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🔎Identifying the Cause (By Age)
Wheezing has different common causes depending on the age of the child.
Infants (0–2 Years):
Bronchiolitis: This is the most common cause. It is a viral infection (usually RSV) of the tiny airways (bronchioles). It peaks between 6–12 months.
Children (Over 2 Years):
Asthma: Wheezing after age 2 is often the first sign of asthma.
“Fake” Wheezing (Nasal Sounds):
Sometimes a blocked nose whistles. This is not true wheezing.
Test: Use saline drops and suction the nose. If the sound stops, it was just a booger/congestion, not wheezing.
⚠️ The Choking Check (Ages 6 months–4 years) or Allergy:
If a child suddenly starts coughing, choking, and then wheezing (especially if heard only on one side), suspect a Foreign Object (peanut, toy part, seed) in the airway.
Allergic Reaction: Did the wheezing start suddenly after a bee sting, medication, or eating a specific food (nuts, eggs)?
Call 911 Now
- Severe Distress: Child is struggling for each breath, can barely cry, or speaks in short words only.
- Color Change: Lips or face turn blue/gray.
- Consciousness: Child passes out or stops breathing.
- Allergy: Sudden wheezing after a sting, food, or medicine.
Call Doctor Now or Go to ER
- New Wheezing: Any child with wheezing needs a doctor’s exam to determine the cause (Asthma vs. Infection vs. Object).
- Breathing: Child is breathing fast but not struggling severely.
Contact in 24hrs
- Breathing slightly fast but playing/smiling.
- Constant cough disrupting sleep.
- Fever lasting more than 3 days.
If the child is breathing comfortably enough to drink and has pink lips, you can support them at home until you see the doctor.
🌫️ Moisture & Mist:
- Warm Mist: Turn the shower on hot and sit in the closed bathroom with the child (not in the water) to breathe the steam. This relaxes the airway and loosens phlegm.
- Humidifier: Use a humidifier if the air in the house is dry.
🥤 Fluids & Feeding:
- Warm Fluids (Age 1+): Warm apple juice or herbal tea can relax the airway.
- Smaller Feedings: Wheezing takes energy. Give small, frequent amounts of breastmilk/formula so the baby doesn’t get tired while eating.
🍯 Cough Management:
- NO OTC Meds: Do not give over-the-counter cough medicines.
- Honey (Age 1+): Give ½ to 1 teaspoon (2–5 mL) of honey to thin secretions and loosen the cough.
- Nasal Saline: Use saltwater drops (2-3 drops per nostril) and suction/blow to clear the nose.
Timeline: The child can return to childcare/school once the wheezing and fever have been gone for 24 hours.