Wheezing (Other Than Asthma)
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 (usually 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 child care after the wheezing and fever are gone.
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 (until you talk with your doctor)
- 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.
- Nasal Washes To Open a Blocked Nose:
- Use saline nose drops or spray to loosen up the dried mucus. If not available, can use warm tap water.
- STEP 1: Instill 3 drops per nostril. (Age under 1 year, use 1 drop and do one side at a time)
- STEP 2: Blow (or suction) each nostril separately, while closing off the other nostril. Then do other side.
- STEP 3: Repeat nose drops and blowing (or suctioning) until the discharge is clear.
- Frequency: Do nasal washes whenever your child can't breathe through the nose.
- Saline nasal sprays can be purchased without a prescription.
- Saline nose drops can also be made: Add 1/2 teaspoon (2 ml) of table salt to 1 cup (8 ounces or 240 ml) of warm water.
- Reason for nose drops: suction or nose blowing alone can't remove dried or sticky mucus.
- Another option: use a warm shower to loosen mucus. Breathe in the moist air, then blow each nostril.
- For young children, can also use a wet cotton swab to remove sticky mucus.
- Importance for a young infant: can't nurse or drink from a bottle unless the nose is open.
- Humidifier: If the air is dry in your home, run a humidifier.
- 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).
- Avoid Tobacco Smoke: Active or passive smoking makes coughs much worse.
- Contagiousness: Your child can return to child care after the wheezing and fever are gone.
- Call Your Doctor If:
- Breathing becomes difficult, tight or loud
- Wheezing becomes worse
Author: Barton D. Schmitt, M.D.
Last reviewed: 9/15/2011
Last revised: 5/25/2011 12:34:28 PM
