Wheezing(Other Than Asthma)

Pediatric HouseCalls Online

DEFINITION

• A high-pitched purring or whistling sound produced during breathing out.
• Use this guideline only if the child has never been treated for asthma.

Causes

• 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 2, may be the first attack of asthma.

Return to Day Care

• Your child can return to day care after the wheezing and fever are gone.

See More Appropriate Topic (instead of this one) If

• Previous diagnosis of asthma, see ASTHMA ATTACK.

WHEN TO CALL YOUR DOCTOR

Call 911 Now (your child 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 over 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 

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.