Patient education: Wheezing in children (The Basics)

What is wheezing? — 

This is when a child makes a whistling sound when they breathe. It happens when the airways are swollen or narrowed.

What causes wheezing in children? — 

The most common causes are:

●Viral infections in infants and young children, such as respiratory syncytial virus ("RSV"), a cold, or the flu

●Asthma, which can get worse with a viral infection and other triggers

●Allergies, smoke, or other things irritating the airways

●Exercise

Other causes of wheezing or similar sounds include:

●An object getting stuck in the airway (called a "foreign body")

●An allergic reaction

●Problems with the vocal cords or windpipe

●Injury to the voice box

●Acid reflux or problems swallowing

Will my child need tests? — 

The doctor might do tests, depending on the most likely diagnosis:

●Young children with RSV infection usually don't need any tests. The doctor can diagnose RSV by asking about the child's history and doing a physical exam. They might do tests for other viruses such as the flu or COVID-19.

●Children over 6 years old who might have asthma can do a breathing test. This checks how air moves in and out of their lungs, and how it changes if they take medicine with an inhaler.

●Children with wheezing from an allergic reaction might need blood or skin tests to check for allergies.

●Children who might have a foreign body in their airway will get a chest X-ray or other imaging tests. These create pictures of the inside of the body.

How is wheezing treated? — 

The first goal is to make sure the child can breathe without trouble and get enough air and oxygen into their lungs:

●Some children need extra oxygen or other things to help with breathing.

●Medicines do not help with RSV infection. The main treatment for wheezing caused by RSV is a mist vaporizer to thin mucus in the nose. Young babies need to have their nose suctioned so they can breathe more easily. If they are having trouble eating or drinking or if they need oxygen, they will need treatment in the hospital.

●For wheezing caused by other viruses, the doctor might give medicine to help open up a child's airways. This can be given using an inhaler with a spacer or a "nebulizer." A nebulizer is a machine that lets the child breathe in medicine as a mist. Children might also get a medicine to decrease swelling in their airways. This is usually given by mouth, or sometimes as a shot.

●Children with wheezing caused by an allergic reaction need treatment with a medicine called "epinephrine." They might get other medicines, too.

●If an object is blocking the child's airway, doctors might need to do a procedure to remove it.

How do I care for my child at home? — 

This depends on the cause of your child's wheezing. Some general tips include:

●Give your child all their medicines as instructed. Make sure you understand how to use your child's inhalers or nebulizers, if they have these. If your child was given an inhaler, they need to use it with a spacer. Ask their doctor about a spacer if you do not have one.

●Help your child avoid things that make their wheezing worse. It's especially important to avoid smoking around your child and places where other people are smoking.

●Use saline nose drops or spray to relieve stuffiness. For babies, you can use a suction bulb or other suction device to remove mucus from their nose.

●Use a cool mist humidifier, if the doctor suggested this. This might help if your child has an upper respiratory infection, like a cold. Clean the humidifier often to avoid mold.

●If your child's wheezing was caused by an allergic reaction, avoid whatever they are allergic to. You might also get medicine to use if your child has another reaction in the future.

When should I call the doctor? — 

Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●Your child stops breathing.

●Your child is having so much trouble breathing they can only say 1 or 2 words at a time.

●Your child cannot eat or drink because they have so much trouble breathing.

●Your child's nostrils flare (get bigger) when they take a breath.

●Your child's lips, gums, or fingernails turn gray or blue.

●Your child is very drowsy or not responding normally.

●Your child is getting tired from working so hard to breathe.

●Your child has hives or a widespread, itchy skin rash along with trouble breathing.

●Your child's lips or tongue are swollen.

Call for advice if:

●Your child has a fever of 100.4°F (38°C) or higher, or chills.

●Your child has trouble breathing when lying down or sitting still.

●Your child's skin and muscles around their ribs pull in with each breath (called "retractions").

●Your child's breathing is not getting better even after using medicine to help them breathe.

●Your child feels weak or more short of breath than usual when doing their normal activities.

More on this topic

Patient education: Wheezing in adults (The Basics)
Patient education: Bronchiolitis and RSV in babies and children (The Basics)
Patient education: Cough, runny nose, and colds (The Basics)
Patient education: Flu (The Basics)
Patient education: Asthma in children (The Basics)
Patient education: Avoiding asthma triggers (The Basics)
Patient education: Swallowed objects (The Basics)
Patient education: Breathing tests (The Basics)
Patient education: How to use a nebulizer (The Basics)

Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics)
Patient education: The common cold in children (Beyond the Basics)
Patient education: Influenza symptoms and treatment (Beyond the Basics)
Patient education: Asthma symptoms and diagnosis in children (Beyond the Basics)
Patient education: Asthma treatment in children (Beyond the Basics)