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 (RSV) of the small airways (bronchioles).
  
• Main cause:  after age 3, may be the first attack of asthma.
  

See More Appropriate Topic (instead of this one) If

• Previous diagnosis of asthma, see ASTHMA ATTACK.
  (To go directly to this topic, click on the link following this document.)
  

WHEN TO CALL YOUR DOCTOR FOR WHEEZING

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 older than 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 or your child develops any of the "Call Your Doctor" symptoms.
  

See Other Topics:

• Asthma Attack
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Lucile Packard Children's Hospital is located in Palo Alto, adjacent to Stanford University Hospital, approximately 20 miles north of San Jose, CA and 40 miles south of San Francisco.




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