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Difficulty breathing and wheeze

  • Wheeze is extremely common in young children. It is most often triggered by a viral infection. Most preschool children with wheeze do not have asthma

  • Children under 2 years of age with breathing difficulty may have bronchiolitis. This is an extremely common condition. It usually starts with a runny nose and cough, but their breathing may get worse over the next 2 to 3 days. For those under 1 year of age, inhalers generally do not help

  • If your child has croup (hoarse voice, barking cough, noisy breathing), they are likely to need assessment by a medical practitioner

  • If you already have a salbutamol (blue) inhaler, please follow the action plan here

  • If your child has been diagnosed with asthma, please see our resources for how to manage asthma attacks

Click here to watch this video in Bengali

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Click here to watch this video in Urdu

 

When should you worry?

If your child has any of the following:

  • Breathing very fast, too breathless to talk, eat or drink 

  • Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)

  • Breathing that stops or pauses

  • A harsh noise as they breathe in (stridor) present all of the time (even when they are not upset)

  • Is pale, blue, mottled or feels unusually cold to touch

  • Difficult to wake up, very sleepy or confused

  • Weak, high-pitched cry or can’t be settled

  • Has a fit (seizure)

  • Has a rash that does not go away with pressure (the ‘Glass Test’)

  • Is under 3 months old with temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red features)

You need urgent help

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has a salbutamol (blue) inhaler please follow your treatment plan

If your child has any of the following:

  • Breathing a bit faster than normal or working a bit harder to breathe

  • A harsh noise as they breathe in (stridor) only when upset

  • Dry skin, lips or tongue

  • Not had a wee or wet nappy in last 8 hours

  • Poor feeding in babies (less than half of their usual amount)

  • Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)

  • Getting worse or you are worried about them 

  • Is 3 to 6 months old with temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)

  • Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)

  • Temperature less than 36°C in those over 3 months

You need to contact a doctor or nurse today

Please call your GP surgery or contact NHS 111 - Go to 111.nhs.uk or call 111.(111 online does not currently take questions about children aged under 5, so if your child is 4 or younger,  please call 111).

If your child has a salbutamol (blue) inhaler please follow your treatment plan

If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features.

If none of the above features are present:

Watch them closely for any change and look out for any red or amber symptoms.

If your child has any other symptoms associated with their fever, you may want to look at the information on sore throat, cough, earache, diarrhoea and vomiting or tummy ache or our other pathways.

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

What should you do?

Inhaler technique

Choose appropriate sized spacer with mask (or mouthpiece if child is over 3 years with good technique and is not significantly short of breath).

 

  1. Shake the inhaler well and remove cap.

  2. Fit the inhaler into the opening at the end of the spacer.

  3. Place mask over the child’s face or mouthpiece in their mouth ensuring a good seal

  4. Press the inhaler once and allow the child to take 5 slow breaths between each dose or count to 10

  5. Remove the inhaler and shake between every puff. Wait 1 minute between puffs.

Repeat steps 1 – 5 for subsequent doses
Plastic spacers should be washed before 1st use and every month as per manufacturer’s guidelines

Click here for videos on inhaler technique.

 

What else should you do?

  • Keep your child well hydrated by offering them lots to drink
  • Most children with coughs and colds do not require treatment with antibiotics
  • If your child seems to be in pain or discomfort, you can give your child paracetamol or ibuprofen, following the instructions on the container
  • Do not give cough syrup. It is not recommended for children under 6 years. It can make children sleepy and does not help
  • Try using saline nose drops or spray if your baby has a blocked nose
  • For children over 2 years, vapour rubs (containing camphor, menthol and/or eucalyptus) may help children sleep better

How long will your child’s symptoms last?

  • Coughs and colds can continue for weeks before they get better.
  • Over the winter, children are likely to get one viral infection after another, which can make you think that they are never well. Things will get better in the summer months.
  • Having a cough for 2 or 3 weeks does not mean that your child needs antibiotics
  • Children under 2 years of age with breathing difficulty may have bronchiolitis. This is a common condition that usually starts as a runny nose and cough, but their breathing may get worse over the next 2-3 days
  • If your child has noisy breathing, they might have croup. Click here for more information.

Where should you seek help?

For wear and tear, minor trips and everything in between

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  • Visit a pharmacy if your child is ill, but does not need to see a GP
  • Remember that if your child's condition gets worse, you should seek further medical advice immediately
  • Help your child to understand - watch this video with them about going to the pharmacy

For information on common childhood illnesses go to What is wrong with my child?

The 0-19 Service for children and young people is delivered by Oxford Health NHS Foundation Trust and offers a single point of access for Health Visiting, School Nursing and the Family Nurse Partnership. You can contact the teams using the details below:

Single Point of Access (SPA): 01865 903 800

Email: cyp0-19@oxfordhealth.nhs.uk

Chat Health Parentline

Text us any time for confidential advice and support and you will have a response the next working day (Monday-Friday exluding Bank Holidays).

Parents and carers for children aged 0-4: Text 07312 263 081

Parents and carers of children aged 5-11: Text 07312 263 227

Young people aged 11-19 and their parents and carers: Text 07312 263 08

Health Visitors

Health visitors are registered nurses or midwives who have additional training in community public health nursing. They provide a universal service, targeted to individual needs for children aged 0-5 years. Learn more about the Oxfordshire Health Visiting Service here!

School and college Health Nurses

School Health Nurses are specialist public health nurses and have offices across Oxfordshire. They work very closely with Health Visitors to support school aged children. They are available for young people to access in secondary schools and colleges, and offer a service to children who are home educated. They work closely with children, young people and their families to support and promote health and wellbeing. Learn more about the Oxfordshire School and college Health Nursing Service here!

Family Nurse Partnership

The Family Nurse Partnership service supports parents who are aged 19 years or under at conception, or under 21 years if they have been in care. The Family Nurse works alongside younger parents in their home, offering health, wellbeing and development support and information from the early stages of pregnancy, usually up until your child is two. Learn more about the Family Nurse Partnership service here!

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  • Doctors or GPs can treat many illnesses that do not warrant a visit to A&E
  • Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, you can call 111 or use 111 online.

Please note that 111 online is for people aged 5 and over. Call 111 if you need help for a child under 5.

An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services

For information on common childhood illnesses go to What is wrong with my child?

Emergency Departments (A&E) provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  • Many visits to A&E and calls to 999 could be resolved by any other NHS services
  • If your child's condition is not critical, choose another service to get them the best possible treatment
  • Help your child to understand – watch this video with them about going to A&E or riding in an ambulance
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