Chest Retractions — What They Are & Why They Matter

What are chest retractions?

Chest retractions happen when a child is working very hard to breathe. You can see the skin pulling in — between the ribs, under the ribs, above the collarbone, or at the throat (neck). Retractions tell you that your child’s body is using extra muscles to move air. They are always a sign that your child needs medical attention.

How to identify retractions

To check for retractions, uncover your child’s chest and watch closely while they breathe:

• Subcostal retractions: skin pulling in just below the rib cage — the belly sucks in with each breath
• Intercostal retractions: skin pulling in between the ribs — you can see the ribs clearly with each breath
• Suprasternal retractions: the skin at the base of the throat (just above the breastbone) pulls in
• Supraclavicular retractions: the skin just above the collarbone pulls in

Mild retractions may appear only when your child is breathing faster than usual. Severe retractions are visible at rest and involve multiple areas.

Using MamaBear to capture retractions

When you see retractions, open MamaBear and record a short video of your child’s chest. Make sure the chest is uncovered and the lighting is good. Send the video report to your provider immediately. Video is the single most useful thing you can give a provider who cannot see your child in person.