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Respiratory Illness Guide: Home or ER?

  • Writer: Natalie Wescott
    Natalie Wescott
  • 2 days ago
  • 12 min read

Respiratory Illness

A respiratory illness is any condition that affects the ability to breathe comfortably. It can be as simple as a runny nose or as serious as pneumonia.


These illnesses affect the airways, lungs, or both, and they’re incredibly common in childhood. An upper respiratory illness would include symptoms such as sneezing, congestion, sore throat, ear pain, and runny nose. A lower respiratory illness would include coughing, wheezing, and difficulty breathing.


These symptoms are common in respiratory illnesses, but it’s important to know when a child switches into respiratory distress.


Respiratory distress

Respiratory distress is when your child is working too hard to breathe, and their body is not able to oxygenate effectively (this is when things can escalate quickly!). A child struggling to breathe can go from stable to critical very quickly. Their smaller airways, higher oxygen needs, and limited reserves mean once they begin to tire, things can unravel fast. If you or your child is experiencing respiratory distress, go to the nearest ER.


Some common causes of respiratory distress include:

  • Bronchiolitis (lung infection usually caused by virus like RSV, flu, COVID, rhinovirus)

  • Asthma (can be triggered by allergens, cold air, exercise, illness)

  • Croup (swelling of the upper airway, usually caused by viruses)

  • Pneumonia (bacterial lung infection)


    Getting these diagnoses does not mean you have to panic! You just need to on higher alert to watch for signs of distress!


Signs of respiratory distress:

  • Retractions

  • Low pulse ox

  • Loud wheezing

  • Stridor (high pitched whistling sound when breathing in)

  • Grunting on exhale (Especially in infants)

  • Head bobbing with breathing

  • Blue lips or extremities

  • Excessive drooling or inability to swallow (indicates swelling of throat)

  • Apnea (long pauses in breathing)

    • short pauses can be normal in infant - know your child's baseline

  • Not able to cry or talk from difficulty breathing

  • Lethargy (hard to wake up)

These signs would warrant a guilt-free ER visit


Watch your child’s breathing when they are healthy, so you can recognize when it looks abnormal.



Example of Retractions and other signs of respiratory distress

Retractions are visible signs that a person, especially a child, is working hard to breathe. They occur when the skin pulls in around the ribs, neck, or collarbone with each breath, due to increased effort to get air into the lungs. 


Retractions can appear in the suprasternal (above the sternum), substernal (below the sternum), intercostal (between the ribs), or subcostal (below the ribs) areas. Watching for these movements during inhalation can help determine the severity of respiratory distress.


Lung Sounds

A stethoscope is a great tool to have at home! Let’s talk about what you may hear through your stethoscope and what that sound may indicate. You can also watch YouTube videos to be able to hear the sounds! Breath sounds are NOT diagnostic!

Click here for a link to a cheap, but effective stethoscope! (This was my first stethoscope out of nursing school!)


1. Wheezing

  • A high-pitched, whistling noise, especially when breathing out.

  • Asthma, bronchiolitis, or allergic reactions.

2. Stridor

  • A harsh, crowing or squeaky sound when breathing in.

  • Upper airway blockage or swelling (like croup or an object stuck in the throat). Very concerning 

3. Crackles (Rales)

  • Popping, crackling, or bubbling (like rubbing hair near your ear or fizzing soda)

  • Fluid in the lungs, common with pneumonia or bronchiolitis

4. Grunting

  • Soft, short moan at the end of exhaling

  • often seen in babies with serious respiratory distress.

5. Diminished or Absent Breath Sounds

  • Very quiet or barely audible air movement on one or both sides.

  • Severe blockage, collapsed lung (pneumothorax), or fluid around the lungs.

6. Rhonchi

  • Low-pitched, rattling or snoring sounds, often during exhalation.

  • Mucus or congestion in larger airways, bronchitis or chronic respiratory conditions.




