Dear Doctor, My toddler sounds like she has breathing problems even though she was checked and she does not have any issues? Why does she sound like she is always out of breath?  Arthur

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Dear Arthur,

A toddler always has a breathing rate faster than adults. Then during waking hours, they always remain active physically, stopping only when tired and breathless.  This can give the false impression of being breathless.  Some small children are hyperactive, hence, may seem more tired and breathless.

If a child is breathless due to some disease, he/she will look sick and listless. There would be associated fever, cough, running or blocked nose, a wheezing sound from the chest, flaring of both nostrils, difficulty in talking, in-drawing of the chest wall, and etcetera, one or more of these features.

Breathing problems can be due to a common cold, which is mostly due to a viral infection.  It subsides within a week or so, without any treatment. It may be associated with a bacterial pharyngitis or laryngitis. Pneumonia and other chest infections, or infection of the air tubes, can cause breathlessness associated with cough, chest pain and fever.

A toddler may have it as a manifestation of allergy to something in the environment, or something used locally or eaten. Sudden onset of breathlessness with wheezing and cough, particularly on exertion, may be part of an acute asthma attack.

Children with defects in the heart have breathlessness on walking or running. But there are many other features which clearly indicate it is a heart problem. The breathlessness progressively worsens and may be present during rest as well. The child gets tired very easily.  She may have bluish discolouration of lips and or nails. Thus, it is easily diagnosed. Precise diagnosis can be made by other special tests.

If the child is healthy, eating, sleeping and playing well, there is nothing to worry about. However, if there is suspicion of some disease, it is better to consult a doctor. Any of the conditions causing breathlessness are easily diagnosed through relevant tests and can be treated.