What is meant by breathlessness?
- Children who are breathless are often anxious as the experience can be frightening: they may worry that they won’t be able to breathe or that they may choke
- It is common for breathless children to have episodes where their symptoms appear to ‘spiral out of control’, although, in between, their symptoms are more manageable
- It is natural for you to feel scared and anxious when your child is breathless
Why is your child feeling breathless?
There are many reasons why your child may feel breathless.
- Your child may have secondary tumours in the lungs or pressing against the airways
- He/she may have a lot of fluid around the outside of the lung which restricts the lung (pleural effusion)
- Your child may be anaemic
- He/she may have a chest infection
These additional problems may make breathlessness worse in children with lung secondaries or pleural effusion.
Whatever the cause, your child may experience ‘attacks’ of severe breathlessness: these are usually brought on, or made worse, by anxiety.
What can your nurse or doctor do to help?
They may be able to treat any factors which are making the symptom worse (e.g. anaemia)
They can prescribe medication to reduce the sensation of breathlessness
They can arrange for you and your child to learn relaxation techniques which can also help to reduce the feeling of breathlessness: this may be with the play therapist, psychologist and/or physiotherapist.
What treatment can your child have?
- Your nurse or doctor will try to treat any factors which may be making the symptom worse
- Morphine is well known as a pain relieving medicine, but in quite low doses it is often very effective for breathlessness
- Mild sedatives may help your child to relax and improve their breathlessness
- If there are lumps pressing on the airway, the swelling can sometimes be reduced with steroids, but steroids will not make much difference to most children
- Some children find oxygen helps their breathlessness: if it helps, your GP will be able to order it for them
- Antibiotics are not often helpful, unless there is a clear evidence of a chest infection
Can you do anything to help?
There are a number of things you can do; find which approach suits your child best.
- Reassurance is very important as anxiety plays such a big part in breathlessness: try to be calm and reassuring, even if you are feeling very scared yourself
- Your child may feel less breathless if he/she can feel ‘fresh air’ on his/her face: an open window or a fan (electric or hand-held) is often effective
- Many children find it easier to breathe in a particular position: this may be sitting up and leaning forward (e.g. over a table or cushion) or lying on one particular side if there is fluid around the lung
- If your child has been taught breathing exercises by the physiotherapists (e.g. breathing out slowly through pursed lips), encourage him/her to do this
- Relaxation techniques or play therapy can help at home (ask your play therapist about this)
- If there is a noticeable difference in your child’s breathing you should contact your nurse or doctor for advice
Cough
What is a cough?
- A cough is the body’s attempt to remove something irritating from the airway or lungs
- A ‘fruity’ or ‘productive’ cough is an attempt to shift phlegm or secretions in the throat or lower down
- A ‘dry’ cough is often caused by irritation in the airways
What treatment can your child have?
- At this stage in your child’s disease, most coughs do not respond to antibiotics or asthma type medications
- For dry coughs, simple Linctus is often effective
- Codeine and Morphine are well known as pain relieving medicines, but they are also very effective at suppressing dry irritating coughs
- Hyoscine patches will reduce excess secretions
Noisy and irregular breathing
- Your child’s breathing may become noisy and ‘bubbly’ if they become unable to swallow all their saliva (secretions), this is most likely in the last few days or hours of life
- Your child will not usually be aware of this, although it may be distressing for you to watch
- Breathing often becomes irregular and infrequent in the last few hours of life – this should not be distressing for your child
What treatment can your child have?
- Your doctor can prescribe medication to reduce secretions and make breathing less ‘bubbly'