Wheezing (Other Than Asthma)

Symptoms

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 Child Care

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

See More Appropriate Topic (instead of this one) If

• Previous diagnosis of asthma, see ASTHMA ATTACK

Should I Call?

WHEN TO CALL YOUR DOCTOR

Care at Home

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. 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.
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 child 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.