Should Your Child See a Doctor?
- A high-pitched purring or whistling sound produced during breathing out
- Use this guideline only if the child has never been treated for asthma
- 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 for Wheezing (Other Than Asthma)
Call 911 If…
- Your child's wheezing started suddenly after medicine, an allergic food or bee sting
- Your child has severe difficulty breathing (struggling for each breath, making grunting noises with each breath, unable to speak or cry because of difficulty breathing)
- Your child recently choked on small object or food
- Your child passed out or has bluish lips
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)
- 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
And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.
- Darville T and Yamauchi T. Respiratory syncytial virus. Pediatr Rev. 1998, 19 (2):55-61.
- Gadomski A. Bronchiolitis dilemma: A happy wheezer and his unhappy parent. Contemp Pediatr. 2002;19 (11):40-59.
- Gentile DA. Considering the differential diagnosis of wheezing in infants. J Respir Dis Pediatrician. 2003;5 (2):84-88.
- Shaw KN, et al. Outpatient assessment of infants with bronchiolitis. Amer Jour Dis Child. 1991;145 (2):151-5.
- Weinberger M, Abu-Hansan M. Pseudo-asthma: When cough, wheezing and dyspnea are not asthma. Pediatrics. 2007;120 (4):855-864.
- Welliver JR and Welliver RC. Bronchiolitis. Pediatr Rev. 1993, 14:134-139.
This information is not intended to 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: 8/1/2010
Last Revised: 10/1/2010
Copyright 1994-2011 Barton D. Schmitt, M.D.