Retractions refer to the visible sinking in of the chest wall with inspiration in a child with respiratory difficulty. They are observed

  • in the area above the collarbone (supraclavicular)
  • between the ribs (intracostal)
  • and below the ribcage (subcostal)

Retractions are seen most often in asthmatics (diagnosed or undiagnosed) who are laboring to breathe through constricted and obstructed breathing tubes. Another time to watch for retractions is during an attack of infant bronchiolitis. Retractions are a sure sign of the need for immediate definitive treatment - as in call your doctor. Retractions in a child with pneumonia would be a bad sign, as well. More benign retracts are seen in babies with laryngomalacia or tracheomalacia.

Retractions are always a sign of significant respiratory distress, which should be reported immediately to your doctor.

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