How to Treat Respiratory Illnesses at Home


What to do at onset of illness to help avoid respiratory distress

Of course, prevention of respiratory distress is not guaranteed, but supportive care beginning at the onset of symptoms will set you up for success!

  • Deep breathing exercises: Expand lung capacity and improve oxygenation. 

    • Try diaphragmatic breathing or box breathing (inhale 4s – hold 4s – exhale 4s – hold 4s).

    • Or use incentive spirometer (linked is a kid-friendly inceptive spirometer with colored balls that move!)

      • Click here for a video on how to use an incentive spirometer (inhale, not exhale!)

  • Immune support: Click here for the link to the FULL immune guide!

    • The guide is super in-depth with lots of resources and recommendations!

    • Plenty of sleep 

    • Herbal support or tinctures 

    • Sunlight + vitamin D

  • Keep airways moist and mucus thin

    • Use vaporizer/humidifier (especially at night)

    • Stay hydrated and use poultices 

    • Nebulize, saline mists, sinus rinse 

  • Reduce exposure to lung irritants 

    • Pollutants (chemicals, fragrance, cleaners), smoke & fumes, mold 

  • Chest percussion and postural drainage

    • For those prone to congestion or infection, especially children or elderly

  • Try skin to skin, no matter the age. 

    • Sometimes your body can help calm and regulate their nervous system and therefore their respiratory system!


Let's expand on some of these concepts!


Cough and Congestion:

Our body produces more mucus when sick to help trap pathogens, while coughing and sneezing helps to expel them.


When you take a decongestant, you are drying up the mucus that is designed to trap and expel pathogens. Instead, focus on thinning the mucus so it can easily be expelled. 


It is best to avoid cough suppressants for the same reasons to avoid decongestants. Coughing is how the body removes pathogens, so taking a suppressant can prolong the illness. However, a suppression may become necessary if coughing is preventing proper sleep which is necessary for healing.



Nebulize Saline to help loosen up mucus

  • Nebulizer: this one is very effective, great for older kids and adults

    • Portable nebulizer

      • I use this one for my young kids (I like that it has a mask instead of having them hold a tube in their mouth)

  • Premade saline

  • Some people DIY saline: ½ tsp of sea salt in 8oz purified water

    • Technically not recommended as it can cause contamination in the nebulizer, but if you decide to go this route make sure you are using purified water NOT tap water.


Set Up Humidifiers

Maintaining humidity in the range of 40-60% can also reduce transmission of pathogens.

  • Humidifier that I use. I like that it has a clear basin so I can see when it needs to be cleaned


Steam Showers

Breathing in moist air is another way to relieve symptoms almost immediately. Head into the bathroom, shut the door, and turn on the shower as hot as it can go. Once the room is nice and moist, bring your child in to breathe in the moist air for 10 minutes. You can also use a humidifier in your child’s room while they sleep. 


STAY HYDRATED, take steam showers, use saline drops or mist in the nose, and REST. These go for fevers as well!



Manual Percussion

If your child is dealing with chest congestion, one supportive technique you can try at home is manual chest percussion. This involves gently clapping on your child’s back and chest using a cupped hand and a relaxed wrist. The cupping creates a pocket of air that vibrates through the chest, helping to loosen mucus in the lungs and move it toward the larger airways, where it can be more easily coughed up or cleared. It’s most effective when paired with hydration and movement. Always be gentle, avoid the spine and ribs, and stop if your child is uncomfortable.


Postural Drainage


Postural drainage is a technique that uses gravity to help drain mucus from the lungs. It involves positioning the body in specific way to allow mucus to flow from smaller airways to larger airways so that it can be more easily coughed up. Listen to your lungs (or your child's) with a stethoscope or pay attention to where you feel the most congestion or discomfort. This will help pinpoint which lobes or segments need drainage. Doing postural drainage after manual percussion will help increase the effectiveness! This is safe for all ages, even babies!

