Worried that I wouldn’t be able to recognise respiratory distress?

[Cinai]

My 1-year old has a chest infection, we’ve seen the GP, all ok so far, but sent home with the usual ‘if there’s any respiratory distress, call an ambulance’. It’s not the first time that he is ill and every single time I think how on earth would I know for sure during the night?

• Sucking in below the ribs: not able to see in a dark room and with baby wearing his sleeping suit/bag. He also usually sleeps on me when unwell. If I put him on this back, strip him and switch on the lights he’d get upset and I wouldn’t be able to tell either.
• blue around the lips: also not possible to tell at night, can’t even tell if I use a torch I don’t think.
• wheezing sounds when breathing: he makes all kinds of sounds when congested.

Am I overthinking this and a real respiratory crisis would be glaringly obvious, or how do other parents know when the child is congested but fine, and when to call an ambulance?

No real advice unfortunately but I just wanted to say that I remember being exactly where you are. Many nights spent looking intently at baby's chest with a torch, listening with baited breath, and counting breaths per minute. It's really hard!.

Could you maybe video them breathing now so you know what "normal" looks like, and then compare? (I never thought to do this at the time)

Noise, they sometimes wheeze.
One of mine had viral wheeze, his whole body including his feet moved with every breath.

We’ve had this a few times and quite honestly when it actually happened it was quite obvious. Her breathing became much faster and shallower with a horrible wheezing sound. You can also usually see the sucking in at the neck too.

My daughter was in distress when she was around 9 month. It's hard to rely on (and obviously you wouldnt 100%) since it isn't tangible but honestly I think you just 'know' when something isn't right.

I'd brought her back in to my room for the night as I had a feeling I should. She was chesty as she often is but wasn't herself which she normally would be. Then I naturally woke during the night a few times but I didn't do it by schedule (though it would have been sensible in hindsight!). In the morning she started sucking in while breathing and that's when I phoned 111 and she went to hospital.

None of that is something I prepared for, just what felt right at the time.

It's hard being responsible for a baby, especially if nothing has happened before and you have seen your instinct at work. But in my opinion, mothers generally just know when something isn't right and when action needs to be taken.

Additionally, take all of that with a pinch of salt. It's your baby and you know them best. If you're worried that something isn't right, get help. It's never the wrong decision to get a medical opinion on something your worried about for a child.

Youll know when you see it. Poor DS has terrible bronchiolitis as a baby and if he was in his bouncy chair the whole thing would start bouncing alarmingly. Whole body breathing is alarmingly clear.

You would know. Sucking in under the ribs is classic - you can often also see them breathing in their back, if that makes sense (under the back of their ribs in a way that you can’t normally). You can see the tendons in their neck when they struggle, and their nostrils flare. They will also eventually start grunting on each outbreath. You can find charts online of normal respiratory rates for children, so look one up and count his breathing - if it’s a lot faster, take him to the GP or call 111. Sometimes it’s self-limiting (my breathing gets faster if I’m ill, and a temperature will increase the resp. rate as well, so if he’s got a temp, give Calpol and recount once he’s a bit cooler), but they’re very little and breathing hard is very hard work for them so you don’t want to leave it too long. My DD had pneumonia last year and lost a kilo in about five weeks just because breathing was such hard work.

Could you sleep with a nightlight on? Just enough light to see his chest properly?

Re wheezing - when my DD gets wheezy, the only way I can describe it is it’s like the breath goes on for way too long, like an accordion that’s leaking a bit. It’s quite distinctive and sounds just wrong - I’m sure you’d notice.

If he’s congested, see how he is when he breathes through his mouth. Sometimes he might sound a bit wheezy or crackly but it goes away when he coughs - that’s more phlegmy around the larynx and throat, in my experience. If the wheeze doesn’t shift with a cough, I’d take him to the GP.

But if you’re in doubt, take him to be seen. He’s much too little not to take care with it.

I hope he’s better soon.

My youngest has viral wheeze. I agree with pp that if they are in respiratory distress you will 'know' it's 999 time.

Sucking in ribs on a 1 year old makes their whole body shake. You'd likely be able to feel it just by putting one hand on top of the sleeping bag.

