Should Your Child See a Doctor?

Wheezing

Is this your child's symptom?

  • Wheezing is a high-pitched purring or whistling sound
  • You can hear it best when your child is breathing out
  • Use this guide only if your child has not been diagnosed with asthma

If not, try one of these:

Causes of Wheezing

  • Bronchiolitis. This is the 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. These small airways are called bronchioles.
  • Asthma. This is the main cause after age 2. The first attack of asthma can be hard to diagnose. Asthma is defined as attacks of wheezing that recur.
  • Airway Foreign Body Serious. Suspect this when there is a sudden onset of coughing, choking and wheezing. A clue is wheezing heard only on one side. Common examples of inhaled objects are peanuts and seeds. Peak age is 1 to 4 years.
  • Nasal Sounds. When the nose is congested, it can produce some whistling sounds. This can happen during a cold or with nasal allergies. Unlike wheezing, the breathing is not tight. Also, nasal rinses with saline will make the sound go away.

Return to Child Care or School

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

Call 911 Now


  • Starts to wheeze suddenly after bee sting, taking allergic food or medicine
  • Severe trouble breathing struggling for each breath, very tight wheezing, can barely cry
  • Passed out or stopped breathing
  • Bluish lips or face
  • Choked on a small object or food recently
  • You think your child has a life-threatening emergency

Call Doctor Now or Go to ER

  • Wheezing, but none of the symptoms above. Reason: Needs a doctor's exam

Care Advice for Mild Wheezing

  1. What You Should Know About Wheezing:
    • Wheezing is a high-pitched purring or whistling sound.
    • Wheezing means the lower airway is tight.
    • This is often part of a cold, but it can become worse.
    • Here is some care advice that should help until you talk with your doctor.
  2. Coughing Fits or Spells:
    • Breathe warm mist such as with shower running in a closed bathroom.
    • Give warm clear fluids to drink. Examples are apple juice and lemonade.
    • Age under 3 months. Don't use.
    • Age 3 - 12 months of age. Give 1 ounce 30 ml each time. Limit to 4 times per day.
    • Age over 1 year of age. Give as much as needed.
    • Reason: Both relax the airway and loosen up any phlegm.
  3. Homemade Cough Medicine:
    • Do not give any over-the-counter cough medicine to children with wheezing. Instead, treat the cough using the these tips:
      • Age 3 months to 1 year: Give warm clear fluids to treat the cough. Examples are apple juice and lemonade. Amount: Use a dose of 1-3 teaspoons 5-15 ml. Give 4 times per day when coughing. Caution: Do not use honey until 1 year old.
      • Age 1 year and older: Use honey ½ to 1 teaspoon 2-5 ml as needed. It works as a homemade cough medicine. It can thin the secretions and loosen the cough. If you don't have any honey, you can use corn syrup.
  4. Nasal Washes To Open a Blocked Nose:
    • Use saline nose drops or spray to loosen up the dried mucus. If you don't have saline, you can use a few drops of tap water. If under 1 year old, use distilled water or boiled tap water.
    • Step 1. Put 3 drops in each nostril. If under 1 year old, use 1 drop.
    • Step 2. Blow or suction each nostril out while closing off the other nostril. Then, do the other side.
    • Step 3. Repeat nose drops and blowing or suctioning until the discharge is clear.
    • How Often. Do nasal washes when your child can't breathe through the nose.
    • Limit. If under 1 year old, no more than 4 times per day or before every feeding.
    • Saline nose drops or spray can be bought in any drugstore. No prescription is needed.
    • Saline nose drops can also be made at home. Use ½ teaspoon 2 ml of table salt. Stir the salt into 1 cup 8 ounces or 240 ml of warm water. Use bottled water or boiled water to make saline nose drops.
    • Reason for nose drops: Suction or blowing alone can't remove dried or sticky mucus. Also, babies can't nurse or drink from a bottle unless the nose is open.
    • Other 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.
  5. Humidifier:
    • If the air in your home is dry, use a humidifier. Reason: Dry air makes coughs worse.
  6. Smaller Feedings:
    • Use small, frequent feedings whenever your child has the energy to drink.
    • Reason: Children with wheezing don't have enough energy for long feedings.
  7. Avoid Tobacco Smoke:
    • Tobacco smoke makes coughs and wheezing much worse.
  8. Return to School:
    • Your child can return to child care after the wheezing and fever are gone.
  9. Call Your Doctor If:
    • Trouble breathing gets worse
    • Wheezing gets worse
    • You think your child needs to be seen
    • Your child 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.

Copyright 1994-2015 Barton D. Schmitt, MD. All rights reserved.