Noisy breathing (including grunting in infants) Retractions (the soft tissue between the ribs gets sucked inward because the child is trying so hard to breathe in) Use of accessory muscles of respiration to breathe (the child is having so much difficulty breathing that he or she needs extra muscles, like the abdominal muscles, to lift the chest and inhale) Nasal flaring in young children Seesaw breathing in infants (where the chest and abdomen "seesaw" up and down; this is a sign of severe respiratory distress in an infant)