Wheezing (Other than Asthma)

Use this guideline only if the child has never been treated for asthma

Symptom Definition

• A high-pitched purring or whistling sound produced during breathing out
• Rapid breathing rate is commonly associated with wheezing (if more then 60 breaths/minute if younger then 2 months old, or if more then 50 breaths/minute if 2-12 months old, or if more than 40 breaths/minute if 1-5 years old)
• 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 3, may be the first attack of asthma

See More Appropriate Topic

• If previous diagnosis of asthma, see Asthma Attack

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
• Your child recently choked on small object or food

Call Your Doctor Now (night or day) If

• Wheezing but with 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: Offer warm apple juice or lemonade if > 4 months old. (Reason: These can relax the airway and loosen up sticky secretions.) Do not give cough suppressants
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 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
   • Wheezing becomes worse or your child develops any of the “Call Your Doctor” symptoms
   • Breathing becomes difficult, tight or loud