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My child is struggling to breathe - how do I know it is serious?

Emergency numbers: 108 ambulance · 112 national emergency · Poison centre (AIIMS, 24x7): 1800-116-117

Quick answer: Trouble breathing is the most common true emergency in children, and it can get worse fast - especially in babies. If your child is fighting for each breath, cannot speak or cry in full sentences, has ribs pulling in with every breath, or has lips turning blue, call 108 now.

How to recognise breathing trouble

Normal breathing is easy and quiet. Watch your child's chest bare for one full minute. Look for:

  • Fast breathing. Count for a full minute while your child is calm. Fast means: 60 or more breaths per minute in a baby under 2 months; 50 or more at 2-12 months; 40 or more from 1 to 5 years. (These are the fast-breathing cut-offs used in Indian Academy of Pediatrics pneumonia guidance.)
  • Retractions - the skin between or below the ribs, or at the base of the throat, sucking in with each breath.
  • Grunting - a short sound with each breath out.
  • Stridor - a harsh, tight sound when breathing in.
  • Wheeze - a whistling sound when breathing out.
  • Blue or grey lips, tongue or face.
  • Too breathless to speak, cry or feed. A baby who cannot keep feeding because of breathing needs help now.

🟢 GREEN - You can usually watch at home when

  • Your child has a blocked or runny nose and a cough, but breathing is comfortable, at a normal speed, and your child is drinking, playing and sleeping normally.
  • A stuffy nose in a baby often sounds noisy but is not dangerous. Saline nose drops before feeds can help.

🟡 YELLOW - Call your paediatrician today if

  • Your child breathes a little faster than normal but is otherwise comfortable, drinking and active.
  • There is a mild wheeze and your child is still talking and playing.
  • A cough is not settling, or your child has had "a wheeze" before and you are not sure what it means.
  • Your child is waking at night coughing.

🔴 RED - Go to the emergency room NOW (call 108 if severe) if

  • Your child is struggling for each breath or can barely speak or cry.
  • Ribs are pulling in with every breath (retractions), or your baby is grunting.
  • Lips, tongue or face look blue or grey.
  • Your child has stridor (a harsh sound breathing in) while resting, or drools and cannot swallow.
  • Breathing trouble started suddenly after a food, a bee sting, or a new medicine - this can be a severe allergic reaction.
  • You suspect your child choked on a small object or food.
  • Your baby is under 1 year with any breathing trouble.
  • Your child is drowsy or exhausted from the effort of breathing - this is a late, dangerous sign.

🆘 SOS - What to do while you get help

  • Sit your child upright or hold them in the position they find easiest. Never lay a struggling child flat.
  • Loosen tight clothing around the neck and chest. Keep them calm - crying makes breathing harder.
  • If your child has asthma and a prescribed reliever inhaler, give it as their doctor has shown you.
  • Do not give anything to eat or drink while breathing is laboured.
  • If your child becomes unconscious and is not breathing normally, start CPR if you know how, and tell the 108 operator.

❌ DO NOT

  • Do not wait to "see if the morning is better" when the signs above are present - children tire out and can stop trying to breathe.
  • Do not give cough syrups or leftover antibiotics to treat breathing trouble. They do not open airways.
  • Do not use steam over a bowl of hot water near a child - scald burns are common and it does not treat the cause.
  • Do not lay your child flat or force them to walk to the car if they are fighting to breathe - carry them upright.

What is happening and why

Children's airways are narrow, so a little swelling or mucus can block them quickly. The most common causes are viral infections like bronchiolitis and croup, asthma, pneumonia, severe allergic reactions, and - in toddlers - a small object stuck in the airway. Doctors decide how serious it is by watching the work of breathing (speed, retractions, sounds, colour) rather than by the cough alone. That is exactly what you can watch at home, and this page gives you the same checklist.

This page is for first-aid education and does not replace examination by a doctor. In an emergency, call 108 or 112.

Sources (last checked 13 Sep 2026)

Reviewed and approved by Dr Anjana Alekhya, MD (Paediatrics) · Published 13 September 2026