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Pediatric - Wheezing

Wheezing (other than asthma)

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Does this describe your child's 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 Day Care

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

If not, see these topics

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.

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.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 1/19/2009

Last Revised: 8/6/2007

Content Set: Pediatric HouseCalls Online

Copyright 1994-2009 Barton D. Schmitt, M.D.

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