Breathing Problems

Asthma and Wheezing


Asthma involves recurrent attacks of wheezing and coughing, which may result in chest tightness and shortness of breath.


Immediately if:

  • lips are blue or dusky
  • pain develops in chest or neck
  • your child is too short of breath to complete a short sentence in one breath.
  • breathing is labored
  • retractions (sinking in of chest) are present:
    • between the ribs
    • below the Adam’s apple
    • above the collar bone
  • severe wheezing is not improved within 20 minutes of when asthma medicines are given.
  • you have other questions or concerns.


Give a dose of asthma medication. This could include:

  • a nebulizer (breathing machine) treatment with Albuterol, Proventil or Ventolin.
  • an inhaler treatment of Albuterol, Proventil or Ventolin in addition to any other inhalers your child usually uses
  • oral (liquid or pills) of Albuterol, Proventil or Ventolin.

Have your child rest until the breathing improves.



Croup is an upper respiratory infection, which causes a hoarse voice, barky (seal-like) cough, and often raspy breathing with labored breathing.


Immediately if:

  • if breathing is still labored after trying the things listed below
  • lips are blue or dusky

During office hours if:

  • your child has more than one croup episode or labored breathing during the day or night.
  • the barky cough doesn’t go away in 3 days.


If your child has raspy, labored breathing:

FIRST - bring your child in the bathroom, close the doors, and run the shower on hot to create steam. Wait 15 minutes to see if the steam will end the raspy, labored breathing

SECOND - If it is cool outside (less than 60 degrees) bring your child outdoors to breathe the cool air. If the raspy, labored breathing doesn’t end within 15 minutes call the office.

If your child has a barky cough and hoarse voice but no raspy, labored breathing:

  • run a vaporizer (hot or cold) or humidifier in the room.
  • if your child is old enough, have them sleep on an extra pillow. If you have a baby, elevate the head of the mattress or have the baby sleep in a car seat. If your child is older than 6 months cough medicine can be given.



Croup is caused by one of a number of viruses, therfore antibiotics are of no use in treating croup. Your child may have a fever with the croup. Also, your child may often have a sore throat with the croup.

Croup is contagious. Your child should stay home from school and daycare until the signs of croup (barky cough, and fever) are gone for 24 hours.




Pneumonia is an infection in the lung. Signs of pneumonia almost always include a prolonged cough and fever. Signs often include rapid breathing, shortness of breath and chest pain. Rattles in the chest or rattly breathing are not a sign of pneumonia.


 Immediately if:

  • breathing is labored
  • lips are blue or dusky
  • chest pain is severe when not coughing
  • your child is short of breath when not coughing

 Call during office hours if:

  • your child has a cough with fever that lasts 3 days or more
  • your child has a cough with chest pain
  • your child has a breathing rate of over 40 times a minute while resting
  • your child’s cough lasts more than 2 weeks
  • coughing causes vomiting 3 times or more
  • coughing spasms cause exhaustion or more than 1-hour sleep lost per night
  • cough causes your child to miss more than 2 days of school
  • you have other concerns or questions


The treatment of pneumonia will often require antibiotics.Your doctor listening to the lungs can usually determine the presence of pneumonia. At times your doctor may order a chest xray to diagnose pneumonia. Pneumonia is not and emergency unless there is labored breathing, the lips are bluish or dusky, there is chest pain when not coughing or there is shortness of breath when not coughing. A rattle in the chest is not a sign of pneumonia. (If mucous is rattling in the chest it is in the back of the throat or upper bronchial tubes and can be coughed up.)

If you suspect your child has pneumonia please contact the office during office hours.


Pneumonia in most cases is treated with antibiotics at home. A rattle in the chest is not a sign of pneumonia.

Respiratory Syncytial Virus (RSV) is a type of viral infection that may cause pneumonia in infants and young children. RSV occurs in the late fall and winter. RSV is a virus, therefore antibiotics are not used to treat it.

Call or Visit

  • phone: (616) 243-9515

  • FAX: (616) 243-1815

  • after hours: (616) 776-7401

  • or contact us via the Patient Portal

  • Alger Pediatrics
    733 Alger St. SE
    Grand Rapids, MI 49507