Symptom Definition

• A high-pitched purring or whistling sound produced during breathing out.
• Rapid breathing rate is commonly associated (more than 60 breaths/minute if less than 2 months, more than 50 if 2-12 months and more than 40 if 1-5 years).
• Main cause in the first 2 years of life: bronchiolitis (peaks at 6-12 months).  This is a viral infection (RSV) of the small airways (bronchioles).
• Main cause:  after age 3, may be the first attack of asthma.
• Use this guideline only if the child has never been treated for asthma.

See More Appropriate Topic

• If previous diagnosis of asthma, see ASTHMA ATTACK.

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Call 911 Now (your child may need an ambulance)

• Wheezing started suddenly after medicine, an allergic food or bee sting.  
• Severe difficulty breathing (struggling for each breath, making grunting noises with each breath, unable to speak or cry because of difficulty breathing).
• Your child passed out or has bluish lips.
• Child recently choked on small object or food.

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

1. Warm Fluids for Coughing Spasms:  Offer warm apple juice or lemonade if older than 4 months old (reason: These can relax the airway and loosen up sticky secretions).  Do not give cough suppressants.
   
   
2. Suction for a blocked nose:  If the nose is blocked up, your child will not be able to drink from a bottle or breast-feed.  Most stuffy noses are blocked by dried or sticky mucus.  Wash out the dried secretions with warm water or saline nose drops. Use 1 drop at a time in infants.  This will loosen up the sticky mucus.  Then use a suction bulb.  Repeat nosedrops until open.  Make saline nosedrops by adding ½ tsp of table salt to 1 cup (8 oz) of warm water.
   
   
3. Humidifier:  If the air is dry in your home, run a humidifier.
   
   
4. Smaller Feedings:  Encourage small, frequent feedings whenever your child has the energy to drink (reason: child doesn't have enough energy for long feedings).
   
   
5. Avoid Tobacco Smoke:  Active or passive smoking makes coughs much worse.
   
   
6. Contagiousness:  Your child can return to day care after the wheezing and fever are gone.
   
   
7. Call Your Doctor If:
   
   Wheezing becomes worse or your child develops any of the "Call Your Doctor" symptoms.
   
   Breathing becomes difficult, tight or loud.

Parent Care for Pediatric Symptoms. Copyright © 2000. Barton D. Schmitt, MD, FAAP

See related topics:

• Asthma Attack