no illness (possible choking)
- Drooling with inability to swallow
- Child is limp or unresponsive
Usually Manageable at Home
Monitor closely but often resolves
- Stuffy nose with noisy breathing but otherwise happy
- Mild cough without laboured breathing
- Slightly faster breathing during a fever
- Able to talk, drink, and play between episodes
- Wheezing that clears quickly with inhaler
- Congestion that sounds worse than it looks
Frequently Asked Questions
How do I know if my child is really struggling to breathe?
Look at the chest: if you can see the ribs pulling in, the belly pumping hard, or the nostrils flaring wide with each breath, that is respiratory distress. Also watch for skin between or below the ribs sucking inward. These are signs the body is working overtime to breathe.
My baby sounds congested — is that the same as breathing difficulty?
Usually no. Babies are obligate nose breathers, so even mild congestion sounds alarming. If your baby is eating normally, has normal skin colour, and is not showing chest retractions, nasal congestion is not a breathing emergency. Use saline drops and suction.
What is croup and when is it dangerous?
Croup is a viral infection that causes a barking (seal-like) cough and sometimes stridor (high-pitched breathing in). It is usually mild and worst at night. It becomes dangerous when stridor occurs at rest (not just when crying), breathing becomes very laboured, or your child cannot drink fluids.
When should I use the rescue inhaler?
Use it at the first sign of wheezing or breathing difficulty in a child with known asthma. Give 2-4 puffs through a spacer. If no improvement after 20 minutes, give another 2-4 puffs. If still no improvement after the second dose, go to the ER.
Can I give my child anything to help them breathe better?
Cool mist humidifiers help. Cool night air helps croup. Saline drops and suctioning help congestion. Honey (over age 1 only) helps coughs. Do NOT give cough suppressants to children under 6 without doctor approval. Never use menthol rubs on babies.
This guide is for quick reference and does not replace professional medical advice. When in doubt, call your pediatrician or go to the ER.