Hand to Hold's Official Blog: Written by Parents for Parents

Healthy Breathing: 5 Tips for Managing Respiratory Symptoms

Many of us have experienced the paralyzing fear that comes as we watch our child struggle to take a breath. You’ve probably been there many times. There isn’t much that has frightened me more than my son’s breathing. The fear began during his NICU days. We were scared out of our minds, and told on a daily basis how bad his lungs were. Thankfully, he has come a long way in his four years. We’re fortunate that now we only have to monitor and treat his asthma symptoms.

When a baby is born early, breathing complications are likely to follow. Lungs are not fully developed until 36 – 37 weeks of gestation. Steroid shots and surfactant do amazing things, but often not enough. Whether it’s oxygen, CPAP, or a ventilator, many premature babies will require some amount of breathing support. Common respiratory complications of prematurity include Respiratory Distress Syndrome, Chronic Lung Disease, Bronchopulmonary Dysplasia, and Apnea. Many of these complications continue into childhood in the form of asthma.


James was intubated at 2 1/2 due to severe respiratory distress.

Managing your child’s respiratory symptoms is important. Illness can go from bad to worse very quickly in a child with poorly controlled breathing issues.  In our case, undiagnosed asthma turned into six weeks in the hospital. Three of those weeks were in ICU, and two of those weeks were on a ventilator. Not what we expected for our son at the age of two and a half. As scary as it was, we learned some things about respiratory health through that experience. Many of these steps we all know; making sure we do them will make a difference in maintaining healthy breathing.

1. Be sure medications are taken as prescribed. I am the first to admit that we slacked off on one of my son’s medications after a couple of respiratory therapists said they didn’t see the value in it. He was on enough meds, I didn’t want to give him something he didn’t need. When James began seeing a Pulmonologist that changed. He described the medication as a “wonder drug” that made a huge difference in preemie lungs. If you aren’t sure about the effectiveness of a medication your child is on, talk to the doctor. Get as much information as possible, and make an informed decision together.

2. Wash hands frequently, yours and theirs. As preemie moms, we usually have sanitizer overflowing in our homes. Using sanitizer and washing hands regularly is one of the best defenses in maintaining respiratory health.

3. Change the air filters in your home regularly. Maintaining good air quality at home is a very effective way to avoid airborne triggers of respiratory issues.

4. Pay attention to air quality outside. If you can, avoid taking your preemie out on days with poor air quality, especially when pollen is high. Pollen is a common allergen that triggers respiratory issues in many preemies. Avoiding it isn’t easy, but will help when possible.

5. Have a plan in place so you know what to do if a breathing issue arises. Talk with your child’s pulmonologist or pediatrician about signs to watch for. Know what your child’s “normal breathing” looks like. Being able to spot faster than usual breathing, or breathing that is more shallow than usual are important in identifying a concern before it becomes an emergency. Know what you can treat at home and when you need the doctor or emergency room.

Health-First.org has some excellent information about asthma, respiratory health, and signs your baby may need emergency care. I included a few here. Keep these in the back of your mind, especially as we’re heading into cold and flu season.

  • More than 40 breaths a minute while asleep (count the number of breaths – inhale and exhale counts as one breath – in 15 seconds and multiply by 4 to get a one-minute count).
  • The baby is feeding less, or sucking less — or stops completely.
  • The skin between the baby’s ribs seems pulled tight, or retracting.
  • The chest gets bigger.
  • Fingernails turn a bluish color.
  • The baby’s crying changes — becomes softer or shorter.
  • Nostrils are open wider — flaring.
  • Noisy, grunting kind of breathing.

Taking a few steps to maintain respiratory health may help you avoid an emergency situation. Sickness will likely come at some point. Healthy lungs prior to illness will help your little one stay strong and fight it off easier. It’s important to not take any chance with breathing concerns. They can be life threatening and they can get bad quickly. Keep your doctor informed of what’s happening. When in doubt, take your child to the doctor or emergency room.

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