Wheezing other than Asthma

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 (usually RSV) of the small airways (bronchioles).
  • Main cause: after age 3, 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

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WHEN TO CALL YOUR DOCTOR

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.
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HOME CARE ADVICE (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 1/2 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 becomes worse or develops any of the "Call Your Doctor" symptoms.

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REFERENCES

  1. Darville T and Yamauchi T. Respiratory syncytial virus. Pediatr Rev. 1998, 19(2):55-61.
  2. Gadomski A. Bronchiolitis dilemma: A happy wheezer and his unhappy parent. Contemp Pediatr. 2002;19(11):40-59.
  3. Gentile DA. Considering the differential diagnosis of wheezing in infants. J Respir Dis Pediatrician. 2003;5(2):84-88.
  4. Shaw KN, et al. Outpatient assessment of infants with bronchiolitis. Amer Jour Dis Child. 1991;145(2):151-5.
  5. Welliver JR and Welliver RC. Bronchiolitis. Pediatr Rev. 1993, 14:134-139.

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.

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