What to do when your child is breathing deep and fast

Dr Bashir Admani

Fewer than five per cent of children with croup, a respiratory illness, require hospitalisation.

The disease mainly occurs in children aged between six months and three years and is more common in boys than girls.

As the illness progresses, the trachea becomes swollen, which narrows the space available for air to enter the lungs. The viruses that cause croup can be spread easily through coughing, sneezing and respiratory secretions such as mucus. Children with croup should be considered contagious for three days after the illness begins or until the fever is gone.

Most children with croup develop mild to high fever. It is usually mild and readily resolves within a few days even without treatment, as the upper airway narrows, a hoarse, "barking" cough develops and the child may breathe faster and become restless. The symptoms are characteristically worse at night and a few individuals may experience more severe disease requiring treatment to avert life-threatening blockage of the airway.

In severe cases, airway obstruction may manifest as blue coloration of the tongue, lips and skin (called cyanosis). Cyanosis may also be noticed in the fingers and toenails, ear lobes and tip of the nose in infants.

Diagnosis of croup is made from medical history and the physical findings as described above.

The healthcare provider must determine if a child is likely to get worse. A child who is breathing fast and deeply, anxious or with blue colour change is more likely to have moderate to severe disease. This requires urgent treatment. The provider will also listen to the child’s lungs and look at the back of the throat for signs of a blocked airway.

Fever is controlled by removal of clothing and giving medicines like paracetamol. Ample amounts of fluids, and a mixture of honey, lemon and warm water may also benefit some children. Parents should seek immediate medical attention if a child develops worsening or severe croup.

— The writer is Consultant Paediatrician Aga Khan University Hospital.