Wheezing a common childhood respiratory symptom . The British Thoracic Society describe wheezing as ‘a continuous high-pitched musical sound coming from the chest’. It is a high pitched squeaky sound that comes deep down from the chest but may often be confused with sounds originating from the nose (snoring). Although a hall mark for asthma, wheeze in a child may be secondary to other conditions as well.

Is all wheezing asthma?

Wheezing is common in babies and young children as their airways are still small and is often due to a cold or virus, and will go away when your child is better. In fact, nearly one-third of young children will wheeze at some point. Croup and bronchiolitis which are both very common in babies and small children also cause wheezing or noisy breathing. Doctors often a simple wheeze as a ‘viral wheeze’. If the child is not distressed or struggling for breath, the doctors may also use the word ‘happy wheezer”.

Exposure to cigarette smoke will make your child’s wheeze worse and last for longer.

By the age of six many children stop wheezing. However some of these children who have early childhood wheezing would continue to wheeze as and would receive a label of asthma. Some signs that may indicate asthma include:

• Presence of other symptoms like cough, and breathlessness
• Wheezing without symptoms of a cold or virus
• Wheezing (or cough) that is triggered by things like running about, crying, pollen, house dust mites, pets or moulds or being around pets

What are the other causes of wheezing in a child?

Although wheezing in an adult is most likely to be due to asthma or COPD (Chronic Obstructive Pulmonary Disease), in a child wheezing may arise because of a number of reasons as listed below:

• Respiratory tract infection (especially in children younger than 2)
• Childhood asthma
• Small or floppy airways (airway malacia)
• Foreign object inhaled (particularly before 5 years of age)
• Allergies and Anaphylaxis (a severe allergic reaction, such as to an insect bite or medication)
• Bronchiolitis (especially in young children)
• Exposure to tobacco smoke
• Gastroesophageal reflux disease (OERD)
• Pneumoniav
• Bronchiectasis (a chronic lung condition in which abnormal widening of bronchial tubes inhibits mucus clearing)
• Bronchitis and airway inflammation
• Epiglottitis (swelling of the "lid" of your windpipe)
• Obstructive sleep apnoea (a condition in which breathing stops and starts during sleep)
• Vocal cord dysfunction (a condition that affects vocal cord movement)

How can we suspect wheeze?

Apart from the musical high pitched sound arising deep down from the chest, some parents can hear it when they put the ears close to the child’s chest. More often it is the doctor or trained nurse who might be able to pick up wheeze by listening to the chest using a stethoscope. However, even with experienced clinicians, wheeze may not be obvious and it may be helpful to record or video your child wheezing to play back to the doctor.

How do we treat wheeze?

In a happy wheezer or a viral wheezing, there is no effective treatment and most get better in a few days. However, it is still advisable to take your child to the doctors for a check-up. However, if there is associated breathlessness or eating difficulties or sleep disturbances and associated symptoms like fever and lethargy, medical help is needed early.

Treatment for wheeze is to address the underlying cause. For example, in an asthmatic child, inhaled medications to open up the closed airways (bronchodilators) and steroids (to reduce airway inflammation) is the treatment of choice. If the wheezing is because of airway obstruction or airway floppiness (airway malacia), other interventions including surgical options may need to be considered.

More Information Link

Mayo Clinic

Asthma UK