Pediatric Wheezing

Wheezing Overview

Wheezing is a high whistling sound usually heard when your child is breathing out (exhaling) It is caused by air flowing through swollen breathing tubes.

Causes

Wheezing can be brought on by any of a multitude of problems—from allergens to asthma to anatomical irregularities. Here is a list of the most common causes:

Asthma (also known as reactive airway disease) is a common problem in children. The most common symptoms include coughing, wheezing and trouble breathing, which are caused by inflammation and tightness in the breathing tubes of the lungs. The coughing and wheezing may be worse after exercise, after exposure to common triggers (cold air, smoke, and other irritants), and at night.
Exposure to allergens (food, pollen, and other substances, that cause a person to have an allergic reaction).
Fumes or weather changes.
Very cold drinks or air.
Bronchiolitis, an infection caused by the respiratory syncytial virus (RSV), which produces swelling and mucus production in the small breathing tubes of your child's lungs. Infants aged two to 12 months are the most likely to become infected and usually begin having the symptoms of a common cold, with a runny nose and mild cough.
Cystic fibrosis, and other genetic disorders.
Foreign Body Aspiration: This is caused when your child swallows an object, such as a coin or a peanut, and it gets stuck in a breathing tube—and it causes wheezing (and/or difficulty breathing). This typically happens to children between one and four years old—and unlike with asthma, the wheezing is occurring on only one side of his/her chest.
Gastroesophageal Reflux: Children with GER can sometimes have wheezing as the stomach contents are inhaled into the lungs or as the esophagus gets more acid in it. The symptoms of coughing and /or wheezing may be worse when they lie down.
Vocal Cord Dysfunction: In some children, the vocal cords close at improper times—which can lead to difficult breathing and is often misdiagnosed as asthma.

Risk Factors

Smoking by adults in the same household, especially maternal smoking.
Household water damage, causing mold.
Indoor allergens.
Psychological stress.
High ozone levels.

Wheezing Prevention

Because wheezing is most common with asthma, in many cases can it be reduced if the child’s asthma is under control. One way to help reduce wheezing is to follow an asthma action plan. This plan is designed with your doctor and health care team and outlines the best way for taking medications and managing an asthma attack. Other ways to prevent wheezing are to be aware of such triggers as smoking, indoor allergens, and psychological stress.

Reduce Your Child’s Risk of Wheezing

Identify and avoid asthma triggers. A number of outdoor allergens and irritants ranging from pollen and mold to cold air and air pollution can trigger asthma attacks. Find out what causes or worsens your child’s asthma, and take steps to avoid those triggers.
Don’t smoke around your children.
Create a calm environment for your child.
Monitor your child’s reaction to very cold air or drinks.

Tests and Screenings

A pulmonary function test may be ordered to measure the amount of air moving through the patient's breathing passages. Chest x-rays are sometimes indicated for patients whose wheezing seems to be caused by other causes.

Wheezing Treatment

Bronchodilators (medications that help widen narrowed airways) may be prescribed for patients whose wheezing is the result of asthma.
Antibiotics are generally used to cure acute bronchitis and other respiratory infections.
Expectorants (cough producing medications) or bronchodilators are prescribed to remove excess mucus from the breathing passages.
Inhaled and/or steroids by mouth might be necessary in chronic cases.
Antihistamines might be prescribed if there are signs of an allergic reaction.

Ongoing Care for Wheezing

Wellstar offers long-standing, community-based pediatricians who are close to home and trained to:

Help you determine healthy lifestyles for your child and useful ways to role model your choices.
Offer advice to prevent illness and injuries.
Provide early and appropriate care of acute illness to prevent its progression.
Treat life-threatening childhood conditions requiring intensive care.
Guide you in anticipating your child’s needs from newborn to adulthood.

Pediatric Emergency Care

Certified nurses with pediatric advanced life support certification work with Wellstar’s board-certified emergency services physicians in the Pediatric EDs at Wellstar Cobb and Kennestone hospitals. The Pediatric Emergency Department at Wellstar Kennestone Hospital is open seven days a week, from 11 AM to 11 PM. The Pediatric ED at Wellstar Cobb Hospital is open seven days a week, 24 hours a day.