Breathing Exercises for Children and Teens: School Programs and Evidence

Urgent first

If a child or teen is struggling to breathe, has chest pain, or faints, treat it as an emergency and call 911 in the US. Breathing practice is not a response to those problems; see when breathlessness needs medical care. If a young person needs immediate help for their mental health, the NIMH says to call or text the 988 Suicide & Crisis Lifeline at 988. [1][2]

What this page covers

Parents, teachers and teens often ask whether slow-breathing exercises help with worry, stress or school nerves. This page looks at what the research on children and teens actually found, which is less than the popularity of breathing exercises suggests. It gives no instructions for breath-holding, fast or forceful breathing, or breathing games in or near water. The sources we read for children describe only slow, comfortable breathing.

A gentle option health services describe

The NHS suggests practising simple relaxation with an anxious child, such as taking 3 deep, slow breaths, breathing in for a count of 3 and out for 3. [3] The NHS adult technique adds that the breath should flow into the belly "as is comfortable, without forcing it." [4] Doing it together, in a calm moment rather than in the middle of a meltdown, is our suggestion; the sources we read do not test timing. "Deep" should never mean big or fast. If a child feels dizzy, tingly or faint, stop and see dizziness, tingling and fainting during breathing exercises. For play-based ideas, see child-friendly breathing games.

What studies found

1. Does one guided slow-breathing session help a child in daily life?

   Mixed

   A micro-randomized trial of 171 children aged 9 to 13, over 15 days, found no immediate effect on negative mood or relaxation compared with two control conditions. Relaxation was higher than in the passive control when children were more worried than usual, but not higher than in the active control. [5]

2. Does resonant (slow, paced) breathing buffer a stress task in young teens?

   Physiological finding only; mixed

   A trial of 150 adolescents aged 12 to 13 found only partial support: no effects on mood or recovery, and the target rate proved difficult to sustain. [6]

3. Do school mindfulness programs help?

   No good evidence of benefit at 1 year

   The MYRIAD trial (10 lessons of psychoeducation and mindfulness, not breathing alone) found no evidence it beat usual teaching at 1 year, and no intervention-related adverse events. [7] One author directs the Oxford Mindfulness Centre and receives royalties for mindfulness books. [7]

4. Do relaxation-type programs in schools reduce anxiety?

   Weak, mixed

   A network meta-analysis of 137 studies found mindfulness and relaxation-based programs reduced anxiety in universal secondary settings, but small-study effects were present and the authors concluded there is little evidence overall. [8]

5. Does yoga (which often includes breathing) reduce anxiety in young people?

   Promising but limited; not breathing-specific

   Nearly all studies in a systematic review reported reduced anxiety, but populations and designs varied widely. [9]

6. Do breathing exercises help children with breathing-pattern problems or asthma?

   Proper evidence not found

   A Cochrane review of dysfunctional breathing in children found no suitable studies. [10] A Cochrane review of children with asthma could draw no reliable conclusions. [11]

Breathing trials cannot hide from participants which group they are in, and many outcomes are self-reported, so expectation can shape results. NCCIH says some relaxation techniques may help children and adolescents, but much of the supporting research was rated low quality. [12]

Take extra care

• Asthma, lung, heart or fainting history: ask the child's clinician first, and never use breathing practice in place of prescribed medicines. See breathing exercises for asthma.
• Trauma or high anxiety: some people report more anxiety or intrusive thoughts during relaxation practice. [12] Offer choice, let the child open their eyes and stop whenever they like. See trauma-informed breathwork.
• Pressure to perform: do not make it a contest or a test.

If a school offers a program

Ask what is taught, whether it is optional, and what happens if a child feels worse. Programs should not involve holding breath or breathing fast. The NHS also advises not forcing a child into a stressful situation without first talking about what is making them anxious. [3]

When to talk to a doctor

The NHS says anxiety becomes a problem when it starts to get in the way of everyday life, and that if a child is really struggling it may be good to talk to a GP or school nurse (UK advice). [3] The NIMH says to contact a health professional if behavioral signs last weeks or months and interfere with daily life. [1] Breathing exercises can sit alongside that care but do not replace it. More for parents: therapies for children and older adults.