Wheezing Isn't Always Caused By Asthma

A child using an albuterol MDI with a spacer and mask, which can help relieve asthma symptoms.
A child using an albuterol MDI with a spacer and mask, which can help relieve wheezing.. Photo by 2007 Vincent Iannelli, MD

Wheezing is a common childhood symptom, and is usually means a child is having some trouble breathing.

Although often associated with asthma, it is important to keep in mind that many infants and younger children wheeze when they get common viral infections, such as RSV. They may never wheeze again and may not develop asthma.

Kids and Wheezing

Wheezing is usually described as a high-pitched whistling sound that can sometimes be heard when a child is breathing in or out.

Wheezing can be caused by:

  • asthma
  • bronchiolitis, especially in infants and younger children
  • bronchitis
  • allergic reactions
  • inhaling a foreign object into the lungs, such as a coin, popcorn or a peanut
  • reflux and aspirating (inappropriately inhaling) liquids your child is drinking
  • vocal cord dysfunction
  • anatomic problems, such as a lung cyst or tumor

It is also important to make sure that your child is really wheezing. Some parents confuse nasal congestion with wheezing.

Is It Asthma?

When a child is wheezing, most people's first thought is asthma, but it is important to remember that not all wheezing is asthma, especially if it is your child's first episode of wheezing. If no one else in the family has asthma or other "allergic" conditions, such as eczema, food allergies, and hay fever, it is probably not asthma.

If your child has repeated episodes of wheezing, even if he gets better in between attacks of wheezing, then he may have asthma.

Other clues that might help point to the cause of your child's wheezing might include wheezing that only occurs after eating certain foods or getting an insect bite -- both signs of an allergic reaction. Wheezing that begins with a choking episode may mean that your child inhaled something into his lungs.

What You Need To Know About Wheezing

Other things to know about wheezing include that:

  • You can't always hear wheezing without a stethoscope until it gets very bad, so if you suspect that your child might be wheezing, don't wait until you can easily hear the wheezing before you seek medical attention.
  • "Stridor" is a sound that children with croup often make and it is often confused with wheezing.
  • Wheezing is not the only symptom of asthma. Some children only have a cough when they are having an asthma attack.
  • If your child's wheezing is not getting under control, a referral to a pediatric pulmonologist might be helpful.

Sources:

Behrman: Nelson Textbook of Pediatrics, 18th ed.

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