Which signs indicate respiratory distress in an infant requiring immediate evaluation?

• A. Only fever.
• B. Sneezing and runny nose.
• C. Tachypnea, grunting, nasal flaring, intercostal or subcostal retractions, cyanosis, poor feeding.
• D. Normal breathing.

Answer: (C)

Infants with respiratory distress show signs of increased work of breathing and possible hypoxemia. Tachypnea means rapid breathing, while grunting is a sound made with exhalation that helps keep the airways open and indicates airway resistance. Nasal flaring shows the baby is working hard to inhale. Intercostal or subcostal retractions are the chest wall pulling inward with breathing, signaling effort beyond normal respiration. Cyanosis points to low oxygen levels, and poor feeding reflects fatigue and compromised oxygen delivery to the body. When these signs are present, they indicate a breathing problem that can deteriorate quickly and requires immediate evaluation.

Fever alone doesn’t indicate distress, and sneezing or a runny nose without increased work of breathing isn’t an urgent respiratory emergency. Normal breathing likewise does not indicate distress.