Wheezing is a relatively high-pitched whistling sound that occurs during breathing when the airways are partially blocked or narrowed.
Wheezing is caused by a narrowing of the airways.
Other symptoms depend on the cause and may include cough, fever, and runny nose.
The diagnosis of the cause is based on chest x-rays and sometimes other tests.
Treatment can include bronchodilators and corticosteroids.
(See also Wheezing in adults.)
Wheezing is caused by a narrowing or blockage (obstruction) of the airways. The narrowing can be caused by 1 or more of the following:
Swelling of the tissues in the airways
Spasm of the tiny muscles in the walls of the airways (bronchospasm)
Accumulation of mucus in the airways
Recurring episodes of wheezing are common in the first few years of life. Until recently, doctors diagnosed these episodes as asthma because, like asthma, episodes could be relieved by inhaling medications that open the airways (bronchodilators) and because most adults who have asthma first developed symptoms in childhood. Now, however, doctors know that only some infants and young children who have such episodes of wheezing have asthma in later childhood or adolescence.
Did You Know...
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Children who are more likely to be eventually diagnosed with asthma include children who have 1 or more of the following risk factors:
Certain rashes (such as eczema)
More severe wheezing episodes
Family members with asthma
A family tendency to have many allergies
Wheezing with viral illnesses (particularly those caused by respiratory syncytial virus and human rhinovirus)
However, in many children, wheezing episodes stop by 6 to 10 years of age, and doctors do not diagnose these children as having asthma. Such children have other causes for their recurring episodes of wheezing.
Causes of Wheezing
The most common cause of a single, sudden episode of wheezing in infants and young children is usually a
Viral respiratory infection
The most common causes of recurring episodes of wheezing are
Frequent viral lung infections
Allergies
Less common causes of recurring wheezing include chronic difficulty swallowing that causes recurring inhalation of food or liquids into the lungs (aspiration), gastroesophageal reflux, a foreign object in the lungs, or heart failure.
Whatever the initial cause of the wheezing, symptoms are often worsened by allergies or inhaled irritants (such as tobacco smoke).
Symptoms of Wheezing
Wheezing is often accompanied by a recurring cough that is dry or brings up sputum (also called phlegm). Other symptoms depend on the cause and may include fever, runny nose, and feeding difficulties (caused by heart failure or difficulty swallowing).
A high-pitched wheezing sound is heard when the child breathes out. If airway narrowing is severe, the wheezing sound can also be heard when the child breathes in. Very ill children may also breathe rapidly, use a lot of their chest muscles to breathe, and have flaring of the nostrils and a bluish or grayish discoloration of the skin (cyanosis). Fever may be present in children with a lung infection.
Diagnosis of Wheezing
Chest x-rays
Rarely swallowing studies, computed tomography, or bronchoscopy
For a first episode of severe wheezing, most doctors do a chest x-ray to look for signs of a foreign object in the lungs, pneumonia, or heart failure. Doctors measure oxygen levels in the blood by placing a sensor on a finger (pulse oximetry).
For children with recurring episodes of wheezing who have already had testing, flare-ups typically do not require testing unless there are signs of severe breathing problems. Children who have frequent or severe flare-ups or symptoms that are not relieved by bronchodilators or other asthma medications may need other tests such as swallowing studies, computed tomography (CT), or bronchoscopy.
Treatment of Wheezing
For flare-ups, bronchodilators and sometimes corticosteroids
For severe wheezing, daily use of bronchodilators and anti-inflammatory medications used for asthma
Children who are unlikely to develop persistent asthma, such as children who do not have signs of allergies or a family history of allergies or asthma and whose episodes of wheezing are relatively mild and infrequent, usually require only inhaled bronchodilators used as needed to control their symptoms.
Most young children with more frequent and/or severe episodes of wheezing are helped by as-needed use of bronchodilators and by daily use of anti-inflammatory medications that are used for asthma (see treatment of chronic asthma
