Babies and children are not small adults. Their airways are narrower, their respiratory muscles weaker and their chest wall more flexible; techniques are not simply scaled down but rebuilt.
Telling a small baby to “take a deep breath and hold it” has no meaning. In this age group the work runs through positioning, gentle techniques and following the baby's own breathing rhythm. In a school-age child, play becomes the most effective tool: blowing up a balloon, making bubbles through a straw in a glass of water, spinning a windmill or blowing out candles are, in fact, breathing exercises.
The family's role is decisive in children. The programme is largely carried out at home by the family, so family training sits at the centre of the work.
When does it come up?
- Cystic fibrosis
- Bronchiectasis and primary ciliary dyskinesia
- Recurrent chest infections
- After bronchiolitis
- Neuromuscular conditions (SMA, muscular dystrophies, cerebral palsy)
- Congenital lung and chest wall anomalies
- Chronic lung problems following premature birth
- Childhood asthma, as a supportive programme on medical referral
- Before and after surgery
An age-appropriate approach
Babies (0–2 years): positioning, gentle techniques, appropriate waiting times after feeds and working with the baby's breathing rhythm. Timing is planned around feeding.
Play age (2–6 years): the exercise is not explained directly but turned into play. Balloons, bubbles through a straw, windmills, whistles and blowing foam are all used. Keeping sessions short and enjoyable reduces resistance.
School age (6 years and over): the child can now understand the technique. Adapted forms of ACBT, huffing and appropriate devices can be used. At this age, explaining why markedly improves cooperation.
The family's role
The programme is sustained at home, not in the clinic, so the family needs to become confident with the technique. Family training covers:
- Hands-on teaching and rehearsal of the technique
- What time of day and how often to carry it out
- Timing in relation to feeding
- What to do when the child resists
- Which signs mean stopping and contacting the doctor
- Cleaning and maintenance if a device is used
The information on this page is for general guidance and does not replace individual advice. A physiotherapist does not diagnose; they assess and plan a programme within the framework of medical referral. Which techniques are suitable for you is determined through a face-to-face respiratory assessment. Please consult your doctor and physiotherapist before starting.
Sudden or rapidly worsening breathlessness, chest pain, bluish discolouration of the lips or nails, or confusion may signal an emergency. Do not attempt exercises in such a situation; call the emergency number (112 in Türkiye) or go to the nearest emergency department without delay.
Frequently Asked Questions
The techniques used with children are selected and adapted to be gentle. A baby crying does not always mean pain; a change of position or being woken can also be the cause. If you notice clear discomfort, however, stop and let us know.
Carrying out the technique immediately after feeding is generally not appropriate, as it can increase the risk of vomiting. The right waiting time is set for your child's age and feeding routine.
This is very common and usually means the method is not right for the age. Turning the exercise into play, shortening it, moving it to a different time of day or offering the child small choices often helps.