A healthy living blog from Marshfield Clinic Health System

Cough, shortness of breath: Difficulty breathing when sick

Some of the viruses during respiratory virus season like respiratory syncytial virus (RSV), influenza, COVID-19 and others cause difficulty breathing, which lead to symptoms like cough and shortness of breath.

Parents and guardians should know what to expect, what to watch for and when to see a provider with kids back in school because health care providers expect to see these respiratory viruses on the rise during the winter months. COVID-19, flu or RSV? Know the difference

Can you treat respiratory illnesses?

“Unfortunately, we still do not have specific treatments for most respiratory viral illnesses,” said Dr. Joshua Freedman, pediatric pulmonologist with Marshfield Children’s. “When possible, it is best to try to minimize the chances of getting sick in the first place by avoiding sick contacts, frequent hand washing, and making sure your kids have gotten all their vaccines, including against influenza.”

Learn more: Why do kids need so many vaccines?

It is also important to stay well-hydrated and get plenty of rest.

cartoon kids with a cough and shortness of breath due to being sick and difficulty breathing

Some of the viruses during respiratory virus season like respiratory syncytial virus (RSV), influenza, COVID-19 and others cause similar symptoms like cough and shortness of breath.

If your child is coughing, it’s not important to try to stop the coughing itself.

“In general, cough suppressing medicines are not recommended for kids, as it is best to not try to keep everything in and let the mucus and congestion build up,” said Dr. Freedman.

Allowing congestion to build up can cause additional complications in children. For example, congestion built up in the ears may cause an ear infection and congestion built up in the nose or sinuses may cause a sinus infection.

The best solution for a cough is to offer comfort measures at home.

This includes:

  • Saline nasal drops to soften mucus to help remove it.
  • Fluids, which help keep airways moist and strong to fight illnesses.
  • Elevating your child’s head when sleeping to help prevent mucus from accumulating in the throat. (Babies and young children should not sleep with any pillows)
  • Add moisture with a humidifier.

Although a cough is expected, monitor for changes

Some amount of cough and congestion is normal and to be expected when sick with most colds and viruses. However, a lingering cough may be cause for concern.

“In children, a cough is considered a chronic cough if it lasts longer than four weeks. While a chronic cough can be made worse by a cold or virus, there is commonly another cause,” said Dr. Freedman. “Children should not have a regular cough, and even if the cause doesn’t seem bad, they should be seen by a provider if it is regular or persistent.”

While it’s not uncommon for a cough to linger for weeks, it’s possible there is a secondary bacterial infection that can develop. Considering seeing your child’s provider if there is no improvement in the cough after about 10 days.

Seek medical attention for worsening symptoms, including difficulty breathing

“Children should be seen right away for grunting, retractions or nasal flaring,” said Dr. Freedman. “Retractions are when the skin and soft tissue around the chest sink in.”

Retractions occur because the regular muscle that helps breathing (the diaphragm) isn’t enough on its own to help kids get the big, deep breath they need when sick. This causes the other chest wall muscles to have to work harder.

These often can be identified by the ‘caving-in’ of the chest, in between the ribs and under the ribs and the nostrils spreading out wider with every breath.

If your child has difficulty breathing, loud or noisy breathing or wheezing or extremely fast breathing, they should be seen by a health care provider immediately.

For immediate care, visit Marshfield Clinic Health System.

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