Belly Breathing for Kids: How to Teach It, with a Script to Read

About this tool

Belly breathing for kids is slow, deep breathing that moves the belly rather than the shoulders, taught to children through play. In adults it is called diaphragmatic breathing: the diaphragm drops on the inhale so the abdomen rises, and the exhale is slow and a little longer than the inhale. For a child, the mechanics are wrapped in a game: a soft toy that rides up and down on the tummy, a bubble wand, a flower to smell and a candle to blow out, a hand to trace with a finger. The purpose is the same at any age: to give the body a signal that it is safe, and to give the child a tool they can use on their own when big feelings arrive.

The reason belly breathing calms is mostly about the exhale. Breathing out is linked to the branch of the nervous system that slows the heart and settles the body, which is why the heart rate dips slightly every time we breathe out. Making the out-breath slow and longer than the in-breath tilts the balance toward settling. Slow breathing at around six breaths a minute, well below a child's resting rate, has been shown in adults to increase heart rate variability and reduce reported anxiety; a 2018 systematic review by Zaccaro and colleagues summarises this work. The evidence specific to children is thinner, mostly small school-based studies of breathing and mindfulness programmes, and it points the same way without being conclusive. What is well established is that it is safe, cheap and easy to teach.

Belly breathing is not new. Slow abdominal breathing sits inside yoga's breathing practices and in the relaxation training of Western psychology, where Herbert Benson's work on the relaxation response in the 1970s made slow breathing a standard component of stress management. Child versions grew out of that tradition and out of school mindfulness programmes. Sesame Street's 'Belly Breathe' song, with Elmo coaching viewers to put their hands on their bellies and breathe slowly when they are upset, probably did more to spread the term among parents than any study. The methods below are the ones that child therapists, teachers and paediatric nurses use most often.

Four methods cover most children. The soft toy on the belly is for the youngest: the child lies down, a small stuffed animal sits on their tummy, and the game is to rock the animal to sleep by making it rise slowly and fall slowly. Bubble blowing teaches the slow exhale without any instruction, because a hard, fast breath pops the bubble and only a long gentle one makes a big one; when there are no bubbles to hand, pretend ones work. Smell the flower, blow out the candle gives a shape to each breath: a gentle sniff in through the nose as if smelling a flower, then a slow steady blow as if the candle must flicker but not go out. Finger breathing, sometimes called five-finger breathing, has the child hold one hand out and trace up each finger with the other index finger while breathing in, and down while breathing out, which gives fidgety hands something to do and makes five breaths concrete.

A useful rule of thumb for practice is about one minute per year of age: two or three minutes for a three year old, five for a five year old, with ten minutes as a sensible ceiling for anyone. That is a guide to attention, not a research finding; stop sooner if the child is done. Daily practice for a couple of weeks, at a calm time such as bedtime or the sofa after school, is what makes the skill available later. A breathing technique taught for the first time during a meltdown will not land, because a child in full distress cannot take in instructions. Teach it in calm, use it in the early stages of upset, and expect it to work only partially at first.

You are the most important part of the exercise. Young children settle largely by borrowing an adult's calm, a process often called co-regulation, and a parent breathing slowly next to them does more than any instruction. So breathe with them, visibly, every time. Keep your voice low and slow. Avoid the command 'take a deep breath', which most children hear as a telling-off, and offer instead: 'Let's do our flower and candle breaths.' If the child refuses in the moment, do it yourself where they can see you and leave it there. The script on the printable is written for you to read, slowly, and to adapt into your own words once you know it.

Belly breathing suits most children from about three upward, and it is used for everyday worry, bedtime restlessness, frustration, the run-up to a test or an injection, and the early stages of a tantrum. It is not a treatment for an anxiety disorder, and it is not enough on its own for a child who is anxious most days, who has had a frightening experience, or whose meltdowns are frequent and severe; those situations deserve a conversation with the child's doctor or a child therapist, where breathing may become one skill among several. Children with asthma can belly breathe, and the slow exhale is often helpful, but breathing exercises never replace an inhaler and should never be tried on a child who is actually struggling to breathe.

The common mistakes are easy to fix. Big gulping in-breaths, which can make a child dizzy; keep the inhale gentle and make the exhale the long part. Lifting the shoulders rather than the belly, which the toy on the tummy corrects. Using the technique only in crises, so the child comes to associate it with being in trouble. Correcting the child's breathing instead of modeling it. And turning it into a demand, so a tool for calm becomes one more thing the child is failing at. If a child says the breathing makes them feel strange or more panicky, which happens with a minority of anxious children, stop, and switch to something with the attention outside the body, such as naming five things they can see.

If worry, sleep problems or outbursts are a daily feature, if a child is avoiding school or friends, or if their distress follows a frightening or painful event, breathing exercises are a support, not a plan. Speak to your child's doctor or a licensed child therapist. The printable gives you the script, the four methods and the timing guide on one page, so you can keep it where you practice.

Reviewed by Michael Callans, MSW
Checked the breathing physiology claims against the cited reviews, confirmed the evidence in children is described as limited, and confirmed the page addresses the adult teaching the skill.

References

1. Zaccaro A, Piarulli A, Laurino M, et al. How breath-control can change your life: a systematic review on psycho-physiological correlates of slow breathing. Front Hum Neurosci. 2018;12:353.
2. Ma X, Yue ZQ, Gong ZQ, et al. The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults. Front Psychol. 2017;8:874.
3. Benson H, Klipper MZ. The Relaxation Response. New York: William Morrow; 1975.
4. Napoli M, Krech PR, Holley LC. Mindfulness training for elementary school students: the Attention Academy. J Appl Sch Psychol. 2005;21(1):99–125.

Belly Breathing for Kids FAQ