WHEEZING (Other Than Asthma)

Symptom Definition

• A high-pitched purring or whistling sound produced during breathing out.
• Rapid breathing rate is commonly associated (more than 60 breaths/minute if less than 2 months, more than 50 if 2-12 months and more than 40 if 1-5 years).
• Use this guideline only if the child has never been treated for asthma.

Cause

• Main cause in the first 2 years of life: bronchiolitis (peaks at 6-12 months). This is a viral infection (RSV) of the small airways (bronchioles).
• Main cause: after age 3, may be the first attack of asthma.

See More Appropriate Topic (instead of this one) If

• Previous diagnosis of asthma, see ASTHMA ATTACK.

WHEN TO CALL YOUR DOCTOR FOR WHEEZING

Call 911 Now (you may need an ambulance) If:

• Wheezing started suddenly after medicine, an allergic food or bee sting. 
• Severe difficulty breathing (struggling for each breath, making grunting noises with each breath, unable to speak or cry because of difficulty breathing).
• Your child passed out or has bluish lips.
• Child recently choked on small object or food.

Call Your Doctor Now (night or day) If

• Wheezing but none of the symptoms described above.

HOME CARE ADVICE FOR MILD WHEEZING (If Your Doctor Doesn't Need to See Your Child)

1. Warm Fluids for Coughing Spasms: For any bouts of severe coughing, offer warm apple juice or lemonade if older than 4 months old. (Reason: These can relax the airway and loosen up sticky secretions). Do not give any cough medicine.
2. Suction for a blocked nose: If the nose is blocked up, your child will not be able to drink from a bottle or breast-feed. Most stuffy noses are blocked by dried or sticky mucus. Wash out the dried secretions with warm water or saline nose drops. Use 1 drop at a time in infants. This will loosen up the sticky mucus. Then use a suction bulb. Repeat nosedrops until open. Make saline nosedrops by adding ½ tsp of table salt to 1 cup (8 oz) of warm water.
3. Humidifier: If the air is dry in your home, run a humidifier.
4. Smaller Feedings: Encourage small, frequent feedings whenever your child has the energy to drink. (Reason: child with wheezing doesn't have enough energy for long feedings).
5. Avoid Tobacco Smoke: Active or passive smoking makes coughs much worse.
6. Contagiousness: Your child can return to day care after the wheezing and fever are gone.
7. Call Your Doctor If:
   • Breathing becomes difficult, tight or loud
   • Wheezing becomes worse or your child develops any of the "Call Your Doctor" symptoms

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Pediatric HouseCalls Online. Copyright © 2000-2005 Barton Schmitt, M.D. FAAP

Reviewed 8/2005

Revised 7/2005

See Other Topics:

• Asthma Attack

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