Identify That Breath Sound!

A wheeze is a high-pitched, whistling sound made when air flows through narrowed or partially blocked airways in the lungs. It often happens during exhalation (breathing out), but can also occur when inhaling if the airway narrowing is severe.

What it sounds like

A continuous, musical noise — not a cough, rattle, or snore. Parents might notice it most when a child is lying down, crying, or after active play.

• A tea kettle starting to whistle
• Air squeezing through a pinched balloon opening
• A musical note played softly on a flute

Why it matters

Wheezing often signals inflammation, mucus buildup, or muscle tightening in the small airways — common in conditions like asthma, bronchiolitis, respiratory infections, and allergic reactions. Not all noisy breathing is wheezing, and not all wheezing is serious — but consistent wheezing should always be reported to a healthcare provider.

Stridor is a harsh, high-pitched sound heard mostly during inhalation (breathing in). It’s caused by a narrowing or blockage in the upper airway — typically around the throat (larynx) or windpipe (trachea).

What it sounds like

It’s loud, alarming, and often heard without a stethoscope. You may notice it when your child is upset, crying, or after they’ve been active.

• A seal barking or dog panting noisily
• A harsh gasp or screeching noise when trying to breathe in
• A child trying to breathe through a narrow straw

Why it matters

Stridor can indicate an upper airway obstruction, which may be caused by croup (a viral infection common in toddlers), laryngomalacia (soft floppy tissue in infants), allergic reactions, or — in emergency cases — a swallowed object. Unlike wheezing, which comes from the lungs, stridor is higher up, in the throat or voice box. If your child has stridor — especially with trouble breathing, drooling, or a muffled voice — seek medical care immediately.

Laryngomalacia (luh-ring-go-muh-LAY-shuh) is a common cause of noisy breathing in infants. It happens when the soft, floppy tissues above the vocal cords collapse inward during inhalation, partially blocking the airway. It’s the most frequent cause of stridor in babies.

What it sounds like

Often described as a musical, fluttery, or squeaky inhale — like the sound of air being pulled through a narrow straw.

• A high-pitched squeak or whistle when your baby breathes in
• Most noticeable when lying on their back, feeding, or excited
• May get louder over weeks, then gradually improve as the airway strengthens

Why it matters

Laryngomalacia is usually mild and improves on its own by 12–18 months of age as the airway matures. However, it’s worth monitoring if you notice poor weight gain, difficulty feeding, cyanosis (bluish color around lips or face), or severe breathing difficulty or pauses in breathing. Your provider may refer you to a specialist (usually ENT) if symptoms interfere with eating, sleeping, or growth.

Stertor is a low-pitched, snoring or rattling sound that happens when your child inhales or exhales. It’s caused by a partial blockage in the nose or back of the throat (nasopharynx or oropharynx).

What it sounds like

Often deeper and more muffled than stridor or wheezing — like your child has mucus or something in their throat or nose that makes it harder to breathe quietly.

• Heavy snoring
• A congested-sounding gasp
• A wet, rumbling breath, especially when lying down

Why it matters

Stertor is typically not as urgent as stridor or wheezing, but it can signal nasal congestion from a cold, enlarged adenoids or tonsils, sleep-disordered breathing, or obstruction from mucus or infection. It may also appear when your child is sleeping or very congested during the day. If stertor is persistent, interferes with sleep, or occurs with signs of distress (like labored breathing or pauses in breathing), check with your doctor.

Grunting is a short, low sound your child makes while exhaling. It’s often an involuntary effort to keep air in the lungs — a sign that your child is working hard to breathe. If grunting is persistent, paired with fast breathing, retractions, or bluish lips/skin, seek medical attention immediately.

What it sounds like

• A soft “uh” or “nn” sound at the end of a breath
• A pushing noise, like trying to lift something heavy
• A brief, muffled groan, especially after each breath out

It may happen with every breath or just during periods of distress.

Why it matters

Grunting can be a sign that your child is struggling to breathe or trying to keep their lungs inflated. It may point to lower respiratory infections (like pneumonia or RSV), collapsed airways or fluid in the lungs, severe nasal congestion, or pain with breathing.

Tracheomalacia (tray-kee-oh-muh-LAY-shuh) is a condition where the walls of the trachea (windpipe) are soft or floppy, making it harder for your child to breathe easily — especially when exhaling. Instead of staying open, the trachea can partially collapse, especially during coughing, crying, or exertion. It can be congenital (present at birth) or acquired after illness, surgery, or long-term ventilation.

What it sounds like

• A honking, barking, or brassy cough
• Noisy exhalation (different from the squeaky inhalation of stridor)
• A persistent wheeze that doesn’t improve with asthma medications
• Can sound like a wet or rattly breath, especially when active or upset

Why it matters

In many cases, mild tracheomalacia gets better over time as the airway strengthens with age. But it may require medical attention if your child has frequent respiratory infections, a lingering harsh cough, difficulty clearing mucus, trouble feeding or gaining weight, or episodes of turning blue (cyanosis). A specialist may recommend monitoring, breathing support, or — in rare cases — surgery if symptoms are severe.