Cough, Cold, or Something More? When to Seek Help for Child Breathing Issues
Written by Dr. Kuntal Roy
Associate Professor of Pediatrics • October 12, 2025
Counting Your Child’s Respiratory Rate
The single most reliable indicator of pneumonia or lower airway compromise in a young child is fast breathing (tachypnea). Count the breaths for a full minute when the child is calm and not crying.
- Infants under 2 months: 60 breaths per minute or more is fast.
- Infants 2 to 11 months: 50 breaths per minute or more is fast.
- Children 12 months to 5 years: 40 breaths per minute or more is fast.
Signs of Increased Work of Breathing
Look closely at your child’s chest and neck while breathing. The following signs indicate that your child is working unusually hard to breathe:
- Chest indrawing: The lower chest wall pulls inward deeply when the child breathes in.
- Nasal flaring: The nostrils widen noticeably with each breath.
- Grunting sounds on exhalation.
- Stridor (a harsh high-pitched sound heard when breathing in at rest).
Why Over-The-Counter Cough Syrups Should Be Avoided
Medical guidelines strongly advise against giving over-the-counter multi-ingredient cough and cold syrups to children under 4 to 6 years of age. They provide little benefit and carry significant risks of sedation and toxicity. For children over 1 year, warm water, saline nasal drops, and half a teaspoon of natural honey provide safe, effective symptomatic relief.
- Fast breathing or noticeable chest indrawing
- Bluish discoloration around the lips, tongue, or fingertips
- Wheezing or whistling sound that does not improve after clearing the nose
- High fever accompanied by extreme drowsiness or refusal to drink fluids
- Cough persisting for more than 2 to 3 weeks without improvement
Clinical Summary
While routine colds are part of growing up, parents should remain observant of their child’s breathing effort and rate. Seek immediate medical attention if you observe fast breathing, chest indrawing, or persistent wheezing.
Medical Disclaimer: These articles provide general pediatric educational information for parents and families in Bangladesh. They are not intended to replace an in-person medical evaluation, diagnosis, or clinical consultation with Dr. Kuntal Roy or your family pediatrician.
Have questions about your child’s health?
Consult Dr. Kuntal Roy at his Dhanmondi or Malibag chambers.