Diaphragmatic (Abdominal) Breathing

What is diaphragmatic breathing?

Diaphragmatic (or abdominal) breathing is a technique that uses the diaphragm muscle to take a deep breath. The diaphragm is a large muscle below the lungs that helps us breathe. Diaphragmatic breathing is sometimes also referred to as “deep,” “relaxed,” or “belly” breathing.

How can diaphragmatic breathing help with pediatric gastrointestinal (GI) conditions?

Diaphragmatic breathing can help with pediatric GI conditions in two different ways:

• Diaphragmatic breathing can be a relaxation strategy during cognitive behavioral therapy for pediatric GI conditions. Diaphragmatic breathing turns on the body’s “rest-and-digest” response (called the parasympathetic nervous system). Once a child or adolescent learns and practices diaphragmatic breathing, they can use the technique to manage GI symptoms and any related stress or anxiety. Diaphragmatic breathing can be a great relaxation strategy because it is relatively simple and quick to use.
• Diaphragmatic breathing also is used as a behavioral treatment for rumination syndrome. This is a disorder in which a child regurgitates (throws up) foods and/or liquids. Diaphragmatic breathing can be used to stop the abdominal wall from contracting, which causes regurgitation. This prevents the abdominal muscles from pushing the stomach’s contents up into the esophagus. Diaphragmatic breathing is used during and after eating meals to help manage regurgitation.

Who can teach diaphragmatic breathing?

Many healthcare providers including physicians, psychologists, and physical therapists are trained to teach diaphragmatic breathing. They can teach children and adolescents how, when, and why to use diaphragmatic breathing for pediatric GI conditions.

There also are many online resources to learn about diaphragmatic breathing. However, it is best to start by discussing diaphragmatic breathing with your child’s healthcare provider.

How is diaphragmatic breathing done?

• First, place one hand on your chest and one hand on your abdomen near the belly button. Take a normal breath in and notice if either of your hands move. If your belly hand moves, you might be a natural belly breather. If your chest hand moves, you are breathing into your chest rather than your belly. During belly breathing, your chest hand should not move.
• Next, take a slow breath in through your nose like you are smelling a warm drink.
• Try to move the air all the way down into your belly to fill it up like a balloon. Your belly hand should move up when you do this. Your chest hand should stay still.
• Breathe out through your mouth like you are blowing on that hot drink to cool it down. Your belly will deflate like a balloon as air is let out, and your belly hand should move down.
• Continue to breathe in and out in this way, with your belly lifting to fill up with the air as you breathe in, and then going down as you breathe out. Try to breathe in for five seconds and breathe out for five seconds, although everyone’s comfortable breathing pace can be slightly different.

Many people notice they relax within a few minutes of practicing diaphragmatic breathing. It can be helpful to practice diaphragmatic breathing for about 5–10 minutes each day. Just like learning any new skill, this practice helps prepare your child to manage GI symptoms by using diaphragmatic breathing. Talk to your child’s healthcare provider about how your child can use diaphragmatic breathing practice.

Author: Kelly A. O’Neil Rodriguez, Ph.D.
Editor: Riha Bhatt, MD
January 2024