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noisy breathing in children

Noisy breathing in children is a common condition, usually caused by a blockage in the air passages.

What is going on in the body? 
Noisy breathing is generally caused when a blockage somewhere in the breathing passages creates abnormal airflow. The blockage can be anywhere from the mouth to deep inside the lungs. Noisy breathing may be harmless or a life-threatening condition.

What are the signs and symptoms of the condition? 
When parents complain that a child has noisy breathing, the doctor will want to know:
  • what the breathing sounds like
  • when the noisy breathing started
  • whether it is constant or only occurs sometimes
  • whether it goes away during sleep
  • whether the breathing is affected by changes in position
  • whether symptoms get worse with feeding
  • if there are any signs of an infection, such as a cough, fever, or runny nose
  • whether the child snores during sleep
  • if there is a family history of noisy breathing
  • what other medical conditions the child has, if any
Other questions may also be asked as well.

What are the causes and risks of the condition? 
There are many causes of noisy breathing in children. Some of the possibilities are these:
  • small objects into the mouth that are accidentally be inhaled into the windpipe
  • a structural defect such as a deviated nasal septum, which divides the two nostrils unequally
  • respiratory infections, such as croup, influenza, pertussis, epiglottitis, pneumonia, RSV infection, bronchiolitis, and the common cold.
  • metabolic conditions, such as cystic fibrosis, an inherited condition that affects the lungs
  • asthma, which results in reversible narrowing of the airways
  • gastro-oesophageal reflux disease, which occurs when stomach contents and acid flow backward all the way up into the throat and mouth. This may affect breathing.
  • sleep apnoea, a condition that results in a blockage of the airway in the throat during sleep
  • tumours or cancer that partially or fully block the airways
  • nervous system problems or damage that affect the ability to breathe, such as cerebral palsy
  • paralysis of a vocal cord
  • heart conditions, such as congestive heart failure that can cause fluid to collect in the lungs
Other causes are also possible.

What can be done to prevent the condition? 
Most cases cannot be prevented. Small objects should be kept away from young children to who might accidentally inhale them. Children should receive routine vaccines to prevent some cases due to an infection, such as pertussis and haemophilus B.

How is the condition diagnosed? 
Diagnosis begins with the history and physical examination. This may be all that is needed in some cases. In other cases, further tests are needed.

Different tests may be ordered, depending on the suspected cause. A chest x-ray is commonly done to look for infections, tumours, and lung or heart diseases. Special x-rays such as a chest CT scan will look for tumours, or a cranial MRI can look for nervous system damage. A test of the sweat called a chloride sweat test may be done if cystic fibrosis is suspected.

In some cases, a procedure called endoscopy or bronchoscopy may be used. A small tube is inserted through the mouth and into the throat and windpipe. The tube has a light and camera on the end of it. This allows the doctor to see the inside of the throat and airway. This test is useful to detect conditions such as vocal cord paralysis, or a tumour or cancer in the throat or lungs.

What are the long-term effects of the condition? 
Long-term effects are related to the cause. For example, cases due to infection often go away and have no long-term effects. Cancer can result in death. Noisy breathing caused by nervous system conditions may sometimes be permanent.

What are the risks to others? 
Noisy breathing itself is not contagious. If the cause is an infection, which is common, the infection can often be transmitted to others.

What are the treatments for the condition? 
Treatment is directed at the cause. A child with a bacterial infection will be given antibiotics. Cases due to anatomic defects, such as deviated nasal septum, can often be corrected with surgery. Foreign bodies can often be removed during endoscopy. gastro-oesophageal reflux disease can be treated with medications to reduce stomach acid.

What are the side effects of the treatments? 
Side effects are related to the treatments used. Antibiotics may cause allergic reactions or stomach upset. Any surgery carries a risk of bleeding, infection, or allergic reaction to the anaesthesia. Endoscopy may cause throat or windpipe irritation or, rarely, damage.

What happens after treatment for the condition? 
A child with asthma may have occasional "flares" and need treatment for many years. A child with an infection usually gets better and needs no further treatment. Someone with cancer may die if treatment is not successful.

How is the condition monitored? 
Any new or worsening symptoms should be reported to the doctor. Other monitoring is related to the cause. For example, a child with cancer may need repeated blood tests or x-rays to monitor the effects of treatment.

Author: Adam Brochert, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 20/09/2004
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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