Alternate Names: Flaring of the alae nasi (nostrils); Nostrils - flaring

Considerations:

Nasal flaring is seen mostly in infants and younger children. Nasal flaring is often an indication that increased work is required for breathing. Any condition that causes the infant to work harder to obtain enough air can cause nasal flaring. While the causes of nasal flaring can be mild, they can also be life-threatening.

In young infants nasal flaring is often a very important sign of respiratory distress.

Common Causes:

• airway obstruction (any cause)
• bronchiolitis
• croup
• asthma (acute)
• acute epiglottitis
• hyaline membrane disease (respiratory distress syndrome seen in newborn infants only)
• transient tachypnea of the newborn
• pneumonia

Home Care:

For suspected airway obstruction (blocked airway), the Heimlich maneuver should be performed and emergency help sought immediately.

For nasal flaring that is not a sign of airway obstruction, prescribed therapy should be followed.

Call If:

• there is any persistent, unexplained nasal flaring, especially in a young child.
• bluish color develops in the lips, nail beds, or skin. This indicates that breathing difficulty is severe and may indicate that an emergency condition is developing.

What To Expect:

A quick physical assessment of the child to determine if the flaring is due to upper or lower respiratory problems. Administration of oxygen if needed and ordering of any lab work or X-Rays that might assist in the diagnosis. Obtaining a medical history.

Medical history questions may include:

• When did it start?
• Is the person getting better or worse?
• Does the person look blue?
• Is the breathing noisy or are there wheezing sounds?
• Are there grunting noises with the breathing?
• Does the person look like they are working hard to breathe?
• Are they getting tired or sweaty?
• Do the muscles of the stomach, shoulders, or rib cage need to be used when the person is breathing (see intercostal retractions)?
• What other symptoms are present?

Physical examination will include careful listening to the breath sounds (auscultation).

Diagnostic tests that may be performed include:

• arterial blood gas analysis
• CBC (blood test)
• ECG
• X-rays of the chest

After seeing your health care provider:
If a diagnosis was made by your health care provider related to nasal flaring, you may want to note that diagnosis in your personal medical record.