Symptom: You see your child's rib cage or the area above his breastbone sucking in when he breathes.
It Could Be: Pneumonia or severe croup (inflammation of the voice box and windpipe). Your child is air-hungry and using extra muscles to pull air in. You might also see this if he's having an asthma attack. Call your doctor right away.
Symptom: You feel a "rattling" in your child's chest when you hold her.
It Could Be: Congestion -- mucus vibrating in her upper airway when she breathes, which is nothing to worry about. Most of the time, it's not actually coming from her chest; it just feels that way. Mention it to your doctor in the morning.
Symptom: You hear a high-pitched squeal or whistle at the end of each breath.
It Could Be: Severe Croup. Call your pediatrician right away, or go to the E.R. if your child is struggling for breath, drools excessively, can't speak, or turns blue. If you hear the sound only when he's upset, call in the morning.
Symptom: Her lips or nails have developed a blue, purple, or white tint.
It Could Be: An emergency. These color changes usually mean that your child is having trouble breathing and not getting enough air. Get her to the E.R. immediately.
Symptom: Your child takes shallow, rapid breaths or grunts with each breath
It Could Be: A signal that he's having trouble getting enough air because of pneumonia, croup, or bronchiolitis. Call your doctor right away.
Symptom: Your child makes a whooping sound as she inhales between coughs.
It Could Be: Whooping cough. Thanks to the pertussis vaccine, this potentially fatal infection has not been common, but it is now on the rise in the U.S.
Originally published in the November 2009 issue of Parents magazine.