The breathing process should be quiet. Difficulty breathing requires urgent medical evaluation and identifies if in your child:

• The pace of your breathing is rapid.
• There are retractions (the space sinks under the ribs, or between the ribs or above the sternum).
• There is a nasal flutter (your child moves the cartilage from the nose).
• There are cyanosis (lips or nails turn purple) because it indicates that your child does not get enough oxygen.

Children with fever can have rapid breaths, precisely to lose heat. It is necessary to lower the fever to evaluate later if it really presents respiratory difficulty. If you think there is, you should consult the doctor.

In children with asthma, a crisis may begin with respiratory distress.

In children with the flu, if it becomes complicated by a bacterial infection, such as pneumonia, respiratory distress will appear.

Signs of alarm that require immediate consultation are: respiratory rate greater than 60 per minute in children under two months, greater than 50 in children from 2 to 12 months and more than 40 for children over one year.