Increased Deep Breathing in Children: A Pediatric Perspective

Children often take deep breaths?

A 7-year-old child (entering second grade) is 120 cm tall and weighs 26 kg.
Previously, the child would occasionally take deep breaths, but recently the frequency of deep breathing has increased.
The child visited a nearby clinic and consulted a familiar physician, who performed a thorough auscultation of the lungs and heart and confirmed that there were no issues.
The child's activity level and stamina are good, and they are proficient in swimming (swimming every day during summer vacation, although their lips tend to turn slightly purple when entering the water, which resolves after warming up).
The child sleeps well but has some difficulty falling asleep.
Overall, the child's learning abilities are satisfactory.
The mother is seeking advice on any further evaluations or tests that might be beneficial.
Thank you for your guidance! Sincerely, a concerned mother.
98/8/5 pm 2:55.

Zheng Mama, 30~39 year old female. Ask Date: 2009/08/05

Dr. Pei Rensheng reply Pediatrics

Dear Mrs.
Cheng,
Hello.
Based on your description, it is very likely that your child has Tourette syndrome, which is one of the common ages for onset at 7 years old.
Tourette syndrome was first described in 1885 by French physician Gilles de la Tourette.
It is characterized by chronic and recurrent involuntary movements or sounds.

There are three types to discuss:
1.
Motor tics: The most common include blinking, pouting, making faces, deep breathing, shoulder shrugging, and head shaking.
2.
Vocal tics: Common vocalizations include throat clearing, grunting, sniffing, coughing, and shouting.
Other behaviors may include gasping, choking, stuttering, whistling, mimicking animal sounds, and uttering inappropriate or obscene words.
Individuals may also repeat what they have said or suddenly change their volume or pitch.
3.
Sensory or psychological aspects: Most individuals with Tourette syndrome experience premonitory urges before a tic occurs, such as blinking due to eye strain or shaking their head and shoulders due to tension.
They may also feel compelled to scratch others if they perceive them as itchy.
Mild cases of Tourette syndrome typically do not require medication and may resolve on their own after some time, only to reappear later.
A small number of cases may persist into adulthood.
If you have further questions, I recommend consulting a pediatric neurologist for additional evaluation.
Wishing you health and happiness!
Sincerely,
Dr.
Pei Ren-Sheng
Chief of Pediatrics, Taoyuan Hospital, Department of Health

Reply Date: 2009/08/05

More Info

Increased deep breathing in children can be a concerning symptom for parents, especially when it appears suddenly or increases in frequency. In the case of your 7-year-old child, several factors may contribute to this behavior, and it is essential to consider both physiological and psychological aspects.

Firstly, deep breathing can sometimes be a response to physical exertion or excitement. Given that your child is active and enjoys swimming, it is possible that the increased breathing rate is simply a reflection of their physical activity. However, you mentioned that your child experiences a tendency for their lips to turn purple when swimming, which could indicate a transient issue with oxygenation or circulation during exertion. This warrants further investigation to ensure that there are no underlying respiratory or cardiovascular issues.

From a pediatric perspective, it is crucial to rule out any potential medical conditions that could cause increased deep breathing. While the initial examination by your physician showed no immediate concerns with the lungs or heart, it may be beneficial to consider additional evaluations. For instance, a pediatric pulmonologist could conduct further tests, such as pulmonary function tests, to assess lung capacity and function. Additionally, an evaluation for exercise-induced bronchoconstriction (a condition where the airways narrow during or after exercise) might be warranted, especially given the symptoms observed during swimming.

On the psychological side, increased deep breathing can also be a response to anxiety or stress. Children often express their emotions through physical symptoms, and if your child is experiencing any form of anxiety—whether related to school, social interactions, or other factors—this could manifest as changes in breathing patterns. It might be helpful to observe if there are specific triggers that lead to increased deep breathing. Keeping a diary of these instances could provide valuable insights.

Moreover, if your child is having difficulty falling asleep, this could also be a contributing factor. Sleep disturbances can lead to increased anxiety and stress, which may further exacerbate breathing issues. Establishing a calming bedtime routine and ensuring a conducive sleep environment could help alleviate some of these concerns.

In terms of immediate steps you can take, consider the following recommendations:
1. Monitor Symptoms: Keep a detailed log of when the deep breathing occurs, any associated activities, and any other symptoms (like the purple lips). This information can be invaluable for healthcare providers.

2. Consult Specialists: If the deep breathing persists or worsens, consider seeking a referral to a pediatric pulmonologist or a pediatrician specializing in respiratory issues. They can provide a more comprehensive evaluation.

3. Evaluate for Anxiety: If you suspect that anxiety may be a factor, consider consulting a child psychologist or counselor. They can help assess your child's emotional well-being and provide strategies to manage anxiety.

4. Encourage Relaxation Techniques: Teaching your child simple relaxation techniques, such as deep breathing exercises or mindfulness, can help them manage stress and anxiety.

5. Follow-Up: Regular follow-ups with your pediatrician are essential to monitor your child's progress and any changes in symptoms.

In conclusion, while increased deep breathing in children can be benign, it is essential to approach it holistically, considering both physical and psychological factors. By monitoring symptoms, consulting specialists, and fostering a supportive environment, you can help ensure your child's health and well-being.

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