Here is a link to more information with a position guide: Postural Drainage: Uses, Benefits, and Risks



Non-Medicated Cough Syrups


Medicated Cough Syrups

It is best to avoid cough suppressants for the same reasons to avoid decongestants. Coughing is how the body removes pathogens, so taking a suppressant can prolong the illness. However, if one becomes necessary due to lack of sleep or unable to eat/drink, Genexa is a good brand.


Cough suppressants are typically not recommended for babies. The FDA advises against OTC cough and cold medicines in infants under 2, while others recommend it against children under 4.


Homeopathy & Tinctures for Congestion


Homeopathy & Tinctures for Cough


Croupy Cough

  • Aconite: Use at the first sign of illness, especially after exposure to cold wind. Sudden onset with dry cough, fever, and restlessness. Most important remedy for croup. 

  • Spongia Tosta: dry mucous membranes of the mouth, nose, throat, and larynx, dry coughs, swollen or inflamed glands, and certain types of respiratory and cardiac problems. This dissolvable supplement can help relieve the dry, barking cough that comes with Croup. 

  • Hepar Sulph: Late-stage croup with wet cough

  • Cold air can help relieve croup-related breathing issues almost immediately. If the weather is cold enough outside you can take your child outside for some fresh, cold air for about 10-20 minutes. Another option is sticking your child’s head in the freezer and letting them breathe in the cold air for 1-2 minutes. 


Chest Rubs



Herbal Support

  • Expectorants: move mucus out

    • Sinus Saver: great for taking everyday to support your sinuses and to help support your body's natural response to allergens.

    • Common Thyme: Research has shown that thyme helps with lung spasms. In this case best taken in the form of a tea or tincture

    • Mullein: Mullein leaf tea or syrup can help relieve inflammation and coughing spells by helping move stuck congestion. This is a great herb for lung issues, specifically.

    • Sage: helps dry up excess mucus and fights off viruses and bacteria. It’s especially helpful for wet coughs, sinus congestion and sore throats

    • Lobelia: powerful relaxant for spasming airways; use cautiously and in low doses

    • Licorice Root: moistening and soothing to dry, irritated lungs (avoid with high blood pressure)

  • Antispasmodics: calm coughing fits

    • Cough-B-Gone: help relieve colds, coughs, and congestion. Support the respiratory system with the natural power of herbs! Mullein is an ancient remedy to support lung health and encourage necessary mucus production. Fenugreek helps to clear mucus from the body. Dandelion root supports liver health and gently detoxes.

    • Wild Cherry Bark: Wild cherry bark helps open up the lower respiratory system and move mucus up while drying it out. It has calming and nervine properties, which can help ease coughing spells, especially at night. It is also cooling to sore and inflamed tissues in the sinuses and throat. You can take this as a tea, tincture, or make your own cherry bark syrup.

    • Marshmallow Root:  coats and soothes inflamed tissues (best as a cold infusion)

    • Slippery Elm: demulcent that calms irritation and supports healing

    • Skullcap: calming to the nervous system and muscle spasms

  • Antimicrobial & Immune Supporting

    • Feel Better Fast: designed to gently help you feel better no matter what the minor illness or discomfort is. It's a catch-all starting place to simplify using a natural remedy without endless research.

    • Echinacea: supports immune response, especially when taken at first signs

    • Oregano: potent antimicrobial (great in oil or tea form)

    • Garlic: nature’s antibiotic, best raw or infused in honey

    • Usnea: strong anti-viral and anti-bacterial for lung infections



Onion Method for Coughs:

  • Slicing up an onion and placing it next to your bed while sleeping can be a powerful decongestant by opening up nasal passages and making it easier to breathe.

  • You also can slice up an onion, place in a plastic bag, put feet in plastic bag, and cover with a sock overnight. The feet are reflexes for the chest, head, and abdomen, so this is especially helpful for coughing, congestion, and head colds.

