Is this your child's symptom?

• Breathing sound that is high-pitched and tight
• A 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

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 Object (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.

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 less than 6 months, only give breastmilk or formula.
   • Age 6 - 12 months. Give 1-2 teaspoons (5-10 mL) each time. Limit to 4 times per day.
   • Age older than 1 year. 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 6 months to 1 year: Give warm clear fluids to treat the cough. Examples are apple juice and lemonade. Amount: Use a dose of 1-2 teaspoons (5-10 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 Saline to Open a Blocked Nose:
   • Use saline (salt water) nose drops or spray to loosen up the dried mucus. If you don't have saline, you can use a few drops of water. Use distilled water, bottled 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 saline 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.
   • 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 childcare 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 health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.