What is wheezing and what causes it in children?
Quick Answer
Wheezing is a whistling sound that occurs when your child breathes, particularly when exhaling, due to narrowed airways in their lungs.
Asthma is a common cause, but infections like bronchiolitis or even inhaled objects can also trigger it.
If you notice your child wheezing, it's important to monitor them closely and consult a doctor to determine the underlying cause and appropriate treatment.
Recommended Practices
Monitor Breathing Patterns
Pay close attention to your child's breathing.
Note when the wheezing occurs (during the day, night, after activity), how long it lasts, and if anything seems to trigger it.
Keeping a record can help your doctor diagnose the cause.
Ensure Proper Hydration
Encourage your child to drink plenty of fluids, especially water or clear soups.
Staying hydrated helps to thin mucus, making it easier to cough up and clear the airways.
This is particularly important during the monsoon and winter seasons.
Keep the Air Clean
Avoid exposing your child to smoke (cigarette, incense sticks, mosquito coils), strong perfumes, or other irritants that can worsen wheezing.
Use an air purifier if you live in a polluted area, especially during Diwali or periods of high pollution.
Elevate Head During Sleep
Slightly elevate your child's head while they sleep by placing a towel or thin pillow under the mattress (not directly under their head for infants).
This can help to ease breathing and reduce wheezing, especially at night.
Steam Inhalation (with caution)
For older children (above 6 years) who can follow instructions, steam inhalation can help to loosen mucus.
Use a bowl of warm (not hot!) water and have them inhale the steam for 5-10 minutes.
Never leave a child unattended during steam inhalation due to the risk of burns.
A warm bath can also help.
Follow Doctor's Instructions Carefully
If your child has been prescribed medication (like inhalers or nebulizers), ensure you understand how to use them correctly.
Follow the dosage and frequency instructions provided by your doctor.
Do not stop or alter the medication without consulting your doctor, even if your child seems better.
What to Avoid
Avoid Over-the-Counter Cough Medicines
Cough medicines are generally not recommended for young children, especially those under 4 years old.
They haven't been proven effective and can have side effects.
Always consult your doctor before giving any medication to your child.
Don't Ignore Persistent Wheezing
Wheezing that doesn't go away or keeps coming back needs medical attention. It could be a sign of a more serious condition like asthma or pneumonia. Don't delay seeking professional help.
Avoid Using Vapor Rubs on Infants
Vapor rubs containing menthol or camphor can be harmful to infants and young children. They can irritate the airways and cause breathing difficulties. Consult your doctor for safer alternatives.
Don't Smoke Around Your Child
Exposure to secondhand smoke is a major trigger for wheezing and respiratory problems in children. Avoid smoking inside the house or car, and ask others to do the same.
Avoid Allergen Exposure
If your child has allergies, try to identify and avoid the allergens that trigger their wheezing.
Common allergens include dust mites, pollen, pet dander, and certain foods.
Regular cleaning and using allergen-proof bedding can help.
Don't Self-Treat with Antibiotics
Wheezing is often caused by viral infections, which antibiotics don't treat.
Unnecessary antibiotic use can lead to antibiotic resistance.
Only use antibiotics if prescribed by a doctor for a bacterial infection.
Common Scenarios and Solutions
My baby is wheezing after a bout of coughing and has a runny nose.
This is likely a viral respiratory infection.
Use a nasal bulb syringe to clear your baby's nasal passages, offer frequent small feeds to keep them hydrated, and monitor their breathing closely.
If they develop difficulty breathing or a fever, consult a doctor.
My child wheezes every time we visit my in-laws' house, which has pets.
This suggests a possible pet allergy.
Try to limit your child's exposure to the pets.
If that's not possible, give your child an antihistamine before visiting (as prescribed by your doctor).
Consider allergy testing to confirm the allergy.
My child's asthma inhaler doesn't seem to be helping their wheezing.
Ensure you are using the inhaler correctly with a spacer. If the wheezing persists despite proper inhaler use, contact your doctor. They may need to adjust the dosage or add another medication.
My child started wheezing suddenly after playing with small toys.
This could indicate that they have inhaled a foreign object. Seek immediate medical attention. Do not attempt to remove the object yourself, as you could push it further down the airway.
Similar Questions Parents Ask
Is wheezing always a sign of asthma?
No, wheezing can be caused by various factors, including infections, allergies, and foreign objects in the airway.
What's the difference between wheezing and stridor?
Wheezing is a high-pitched whistling sound, usually heard when exhaling, while stridor is a harsh, crowing sound, usually heard when inhaling, indicating an upper airway obstruction.
Can wheezing be prevented?
While not all wheezing can be prevented, avoiding triggers like smoke, allergens, and pollutants can help reduce the frequency and severity of episodes.
When should I use a nebulizer for my child's wheezing?
Use a nebulizer as prescribed by your doctor. It's typically used for more severe wheezing episodes or when a child has difficulty using an inhaler.
Signs to Consult Immediately
Severe difficulty breathing
Bluish discoloration of the lips or skin (cyanosis)
Inability to speak or cry
Extreme lethargy or unresponsiveness
High fever (especially in infants)
Wheezing accompanied by stridor (a harsh, crowing sound)
Detailed Explanation
Wheezing occurs when the airways in the lungs become narrowed or inflamed, making it difficult for air to pass through.
This creates a whistling sound, usually heard when exhaling.
In children, the most common causes include viral respiratory infections (like bronchiolitis), asthma, allergies, and sometimes, inhaling a foreign object.
It's important to remember that not all wheezing is asthma.
Many young children wheeze with viral infections, especially during their first few years.
This is because their airways are smaller and more easily blocked by mucus and inflammation.
However, if wheezing is recurrent or persistent, asthma becomes a more likely possibility.
Normal breathing in infants and young children is often faster and more shallow than in adults.
You should become familiar with your child's normal breathing pattern so you can recognize when something is wrong.
Look for signs of increased effort, such as flaring nostrils, retractions (skin pulling in between the ribs), or rapid breathing.
Warning signs that require immediate medical attention include severe difficulty breathing, bluish discoloration of the lips or skin (cyanosis), inability to speak or cry, and extreme lethargy.
If your child exhibits any of these symptoms, seek emergency medical care immediately.
The management of wheezing changes with age.
For infants (0-3 months), viral infections are the most common cause, and treatment focuses on supportive care like nasal suctioning and ensuring adequate hydration.
In older children (3-12 months and beyond), asthma becomes a more important consideration, and your doctor may recommend allergy testing or asthma medications.
Premature babies are at higher risk for respiratory problems, including wheezing, due to underdeveloped lungs.
They may require specialized care and monitoring.
Children with underlying health conditions, such as heart defects or cystic fibrosis, may also be more prone to wheezing.
In India, seasonal changes can significantly impact wheezing.
During the monsoon season, increased humidity can promote mold growth and worsen allergies.
In winter, cold air can trigger bronchospasm (narrowing of the airways).
During summer, dust and pollution can irritate the airways.
Take appropriate precautions based on the season, such as using air purifiers, avoiding outdoor activities during peak pollution times, and ensuring proper ventilation.
Sources
Indian Sources
Refer to the IAP guidelines for the latest recommendations on asthma diagnosis and treatment in children.
Search for articles on respiratory illnesses and wheezing in children published in the Indian Pediatrics journal.
International Sources
WHO provides information and resources on the global burden of asthma and its management in children. "Asthma is a chronic disease characterized by recurrent attacks of breathlessness and wheezing."
UNICEF works globally to improve child health, including respiratory health.
Recommended Reading for Parents
Educational website by Cipla on Asthma and other respiratory diseases.