Garlic on the Feet:

  • Crush a clove, mix with olive oil, and rub it on the bottoms of baby’s feet. Cover with socks. Garlic is antimicrobial and absorbs through the skin.

    Always dilute as raw garlic can irritate skin.



Chest Poultices to Loosen Mucus

  • Onion

    • Thinly slice an onion. 

    • Sauté in olive oil or steam in water until soft - 4-5 minutes. 

    • Drain the juice and onion into a square tea towel and fold the corners over. 

    • Place on the chest or throat depending on where the cough is most bothersome. 

    • Leave the poultice on for as long as possible. At least 20 minutes, hours if possible. 

    • You can ace bandage the poultice to your chest and keep it on all night!

    • Cover up with a towel and blankets on top of you to keep the heat in.

  • Castor Oil

    • Pour castor oil onto the cloth until it’s saturated but not dripping.

    • Lay the cloth directly over the chest (avoid broken skin).

    • Cover with plastic wrap or an old towel to protect clothes/sheets.

    • Apply heat over the top (warm, not hot) for 30–60 minutes (optional for kids, but helpful).

    • Rest while it’s on. Let your child relax, read, or watch a show.

    • Remove the pack and wipe the area with a warm, damp cloth (castor oil stains, so avoid rinsing in a nice towel).

    • Repeat daily or nightly as needed until the cough improves.


Red Light Therapy

  • Red and near-infrared light (630–850nm) penetrate tissue and stimulate mitochondria to make more ATP which is the energy your cells need to heal and regulate inflammation.

  • During respiratory illness, this matters because it can:

    • Reduces inflammation in the airway and lungs. this can potentially ease breathing and alleviate symptoms.

    • Enhances oxygenation by improving blood flow and circulation. It can also improve oxygen utilization at the cellular level

    • Alleviates muscle tension in the chest and diaphragm making breathing easier

    • Promotes tissue repair by stimulating cellular repair and regeneration

  • Red light boxes are expensive. This isn't a necessary tool but can be so worth it!

  • Use code BECCANATURALLY to save $260 on you Lumebox.



Hydration

Staying hydrated during illness, especially with respiratory infections, is crucial for recovery and symptom relief. Proper hydration helps thin mucus, making it easier to clear from the lungs and airways, which can reduce coughing and congestion. It also supports immune function, aids in temperature regulation, and prevents dehydration from fever, sweating, or increased respiratory rate. When the body is fighting infection, fluids are lost more quickly, so replenishing with water, herbal teas, broths, or electrolyte-rich drinks helps maintain energy, flush out toxins, and keep the respiratory tract moist allowing the body to heal more efficiently.

Here is a link to low-tox electrolytes 

If having extended vomiting, diarrhea, or other symptoms without adequate re-hydration, call your pediatrician. You want to avoid severe dehydration.


Rest

Your body heals when it sleeps, so if you follow a strict sleep schedule don’t hesitate to throw it out. Let your kiddo nap longer than usual, go to bed earlier if needed, sleep in, etc. Resting allows the body to focus all its energy on healing, cleansing toxins, and immune support. If a fever or cough is keeping your child up at night, that would be a time where you could consider medication if you feel that their body needs to rest and reset.


Fevers often go hand-in-hand with respiratory illness. Here is a detailed fever guide!


Supporting the Immune System is a crucial part of healing from illness. Here is a detailed immune support guide!



The middle of the night is the worst time to realize you’re not ready, and that’s usually when respiratory illness hits. 

Have what you need on hand - the herbs, the tools, the knowledge - so when your child wakes up coughing or struggling, you’re not scrambling… you’re already one step ahead.

You don’t have to fear respiratory illness when you know what to look for and how to act early.

And remember, respiratory illness is a time when we are thankful for modern medicine when natural remedies can’t do it. But also remember, herbs and homeopathy are powerful tools, and being prepared might make all the difference!



As always, this is not medical advice! Talk to your trusted provider for personalized recommendations.


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