Breathing can also be far too fast (like they've just run a race when they are lying down) and will be noisy if in distress, but not normal chesty/snotty, more wheezy/panting.

We've never once had any health professional say that we shouldn't have had DC checked over, so if you are worried just get help.

My youngest had bronchiolitis and was in respiratory distress at home before we took him to hospital and the bronchiolitis was diagnosed. We were taking it in turns to watch him all night that night as it was obvious he was struggling to breath and it was getting worse not better. I agree with everyone else about the sucking in under the ribs, the massive effort to breath and general distress. It was like nothing else we'd seen before in our older child with the usual coughs and colds.

DD2 has had a number of trips to hospital with viral wheeze. I agree with others that once it reaches whole-body breathing, it's obvious. Before that, put a gentle hand on his stomach and then on his shoulder (ideally do it now so you know what 'okay' feels like). They'll move much more if he starts working harder to breathe. Very fast breathing is also a sign of distress – perhaps do a count now or during nap time so you have a reference for his normal.

Despite the name, DD2 doesn't always wheeze, so I wouldn't assume that the absence of wheezing means he's managing.

Just to echo what everyone else has. My 2 year old goes into respiratory distress with every single cold he gets (you can imagine that I live on edge every day dreading the next time I see a runny nose or a hear a cough).

It’s really very obvious because of how hard they’re working to breathe. Pulling in at the ribs and also the bottom of the neck in the tracheal area, grunting, their body moving as they breathe and fast breathing. We’ve dealt with this long enough to know when it’s bad enough to need a trip to A&E or we can manage at home, but if you have any of those symptoms and you’re unsure, go to the hospital if it seems urgent or GP if your child seems to be doing ok. They would rather see you when it’s not needed than not see you when it is needed.

Like PP, when they start sucking in it's really obvious, even with a sleepsuit on. You'll see it in the movement of their entire abdomen.

We haven't had a proper wheeze, we've had croup and the horrific sound of stridor when breathing in, and it just sounds wrong. Like it set off internal alarm bells without really realising why.

I think if any of those things are happening they're unlikely to be sleeping soundly in their bed anyway so you're not going to be needing to hunt around in the dark. They'll be with you or waking frequently or generally unwell/clingy

I'd recommend buying a pulse oximeter if you're really unsure/for peace of mind. They're about £15 off Amazon and you can just put them on their finger. DD had bronchiolitis at 12months....her breathing was noticeably faster but not too bad, but what made me call 111 was the pulse ox at 80

You will know the difference when you hear it, OP. When one of mine was 18m old he had croup. The difference all of a sudden from 'coughy, wheezy, congested baby' to rapid, extreme difficulty breathing was really very obvious. Very rapid breathing is an early sign.

A vaporiser or other form of steam in the room is very helpful for relieving congestion in babies. I cant recall the brand but there are a number of infant safe olbas type oils you can buy for this purpose. Hope your little one feels better soon.

@Overthebow Same as you, when I saw it, I knew it wasn't right - when I got my then 7mo up and put them on the floor, they were panting like they'd run a marathon. Ribs going in. There were others signs, like baby being very sleepy (fell asleep mid nappy change, etc).

Generally - and obviously you have to use your adult judgement here - younger children (babies) go down hill quicker than older children. An eight week old needs more watching than a 1 year old. You would normally get more obvious signs that your LO needed to see someone before you got to blue lips, especially at a year.

It's really worrying, you absolutely have my sympathy! Hope LO is better soon.

Under about 15 months it was very difficult to see (my son was very plump as a baby so difficult to see the retractions) so I would sleep with the baby if you don’t already and have a nightlight or lamp on. Learn how to time the speed of his breathing so you can check. A pulsoximeter isn’t very expensive and is very helpful.
Over that age, it became easy and I could tell on the first gasp that we were going to need an ambulance. From about 3 he would say himself that he needs a doctor. (Aged six he completely grew out of it.)

Thanks all. Today my little one is already better, fever went down and although congested, he’s overall more like his usual happy self. Hopefully I’ll have a less worrisome night!